Download Maryville University NURS 615 Pharmacology Exam 2 and more Exams Nursing in PDF only on Docsity!
Pharmacology Exam 2 graded 100%.
Maryville University NURS 615
Pharmacology Exam 2 graded 100%.
How does carbamazepine work? - Answer = Works by decreasing nerve impulses that cause seizures and pain How often should carbamazepine lab values be monitored? What labs? - Answer = CBC q 3-4 months What anti-seizure med auto induces metabolism? - Answer = Carbamazepine What medication decreases the production of RBCs, WBCs, and platelets? - Answer = Carbamazepine What is carbamazepine half-life? - Answer = Single dose: 30 hours Multiple dose: 15 hours What is a great risk of seizure potential while taking anti-seizure medications? - Answer = Stopping the medication abruptly. What type of medication is topiramate (Topamax)? - Answer = Anti-seizure med What does topiramate cause? - Answer = Electrolyte imbalance -- hyperchloremic metabolic acidosis What are adverse effects of topiramate? - Answer = Weight loss, high temperature, and inability to sweat What medication affects Lamictal? - Answer = OCPs decrease the effects of this drug, so the dose must be doubled Can valproate (Depakote) be used during pregnancy? - Answer = It is a known teratogen. If needed, must be used after 1st trimester. What must be ruled out in patients before starting an anti-depressant? - Answer = hypothyroidism Anti-depressant that is to be used with caution in cardiac patients due to behaving like class 1 anti-arrythmics? - Answer = TCAs TCA side effects are mainly of what type? - Answer = Anti-cholinergic
Pharmacology Exam 2 graded 100%.
What is a first-line antidepressant in children? - Answer = fluoxetine (Prozac) How do you discontinue an SSRI? - Answer = Taper by reducing the dose by 50% for 3- 4 days When are MAOIs effective? - Answer = In atypical depression or Parkinson's Why are MAOIs reserved for last line of treatment? - Answer = Lethal drug interactions and food interactions How long before starting a new antidepressant after MAOIs? - Answer = At least 2 weeks to clear it from system What are high tyramine foods and when are they contraindicated? - Answer = Fermented foods; aged cheese, wine alcohol Contraindicated with MAOI use Important drug interaction and side effect with MAOIs? - Answer = Avoid other serotonin drugs and watch for hypertensive crisis What anti-depressant may have sleep issues if taken at night? - Answer = fluoxetine (Prozac) (SSRI) How do SSRIs work? - Answer = They block the reuptake of serotonin at the synaptic cleft so there is more serotonin around How are sexual side effects linked to SSRIs? - Answer = Sexual side effects may start after 1 month; especially common in Paxil How long does it take for SSRIs to work? - Answer = 2-6 weeks; usually within 4 weeks; some symptoms may improve within 1 to 2 weeks What medication is a seroternergic 5-ht receptor partial agonist (partial alpha 1 receptor agonist)? - Answer = buspirone (Buspar) What is special about buspirone (Buspar)? - Answer = It has both anti-anxiety and anti- depressant effects. How is treatment with buspirone (Buspar) usually conducted? - Answer = Can be combined with an SSRI to treat patients with agitated or anxious depression Benzodiazepines affect what neurotransmitter and how? - Answer = Increases the effects of GABA
Pharmacology Exam 2 graded 100%.
These antibiotics suppress bacterial growth and also rely on the immune system to remove the bacteria from the body. - Answer = Bacteriostatic antibiotics Which antibiotics contain the beta-lactam ring which allows them to inhibit PBPs in the bacteria? - Answer = Beta-Lactams (PCNs, cephalosporins, carbapenems, monobactems) What is beta-lactamase? - Answer = It is an enzyme that is produced by some bacteria that inactivates some antibiotics. Are PCNs bactericidal or bactriostatic? - Answer = Bactericidal What doe PCN-beta-lactame inhibitor combos do? - Answer = They make the antibiotics stronger and more effective because they work against the beta-lactamase enzyme that is trying to inactivate the antibiotic; they increase the spectrum of action Are cephalosporins bactericidal or bacteriostatic? - Answer = Bacteriocidal Do cephalosporins become more broad or narrow in spectrum as you go up in generation? - Answer = More broad spectrum How is the gram coverage in Cephalosporins? - Answer = 1st generation are gram positive and as you go up in generations, you lose gram positive coverage and more gram negative What is the most common reported allergy and the most common cause of severe allergic drug reactions? - Answer = PCN Why is there up to a 10% cross-sensitivity between PCNs and cephalosporins? - Answer = They share the beta-lactam ring and all beta-lactams have the intrinsic hazard of very serious reactions in susceptible patients What is the safest antibiotics in pregnancy and children? - Answer = PCN and cephalosporins What antibiotics are avoided in pregnancy and children? - Answer = Tetracyclines and fluoroquinolones What medication is a common cause of diarrhea in childreN? - Answer = Amoxicillin How should you educate parents with a child that has PCN-induced diarrhea? - Answer = Keep taking the medication, increase water intake, eat yogurt or take a probiotic
Pharmacology Exam 2 graded 100%.
What medication is a lipoglycopeptide? - Answer = Vancomycin Is vancomycine bacteriostatic or bacteriocidal? - Answer = Bacteriocidal Why is vancomycin typically given IV? - Answer = It is too large to pass through cell membranes of the GI tract so it is not absorbed systemically When and why is vancomycin given orally? - Answer = In C. Diff infection because it works topically in the gut to kill C. Diff What is vancomycin used for? - Answer = MRSA Vancomycin peak and trough levels: for who and why? - Answer = Vancomycin is excreted unchanged by the kidneys; caution in elderly and renal insufficiency patients What is a serious adverse effect of vancomycin? - Answer = Red Man Syndrome Which antibiotics target DNA replication? - Answer = Fluoroquinolones and sulfonamides How would you describe fluoroquinolones? - Answer = Bacteriocidal and BROAD spectrum What are fluoroquinolones used for? - Answer = Serious infections; hospital or community acquired infections What is the black box warning for fluoroquinolones? - Answer = Tendonitis and tendon rupture in all age groups; especially in Achille's tendon What medication does fluoroquinolones enhance the effects of? - Answer = Warfarin; increases bleeding risk because it interacts with the CYP450 system Why are fluoroquinolones avoided in children and pregnancy? - Answer = They can inhibit bone growth and they are bad for tendons When is the risk for tendon rupture the greatest with use of fluoroquinolones? - Answer = 1. transplant patients
- recent corticosteroid use
- advanced age
- increased quinolone doses Are sulfonamides bacteriocidal or bacteriostatic? - Answer = Bacteriostatic
Pharmacology Exam 2 graded 100%.
Other main effects of doxycycline: - Answer = GI symptoms, lightheadedness, dizziness, rashes, SJS, TEN Aminoglycosides block protein production and consist of which antibiotics? - Answer = gentamicin, streptomycin, tobramycin What are aminoglycosides typically reserved for? - Answer = Severe infections Ototoxicity is a concern when using what medication and the medication must be stopped immediately? - Answer = Gentamycin (Aminoglycoside) What type of antibiotics are clindamycin? - Answer = Lincosamides; bacteriostatic, and narrow spectrum What is clindamycin used for? - Answer = MRSA, gram positive What is the greatest risk of clindamycin? - Answer = C. Diff What type of antibiotics are macrolides? - Answer = Block protein production; bacteriostatic; resistance issues What medication is used for strep throat when there is a PCN allergy? - Answer = erythromycin; 30 to 50mg/kg/day every 6-8 hours What is a side effect of erythromycin? - Answer = GI distress (which is why it is used for ileus) How is clarithromycin excreted? - Answer = It is excreted by BOTH the liver and the kidneys so dose adjustments are not required in patients with impaired liver function What is rifampin used for and what type of antibiotic is it? - Answer = Of the erythromycin group; used for TB, legionella, leprosy Is rifampin bacteriocidal or bacteriostatic? - Answer = Bacteriocidal What is an adverse effect of rifampin? - Answer = It turns tears, pee, saliva, and sweat red/orange in color Is rifampin used in pregnancy? - Answer = It is used in pregnancy for treatment of TB, but its safety is unknown What lab values must be tested before long term treatment of rifampin? - Answer = CBC and liver function studies
Pharmacology Exam 2 graded 100%.
How does ethambutol work as an anti-TB drug? - Answer = It inhibits the sythesis of mycelic acids which is an important part of the cell wall How should ethambutol be used? - Answer = Never should be used as monotherapy; used with INH, rifampin, or PZA What is a main side effect of ethambutol? - Answer = EYES - optic neuritis -- do not use in children under 6 Red/green color blindness, inform immediately as it could be permanent What is the first line treatment for prevention and treatment of TB and a POTENT bactericidal drug? - Answer = Isonazid (INH) How do anti-TB drugs work? - Answer = They inhibit the formation of mycolic acids which are an important part of the cell wall What are the liver effects associated with INH? - Answer = Increase in liver enzymes that is usually harmless and an uncommon effect of liver inflammation -- Liver function should be monitored in all people receiving therapy What is another main side effect of INH? - Answer = Peripheral neuropathy (inflammation of nerves causing numbness in arms and legs) What vitamin decreases peripheral neuropathy associated with INH? - Answer = pyridoxine (Vitamin B6) How does pyrazinamide (PZA) act on bacteria? - Answer = It is largely bacteriostatic, but can be bacteriocidal in actively replicating bacteria What is the most dangerous side effect of PZA? - Answer = Hepatotoxicity (dose- related); not possible to distinguish PZA-induced hepatitis from hepatitis caused by INH and rifampin --> test dosing is required What are the most common side effects of PZA? - Answer = Increase in gout flares due to decreased renal excretion of uric acid Joint pains, but not so severe the patient has to stop How do anti-virals (neuramidase inhibitors) work? - Answer = These medications break the bond that attaches the viral particles to the host cell and keeps them from replicating What anti-viral is used as prophylaxis and treatment for influenza A and B? - Answer = oseltamivir (Tamiflu) (oral) and zanamivir (Relenza) (inhaled)
Pharmacology Exam 2 graded 100%.
What do "azole" anti-fungals require for absorption? - Answer = ACID What should "azole" anti-fungals NOT be administered with? - Answer = H2 Blockers or Protein pump inhibitors What type of anti-fungal is terbinafine and what is it used for? - Answer = An allylamine anti-fungal highly effective against dermatophyte infections (not much against Candida) What are the side effects of terbinafine? - Answer = MANY side effects; skin, GI, and liver toxicity (LFTs must be monitored) What medications are used for parasitic worms and intestinal parasites? - Answer = mebendazole agromectin ivermectin What medications are used for scabies and lice? - Answer = Ivermectin and permethrin cream What type of medication is metronidazole (Flagyl) and what are its characteristics? - Answer = 1. Antibiotic and anti-protazoal
- It is bacteriocidal and BROAD spectrum What is metronidazole used for? - Answer = PID, endocarditis, bacterial vaginosis, giardiasis, trichomonad, amebiasis What is the drug of choice for the first episode of mild-moderate C. Diff? - Answer = Metronidazole (Flagyl) What should not be ingested with metronidazole (Flagyl)? - Answer = Alcohol -- causes a disulfiram-like reaction What is a disulfiram-like reaction? - Answer = N/V, flushing of skin, tachycardia, SOB How long should alcohol be avoided after metronidazole treatment? - Answer = At least 48 hours Metronidazole inhibits liver metabolism of propylene glycol and should not be used with what? - Answer = Meds like Miralax and E-Cigs; could also cause disulfiram-like reaction What type of medication is Linezolid? - Answer = Oxazolidinone -- It is an antibiotic and an MAOI
Pharmacology Exam 2 graded 100%.
What. should Linezolid not be used with? - Answer = Not to be used with other MAOIs, serotonergic drugs, or foods with tyramine What does Linezolid do if used with Sudafed? - Answer = Increases blood pressure Linezolid should not be given with what drugs due to risk of serotonin syndrome? - Answer = SSRIs, Demerol, and MAOIs
