Pharm Chapter 46 – Flashcards
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What are some medications used to treat UTIs?
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Sulfonamides, trimethoprim, and urinary antiseptics
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What is the expected pharm action of Sulfamethoxazole-trimethoprim (SMZ-TMP, Bactrim, Septra, Co-Trim)
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Sulfonamides and trimethoprim inhibit bacterial growth by preventing the synthesis of folic acid. ~~Folic acid is essential for the production of DNA, RNA, and proteins~~
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What are some therapeutic uses of SMZ-TMP?
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used to treat urinary tract infections. ■ Causative agents include Escherichia coli, klebsiella, proteus, enterobacter, and Neisseria gonorrhoeae. ■ Other infections include otitis media, bronchitis, shigellosis, and Pneumocystis jiroveci pneumonia.
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What are some adverse effects of SMZ-TMP?
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--hypersensitivity --Blood dyscrasias --Crystalluria --Kernicterus --Photosensitivity -- Sulfonamides
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What can sulfoamides increase the effect of?
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Warfarin, phenytoin, sulfonylurea oral hypoglycemics, and tolbutamide
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What are some SMZ-TMP contraindications?
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--SMZ-TMP is contraindicated in clients who have folate deficiency (increases risk of megaloblastic anemia)
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What patients should be careful when taking SMZ-TMP?
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--Use cautiously in clients who have renal dysfunction. Reduced dosage of SMZ-TMP is recommended. -- Administer with caution in adults older than age 65 years who take angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blockers (ARB) because of risk for hyperkalemia.
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How should SMZ-TMP be taken?
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Instruct clients to take SMZ-TMP on an empty stomach with a full glass of water
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What are some examples of urinary tract antiseptics?
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nitrofurantoin (Furadantin, Novo-Furan) and nitrofurantoin macrocrystals (Macrodantin, Macrobid), methenamine
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What is the expected pharm action of urinary tract antiseptics?
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--Nitrofurantoin is a broad-spectrum urinary antiseptic with bacteriostatic and bactericidal action. --Bacterial injury occurs by damaging DNA.
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What are some therapeutic uses of Nitrofurantoin?
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--Acute urinary tract infections --Prophylaxis for recurrent lower urinary tract infections
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What are some adverse effects of nitrofurantoin?
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--GI discomfort --Hypersensitivity reactions with pulmonary manifestations --Blood dyscrasias --peripheral neuropathy --headache, drowsiness, dizziness
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What are some contraindications of nitrofurantoin?
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contraindicated in clients who have renal dysfunction and creatinine clearance less than 40 mL/min
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What will impaired renal function increase?
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the risk of medication toxicity because of inability to excrete nitrofurantoin.
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What are some nursing considerations for nitrofurantoin?
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--Inform clients that urine will have a brownish discoloration --Encourage clients to administer with food if GI symptoms occur
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What is an example of a fluoroquinolone?
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ciprofloxacin
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What is the expect pharm action of ciprofloxacin?
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Fluoroquinolones are bactericidal as a result of inhibition of the enzyme necessary for DNA replication.
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What are some therapeutic uses of ciprofloxacin?
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--Broad-spectrum antimicrobials used for a wide variety of micro-organisms such as aerobic gram-negative bacteria, gram-positive bacteria, klebsiella, and E. coli --Urinary, respiratory, and GI tract infections; infections of bones, joints, skin, and soft tissues
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What is the medication of choice for prevention of anthrax in clients who have inhaled anthrax spore?
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Ciprofloxacin (fluoroquinolone)
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What are some adverse effects of ciprofloxacin?
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--GI discomfort --Achilles tendon rupture --Suprainfection (thrush) --Phototoxicity (sunburn)
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Can children under the age of 18 be given ciprofloxacin?
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No, only if they are being treated for an E. coli infection
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What are some interactions of ciprofloxacin?
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Plasma levels of theophylline (Theolair) can › increase with concurrent use of ciprofloxacin
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What decreases absorption of ciprofloxacin?
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Cationic compounds (aluminum-magnesium › antacids, iron salts, sucralfate, milk and dairy products)
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What can increase plasma levels of warfarin?
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Ciprofloxacin
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What patients should have decreased levels of ciprofloxacin?
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Patients who have renal dysfunction
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A nurse is reviewing a client's medication history and notes an allergy to sulfonamides. Which of the following medications are contraindicated due to this allergy?
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Hydrochlorothiazide (Microzide) Tolbutamide (Orinase) Furosemide (Lasix)
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A nurse is planning discharge teaching for a female client who has a new prescription for sulfamethoxazole-trimethoprim (Septra). Which of the following information should the nurse include in the teaching?
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Take the medication on an empty stomach.
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A nurse is providing teaching to a client who has a new prescription for nitrofurantoin (Furadantin). Which of the following information should the nurse include in the teaching? (Select all that apply.)
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--Observe for bruising on the skin --Take the medication with milk or meals --Expect brownish discoloration of urine
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A nurse is teaching about ciprofloxacin (Cipro) to a female client who has a severe urinary tract infection. Which of the following information about adverse reactions should the nurse include in the teaching? (Select all that apply.)
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--Observe for pain and swelling of the Achilles tendon --Monitor for a vaginal yeast infection --Inspect the mouth for cottage cheese-like lesions
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A nurse is planning to administer ciprofloxacin (Cipro) IV to a client who has cystitis. Which of the following is an appropriate action by the nurse?
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Infuse medication over 60 min.
