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Name 2 anti-gout medications
How should they be given
What should they not be taken with
Colchicine, and Allopurinol
Take at the 1st sign of an attack, and the 2nd dose 1 hr after
take with food not grapefruit or purines
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What should Colchicine not be taken with
adverse effects to notify
Cyclosporine/ ranolazine
anticoagulants and aspirin work more
notify if urine output is less or cloudy
-
Name an anti-inflammatory salicylate
how to give it?
who not to give it to?
acetylsalicylic acid
Take it with food
Dont give it to those under 18 or pregnant = reyes syndrome
-
Sign of salicylism toxicity
serum level over 300
- dizzy, tinnitus, hearing loss
other adverse effects: GI blood loss, hemmorrhage, petechia, bruising
-
What lowers and raises the effects of acetylsalicylic acid
- lowers:
- sodium bicarb ( antidote)
- ibuprofen
- misoprostol
- raises:
- acids ( ex. vit c )
- angiotensinb
- betaadrenergics
- corticosteroids
-
Name a nonnarcotic analgesic antipyretic
whats the max dose?
contraindication
acetaminophen
max dose: 4g, if too high= MI
contraindication: liver, hypersensitivity ( rash)
-
If someone takes too much acetaminophen what are the signs, and what can be done?
early: vomit
24-48 hr: symptoms go down, liver prob go up
3-4 days: hepatotoxicity
antedote : acetylcysteine within 8-10 hrs
-
Name a propionic nonsteroidal anti inflammatory
how to take it
when not to take it
Ibuprofen for mild-mod pain/fever
Must be at least 6 months old, and should be taken with food
- Not for periop or coronary artery bypass
- report bleeding
and dont take with alcohol or ginger
-
Name a oxicam nonsteroid anti inflammatory
and the risks , what not to take with it
Meloxicam inhibits inflammation
risks for CVD, GI bleed
Dont take it with lithium
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Name a nonsteroidal anti inflammatory acetic acid
risks
- Indomethacin
- Etodolac
- Ketorolac ( limit to 5 days)
- for RA, OA , tend pain
Risk for clotting and MI
-
Name a nonsteroid anti-inflammatory Cox-2 inhibitor
how to take it and what are the risks
- celecoxib: decrease inflammation and protects the GI
- - arthritis
take with food
MI risks increases
-
What do glucocorticoids ( exogenous) end with
what to be aware of while taking (5 points)
- - Predinose
- - sone ( betamethaosne, dexamethasone, fluticasone ...etc)
- - Lowers immune system
- -Tape off ( dont miss a dose) if you stop abruptly = addisons
- - No live viruses
- - weight frequently
- - raise dose with stress
- -Give bronchodilators first
-
Name a mineralocorticoid
Aldosterone
- reabsorbs water and salt
- gets rid of K+
-
What do Penicillins end with
How to give
What not to give with
Ampicillin ( -cillin)
- Broad spectrum
- Give 1hr ac or 2 hr pc ( empty stomach no acid)
IV ( dilute over 30-60 min : causes cardiac arrest) or IM no deltoid
common prob = rash
Dont give with cephalosporins
-
How to remember cephalosporins
How to give
What not to give with
interactions
- Start with - Cef
- Broad spectrum , gen 5 can cause MRSA
If allergic to -cillins dont give cephs
- - causes prothrombin time to go down
- -renal fail with: aminoglycoside, furosemid, vancomycin
-
How to remember Carbapenems
how to give
who not to give it to
Imipeneme-celastatin ( end in -nem)
- Broad spectrum for drug resistance
- IV rapid onset, IM with lidocaine
Dont give to kids under 8 or those with seizures
dont give if allergic to - cillins or - cephs
-
What to monobactams end with
what are they used for
adverse effects
gram -
- aztreonam
cause liver toxicity, and prolonged c diff
-
Name a aminoglycoside
how to give
cautions
Gentamicin: bacteriostatic for gram (-) Ecoli, sepsis
IM/IV/ Opthalmic gtt - 10 min apart NOT PO
based on drug levels, crCL
covers ototoxicity if taken with antihistamines or ginger
penicillin decreases the effects
-
Fluoroquinolones end with
how to give
precautions
who not to give it to
Ciprofloxacin ( end in -oxacin)
- Admin IVPB over 60 minutes
- PO with food ( for anthrax of bone/joints)
- Dont give to kids = erodes joints
- Dont give to myasthenia gravis
- Wait 4 hr before antacids/vitamins
- No dairy , stay hydrated
= tendonitis, tendon rupture , photosensitive
-
What do tetracyclines end with
How to give / what to avoid
Who not to give
End in - cycline
PO: empty stomach : acne, hpylori, std, lyme
No dairy, antacids, iron, photosensitive
lowers the effects of bc
dont give to pregnant or kids under 8 = bad teeth
-
Sulfonamides end with
How to take
What to be aware of
- Trimethoprim-sulfamethazole
- ( end in -azine)
Take with water, or topically for burns
causes BC to work less, photosensitive, hypoglycemia, steven johnson sydrome, hematuria
-
What is nitrofurantoin for
to treat UTI take with food
-
What is phenozopyridine hydrochloride for
- to help UTI pain
- pee=orange
-
What is trimethoprim
what to give it with
for UTI
take with sulfamethaxazole
drink 2000-3000 ml of water
-
What meds not to give to pregnant people ( think MCAT)
- Metronidazole ( 1st for cdiff)
- Chloramphenicol
- Aminoglycoside
- Tetracycline
-
What do macrolides end with
when are they used
How to give
Erythromycin end in -mycin
- For penicillin allergy
- Dental procedure with heart valve
- STD
- Newborns born with chlamydia conjunctivitis
PO, ophthalmic ointment, IV around the clock , 2 hrs before meals
-
What do macrolides interact with and the side effects
- no grapefruit juice
- no antacids ex. aluminum magnesium
If IV admin check for vfib/ hearing loss
-
Name a lincosamides
adverse problems
Clindamycin
bacteriostatic
Ordered with aminoglycoside/fluquindones
can lead to cdiff, colitis, diarrhea
-
Name an oxazolidinone
what not to give it with
Lineozolid ( bacteriostatic and cidal)
for pneumonia and vancomycin resistance
dont give it with antidepressents, or tyramine rich foods
check cbc , myelosuppresion
-
Name a nitromidazole
What does it treat
adverse rxn
metronidazole
treats c diff , hpylori
- adverse: taste metal
- not for pregnant
-
Name a glycopeptide
what does it treat
what to be aware of
vancomycin
treats MRSA, endocarditis , colitis, cdiff
If IVPB is infused too rapid = red man syndrome ( flush, hypotension, rash)
Give 1g=1hr
-
Drugs for TB
how to take
what to be aware of
- latent= isoniazid ( need B6)
- active= isoniazid, and rifampin ( orange, bc works less)
- take on an empty stomach
- warfarin works more, neuropathy
-
Herpes antiviral drug endings
how to give
who not to give
otc drug
- Acyclovir ( ends in -clovir)
- OTC: docosanol ( cold sore)
topical: need gloves, oral: need food IV: 1hr+
dont give to heart fail, renal, lactation
-
Cytomegalovirus antivirals ( type of herpes)
how to give , when not to give
- ganciclovir
- valganciclovir ( for org transplant)
- PO: prevent CMV in hiv/ immunocomp
- IV: CMV retinitis ( infuse 1hr+)
- Dont get pregnant ( be on bc 90 post )
- Dont eat salt , eat high fat diet
- Dont give if platelets <25000
- neutrophils <500
black box: neutropenia, anemia, thrombocypenia
-
Antiviral RSV drug
when not to give
- Ribavirin
- - dont mix with other inhaled rx
- -dont get pregnant
-
4 Flu antivirals
how to give
when to give
- Amantadine hydrochloride
- rimantadine
- oseltamivir phosphate
- zanamirvir
- BID q12hr with food and water
- no alcohol,
- start 48hrs of symptoms
-
Polyenes for fungal infection
how long to give
what to avoid
- Amphotericin B: serious infection only 4-12wk
- Nystatin : 1L bolus
no lactation, causes hypokalemia, hyponatremia
-
Name a fungal azole
how to give
Fluconazole ( end in -azole)
PO, IV ( dont mix with other rx)
1st line local candida, lots of interactions
-
Name a fungal echinocandins
how to give
what not to give it with
Caspofungin
- IV only for azole resistant,
- bad with aspergillus
Dont give with mannitol
-
2 rx for fungacide against dematophyles
what its used for
how to give
ring worm, jock itch, athletes foot
topical/ PO ( may need only 1 dose)
bc works less
-
Name a amebicide
whats it for
adverse effects
For amoebas, trich, c diff
- metroniadazole - cylcines too
- with food not alcohol
- causes metallic taste
- bleeding goes up, and dark pee
-
Name 2 antimalarial how to take
- Chloroquine phosphate
- Hydroxychlorquine
- same day each week with food
- 1week before, during ,and 4 wks after travel
-
Name a anthelmintic
whats it used for
nursing job
Mebendazole
round work, pinworm, hookworm
PO chew/ crush with food
collect stool for ova 3 weeks after
-
Pediculicide rx
what its used for
how to give
Permethrin
PO/topical 1 dose total
scabies/lice: cream head to toe, 8 hrs then wash
-
Name a nasal decongestant
what not to use it with
- Pseudoephedrine ( vasoconstricts)
- for rhinitis
extended released 12+
dont use hypertension, antidepression, hyperthyroid
-
Antitussive
meds
- Non narcotic...
- Dextromethorphan for non productive cough
- -cough drop form
- Benzonatate
Narcotic : codeine
-
Name an expectorant , how it works
Guaifensin
- thins secretions making more but easier to remove
- - suction
-
Mucolytic
how to give
Acetylcystein : inhale and liquify mucus
for tylenol overdose
-
2 Antihistamins how they work
- Dipenhydramine
- - = drowsy, crosses blood brain
- Fexofenadine
- for allergies and rash , good for asthma non drowsy
-
Type 3 : serum sickness
7-10 days of excess antigen
type 4: epinephrine
-
Name an adrenergic bronchodilatior
how to use
when to use
- Albuterol to treat bronchospasm
- metered dose inhaler 5-15 min
- Always 1st before other inhalers, 1st for status asthmaticus
- - doesnt work for bronchospasm
- -dont take with beta blockers
Salmeterol : not fast enough alone
-
Name an anticholinergic how to use
Ipratropium
Inhale but not for rescue its just main
cons: glaucoma, BPH
-
Name an xanthine
theophylline
PO AC dont crush/ chew
blood levels 5-15 >20=toxic
no caffeine , macrolide, lithium
-
Name a corticosteroid for asthma
- Beclomethasone
- not rescue just preventative
- Inhale PO/IV for acute
- intranasal- rhinitis
<3 years growth restriction, bone marrow down
-
Leukotriene modifier for asthma
Montelukast
- PO hs , excercise induced
- long term, neuropsych
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