Term
| Flouroquinolones *general* |
|
Definition
Broad-spectrum
disrupts dna replication and cell division
oral/IV
Tendon rupture
end in -floxacin |
|
|
Term
|
Definition
Tendon rupture
Broad-spectrum |
|
|
Term
|
Definition
Oral/IV
Bactericidal (quickly)
aerobic infections (Respiraotyr, UTI, GI,Bone,joint, skin and soft tissue, ANTHRAX, cannot be used for anaerobic infections (Only systemic approved for children) |
|
|
Term
|
Definition
|
|
Term
|
Definition
Candida (pharynx and vagina)
Tendon rupture (achilles- pain, swelling or inflammation *exercise avoid*)
* Phototoxicity *severe sunburn*
* increased C. Diff |
|
|
Term
| Tendon rupture increased risk |
|
Definition
| >60 or <18, used with glococorticoids, heart/lung/kidney transplant (no risk to nursing infant) |
|
|
Term
| Ciprofoxacin (Cipro) (food/drug) |
|
Definition
Cationic compounds can reduce absoption
*take 6 hours before or 2 hours after
raise levels (theophylline, warfarin(coumadin), tinidazole) |
|
|
Term
| Cationic compounds(positive charged) |
|
Definition
1.aluminum
2. iron salts
3. zinc salts
4. Sulcrafate
5. Calcium supplements
6. milk/other dairy products |
|
|
Term
| Ciprovoxacin (to tx anthrax) |
|
Definition
| IV slowly over 60 minutes |
|
|
Term
| Metronidazole (Flagyl) *main* |
|
Definition
protozoal/anaerobic bacterial infections
Resistance is rare |
|
|
Term
| Metronidazole (Flagyl) (tx what?) |
|
Definition
CNS
Abd. organs
Bones/joints
Skin/soft tissues
GU tract
C.DIFFICILE COLITIS
Prophylaxiz for some surgeries
treat PUD (helicobacter pylori) |
|
|
Term
| Drug of choice for C diff. |
|
Definition
|
|
Term
| Prophylaxis (surgeries where it's likely to get infection with anaerobes) colorectal, abd., vaginal |
|
Definition
|
|
Term
| Daptomycin (Cubicin) *General* |
|
Definition
Can use to treat MRSA
Can cause muscle injury (myopathy)
IV only
cyclic lipopeptides |
|
|
Term
| Can kill almost all "relevant" gram-positive bacteria including MRSA (approved for bloodstream infection with staph aureus and complicated skin and structure infections (including MRSA and VRE) |
|
Definition
|
|
Term
|
Definition
| monitor CPK (creatinine phosphokinase); marks muscle injury- monitor weekly, stop if goes up significantly (10 times) |
|
|
Term
| Daptomycin (Cubicin) *main* |
|
Definition
|
|
Term
| Cipro nursing implications (Cipro) |
|
Definition
| *Cationic avoid, tenton rupture, phototoxcity |
|
|
Term
|
Definition
Human immunodeficiency virus
Kills CD4 T lymphocytes |
|
|
Term
|
Definition
| syndrome in which individual is HIV positive and has CD4 T cell counts below 200 or an AIDS-defining illness |
|
|
Term
|
Definition
pneumocystic pneumonia
CMV retinitis
TB |
|
|
Term
| Highly active antiretroviral therapy (HAART) |
|
Definition
Decrease plasma HIV levels
*Delay or reverse loss of immune function, preserve health and prolong life
*Expensive,complex, risk of toxicity and severe drug interactions, lifelong tx.
* Cannot cure HIV infection |
|
|
Term
|
Definition
Cant self-replicate- obligate intracellular parasite
converts their RNA into DNA and instead of reverse |
|
|
Term
|
Definition
| CD4 T cells (helper T lymphocytes) |
|
|
Term
| What is drug resistence in HIV related too? |
|
Definition
|
|
Term
|
Definition
| massive HIV replication occurs (flu-like acute retroviral syndrome |
|
|
Term
|
Definition
| prolonged clinical latency butstill replicating |
|
|
Term
|
Definition
CD4 T cells drop critically low- opportunistic infectionsand neoplasms
AIDS 20-40% neurologic complications |
|
|
Term
| HIV- combination drug therpy |
|
Definition
Two NRTIS combined with either a PI or NNRTI
*Attacks HIV in different ways
*Reduces risk of resistance
* Reduces plasma HIV levels, cause CD4 T-cell counts to return to normal, restoring some immune function
Great potential AE and drug interactions |
|
|
Term
| Threshold for initating drug therapy |
|
Definition
|
|
Term
|
Definition
| decrease to undectable level |
|
|
Term
|
Definition
Maximal and durable supression of viral load
*Restoration or preservation of immune function
*Improved quality of life
*Reduction of HIV-related morbidity and mortality
*Reduction of sexual HIV transmission
* Prevention of vertical HIV transmission (mother to baby) |
|
|
Term
| opportunistic infections (long list) |
|
Definition
Pneumocystis carinii pneumonia (PCP)
cytomegalovirus retinitis(CMV)
Myobacterium TB and Mycobacterium avium complex
Toxoplasma encephalitis
Cryptococcal meningitis
Varicella-Zoster
Herpers Simplex
candidiasis |
|
|
Term
Antiretroviral therapy (ART)
HAART and 3-4 drugs *benefits* |
|
Definition
| decreased incidence of new OIs has declined dramatically; ART can cause CD4 counts to rise, restoring come immunocompetence |
|
|
Term
| Nursing implications- goals |
|
Definition
| decrease viral loag, improve quality and quantity of life |
|
|
Term
|
Definition
correct drug administration
adverse effects are serious and debilitating
Patients need to be followed closely |
|
|
Term
|
Definition
| Hypertension- move edmatous fluid (HF, cirrhosis, kidney disease) - prevent renal fauilure( maintaining urine flow) |
|
|
Term
|
Definition
| basic functional unit of kidney- 4 regions |
|
|
Term
|
Definition
| contained in the renal corpuscle |
|
|
Term
| Proximal convoluted tubule |
|
Definition
| one of 4 functionally distinct regions |
|
|
Term
| upper portion of Henle's loop |
|
Definition
| located in the renal cortex and the lower end of the loop descends toward the renal medulla. |
|
|
Term
| The final segment of the distal convoluted tubule plus the collecting duct into which it empties can be considered a single functional unit |
|
Definition
|
|
Term
|
Definition
1.Cleanse extracellular fluid and maintain ECF volume and composition
2. Maintain acid-base balance
3. Excrete metabolic wastes and foreign substances. |
|
|
Term
|
Definition
| Occurs at glomerulus and is nonselective |
|
|
Term
|
Definition
Most water, electrolytes and nutrients get absorbed
Solutes are reabsorbed by active transport
Diuretics act by disrupting solute reabsoption |
|
|
Term
|
Definition
| In proximal convoluted tubule |
|
|
Term
| Effects of the kidney on ECF are the net result of three basic processes |
|
Definition
| filtration, reabsoption, and active secretion |
|
|
Term
|
Definition
| 99% of water, electrolytes, and nutrients that are filtered |
|
|
Term
| Filtration is nonselective |
|
Definition
| Reabsoption and secretion are selective and determine composition of urine. |
|
|
Term
|
Definition
|
|
Term
|
Definition
| sodium and chloride ions, also bicarbonate and potassium ions in smaller amounts. |
|
|
Term
| what remains behind in blood |
|
Definition
|
|
Term
| small molecules present in plasma undergo filtration |
|
Definition
| electrolytes, aminoacids, glucose, drugs, metabolic wastes |
|
|
Term
|
Definition
| interfer with reabsoption |
|
|
Term
| active transport- what solutes |
|
Definition
| electrolytes, amino acids, glucose |
|
|
Term
|
Definition
|
|
Term
| Proximal convuluted tubule |
|
Definition
| high reabsoptive capcity (65% Na and Cl reaborded,also HCO3 and K+) as these are actively reabsorbed, water follows passively |
|
|
Term
|
Definition
| descending limb: freely premable to water so it is drawn into the interstitial space,urine becomes concentrated.ascending limb: 20% of Na and Cl is reabsorded, Not permeable to water so concentration of urine returns to original state |
|
|
Term
|
Definition
| 10% of Na and Cl reabsorbed in early segment followed by water |
|
|
Term
|
Definition
| site of two important processes: exchange of Na for K+ which is under the influence of aldosterone and final concentration of urine determined (regulated by ADH) |
|
|
Term
| Diuretics *main function* |
|
Definition
Block sodium and chloride reabsoption
* causes water and solute retention in the kidney and eventual excretion
* amount of diuresis directly related to amount of sodium and chloride reabsoption blocked. |
|
|
Term
| greater the diuretic effect |
|
Definition
| the earier inthe kidney/nephron that the drug action occurs- amount gets smaller as you go alone |
|
|
Term
|
Definition
| Hypovolemia, Disturbance of electrolyte levels, Acid-base disturbance |
|
|
Term
|
Definition
Use short-acting diuretics
allow periods of kidney being "drug free" |
|
|
Term
| High-ceiling (loop) diuretics *drug* |
|
Definition
|
|
Term
|
Definition
| hydrochlorothiazide (HCTZ) |
|
|
Term
| Potassium-sparing diuretics |
|
Definition
aldosterone antagonists (spironolactone)
nonaldosterone antagonists triamterene |
|
|
Term
|
Definition
|
|
Term
| Mannitol *part of nephron* |
|
Definition
Proximal Convuluted Tubule
65% |
|
|
Term
|
Definition
| Thick Segment- ascending limb of henle's loop 20% |
|
|
Term
|
Definition
| Early Distal Convoluted tubule 10% |
|
|
Term
| spironolactone, triamterene |
|
Definition
| late distal convoluted tubule and collecting duct (distal nephron) |
|
|
Term
|
Definition
most effective diuretic, rapid onset
for pulmonary edema associated with CHF
Edema of hepatic, cardiac,or renal origin unresponsive to other diuretics.
Hypertension uncontrolled by other diuretcs |
|
|
Term
|
Definition
| *** Can use when renal flow blood flow and glomerular filtration are low |
|
|
Term
|
Definition
Hyponatremia
Hypochloremia
Dehydration
Hypotension
Hypokalemia
Avoid use during pregnancy
Ototoxicity
***Hyperglycemia, hyperuricemia, lower HDL, raise LDL and triglycerides, hypomagnesemia, hypocalcemia |
|
|
Term
|
Definition
digoxin- low potassium
ototoxic drugs- aminoglycosides
Potassium-sparing diuretics
Lithium
Antihypertensive- hypotension
NSAIDS-blunt (prostaglandin) |
|
|
Term
| Thiazides- Hydrochlorothiazide (HCTZ) |
|
Definition
CANNOT be used when renal blood flow is low!!
indications- hypertension and edema |
|
|
Term
| Thiazides and related diuretics AE |
|
Definition
Hyponatremia,hypochloremia, and dehydration
Hypokalemia
Hyperglycemia, hyperuricemia, increased lipds hypomagnesemia
Avoid in pregnancy and breastfeeding |
|
|
Term
|
Definition
chlorothiaside (Diuril)
metolazone (Zaroxolyn) |
|
|
Term
| Thiazides (drug interactions) |
|
Definition
| same as loop except not ototoxic |
|
|
Term
| Potassium-sparing diuretics *general* |
|
Definition
Modest urine output
Less potassium excretion
minimize K+ loss
delayed action
Hypertension/edema/HF
protective effects of aldosterone blockade in heart
(ACE's, ARB's, DRI's elevate K+)
distal nephron |
|
|
Term
| Non-aldosterone antagonists *drugs* |
|
Definition
| trimterene (Dyreium) and amiloride (Midamor) |
|
|
Term
| Non-aldosterone antagonists *general* |
|
Definition
distal nephron
alone or combined with other diuretic
Uses- Hypertension and edema
AE- Hyperkalemia, N V leg cramps and dizziness possible
works more quickly |
|
|
Term
|
Definition
No significant impact on electrolyte balance
given IV |
|
|
Term
|
Definition
Prevent renal failure
Reduce intracranial pressure
Reduce intraocular pressure |
|
|
Term
|
Definition
|
|
Term
| foods that contain potassium |
|
Definition
| nuts, dried fruits, spinach, citrus fruits, potatoes, bananas |
|
|
Term
|
Definition
|
|
Term
| HF *progressive disorder characterized by* |
|
Definition
Ventricular dysfunction
Reduced cardiac output
Inefficient tissue perfusion
Signs of fluid retention- volume overload |
|
|
Term
| Inefficient tissue perfusion |
|
Definition
| fatigue, SOB, exercise intolerence |
|
|
Term
| body compensates decreased CO |
|
Definition
cardiac dilation
Increased sympathetic tone
water retention and increased blood volume
Natriuretic peptides seceted |
|
|
Term
|
Definition
blocks angiotensin II production and decreases aldosterone release
* Can cause hypotension, hyperkalemia, cough, angioedema and fetal injury |
|
|
Term
| Angiotension II receptor blockers (ARB) |
|
Definition
can't use ACE
Aldosterone antagonist
* Either block aldosterone receptors or decrease aldosterone production
* Can cause hyperkalemia |
|
|
Term
| ACE inhibitors *drugs/facts* |
|
Definition
lisionpril, enalapril
arteriolar and venous dilation; suppress release of aldosterone (that can cause sodium andwater retention) |
|
|
Term
| DRI- only Tekturna and not approved for HF |
|
Definition
| shut down the renin system because it prevents angiotension from being produced |
|
|
Term
|
Definition
HF and dysrhythmiz control
Positive inotropic action |
|
|
Term
|
Definition
0.5-0.8 ng/ml
Cardiac glycoside |
|
|
Term
| Management of dysrhythmias with dig |
|
Definition
* stop digoxin and K+ wasting diuretics
* Monitor serum K+
* possible antidysrhythmic drugs
* Digibind IV, cholestyramine or activated charcoal po |
|
|
Term
|
Definition
| phenytoin, lidocaine, atropine and pacemaker |
|
|
Term
|
Definition
GI: anorexia, N, V
Fatigue
Visual disturbance (blurred, yellowed or halos) |
|
|
Term
| Sympathomimetics with dig |
|
Definition
| dopamine and dobutamine can add positive inotropic effects of dig but can increase risk of fast dysrhythmias. |
|
|
Term
|
Definition
| can increase dig levels dramatically- supress myocardial contractility and counter act |
|
|
Term
|
Definition
po or iv
reduce for kidney dysfunction
monitor levels
avoid bran decrease adsoption
IM- tissue damage and pain |
|
|
Term
| Patient education digoxin |
|
Definition
take digoxin exactly as prescribed
limit salt intake 2gm/day and avoid excess fluids
Avoid excess alcohol intake
weight control
exercise
recognize dysrhythmias
ss hypokalemia and toxcity |
|
|
Term
|
Definition
chronic stable angina (exertional)
Variant angina (prinzmetal's or vasospastic)
Unstable angina |
|
|
Term
|
Definition
reduced blood flow- angina
Complete blockage- myocardial infartion |
|
|
Term
|
Definition
| cold, large meal, emotional excitement |
|
|
Term
|
Definition
| organic nitrates, beta blockers, CCB, ranalozine- symptomatic releif don't change pathology |
|
|
Term
|
Definition
CCB and Organic nitrates
beta blockers- aren't effective |
|
|
Term
|
Definition
|
|
Term
|
Definition
| HA, orthostatic, Reflex tachycardia |
|
|
Term
| Nitroglycerin drug interactions |
|
Definition
Hypotensives- + BB, CCB, diuretics and other
PDE5- viagra, cialis and levitra
BB, Verapamil, Diltiazem- suppress tachycardia |
|
|
Term
|
Definition
1-3 minutes up to 60 minutes
take every 5 minutes (call 911 if one doesn't releive) |
|
|
