M4-5 drugs.txt

• Antibacterial
• Fourth-generation Cephalosporin

• Notes:
• → Resistant to most beta-lactamase bacteria.
• → Has a broader gram-positive coverage than the third-generation cephalosporins.

• Tx:
• → pneumonia
• → Klebsiella
• → Proteus
• → streptococci
• → certain staphylococci
• → P. aeruginosa

• Sides:
• → nausea
• → diarrhea

May cause hands to go cold or numb

• → Use of immunosuppresants
• → IV catheters
• → Prosthetic devices
• → Not using gloves to start an IV

• Antibacterial
• Cephalosporins

• Tx:
• → Neisseria
• → gonococcal
• → Lyme disease

• When:
• → Has a very long half-life, so is given once or twice a day.

• Sides:
• → nausea
• → diarrhea

• Antibacterial
• Cephalosporins

• Tx:
• → Pseudomonas spp.

• Sides:
• → nausea
• → diarrhea

• Antibacterial
• Cephalosporins

• Tx:
• → severe infections
• → septicemia

• Sides:
• → nausea
• → diarrhea

• Antibacterial
• Cephalosporins

• Tx:
• → respiratory
• → urinary
• → skin
• → bone & joint
• → genital
• → endocarditis (inflammation of inner layer of heart)

• Notes:
• → Antibiotic allergy is one of the most common drug allergies. These allergies also have the potential to cause severe anaphylaxis and death.

• Sides:
• → nausea
• → diarrhea

• Antibacterial
• Cephalosporins

• Notes:
• → First acid-stable cephalosporin sufficiently absorbed from the Gl tract.

• Tx:
• → otitis media
• → skin
• → bone
• → respiratory tract
• → urinary tract

• Sides:
• → nausea
• → diarrhea

• Antibacterial
• Extended-Spectrum Penicillin

• Tx:
• → severe appendicitis
• → skin infections
• → pneumonia
• → beta-lactamase producing bacteria

• Notes:
• → Tazobactam is a beta-lactamase inhibitor.

• Nurse:
• → with food to avoid GI irritation
• → Assess for allergy to PCN (cephalosporins) 5-10%

• Antibacterial
• Broad-Spectrum Penicillin

• Tx:
• → G+ & G-

• Nurse:
• → with food to avoid GI irritation
• → Assess for allergy to PCN (cephalosporins) 5-10%

• Antibacterial
• Broad-Spectrum Penicillin

• Tx:
• → respiratory tract
• → otitis media
• → sinusitis

• Works:
• → Inhibition of bacterial cell-wall synthesis

• Teach:
• → "I will take my entire prescription of medication."
• → "I should report to the physician any genital itching.
• → "I should report to the health care provider any excess bleeding."

• Nurse:
• → with food to avoid GI irritation
• → Assess for allergy to PCN (cephalosporins) 5-10%

• Antibacterial
• Broad-Spectrum Penicillin

• Tx:
• → respiratory
• → otitis
• → sinusitis
• → skin
• → UTI

• Nurse:
• → with food to avoid GI irritation
• → Assess for allergy to PCN (cephalosporins) 5-10%

• Antibacterial
• Basic Penicillin

• Tx:
• → Acid-stable and less active than penicillin G against some bacteria.

• Con:
• → renal failure.

• Anthrax Bioterrorism
• → Can be prevented by vaccination.
• → Symptoms 7-8 days
• → No antibiotics before symptoms → 90% mortality
• → ciprofloxicin, a floroquinolone
• → Vibramycin, a tetracycline
• → Penicillin V

• Nurse:
• → with food to avoid GI irritation
• → Assess for allergy to PCN (cephalosporins) 5-10%

• Antibacterial
• Basic Penicillin

• Notes:
• → For moderately serious infections.
• → Slow IM absorption with prolonged action.
• → The solution is milky.

• Teach:
• → Collect C & S prior to first dose.
• → Monitor client for mouth ulcers.
• → Have epinephrine on hand for a potential severe allergic reaction.

• Nurse:
• → with food to avoid GI irritation
• → Assess for allergy to PCN (cephalosporins) 5-10%

• Antibacterial
• Macrolides

• Tx:
• → gram-positive
• → some gram-negative
• → respiratory
• → gonorrhea
• → skin
• → bacterial conjunctivitis

• Notes:
• → This drug is like erythromycin but has less severe gastrointestinal side effects
• → Penicillin substitute

• Teach:
• → Monitor periodic liver function tests.
• → Tell the client to report any hearing loss. d. Instruct the client to report evidence of superinfection.
• → Teach the client to take oral drug 1 hour a.c. or 2 hours p.c.
• → Avoid antacids from 2 hours prior to 2 hours after azithromycin administration.

• Antibacterial
• Macrolides

• Tx:
• → upper and lower respiratory
• → skin & soft-tissue
• → Helicobacter pylori
• → myco-bacterium
• → gram-positive
• → gram-negative

• Notes:
• → Penicillin substitute

• CON:
• → Report persistent diarrhea
• → More gastrointestinal side effects compared to azithromycin (Zithromax)

• Antibacterial
• Lincosamides

• Tx:
• → serious infections

• Admin:
• → Should be taken with full glass of water

• CON:
• → May cause fatal colitis

• Antibacterial
• Glycopeptides

• Tx:
• → OF Choice for MRSA
• → cardiac surgical prophylaxis in clients with penicillin allergy.

• Adverse:
• → vascular collapse
• → ototoxicity
• → nephrotoxicity
• → red neck (or man) syndrome - heart rate is 120, BP is 70/50, and flushed → Reduce the infusion to 10 mg/min.

• → Not for renal Pt
• → Not for Kids under 8
• → w/ food
• → NO dairy
• → Photosensitivity
• → Rpt severe nausea, vomoting, dizziness

• Antibacterial
• Long-Acting Tetracycline

• Tx:
• → G+ & G-
• → respiratory
• → skin infections or disorders
• → chlamydial
• → gonorrhea
• → syphilis
• → rickettsial
• → inflammatory papules and pustules associated with rosacea in adults

• Sides:
• ↓ eff oral contaceptives
• ↓ serum K+ (low)

• Nurse:
• → 1948, 1st broad-spec G+, G- and many other organisms
• → Inhibit bacterial protein synth
• → bacteriostatic effect (does not harm, but stops reproduction)
• → Not effective: S. aureus (except newer), Pseudomonas or Proteus.
• → nausea
• → vomiting
• → photosensitivity
• → 1st trimester terotogenic effects
• → 3rd trimester & children younger than 8: irreversibly discolors permanent teeth
• → discard outdated → breaks down to toxic
• → Can cause superinfection because of disruption of body flora.

• Anthrax Bioterrorism
• → Can be prevented by vaccination.
• → Symptoms 7-8 days
• → No antibiotics before symptoms → 90% mortality
• → ciprofloxicin, a floroquinolone
• → Vibramycin, a tetracycline
• → Penicillin V

can be given together, but should not be mixed together in the same container.

• → Are NOT metabolized, they go out in the urine the same way they came in UNCHANGED
• → Unless they collect in the ear and the kidneys resulting in toxicity
• → Monitor for nephrotoxicity: ↑BUN, Creatinine, urinalysis, casts, proteins, RBC or WBC
• → Monitor for ototoxicity: deafness, ↓hearing, tinitis, dizziness, ataxia (NS affecting walking)

• Antibacterial
• Aminoglycosides

• Tx:
• → gram-negative, including those resistant to other aminoglycosides
• → respiratory tract
• → bone & joint
• → skin & soft tissue

• Monitor for:
• → hearing loss
• → hepatotoxicity
• → nephrotoxicity

• Admin:
• → Hydrate to min toxcity

• Antibacterial
• Aminoglycosides

• Tx:
• → serious infections
• → gram-negative organisms (e.g., Pseudomonas aeruginosa
• Proteus)
• → pelvic inflammatory disease
• → for methicillin-resistant Staphylococcus aureus (MRSA), Vancocin is Tx of choice

• Admin:
• → Hydrate to min toxcity

• Teach:
• → Client should report any hearing loss.
• → Client must use sunscreen.
• → IV to infuse over 60 minutes
• → Client will be monitored for mouth ulcers and vaginitis.
• → Client should increase fluid intake.

• Antibacterial
• Aminoglycosides

• Tx:
• → amebiasis
• → tapeworm

• Antibacterial
• Aminoglycosides

• Tx:
• → orally for hepatic coma
• → gram-negative bacteria, except Pseudo-monas aeruginosa

• Monitor:
• → for hearing loss
• → nephrotoxicity

• Admin:
• → Hydrate to min toxcity

• Antibacterial
• Aminoglycosides

• Tx:
• → Decreases bacteria in the bowel and is used as a preoperative bowel antiseptic
• → skin infections
• → diarrhea caused by E. coli

• Admin:
• → Hydrate to min toxcity

• Antibacterial
• Aminoglycosides

• Tx:
• → tuberculosis
• → Tularemia
• → bubonic pneumonic plague

• Watch:
• → Ototoxicity is a major problem
• → Monitor for hearing changes

• Admin:
• → Hydrate to min toxcity

• Antibacterial
• Aminoglycosides

• Tx:
• → Very effective against Pseudomonas aeruginosa

• Monitor:
• → for hearing loss
• → nephrotoxicity

• Notes:
• → Fewer toxic effects than other aminoglycosides.

• Admin:
• → Hydrate to min toxcity

• Antibacterial
• Quinolones

• Tx:
• → G+ & G-
• → renal
• → bone
• → joint
• → skin
• → lower respiratory tract
• → UTI

• Teach:
• → Obtain culture prior to drug administration.
• → Tell the client to avoid taking Cipro with antacids.
• → Monitor the client for hearing loss.
• → Encourage fluids to prevent crystalluria.
• → Infuse IV Cipro over 60 minutes.
• → With water (6-8 8oz/d)
• → photosensitivity

• Anthrax Bioterrorism
• → Can be prevented by vaccination.
• → Symptoms 7-8 days
• → No antibiotics before symptoms → 90% mortality
• → ciprofloxicin, a floroquinolone
• → Vibramycin, a tetracycline
• → Penicillin V

• Antibacterial
• Quinolones

• Tx:
• → mod to severe lower respiratory tract
• → renal
• → bone & joint

• Adverse:
• → includes dysrhythmias

• Admin:
• → 2 hours before or after antacids and iron products for absorption
• → with a full glass of water
• → "Should" be taken w/o food, but very hard on stomach, so may be taken with food IF GI distress.

• Teach:
• → photosensitivity

• → 1st synthetic antibacterial
• → Interferes w/ PABA → can't replicate

• Antibacterial
• Intermediate-Acting Sulfonamide

• Tx:
• → ulcerative colitis
• → Crohn's disease
• → rheumatoid arthritis (some cases)
• → reduces Clostridium & E. coli in stools

• Admin:
• → after eating
• → Drink several quarts of fluid per day to avoid crystaluria

• Antibacterial
• Intermediate-Acting Sulfonamide

• Tx:
• → UTI
• → otitis media
• → bronchitis
• → pneumonia
• → Pneumocystis carinii
• → rheumatic fever
• → burns

• Admin:
• → after eating
• → Drink several quarts of fluid per day to avoid crystaluria → kidney stones
• → The half-life of this drug is 8 to 12 hours, and the client should receive it twice a day

Bactrim is twice a day dosing with fluids encouraged - I hope this helps. ---- Maddie

• Antibacterial
• Additional Agent

• Tx:
• → serious gram negative infections (e.g.
• → UTI
• → septicemia
• → bacteremia
• → meningitis
• → Pseudomonas aeruginosa
• → skin

• Notes:
• → when other antibiotics are ineffective or contraindicated
• → do focus though on the nursing care related to the administration of Flagyl. ---- Maddie

• Teach:
• → Does color urine reddish-brown
• → No alcohol (leads to disulfram reaction: facial flush, severe headache, tachy, hypotension,...

• Antiinfective
• First-Line Antitubercular

• Tx:
• → tuberculosis
• → tuberculosis prophylaxis

• Nurse:
• → Pyridoxine will prevent numbness and tingling that can occur when taking isoniazid

• Sides:
• → Hepatotoxicity, so monitor serum liver enzymes

• Admin:
• → 1 h before or 2 hr after food, which decreases absorption
• → Collect sputum specimens early in AM for acid-fast bacilli, 3x days, repeat @ several weeks

• In combination with rifampin and ethambutol, Teach:
• → Encourage periodic eye examinations.
• → Suggest that client take antacids with medications to prevent GI distress.
• → Advise client to report numbness and tingling of hands or feet.
• → Alert client that body fluids may develop a red-orange color.
• → Teach client to avoid direct sunlight and to use sunblock.

• Antiinfective
• First-Line Antitubercular

• Tx:
• → Used in combination with other antitubercular drugs for short-term and initial phase of therapy.

• Admin:
• → Promote fluid intake

• Antiinfective
• First-Line Antitubercular

• Tx:
• → Used as a combination drug for active TB
• → For selective gram-positive and gram-negative bacteria, including Neisseria meningitidis

• Monitor:
• → liver enzymes

• Nurse:
• → Red-orange discoloration of body fluids is a common side effect of rifampin (Mycobutin), but it is not harmful and does not indicate infection. There is no need to call the health care provider or have a 24-hour urine collection.

• Antibacterial
• Aminoglycosides
• First-Line Antitubercular

• Tx:
• → Used against TB as the third drug with isoniazid and rifampin or with isoniazid and ethambutol
• → First drug used to treat TB

• Adverse:
• → ototoxicity
• → Monitor for hearing changes
• → Hepatotoxicity, so monitor serum liver enzymes

• Antiinfective
• Antifungal: Polyenes

• Tx:
• → systemic fungal (mycotic)
• → aspergillosis
• → blastomycosis
• → coccidioidomycosis
• → cryptococcosis
• → histoplasmosis

• Watch:
• → Nephrotoxicity may occur when given in high doses
• → Creatinine levels
• → Hypokalemia may occur
• → Hypomagnesia may occur
• → VERY Toxic

• Nurse:
• → Premedicate the client with an antipyretic, antihistamine, and antiemetic as ordered. Because almost all clients given intravenous amphotericin B (Fungizone) develop fever, chills, nausea and vomiting, and hypotension.

• Antiinfective
• Antifungal: Polyenes

• Tx:
• → Candida

• Teach:
• → "swish and swallow" to treat an oral infection of candida.

• Antiinfective
• Antifungal: Azoles

• Tx:
• → Candida
• → cryptococcal meningitis

• Antiinfective
• Antifungal: Azoles

• Tx:
• → fungal meningitis
• → fungal bladder
• → vaginal fungal

• Systemic Non-HIV Antivirals
• Nonclassified Antivirals

• Tx:
• → Primary use is prophylaxis against influenza A
• → Originally used to treat Parkinson's

• Nurse:
• → evaluate the client for orthostatic hypotension (BP blood pressure sitting and standing)

• Systemic Non-HIV Antivirals
• Purine Nucleosides

• Tx:
• → HSV-1
• → HSV-2 (genital)

• Notes:
• → herpes simplex

• Nurse:
• → Monitor BUN and creatinine.
• → Advise client to maintain adequate fluid intake.
• → Teach client to perform oral hygiene several times aday.
• → Monitor client's CBC, especially WBC, platelets, hemo-globin, and hematocrit.

• Systemic Non-HIV Antivirals
• Purine Nucleosides

• Tx:
• → respiratory syncytial viral infection in infants and children
• → hepatitis C

• Systemic Non-HIV Antivirals
• Neuraminidase Inhibitors

• Tx:
• → uncomplicated acute influenza A and B
• → bird flu

• Admin:
• → Treatment should begin within 48 h of flu symptoms
• → May be taken with or without food

• Antiviral
• Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

• Admin:
• → Take 1/2 h before or 2 h after meal
• → Excreted renally
• → dosage adjustment in renal insufficiency

• Sides:
• → pancreatitis
• → peripheral neuropathy
• → nausea
• → lactic acidosis with hepatic steatosis(rare)

• Antiviral
• Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

• Admin:
• → Take without regard to meals
• → Excreted renally; dosage adjustment in renal insufficiency

• Antiviral
• Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

• Admin:
• → Take without regard to meals
• → Excreted renally
• → dosage adjustment in renal insufficiency

• Sides:
• → peripheral neuropathy
• → lipodystrophy
• → pancreatitis
• → hyperlipidemia
• → rapidly progressive ascending neuromuscular weakness (rare)
• → lacticacidosis with hepatic steatosis (rare)

• Antiviral
• Nucleoside Reverse Transcriptase Inhibitors (NRTIs)

• Tx:
• → Management of clients with HIV infection → prevention of maternal-fetal HIV transmission

EA$: $6040

• Admin:
• → Take without regard to meals
• → Excreted renally
• → dosage adjustment in renal insufficiency

• Notes:
• → All antiretroviral agents work to reduce the viral load, which is the number of viral RNA copies per milliliter of blood.
• → Nevirapine (Viramune) may be used as an alterative for women who are pregnant, especially in the first trimester of pregnancy.
• → Clients may confuse side effects of therapy with new onset of symptoms.

• Teach:
• → "I may get a headache from this medication."
• → "I might have difficulty sleeping with this medication."
• → "I don't have to worry about taking the medication on an empty stomach or not."

Hgb F: 12-16 g/dL, M: 14-18 g/dL

Hct F: 37%=47%, M: 42%-52%

Assess for fatigue, shortness of breath, low blood pressure, increased heart rate, increased respiratory rate, and oliguria. Assess for cyanosis. Plan rest periods. Administer oxygen as prescribed. Elevate head of bed to facilitate breathing. Provide pain mediation if pain is increasing oxygen consumption. Provide assistance to bathroom. Monitor for mental status changes. Anemia may be treated with ferrous sulfate or infusions of RBCs. Erythropoietin may be administered to stimulate production of RBCs.

WBC 5,000-10,000/mm³

inc: infection, inflammatiuon, autoimmune & leukemia

dec: prolong infection or bone marroe suppression

Susceptibility to infection increases as WBCs decrease. Visitors with colds or infections should take pre-cautions (e.g., wear mask) or avoid visiting the client. Fever, chills, upper respiratory infections, or sore throat should be reported to health care provider. Health care providers and visitors should wash hands before and after contact with the client.

Neutrophils are the primary WBCs that fight infections. Usual signs of infection (pain, swelling, redness,warmth, pus) may be absent or greatly reduced in neutropenic clients. Monitor for increase (or decrease)in body temperature. Elevated temperature is considered a sign of infection.

Temperatures of 38.3° C orabove should be reported to health care provider immediately. Appropriate cultures (e.g., blood, urine,sputum) are collected, and an antibiotic regimen is initiated. Assess for localized infections. Auscultate breath sounds. Monitor WBC.

Colony-stimulating factors (e.g., filgrastim) may be administered to stimulate production of WBCs.

Platelet count: 150,00-400,000/mm³

Prothrombin time (PT) 11-12.5 sec

Petechiae, bruising, bleeding of gums, and nose bleeds are signs of a low platelet count and should be reported to health care provider. Assess for bleeding, petechiae, and ecchymosis. Assess for occult bleeding in urine, feces, and emesis. Monitor platelet counts and bleeding time. Apply pressure to injection sites. Platelet transfusions may be needed. Avoid medications that may promote bleeding (e.g.,aspirin). Avoid invasive procedures (e.g., injections, indwelling urinary catheters, rectal temperature).

• Antineoplastics
• Nitrogen Mustards

• Tx:
• → Breast
• → Lung
• → Ovarian
• → Hodgkin's disease
• → leukemias
• → lymphomas

An immunosuppressant agent

• Nurse:
• → Encourage fluids before, during, and after drug administration - 2 to 3 L of fluid per day/
• → Cyclophosphamide (Cytoxan) causes bone marrow suppression, which is evidenced by a decrease in red blood cells, white blood cells, and platelets. Any significantly lower than normal value → the chemotherapy should be held.

• red blood cells
• F 4.2-5.4M/mm³
• M 4.7-6.1M/mm³

• white blood cells
• 5,000-10,000/mm³

platelets150,000-400,000/mm³

• Antineoplastics
• Alkylating-like Drugs

• Tx:
• → Ovarian and testicular cancer
• → Used as adjunctive treatment
• → bladder
• → head and neck
• → endometrium

• Notes:
• → Ototoxicity in 30% of clients

• Immediate action by nurse:
• → Increased blood urea nitrogen and creatinine - known to be ototoxic, nephrotoxic, neurotoxic, and emetogenic.

• Nurse report:
• → Stomatitis (indic of toxicity) - an inflammation of the mucous lining of any of the structures in the mouth

• Antineoplastics
• Pyrimidine Analogues

• Tx:
• → Cancer of breast
• → cervix
• → colon
• → liver
• → ovary
• → pancreas
• → stomach

• It burns like hell, hense the 5-fuckU moniker
• → rectum

• Nurse report:
• → Stomatitis - an inflammation of the mucous lining of any of the structures in the mouth

• Antineoplastics
• Antitumor Antibiotics

• Tx:
• → Breast
• → bladder
• → ovarian
• → lung
• → leukemias
• → lymphomas
• → soft-tissue and bone

• Sides:
• → Stomatitis - an inflammation of the mucous lining of any of the structures in the mouth
• → Causes discolored urine (pink to red) for up to 48 h

• Nurse:
• → Green tea (Camellia sinensis) may enhance antitumor effects of doxorubicin (Adriamycin). Use of green tea should be reported to the health care provider.
• → Clients receiving doxorubicin need to be monitored for cardiac toxicity. Dexrazoxane (Zinecard) is a cytoprotective (chemoprotective) agent that may be given to help prevent cardiac toxicities associated with doxorubicin administration.

• Teaching:
• Report any shortness of breath, palpitations, or edema your doctor.

• Antineoplastics
• Vinca Alkaloids

• Tx:
• → breast
• → leukemia
• → lungs
• → cervix
• → multiple myelomas
• → sarcomas
• → lymphomas
• → Wilms tumor
• → Hodgin's disease

• Adverse:
• → Sensory loss
• → hypotension
• → visual disturbances
• → ptosis (drooping)
• → ileus ( bowel obstruction)
• → SIADH (syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH) is characterized by excessive release of antidiuretic hormone - ADH or vasopressin)
• → hyponatremia
• → hyperuricemia (uric acid in the blood that is abnormally high)
• → severe local reaction with extravasation
• → fever
• → Life-threatening: intestinal necrosis
• → seizures
• → coma
• → acute bronchospasm
• → bone marrow depression

• Admin:
• Never should be given intrathecally - introduced into or occurring in the space under the arachnoid membrane of the brain or spinal cord.

• Nurse:
• Assess for peripheral neuropathy.

• Antineoplastics
• Antimicrotubues/Taxanes

• Tx:
• Metastatic ovarian and breast cancer.

• Adverse:
• → Sensory loss
• → hypotension
• → visual disturbances
• → ptosis (drooping)
• → ileus ( bowel obstruction)
• → SIADH (syndrome of inappropriate antidiuretic hormone hypersecretion (SIADH) is characterized by excessive release of antidiuretic hormone - ADH or vasopressin)
• → hyponatremia
• → hyperuricemia (uric acid in the blood that is abnormally high)
• → severe local reaction with extravasation
• → fever
• → Life-threatening: intestinal necrosis
• → seizures
• → coma
• → acute bronchospasm
• → bone marrow depression

• Monitor:
• vital signs
• electrocardiogram

• Nurse - instruct the client to monitor for:
• Myalgias (muscle pain) and arthralgias (joint pain) are a common side effect of paclitaxel that the client should be prepared to expect.

• Antineoplastics
• Androgens

• Tx:
• Palliative treatment of breast carcinoma in postmenopausal women.

• Monitor:
• → Serum calcium levels should periodically be checked
• → Voice may deepen and facial hair may increase

• Antineoplastics
• Hormonal Antagonists

• Tx:
• → Palliative treatment of advanced carcinoma of breast and endometrium.
• → May Promote weight gain by increasing appetite.

• Opthalmic
• Antibacterials

• Tx:
• → Most commonly used antibacterial
• → For superficialocular infections
• → prevention of ophthalmia neonatorum ()

• Opthalmic
• Antibacterials

• Tx:
• For prevention and treatment of ophthalmia neonatorum (bacterial conjuctivitis)

• Opthalmic
• Antibacterials

• Tx:
• Combination dosage form effective against many gram-negative organisms

maintain sterility - use barrier --- Maddie

• Opthalmic
• Antivirals

• Tx:
• To treat cytomegalovirus or herpes simplex keratitis

• Admin:
• → Store in refrigerator
• → do not mix with boric acid
• → If no response in 1 wk, discontinue.

• Miotics
• Direct-Acting Cholinergics

• Tx:
• → Induce miosis (pupil constriction, not meiosis)
• → Decrease IOP (intraocular pressure) in glaucoma

• Miotics
• Beta-Adrenergic Blockers

• Tx:
• → Selective beta blocker
• → Used to decrease elevated IOP in chronic open-angle glaucoma and ocularhypertension

• Con:
• clients with asthma caused by increased airway resistance from systemic absorption.

• Watch:
• caution in clients receiving oral beta blockers

• Miotics
• Beta-Adrenergic Blockers

• Tx:
• → Reduces production of aqueous humor

• Monitor:
• → vital signs during initial therapy
• → Concurrent use of similar drugs must be individualized
• → Blurred vision decreases with use

• Miotics
• Carbonic Anhydrase Inhibitors

• Tx:
• To reduce aqueous humor formation, thus lowering IOP

• Monitor:
• → for dehydration
• → postural hypotension Need good BP!
• → electrolytes
• → Avoid hazardous activities if drowsy.

Most frequently prescribed

• Otic
• Antiinfectives, External

• Tx:
• OTC preparations to dry the ear canal and to loosen and remove impacted wax (cerumen) from the ear canal.

• Debrox:
• instill for up to 4 d. If no improvement, call health care provider.

Carbamide peroxide (Debrox) works to soften earwax for easy removal while providing a weak antibacterial action to prevent infection.

• Otic
• Antiinfectives, External

• Tx:
• → Usually given in combination with neomycin and hydrocortisone
• → For disorders of external ear
• → Discontinue after 10 days to prevent fungal over-growth

• Nurse:
• → 1948, 1st broad-spec G+, G- and many other organisms
• → Inhibit bacterial protein synth
• → bacteriostatic effect (does not harm, but stops reproduction)
• → Not effective: S. aureus (except newer), Pseudomonas or Proteus.
• → nausea
• → vomiting
• → photosensitivity
• → 1st trimester terotogenic effects
• → 3rd trimester & children younger than 8: irreversibly discolors permanent teeth
• → discard outdated → breaks down to toxic → Can cause superinfection because of disruption of body flora.

• Otic
• Antiinfectives, External

• Tx:
• To loosen and remove impacted wax (cerumen) from ear canal

• → 1948, 1st broad-spec G+, G- and many other organisms
• → Inhibit bacterial protein synth
• → bacteriostatic effect (does not harm, but stops reproduction)
• → Not effective: S. aureus (except newer), Pseudomonas or Proteus.
• → nausea
• → vomiting
• → photosensitivity
• → 1st trimester terotogenic effects
• → 3rd trimester & children younger than 8: irreversibly discolors permanent teeth
• → discard outdated → breaks down to toxic
• → Can cause superinfection because of disruption of body flora.

IM/IV only

• Otic
• Antiinfectives, Internal

• Tx:
• → For otitis media

• Notes:
• → Clavulanate inhibits beta lactamase degradation of amoxicillin
• → Allergies 5%-10% people getting penicillin cmpds