Exam 6

• Drugs to prevent transplant rejection: basiliximab, cyclosporine, tacrolimus, prednisone
• Transplant drug side effects: fever, chills, opportunistic infections, leukopenia, thrombocytopenia, poor wound healing
• Basiliximab- used for kidney cancer treatment and transplant rejection prevention
• Colony stimulating factor drugs: Epoetin alpha, darbepoetin alfa, filgastrim
• What do colony stimulating factors treat?

  Cancer and neutropenia
• Nadir- when patient receiving chemo are most susceptible to infection

  • 7-10 days after starting treatment
• Which blood cells are affected by chemotherapy?

  WBCs, RBCs, platelets
• Cyclophosphamide- chemotherapy drug

  • Patient teaching: stay hydrated, urinate frequently, wear sunscreen, eat small and frequent meals high in protein, report signs of infection, report bleeding, avoid sick people, maintain low purine diet
• Dexrazoxane- prevents cardiomyopathies due to doxorubicin
• Corticosteroids used in preterm labor: Betamethasone, dexamethasone
• Corticosteroids for preterm labor- used to accelerate lung maturation and lung surfactant development in fetus
• Magnesium sulfate- inhibits uterine contractions and delays labor

  • Nursing interventions- monitor BP, monitor magnesium levels, monitor resp rate, monitor fetal HR, check patellar reflexes, keep suction nearby, keep calcium gluconate nearby
• Dinoprostone- softens cervix and shortens duration of labor
• Oxytocin- stimulates uterine contractions to stimulate or augment labor

  • Monitor for hyperstimulation
• Methylergonovine- enhances uterine contractions by direct smooth muscle cell receptor stimulation

  • Contraindications: active labor, HTN, PVD
• Drugs given to newborns:

  • Erythromycin- prevents blindness due to maternal STI's
  • Vitamin K- prevents Vit K deficient bleeding
  • Hep B- gives immunity to Hep B
• Contraceptive risk factors:

  CHCs- skin reactions, cramps, vision changes, VTE

  Progestin only- irregular bleeding, spotting, depression, mood changes, fatigue, decreased sexual desire, weight gain
• What can prevent withdrawal bleeding when taking contraceptives?

  Take continuously
• Vaginal ring pt education: Use back up contraception for first 7 days after placement
• Testosterone- used to maintain sexual processes, accessory sex organs, cell metabolism, and bone/ muscle growth

  • Treats androgen deficiency, hypogonadism, and delayed puberty
• Testosterone patient education: Wash hands if administered topically, take IM shot Q3-4wks
• Phosphodiesterase-5 inhibitors: sildenafil, tadalafil, vardenafil

  • Use- Erectile dysfunction
  • Precautions- Avoid grapefruit. Do not use with alpha blockers to prevent hypotension.
  • Contraindications- Cardiovascular disease, predisposition for priapism
• 5-Aplha-Reductase Inhibitors- Finasteride, dutasteride

  • use: BPH
  • precautions: women of childbearing age cannot touch crushed tablets
• Bisphosphonates- alendronate, ibandronate

  • Use: Osteoporosis
  • Interactions: ASAs, NSAIDs, antacids
• Alpha adrenergic blockers- tamsulosin, doxazosin, terazosin

  • Patient education: Take at bedtime to avoid hypotensive episodes, stand slowly
• Treatment for herpes simplex virus

  Acyclovir, valacyclovir, famciclovir
• Treatment for gonorrhea

  Ceftriaxone, doxycycline
• Treatment for chlamydia

  Azithromycin, erythromycin, doxycycline, amoxicillin
• Beta adrenergic blockers- treat glaucoma

  • Interventions: Monitor HR, use caution in patients with asthma and COPD
  • Interactions: Anticholinergics
• Isotretinoin- treats severe acne

  • Precautions: DO NOT use during pregnancy, do not breastfeed or give blood during first month, avoid rigorous activity, stop taking if muscle weakness occurs
  • Interventions: Ensure patient pledges to use two forms of contraception, obtain baseline hepatic function, lipid panel, and pregnancy test
• Drugs for burns- Silver sulfadiazine, mafenide acetate
• Sunscreen education: SPF of 15 or more is needed to prevent skin cancer, limit sun exposure from 1000 to 1400, reapply sunscreen Q2hrs
• Calcipotriene- treats psoriasis

  • Monitor serum calcium levels
• Drugs for excess ear wax- carbamide peroxide, hydrogen peroxide, normal saline, acetic acid
• Ear wax drug procedure: Tilt head, pull ear down, instill drops, maintain position for 2-3 mins
• First line drug for OM- Amox