What is inflammation?

an immune response that can localize infection and helps with healing

What are signs and symptoms of inflammation?

pain, redness, warmth, swelling and loss of function

What enzymes do non selective NSAIDs block?

COX-1 and COX-2

What are examples of nonselective enzymes?

ibuprofen and aspirin

What is COX-1 important for?

the lining of the stomach and function of platelets

NSAIDs increase the risk of what?

bleeding and renal dysfunction

NSAIDs should be taken with what?

full glass of water and food

When taking NSAIDs your patient should report signs of what?

bleeding and bruising

When administering NSAIDs as a nurse what should you report before?

any associated causes that increase bleeding, vitamin K deficiency, or history of peptic ulcer disease

What is salicylism?

aspirin toxicity

What are clinical manifestations of salicylism?

tinnitus, sweating, fever, dehydration, headache and dizziness and respiratory depression

If your patient reports ringing in the ear while taking aspirin what should you do?

withhold the medication and call the provider

What patients shouldn't you give aspirin too?

patients under the age of 15

What is Reye syndrome?

a rare but serious complication that causes confusion, swelling in the brain and liver damage

What causes Reye Syndrome?

occurs when aspirin is used for fever reduction in children and adolescents who have a viral illness, such as chickenpox or influenza

What would you give a child with a fever since aspirin is dangerous for them?

acetaminophen

Selective NSAIDs block which enzyme?

COX-2

Selective NSAIDs increase the risk for what?

Myocardial infraction and stroke

What suffix do corticosteroids (glucocorticoids) have?

-sone and -solone

Corticosteroids is produced by what part of our body?

adrenal cortex

Why shouldn't you stop taking corticosteroids abruptly?

can cause adrenal glands atrophy also known as acute adrenal insufficiency

What are some effects of corticosteroids?

weight gain, water retention, buffalo hump, moon face, increased blood sugar levels, increased BP and depresses immune system

What does DMARDs stand for?

disease modifying antirheumatic drugs

Why do you give DMARDs?

to suppress the immune system

What are examples of DMARDs?

adalimumab and etanercept

What is the route for administering DMARDs?

subcutaneous injection

What should you educate your patient on when administering DMARDs at home?

rotate site of injection

What is gout?

metabolic disorder that causes a person to either make too many uric acid crystals from the proteins he/she eats or to not eliminate the crystals in the urine

What do uric acid crystal cause?

causes arthritis with symptoms of pain, redness, swelling and progressive joint damage with function loss; usually in the big toe

If your patient has gout what should you educate them on?

avoid eating uric acid producing foods such as meat, chicken and tuna

What medications are best for a patient with history of gout?

febuxostat (Uloric) and allopurinol (Aloprim, Zyloprim)

What should you educate your patient on if they are taking antigout medications?

drink plenty of water usually 3 L every day

What are broad spectrum antibiotics?

they are effective against a wide variety of bacteria

What are narrow spectrum antibiotics?

they are effective against a few strains of bacteria

Penicillin family medications usually have what suffix?

-cillin

The penicillin family medications can cause?

an allergic reaction that is mild or severe or anaphylaxis

What does anaphylaxis cause?

swelling of lips and tongue, hives, difficulty breathing, wheezing, low BP, fast heart rate

If a patient is taking penicillin for the first time what should you do?

advise them to stay at the clinic for at least 30 minutes to monitor any effects; especially check for any wheezing

Penicillin can decrease effectiveness of what other medications?

oral contraceptives

Medications in the cephalosporin family usually have what prefix?

ceph- or cef-

Cephalosporin may cause?

nephrotoxicity

(kidney)

If a patient has history of allergy to penicillin can they take cephalosporin?

No because their is cross sensitivity in both medications

What is an example of a medication in the carbapenem family?

imipenem cilastatin

What are side effects of imipenem cilastatin?

Upset GI, nephrotoxicity and increase risk of seizures

Medications in the macrolides family usually have what suffix?

-thromycin

What are adverse reactions of Macrolides?

GI discomfort, diarrhea, interactions with other drugs such as anticoagulants

Vancomycin is used for what types of infections?

helps treat infections caused by multidrug-resistant (MDR) bacteria and C.diff

What is the mechanism of vancomycin?

it is a cell wall synthesis inhibitor drug

What are effects of vancomycin?

ototoxicity (hearing problem) and nephrotoxicity

Fast infusion of vancomycin may cause?

Redman syndrome

What medication is an example of the sulfonamides family?

trimethoprim- sulfamethoxazole

What is sulfonamides usually used for?

Urinary tract infections (UTIs)

What are effects of sulfonamides?

photosensitivity, suppress bone marrow function and increase for bleeding

What are examples of fluoroquinolones?

ciprofloxacin, ofloxacin, levofloxacin

What are indications for fluoroquinolones?

urinary tract infections, COPD and pneumonia

A patient who was exposed to anthrax needs to receive what type of medication?

ciprofloxacin

What are adverse effects of fluoroquinolones medications?

damage to joints, tendons, ligaments and cartilage

What medications treat tuberculosis?

isoniazid, pyrazinamide, rifampin, ethambutol

A patient with tuberculosis should take treatment medication for how long?

9-12 months

Macrobacterium tuberculosis enters our body at what percent due latent tuberculosis (no signs or symptoms)?

90% - 95%

What percent of patients may experience active tuberculosis?

5% - 10%

What are signs and symptoms of active tuberculosis?

fever, night sweats, weight loss, productive cough

What are effects of anti-tuberculosis medications?

hepatotoxicity, neuropathy, kidney disfunction, orange secretion (tear, urine), changes in vision

Before taking treatment for tuberculosis what organ function should you check?

liver function

What are examples of anti-fungal medications (SATA)?

amphotericin B and Nystatin

Amphotericin B should only be given for what types of fungal infections?

life threatening fungal infections

Nystatin is usually given to treat what type of infection?

vaginal candidiasis (yeast)

For a patient who has been prescribed fluconazole for treatment of a fungal infection which symptoms would indicate a medical emergency due to an adverse reaction?

painful red or purple rash and blisters

Metronidazole treats what types of infections?

protozoa and bacterial infections

What is disulfiram reaction?

patient can't tolerate alcohol because metronidazole blocks enzymes that are supposed to metabolize alcohols

If a patient who has been receiving metronidazole, reports severe nausea and facial flushing what does it usually indicate?

patient might have unintentionally taken alcohol; cough syrups contain alcohol

What medications treat malaria?

chloroquine, primaquine

If your patient want to travel to areas in which malaria is common what type of treatment should you give and how often?

antimalarials weekly for two weeks before traveling and continue for 8 weeks after patient comes back