Cinoxacin doses should be reduced in clients with....?
Renal impairment...failure to do so could result in accumulation of the medication to toxic levels
Methenamine is used to treat .... ?... but is not recommended for... ?....
...chronic UTIs, but is not recommended for acute infections
When should Methenamine be administered?
after meals and at bedtime to reduce gastric distress
Methenamine should not be used in clients with....?
Renal impairment or liver dysfunction
What pH urine does methenamine require?
5.5 or lower (acidic)
What does increasing fluid intake do when taking methenamine?
Reduces its antibacterial effects by diluting the medication and raising urine pH
What should not be taken with methenamine?
Sulfonamides (risk of crystalluria and urinary tract injury)
Alkalinizing agents
What are some side effects of nalidixic acid?
5
GI upset
Rash
Photosensitivity
Visual disturbances
Insomnia
What side effect can nalidixic acid have in pediatric patients?
Intracranial hypertension and shouldn't be given to infants under 3 months
What drugs can be affected by nalidixic acid?
Anticoagulant effects can be intensified
In what patients is nalidixic acid contraindicated in?
Hx of convulsive disorders
What are some of the pulmonary reactions when taking nitrofurantoin and how long does it take them to resolve?
6
Dyspnea
Chest pain
Chills
Fever
Cough
Alveolar infiltrates
2-4 days following cessation of treatment
What may nitrofurantoin do to urine?
Cause it to be a brown color (harmless)
Who is nitrofurantoin contraindicated for?
Clients with renal impairment
Do not take nitrofurantoin with....?
antacids
What do fluoroquinolones do?
Suppress bacterial growth by inhibiting an enzyme necessary fro DNA synthesis
Fluoroquinolones
4
Ciprofloxacin
Enoxacin
Levofloxacin
Norofloxacin
What are some of the side effects of fluoroquinolones?
5
Dizziness
Drowsiness
GI distress
Diarrhea
Nausea and vomiting
What are some of the adverse effects of fluoroquinolones?
5
Psychosis
Hallucinations
Confusion
Tremors
Interstitial Nephritis
Who should fluoroquinolones be used with caution in?
Clients with hepatic, renal, or CNS disorders
What urine output should persons taking fluoroquinolones maintain and why?
1200-1500 mL daily to minimize the development of crystalluria
What are the indicators of fluoroquinolones CNS toxicity?
5
Dizziness
Lightheadedness
Visual disturbances
Increased light sensitivity
Depression
Fluoroquinolones are toxic to ....
...the renal and hepatic systems
What do sulfonimides do?
Suppress bacterial growth by inhibiting the synthesis of folic acid
What are sulfonamides primarily used to treat?
Acute UTIs
What are the hypersensitivity reactions of sulfonamides?
4
Rash
Fever
Photosensitivity
Stevens-Johnson syndrome
What is Stevens-Johnson syndrome?
The most severe sulfonamide hypersensitivity response producing symptoms that include widespread lesions of the skin and mucous membranes, fever, malaise, and toxemia
Sulfonamides
4
Sulfadiazine
Slufisoxazole
Trimethoprim
TMP/SMZ
Adults should maintain a daily urine output of ...
1200 mL to minimize risk of renal damage
How is an IV dose of TMP/SMZ administered?
Over 60-90 minutes and NOT mixed with any other meds
What is phenazopyridine?
A urinary tract analgesic
What are the side effects of phenazopyridine?
3
Nausea
Headache
Vertigo
Who are urinary tract analgesics contraindicated in?
Renal or hepatic disease
What are anticholinergics-antispasmodics used for?
Overactive bladder
Anticholinergics-Antispasmodics
5
Darifenacin
Oxybutynin chloride
Solifenacin
Tolterodine
Trospium
Side effects of anticholinergics-antispasmodics?
6
Anorexia
Nausea/Vomiting
Dry Mouth
Blurred Vision
Drowsiness
Urinary Retention
Signs of anticholinergic-antispasmodic toxicity?
6
Hypotension/Hypertension
Confusion
Tachycardia
Flushed/Red Face
Respiratory Depression
Nervousness
What is bethanechol chloride?
A cholinergic used to increase bladder tone and function and to treat nonobstructive urinary retention and neurogenic bladder
When should bethanechol chloride be administered?
1 hour before or 2 hours after a meal to lessen nausea and vomiting
What are the signs of cholinergic overdose?
5
Excessive salivation
Sweating
Involuntary urination/defecation
Bradycardia
Severe hypotension
What is the antidote to bethanechol chloride (cholinergic)?
Atropine sulfate
What types of medications are used for preventing organ rejection?
4
Immunosuppressants
Corticosteroids
Cytotoxic medications
Antibodies
What is cyclosporine used for?
Preventing rejection of allogeneic kidney, liver and heart transplants
Immunosuppressants
3
Cyclosporine
Sirolimus
Tacrolimus
What route of administration is preferred for cyclosporine?
Oral
What system is cyclosporine toxic to?
Nephrotoxic
What are the most common adverse effects of cyclosporine?
5
Nephrotoxicity
Infection
Hypertension
Tremor
Hirsutism
In whom is cyclosporine contraindicated in?
Pregnancy/Breast feeding
Recent inoculation with live virus
Recent contact with active infection such as chickenpox
What should a client unable to swallow their cyclosporine pill do?
Mix liquid with milk or OJ in a glass container and drink immediately
What risks do sirolimus increase?
4
Infection
Renal injury
Lymphocele
Raises triglycerides
What are some of the side effects of tacrolimus?
9
Nephrotoxicity
Infection
HTTN
Tremor
Hirsutism
Neurotoxicity
GI effects
Hyperkalemia
Hyperglycemia
Glucocorticoid
Prednisone
What can occur with prednisone use?
2
Hyperglycemia
Hypokalemia
Cytotoxic medications
2
Azathioprine
Mycophenolate mofetil
What are some of the side effects of azathioprine?
Neutropenia
Thrombocytopenia
(Due to bone marrow suppression)
What are some of the adverse effects of mycophenolate mofetil?
4
Diarrhea
Severe neutropenia
Vomiting
Sepsis
Antibodies
4
Antithyocyte globluin, equine
Basiliximab
Daclizumab
Muromonab-CD3
What should a client do before the first infusion of antithymocyte globulin, equine?
Undergo intradermal skin testing to determine hypersensitivity
What are some of the adverse reactions to muromonab-CD3?
5
Fever
Chills
Dyspnea
Chest pain
Nausea/Vomiting
Types of hematoporetic growth factors
3
Erythropoietic
Leukopoietic
Thrombopoietic
Erythropoeitic growth factors stimulate production of...?
RBCs
Leukopoietic growth factors stimulate production of...?
WBCs
Thrombopoietic growth factors stimulate production of...?
Platelets
What is the major side effect of erythropoeitic growth factors?
HTTN
What are some of the adverse effects of erythropoeitic growth factors?
3
Heart failure
Thrombotic events
Cardiac arrest
Side effects of leukopoietic growth factors?
3
Bone pain
Leukocytosis
Elevated plasma uric acid
What are some of the adverse effects of thrombopoietic growth factors?
5