SYSTEM SYMPATHETIC PARASYMPATHETIC Vasopressor/vasodilation - stimulates alpha

EYES DILATE PUPILS CONSTRICT PUPILS adrenergic/increases BP

LUNGS DILATES CONSTRICTS Supraventricular tachycardia - betablockers-
BRONCHIOLE BRONCHIOLES AND slows CR
S INCREASES Continue to administer maintenance medication
SECRETIONS - clarify
HEART INCREASE DECREASES HEART Atropine sulfate - sympathetic - decrease
HEART RATE RATE salivation before op; dry mouth
BLOOD CONSTRICTS DILATES BLOOD Decrease oropharyngeal secretions - anti
VESSEL BLOOD VESSELS cholinergic
S VESSELS Cholinergic agonist - stimulates cholinergic
GI RELAXES INCREASES receptors
SMOOTH PERISTALSIS Neurotransmitter - Ach , epinephrine, norepi,
MUSCLES OF dopa, serotonin
GI TRACT CNS depressant -
BLADD RELAXES CONTRACTS Ibuprofen - propionic acid
ER BLADDER BLADDER Mefenamic acid - fenamate
MUSCLES ASA - salicylic acid
UTERUS RELAXES Amphetamin - CNS stimulant
UTERINE Procaine - anesthetic
MUSCLES Thiopenthal sodium - anesthetic that causes
PITUITA INCREASES sedation - depressant
RY SALIVATION Morphine sulfate - opiod/narcotic analgesic -
GLAND assess pain
Side effect of morphine - urinary retention;
BETA-BLOCKERS - olol hypotension
Digoxin (lanoxin) - cardiac glycosides; digitalis - Antidote for morphine sulfate - naloxone
monitor potassium and magnesium (nausea, NSAID - naproxen (propionic acid),
vomiting, anorexia, diarrhea, visual disturbances) indomethacin (Acetates), piroxicam (oxicam),
Digitalis toxicity - hypomagnesemia, fenamte, pyrazolones, salicylates
hypokalemia - increases potency of toxicity Prednizone - antiinflammatory corticosteroid
Restlessness and diaphoretic in digoxin - monitor NSAID + antacid - decreases potency
cardiac rate - if below 60 above 110, do not give Sedation for elderly - decrease dose because of
Vasodilator (cholinergics) what to do - change drug toxicity and dependency because of
position slowly; does not cause seizure decreased excretion
90/60 - do not give vaso dilator Pt taking hypnotic meds (insomnia) - safety
Betablockers- do not give to pts with asthma Barbiturates - tapering to prevent rebound
Resp complications (wheezing sounds upon Phenobarbital - anticonvulsant (emergency
auscultation) - serious complication with resuscitative equipment) causes resp depression
betablockers Dexamethazone - prednizone - anti inflammatory
Pt mgh with betablockers - teach how to check corticosteroid (do not dilute)
PR because PR decreases; below 60, do not give Drug abuse/alcoholic for OR - increase dose
and inform physician Epidural and iv anesthesia - edipural causes
Betablocker - atenolol longer effect and more side effects
Adrenergic blocking drug - sympatholytic Anesthesia - chills/shivering because of
CNS drugs should not be withdrawn abruptly - vasodilation/relaxation
causes rebound effect Propofol - general anesthetic
Hypertension - rebound effect of betablocker Alcohol - depressant
Alpha 1 - vasocons Benzodiazepine - am (causes sedation); no to
Alpha 2 - vasodilator alcohol because of enhanced effect
Beta 1 - vasconstrictor GABA (gamma aminobutyric acid) - NT
Beta 2 - brochodilator enhanced by benzodiazepine
Betablocker - decreases conduction of cardiac Benzodiazepine - category c
muscles Phenytoin/hydantoin - gingival hyperplasia

BLANCO 2019
Dilantin (phenytoin) - antiseizure; CNS depressant;
if if pt has seizure
Seizure - rolling of eyeball, twitching, drooling of
saliva, vomiting, restlessness
Phenytoin - block sodium channels
Antibiotic - RE superinfection
Phenytoin - RE status epilepticus
Gabapentin (neurontin) - anticonvulsant; post
herpetic neuralgia; not to tonic clonic seizure
Belladonna plant - blocks cholinergic
Epinephrine - vasocontrictor; cardiac stimulant,
anti arrhythmic
Dopamine - vasoconstrictor ???????
Phenobarbital - antiseizure
Amitriptyline - anti depressant
Phenytoin - anti convulsant
Valproic acid - anti seizure
Myoclonic seizure -
Absent seizure -
Tonic clonic -
Antagonist for resp depression - naloxone - opiod
analgesic
Infliximab - rheumatoid arthritis
NSAID - antacid, aspirin, ibuprofen, gingko -
check for gums bleeding, tarry stool
Tolmetin
Chronic gout - allopurinol
Cefepime - 4th gen cephalosporin - observe for
superinfection
piperacillin tazobactam -
Antibiotic - full course, send specimen for culture,
monitor for superinfection (itis)
Cephalosporin - check for superinfection
Yeast infection - kills normal flora
MRSA - vancomycin
Vancomycin - does not cause diarrhea because
cannot cause pseudo membranous colitis
INH isoniazid - 1h before and 2h after meals -
periodic eye exam; compliance; causes
numbness
Rifampicin - red orange
TB - multidrug RIPES
Streptomycin - tinnitus
Candida - nystatin (antifungal)
Antiviral - acyclovir - causes crystalluria
Amphotericin B - antifungal - causes
hypokalemia
Azole - metronidazole, fluconazole causes
hypoglycemia
TMP - SMZ - crystalluria
CD
MEASLES - Rubeola / Morbilli
Koplik spots - cheeks (inside) pre-eruptive stage;
pathognomonic sign
Stimson’s line - pre-eruptive stage
Exanthem - outside
Enanthem - inside
Highly communicable - height of rash
Complications - otitis media, bronchopneumonia,
encephalitis
Isolation - first management
*Assess behind ears and neck
*life long immunity after occurrence
*advise complete bed rest and increase fluid
GERMAN MEASLES - rubella/ Toga
virus/togaviridae
Forchheimer’s spots - rash on soft palate
Cardinal sign - rash - oval rose red colored
papules
Pregnant - baby is affected
Can be transferred uterinely
SMALL POX - variola virus
Contagious - sores appear
S/S - fever, severe headache, backache,
exanthem (eruptive stage)
Pockmark- desquamation
Complications - blindness, conjuctivitis, otitis
media
Vaccine - vaccinia immune globulin
Do not apply alcohol before vaccination -
bifurcated needle to every blister
MUMPS - parotid gland
Contagious - 6 days before and 9 days after
onset of swelling
Complications - orchitis (swelling of testicles)
Vaccine - MMR (measles - mumps - rubella)
INFLUENZA - Highly contagious acute viral disease
IP - 24 - 48 hrs
MOT - Airborne, Droplet, Direct contact, virus
persist 4hrs in dried mucus
Pathognomonic - joint pain
prevention
Prevention - immunization, annual vaccine, avoid
crowded places, hygiene
ANTHRAX - bacillus anthracis
Isolation should be done
Cutaneous - scars/lesions neck face
GI - vomiting, diarrhea
Inhalation - severe viral resp disease
BLANCO 2019
Initial s/s - fever, cough, dyspnea, stridor
DIPHTHERIA - Corynebacterium diphtheria/
Klebs-Loffler bacillus
MOT - direct contact, carrier, indirect
Bullneck with grayish pseudomembrane
Diagnostic Test
- schick test (immunity/susceptibility) -
Moloney’s (hypersensitivity)
- nose & throat swab (communicability)
Complication - airway obstruction
Management - tracheostomy, DPT vaccine, ice
collar, CBR, Vit C, soft diet, nose throat care
Wound/cutaneous - skin and mucus membrane
First line of treatment - penicillin
PERTUSSIS (whooping cough)- bordetella pertussis
- easily destroyed by light, heat and drying.
MOT - direct and indirect
Diagnostic - cbc, swab, sputum culture
Paroxysmal stage - seizure, increased ICP,
disoriented, high BP
Complication - broncho pneumonia, abdominal
hernia, severe malnutrition, atelectasis
*booster is recommended
PNEUMONIA - streptococcus pneumoniae
Pathognomonic - rusty sputum
Diagnostic - chest xray
Community acquired (CAP) - work, school,
crowded places
Aspiration pneumonia - foreign body is inhaled
Lobar pneumonia - bedridden - turn side to side
Management - increase fluid intake
*advise bed rest to decrease oxygen demand
and encourage shallow breathing
*sputum analysis before giving antibiotic
MENINGITIS -
MOT - droplet, ear discharges after skull fracture
Diagnostic - CT scan, xray, imaging, MRI
Lumbar puncture - for strain determination
S/S - photophobia, opistothonos, nuchal rigidity, +
kernig and brudzinski
Increased ICP - increased BP, projectile vomiting,
seizure
Petechial or purpuric rash - fatal
Management - assess LOC and ICP, monitor fluid
and electrolytes, turn side to side
Prophylaxis for meningococcemia - rifampicin
AVIAN FLU
Severe pneumonia/resp distress/multiple organ
failure - fatal
IP - 3-5 days
Assess origin of pt
TUBERCULOSIS - mycobacterium tuberculosis
Lesion - xray
Sputum culture/smear and sensitivity -
confirmation PTB
MOT - droplet
S/S - Low afternoon fever, cough (2weeks), night
sweats, weight loss
Meds - RIPES
Sputum collection - 3 consecutive mornings
Mantoux test - Protein derivative (PPD);
If 5-10 +, then sputum culture
Pathognomonic sign - hemoptysis
*follow up for treatment
Streptomycin - tinnutus
Isonizid rifampicin - hepatotoxicity
LEPROSY (hansen’s disease, hansenosis)
S/S - loss of sensation and hair, muscle sickness
(early)
Loss of eyebrows, inability to close eyelids, saddle
nose (late)
Cardinal Signs
L - Loss of sensation on skin patches
E - Enlargement of peripheral nerves
P - Presence of leprosy bacilli in the skin
smear
Anti - leprosy drugs - multi drug 9rifampicin,
dapsone, lamprene
Prevention - Separation of infants from
lepromatous parents at birth, BCG, avoid
contact
SARS - corona virus
no specific treatment
Early detection
IP - 2-10 days
Precaution - standard precaution - PPE; all are
infectious
prodromal stage - Non-communicable
handwashing
CHICKEN POX - herpes virus varicella
Starts in covered areas
Contagious - rashes appeared until last crust
Fever - no aspirin, can cause reye’s syndrome
(brain and liver damage) and bleeding
Management- Isolation
Acyclovir - do not give to pt with many rashes
BLANCO 2019