PHARMA – SEMIS GUTIERREZ
18-month old for 4th dose of DPT – 3rd DPT
HIV & AIDS-RELATED DRUGS
1. Prevent perinatal transmission of HIV to fetus
– Provide written & oral ed of antiretroviral drug
therapy
2. “Undetectable” HIV viral load – Educate about
continued need for meds lab monitoring
3. When & how should CD4+ should be done –
At same lab, same time of day
4. NOT Plan of care for antiretroviral therapy –
Lab blood work within normal limits
5. NOT Health teaching for pt on Efavirenz –
Dose after breakfast; hyperglycemia, jaundice &
diabetes are side effects
TRANSPLANT DRUGS
1. ^risk for transplant plus immunosuppressant
drug – Infection
2. Virus associated with posttransplant
lymphoproliferative disorder – Epstein-Barr
Virus
3. Factors influencing adherence to drug
regimen – Drug side effects, episodes of
rejection, cost, other health care issues
4. Expect to see from Basilliximab = cytokine
release syndrome – Chills
5. Belatacept induced by recently pregnant pt –
Contact pregnancy registry
VACCINES
1. 4-month old reacts to immunization, elicit info
about – S/Sx experienced
2. Implication of Varicella vaccine of young
woman – Pt is pregnant
3. 38-yr old farmer with DPT vaccine – Provide
vaccine info in pt’s primary language
4. Immunocompromised 1 yr old – Give info
about type of vaccine
5. HPV after first dose health teaching – Inform
about date of return to clinic
6.
was from 4 months ago
7. Eligible to receive flu vaccine – 18-month old
child
8. DPT and MMR vaccines done – Provide
vaccine info in preferred language; Document
ANTINEOPLASTICS & BIOLOGIC
RESPONSE MODIFIERS - ANTICANCER
1. Alkylating agent plus Anti-tumor antibiotic –
Combi chemo ^ extent of tumor cell killing
2. Chemo drugs cause myelosuppression –
Monitor temp changes
3. Report symptom from fluorouracil intake due
to colorectal cancer – Bleeding gums
4. Fatigue complaint – Assess contributing
factors such as trouble sleeping
5. Additional teaching about Mucositis – Use
mouthwash with alcohol
6. Health teaching about Cyclophosphamide –
Drink 2L of fluid per day
7. Health teaching about Doxorubicin intake –
Report SOB, palpitations, edema
8. Highest priority of cancer pt with Vincristine
intake – Decreased phenytoin effects
9. Inappropriate symptomatic treatments for
Mucositis after chemo – Anti-emetics & Stress
reduction
10. Teaching plan for post-chemo
Thrombocytopenia – Use razor, soft bristled
brush, & report bleeding
ANTINEOPLASTICS & BIOLOGIC
RESPONSE MODIFIERS – TARGETED
THERAPIES TO TREAT CANCER
1. Breast cancer pt not receiving Trastuzumab –
Cancer cells don’t have target for it
2. Imatinib therapy teaching – Don’t drink
grapefruit juice while taking drug
3. Priority Dx for pt with epidermal growth factor
receptor inhibitors – Risk for impaired skin
integrity r/t skin side effects
4. Most concern for possible infusion reaction –
Monoclonal antibodies
5. Sunitinib intake report of hands & feet red,
painful with blisters – Notify oncologist to
determine dosage reduction
6. Tositumomab intake teaching – Use separate
bathroom & sit while urinating for 1week
7. High priority to avoid while taking Ixazomib –
Take 1hr before or 2hrs after food
8. St. John’s wort should be avoided –
Decreases blood levels of targeted therapies
and reduce effectiveness
9. Imatinib intake gains 5lbs – Indicate water
retentions & renal impairment
ANTINEOPLASTICS & BIOLOGIC
RESPONSE MODIFIERS
1. Primary action of Interferon-alfa – Enhance
immune fxn, produce WBC & antigen-antibody
rxn
2. Interferon-alfa 2a side effect – Flu-like
syndrome
3. RBC production stimulated by – Epoetin alfa
4. Rarely used drug given thru IV infusion only –
Interleukin 2
5. Pegfilgrastim order – requires one injection
per chemo cycle
6. Scheduled dose of erythropoietin stimulating
agent – Contact HCP to discuss lab results &
D/C of order
UPPER RESPIRATORY DRUGS
1. Side effects of OTC antihistamine
Diphenhydramine – Avoid driving motor vehicle
until stabilized
2. Sore throat due to Beta hemolytic
streptococcal infection – leads to Pharyngitis
3. Health teaching about Oxymetazoline – Limit
use to 5-7 days to prevent nasal bound
congestion
4. Purpose of Guaifenesin – Loosen bronchial
secretions
5. Beclomethasone for allergic rhinitis – With
Continuous use, nasal mucosa may dry
6. Diphenhydramine NOT TEACH – Take meds
on empty stomach for absorption
LOWER RESPIRATORY DRUGS
1. Fluticasone propionate & Salmeterol for
COPD NOT – Used to treat acute attack;
contains beta 1 agonist & cromolyn
2. Acute bronchospasm plus COPD order –
Epinephrine
3. Adverse effect of Aminophylline-Theophylline
- ^ HR
4. Serum Theophylline level 32mcg/mL – Notify
HCP
5. COPD pt taking Leukotriene antagonist
Montelukast – Maintenance treatment of
asthma
CARDIAC GLYCOSIDES, ANTIANGINALS,
ANTIDYSRHYTHMICS
1. Digoxin treatment for heart failure
IMPROVED – Absence of peripheral edema
2. Digoxin level 3.0ng/mL – in High elevated
range
3. S/Sx for Digitalis Toxicity – Apical pulse
48bpm, irregular rate
4. Low potassium level (Hypokalemia) could
affect Digoxin - ^Digoxin sensitivity level
5. Symptom for initial dose of Nitrate –
Headaches
6. Beta blockers as effective as antianginals –
Decrease HR & myocardial contractility
7. D/C beta blocker – Dose should be tapered
down
8. Acebutolol Primary purpose – Block Beta1 8. Amlodipine (Calcium channel blocker) S/Sx of
adrenergic receptors in Cardiac tissues side effects – Dizziness, Headache, Ankle
Edema
9. Anginal pt with Nitroglycerin intake NOT –
Apply to hairy area & Call HCP after 5 tabs
intake
DIURETICS
1. Hydrochlorothiazide & Digoxin leads to
electrolyte imbalance – Hypokalemia
2. INCORRECT about Hydrochlorothiazide –
Monitor for hypoglycemia
3. Favorable response to Furosemide – RR &
depth decreases from 28 to 20bpm
4. Mannitol use – Decreases ICP
5. Furosemide intake – Assess bp before admin
6. Purpose of Triamterene and
Hydrochlorothiazide intake - ^Potassium level
7. Spironolactone for heart failure intake –
Monitor for Hyperkalemia
ANTIHYPERTENSIVES
1. NOT nonpharmacological method to lower bp
- ^Protein diet
2. First-line drug to treat mild hypertension –
Diuretic
3. Less effective antihypertensive drugs for
African Americans – Beta blockers &
Angiotensin-converting enzyme inhibitors
4. Diuretic drug combined with Antihypertensive
drug – Hydrochlorothiazide
5. Before admin of beta blocker – Assess Apical
Pulse
6. Common side effect of Captopril
(Angiotensin-converting enzyme drug) –
Constant irritating cough
7. Losartan action (Angiotensin II receptor
blocker) – Block Angiotensin II from Angiotensin
I receptors