Mignon Angel Dominique C.

Estrellado

Pharmacology-A

9/24/11

Worksheet #4 ANTIBIOTICS PART 2 I. 1. Aminoglycosides have synergistic effects with 3 other antibiotics or groups of antibiotics. List them. Beta-lactams Carbapenems 2. List 2 major toxicities of aminoglycosides. Nephrotoxicity Ototoxicity 3. Is there an antibiotic that can treat Vancomycin-resistant Enterococcusfaecium, more commonly referred to as VRE? If yes, what is the antibiotic? Linezolid 4. What is the antibiotic of choice for multi drug-resistant (also called methicillin-resistant) Staphylococcus aureus (MRSA) infections, if any? Vancomycin 5. Which antibiotics are given in a 30:70 combination for a synergistic effect? Aminoglycosieds & Beta-lactams II. For each condition below, indicate the appropriate antibiotic that is most likely to be used. Write the capital letter corresponding to the correct answer on the blank. A. Vancomycin B. Dapsone C. Linezolid 1. 2. 3. 4. 5. 6. D. Nitrofurantoin E. Clindamycin F. Neomycin

Preoperative bowel cleansing = F Leprosy (Hansens disease) = B Enterococcus faecium (VREF) = C Streptococcal & Staphylococcal infections of the bone, skin = E Methicillin-resistant Staphylococcus Aureus (MRSA) = A Urinary tract infections caused by gram + organism & staphylococcus aureus = D

Worksheet #5 Antivirals I. 1. Identify the contraindications for the use of acyclovir (Zovirax) Contraindicated with allergy to acyclovir, seizures, heart failure, renal disease, & lactation. Use cautiously with pregnancy. 2. Which antiviral drug is also an Antiparkinsonian drug? 3. Zidovudine (Retrovir) is indicated for the use with HIV who has AIDS. 4. What are the important nursing considerations for antivirals? Before administering an antiviral drug, the nurse should perform a thorough medical and physical assessment and medication history. This is important to ensure safe medication use. Wearing gloves and thorough hand washing, before and after administration of the medication, are necessary to prevent contamination of the site and spread of infection. Strict adherence to standard precautions is important to the safety of both the patient and the nurse. 5. When treating influenza A, oseltamivir, & zanamivir should ideally begin within 2 days of influenza symptom onset. II. What drug am I? Each question/statement is a clue to a drug from Chapter 39. Provide both the generic & trade names for each drug. 1. The very first anti-HIV drug medicine? = Zidovudine (Retrovir) 2. This drug is the one most frequently used to treat cytomegalovirus (CMV) infections. = ganciclovir (Cytovene) 3. A protease inhibitor that may cause nephrolithiasis (kidney stones) in some patients. = Indinavir (Crixivan) 4. One of the earliest antiviral drugs that is only active against influenza A viruses. = amantadine (Symmetrel) 5. One of the newer antivirals in the neuraminidase inhibitor class, that is used for both prophylaxis & treatment of influenza viruses Type A & Type B. = Oseltamivir (Tamiflu) & zanamivir (Relenza) 6. Only medication in the newest class of antiretroviral drug, fusion inhibitors. = Enfuvirtide (Fuzeon) 7. The drug of choice for initial & recurrent episodes of herpes-simplex virus (HSV) 1 & 2 as well as the varicella-zoster virus (VZV) which cause chicken pox & shingles. = Acyclovir (Zovirax) 8. Inhalation form of this drug is primarily in hospitalized infants for treatment of severe lower respiratory tract infections caused by respiratory syncytial virus (RSV) = Ribavirin

Worksheet # 6 Antifungals I. 1. Amphotericin B is used in the treatment of severe systemic mycoses. 2. Fluconazole (Diflucan) is only administered as vaginal cream or suppository. True or False? If false, correct the statement. False, because it is available only in oral and injectible forms. 3. Nystatin is used in the management of candidial infections & comes in oral and topical dosage forms. 4. 3 Adverse effects of systemic antifungals are hepatotoxicity, neurotoxicity, & _________ 5. What are the major nursing considerations for antifungals? Vital signs, weight, hemoglobin (Hgb), hematocrit (Hct), red blood cells (RBCs), complete blood counts (CBCs) with differential, liver and renal function tests, and confirmation of culture/sensitivity test results should all be assessed and noted prior to beginning antifungal therapy. It is important for the nurse to identify any contraindications, cautions, and drug interactions, before administering medications. II. What drug am I? Each question/statement is a clue to a drug from Chapter 39. Provide both the generic & trade names for each drug. 1. I am the swish & swallow suspension used to treat oral candidiasis. = Nystatin 2. I am used to treat jock itch, athletes foot & ringworm. = terbinafine 3. I am used for invasive aspergillosis in patients who have not responded to other drugs. = caspofungin 4. I can cure vaginal candidiasis in one oral dose! = 5. Pretreatment an antipyretic (acetaminophen), antihistamines, & antiemetics may be given to decrease the severity of my infusion-related reactions. = amphotericin B

Worksheet #7 Antimalarial, Antiprotozoal, & Antihelmintic Drugs I. Answer briefly and concisely Complete the following chart Drug 1. Chloroquine 2. Primaquine 3. Mefloquine Indications Malarial prophylaxis Malarial treatment Malaria infections Malaria treatment Malaria prophylaxis Available Dosage forms Oral, Parenteral Oral Oral Adverse Reactions Diarrhea, dizziness Nausea & vomiting, abdominal distress Headache, Anorexia

4. List 2 teaching tips for antimalarials Take full course of drug therapy. Take drug with meals if GI upset occurs. 5. List at least 3 of the drug interactions for antimalarials Chloroquine (divalproex, valproic acid) Mechanism: Decreased serum levels of valproic acid Result: Loss of seizure control Mefloquine (Beta-blockers, CCBs, quinidine, quinine) Mechanism: Unknown Result: Increased risk of dysrhythmia, cardiac arrest, seizures Primaquine (Other hemolytic drugs) Mechanism: Unknown Result: Increased risk for myelotoxic effects (monitor for muscle weakness) 6. List 2 teaching tips for antihelmintic drugs II. A. B. C. D. Match the description Protozoa Plasmodium Pneumocystis jiroveci Erythrocytic phase E. F. G. H. Exoerythroctic phase Enterobiasis Giardiasis caused by Giardia Lamblia Ascariasis

I. Toxoplasma gondii

J. Malaria

1. Pneumonias caused by this organism occur exclusively in immunocompromised people =C 2. A systemic protozoal infection that can occur due to exposure to cat feces = I 3. Also known as giant round worm = H 4. Also known as pinworm = F 5. The organism that causes malaria = B 6. Another name for the tissue phase of the malarial parasite = E 7. This disease has cycles of extreme chills, tigors, fever, & diaphoresis, followed by extreme fatigue & sleep = J 8. Single-celled organisms that may cause infections in a human = A 9. The most common intestinal protozoal infection, causes foul-smelling diarrhea = G