RX ADMINISTRATION

1) Routes
a) IV  Fastest
b) PO  Slowest
2) Metabolism
a) How the body breaks it ↓
3) Excretion
a) How the body gets rid of it
4) Therapeutics effect
a) What it’s supposed to do
b) Ex  BP w/in normal limits
5) Adverse Reaction
a) Undesired effect of Rx
b) Stool softener  2 laxative
c) Constipation  diarrhea
6) Rectal Rx
a) ≠ PT w/
i) Rectal bleeding
ii) Diarrhea
b) Administer
i) Pt on L side
ii) Lubricate suppository
iii) Pt take deep breath @ insertion
iv) Stay in L lying position 10 – 15 min
7) Injections
a) Insulin
i) SubQ
ii) 45˚- 90˚
iii) Location
(1) Abdomen  1 in 4m belly button
(2) Vastus Lateralis
b) IM

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 i) 90˚
ii) Z-track 
iii) Location  muscle

ANTIBIOTICS
Definitions

1) PROPHYLAXIS
A) 2 prevent infection
2) SUPER-INFECTIONS
A) Caused by disruption of Flora
3) COMMON A/E
a) DNV
i) Diarrhea
ii) Nausea
iii) Vomiting
4) HALF LIFE 
a) Half of Rx 2 leave body
b) How long Rx working
c) Strong half life weaker dose
d) Usually 1/day
5) PEEK & TROUGH
a) ↑ level in blood
b) ↓ level @ body

ANTIBIOTIC CLASSES

1) Penicillin
a) _____cillin
2) Cephalosporin
a) Ceph___
b) Cef____
3) Sulfonamides
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 a) Sulfa____
4) Macrolides
a) ____thromycin
b) ____xomicin
5) Quinolones
a) FluoroQuinolones
b) _____floxacin
6) Aminoglycoside ANTHRAX
a) _____mycin 1) Ciprofloxacin
2) Amoxicillin
7) Tetracyclines
a) ____cyclines

PENICILLIN
AMOXICILLIN
1) TX ANTHRAX
CEPHALOSPORIN
ROCEPHIN 

1) CEFTRIAXONE
2) Cross sensitivity w/ Penicillin
3) Long ½ life  1/day
4) 60+ min infusion
5) Hepatoxicity
6) Tx CNS infection
7) ≠ Ca+ infusion

SULFONAMIDES
BACTRIM

1) Can’t take if allergic

2) Tx
a) UTI
b) Kid ear infection
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3) S/E
a) Bone marrow suppression
b) Peeling of skin
c) Sloughing  extreme peeling
d) Blisters
e) Steve-Jonson syndrome
f) Hepatoxicity
MACROLIDES
Erythromycin
1) A/E
a) Nephrotoxicity
b) Ototoxicity
c) Hepatoxicity
2) What 2 do
a) Check labs
b) Run Fluids

DIFICID
1) FIDAXOMICIN
2) TX  C-DIFF
QUINOLONES
CIPRO

1) CIPROFLOXACIN
2) A/E
A) Tendon Rupture
AMINOGLYCOSIDE
GENTAMYCIN My SIN 2 treat w/ TOXIC MYCIN

1) Prevent toxicity 1. Vancomycin NEPHROTOXICITY

2. Gentamicin 1. Creatin ↑ 1.3
a) Peek & Through 3. Neomycin 2. BUN ↑ 20
2) Toxicity 3. Urine output ↓ 30
OTOTOXICITY 4. Peek & Trough
a) Nephrotoxicity
1. Vertigo a. ↑  Kidney dies
4 b. ↓  Infection grows
2. Tinnitus
 b) Ototoxicity
i) Ringing in ears
ii) Tinnitus
iii) Trouble hearing

VANCOMYCIN

1) Tx  MRSA
2) Red Man Syndrome
a) Slow infuse
i) 90+ min
3) Labs  10 – 20
TETRACYCLINES
1) Avoid
a) Ca+
i) Dairy
ii) Antiacids
b) Iron
2) Sunlight

ANTIVIRALS
1) Facts
a) Kill Host Cell
b) Slow replication of virus
c) Give w/in 24-48 hrs

ACYCLOVIR

1) Tx
a) HSV-1
b) HSV-2
c) Varicella
2) Topical  A/E
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 a) Burning
b) Wear gloves
3) IV  60+ min infusion
a) Cause phlebitis

GANCICLOVIR
1) Tx  CMV  cytomegalovirus

RIBAVIRIN

1) Tx RSV Infection

a) Premature baby resp disorder

TAMIFLU

1) Tx  Influenza A & B

ZIDOVUDINE

1) Tx 
a) Prego women w/ HIV
b) ≠ transmission 2 bb
2) A/E
a) Bone marrow suppression
i) *monitor labs* Pancytopenia
(1) ↓ RBC
(2) ↓ WBC
(3) ↓ Platelets
b) Rash

CHEMO

1) Contraindications (select all that apply)

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 a) Prego  1st trimester
b) ↓ WBC
c) Ongoing infection
d) ↓ kidney function
e) ↓ liver function
f) Severe malnutrition
g) Hydration
2) Extravasation (select all that apply)
a) Rx going in2 tissue
b) What 2 do
i) Stop IV
ii) Aspirate
iii) Elevate arm
iv) Hot/Cold pack
v) Do not remove IV
3) Pregnancy
a) Antiemetics
i) 30 – 60 min b4 chemo
b) Avoid in 1st trimester
4) A/E
a) Bone merrow suppression
i) AKA  Myelosuppression
ii) *monitor labs* Pancytopenia
(1) ↓ RBC
(2) ↓ WBC
(3) ↓ Platelets
iii) Usually has transfusion
b) Alopecia
i) Hair loss
c) GI
5) Nadir
a) ↓ Neutrophil level
i) Neutropenic

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 ii) Pt will be in isolation
(1) No fruit
(2) Bottle H2O only

METHOTREXATE

1) Tx
a) RA
b) Lupus
c) Cancer
2) Look at levels
a) Can be toxic
b) Bone marrow suppression
3) Given w/ Leucovorin

LEUCOVORIN

1) ↓ Bone Marrow suppression

2) Recovery drug

DOXORUBICIN  Red urine

TB

1) Synergistic effect
a) Given w/ antibiotic
b) Makes TB meds work better
2) Contraindicated
a) Pts w/ liver disease
b) Pts w/ kidney disease
c)
3) A/E
a) Hepatoxicity

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 i) Monitor liver function
(1) AST
(2) ALT
b) Nephrotoxicity

Isoniazid  INH

1) Time
a) Latent  6 months
b) Active  12 – 24 months
2) Peripheral neuropathies
a) Give Vit B6

Ethambutol:

1) Retrobulbar neuritis,
a) Blindness
b) Vision change

RIFAMPIN:  Red – orange fluid

ANTIFUNGAL

AMPHOTERICIN B

1) Tx
a) Systemic infection
b) Broad Spectrum fungi
2) A/E
a) Looks @ Cardiac Dysrhythmias
b) Hypokalemia
i) 3.5 – 5

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 ANTIMALARIA

1) A/E
a) Visual disturbance
b) GI upsets

HYDROXYCHLOROQUINE

1) Tx
a) RA
b) Lupus
2) A/E
a) Visual
i) Exam 3 – 6 months
b) Dizziness
c) Diarrhea
d) Headaches

PYRANTEL

1) Tx  worms
2) A/E  diarrhea

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