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Saunders Comprehensive Review For The NCLEX-RN Examination, 7 Ed.
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67 - Immunological Medications

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Saunders Comprehensive Review For The NCLEX-RN Examination, 7 Ed. | Registered Nurse (RN) School Study Aid

67 - Immunological Medications
25 Picmonics to Learn | 40 mins
NNRTI Drug Names
Nevirapine (Viramune)
Rilpivirine (Edurant)
Delavirdine (DLV, Rescriptor)
Efavirenz (EFV, Sustiva)
Etravirine (ETR, Intelence)
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54 secs
NRTI Toxicity
Bone Marrow Suppression
Reverse with G-CSF and Erythropoietin
Rash
Neuropathy
Anemia
Pancreatitis
Lactic Acidosis
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1 min
Azoles (Ketoconazole)
"-azole" suffix
Indications
Local and Less Serious Systemic Mycosis
Mechanism
Inhibits Ergosterol Synthesis
Inhibits P450
Side Effects
Liver Dysfunction
Inhibition of Testosterone Synthesis
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1 min
Amphotericin B
Indications
Systemic Mycosis
Fungal Meningitis
Last Resort for Protozoan infections
Mechanism
Polyene
Binds Ergosterol
Forms Membrane Pores
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1 min
Amphotericin B Side Effects & Toxicity
Side Effects
Fever/Chills "Shake and Bake"
Nephrotoxicity
Milder with Liposomes
Hypotension
Anemia
IV Phlebitis
Arrhythmias
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1 min
Tacrolimus (Prograf) Overview
Mechanisms
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Transplant Rejection
Atopic Dermatitis
Considerations
Increased Lymphoma Risk
Avoid Grapefruit Juice
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1 min
Tacrolimus (Prograf) Side Effects
Nephrotoxicity
Neurotoxicity
GI Distress
Infection
Hypertension
Hyperkalemia
Hyperglycemia
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1 min
Methotrexate
Indications
Rheumatoid Arthritis
Cancer
Medical Abortion
Mechanism
Folic Acid Analog
Inhibits Dihydrofolate Reductase
Side Effects
Pulmonary Fibrosis
Myelosuppression is Treated with Leucovorin Rescue (Folinic Acid)
Macrocytic Anemia
Hepatitis
Teratogenic
Mucositis
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2 mins
RhoGam [Rho(D) Immune Globulin]
Indications
Antepartum Prevention at 28 weeks
Suppress Antibody Production
Mechanism of Action
Lysis of Fetal RBC in Maternal Bloodstream
Side Effects
Myalgia and Lethargy
Considerations
Negative Coombs Test
Standard Dose 300 mcg
Microdose 50 mcg
Blood Product
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2 mins
Cyclosporine (Sandimmune) Overview
Mechanism
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Prevent Transplant Rejection
Psoriasis
Rheumatoid Arthritis
Considerations
Monitor Plasma Levels
Avoid Grapefruit Juice
Increased Risk of Lymphoma
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2 mins
Cyclosporine (Sandimmune) Side Effects
Side Effects
Nephrotoxicity
Hepatotoxicity
Infection
Hypertension
Hirsutism
Tremor
Hyperkalemia
Hypomagnesemia
Gingival Hyperplasia
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1 min
Aminoglycoside Overview
End in "-mycin"
GNATS
Gentamicin
Neomycin
Amikacin
Tobramycin
Streptomycin
Mechanism of Action
Bactericidal
Indications
Severe Gram Negative Infections
Bowel Surgery Prep
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1 min
Aminoglycoside Side Effects
Side Effects
Ototoxicity
Nephrotoxicity
Respiratory Paralysis
Contraindications
Pregnancy
Considerations
Peak and Trough
Never Mix with Penicillin in Same IV
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2 mins
Cephalosporins
Starts with "Cef-"
Mechanism of Action
Bactericidal
Indications
Gram-Positive and Gram-Negative Infections
Side Effects
Allergic Reactions
Thrombophlebitis
Bleeding
Contraindications
Renal Impairment
Considerations
Avoid IV Calcium with Ceftriaxone
No Alcohol
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2 mins
Fluoroquinolones
End in "-floxacin"
Mechanism of Action
Bactericidal
Indications
Variety of Infections
Side Effects
GI Distress
Photosensitivity
Achilles Tendon Rupture
Contraindications
Pregnancy
Children
Myasthenia Gravis
Considerations
Avoid Milk Products or Antacids
Slow IV Infusion
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2 mins
Fluoroquinolones Toxicities
Diarrhea
Skin Rash
Headache
Tendon Rupture in Adults
Myalgias in Kids
Damage to Cartilage
Teratogen
QT Prolongation
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1 min
Macrolides
Mechanism of Action
Bacteriostatic
Bind to 23S rRNA of 50S Subunit
Inhibit Protein Synthesis by Blocking Translocation
Macrolides
Erythromycin
Azithromycin
Clarithromycin
Indications
Gram-Positive Cocci
Atypical Pneumonia
Chlamydia
Considerations
Resistance by Methylation of 23S rRNA Binding
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2 mins
Penicillin
Mechanism of Action
Weakens Cell Wall
Indications
Gram-Positive Infections
Prophylaxis
Side Effects
Pain at IM Injection Site
Allergic Reaction
Considerations
Skin Tests
Allergy ID
Medication Education
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2 mins
Ampicillin and Amoxicillin
Mechanism
Aminopenicillin
Broad Spectrum Penicillin
Indications
Gram-Positive and Some Gram-Negative Infections
Side Effects
Rash
Diarrhea
Considerations
No Effect Against Staph Aureus
Often combined with Beta Lactamase Inhibitor
Allergic Reaction
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2 mins
Sulfonamides
Mechanism of Action
Bacteriostatic
Indications
Urinary Tract Infection
Side Effects
Crystalluria
Photosensitivity
Hemolytic Anemia
Kernicterus
Rash
Considerations
Sulfa Allergy
Encourage Fluids
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2 mins
Sulfonamides Side Effects
Side Effects
Hypersensitivity
Nephrotoxicity
Photosensitivity
Kernicterus in Infants
Displaces Warfarin from Albumin
Considerations
Hemolysis with G6PD Deficiency
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3 mins
Tetracyclines Overview
End in "-cycline"
Mechanism of Action
Bacteriostatic
Indications
Infectious Diseases
Acne
Periodontal Disease
Nursing Considerations
Avoid Milk, Antacids, Iron
Sunlight Protection
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1 min
Tetracyclines Side Effects
Side Effects
Superinfection
Clostridioides difficile
Discoloration of Teeth
Bone Deformities
Photosensitivity
Contraindications
Children Under 8
Pregnancy
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1 min
Acyclovir (Zovirax)
Mechanism
Guanosine Analog
Inhibits Viral Replication
Thymidine Kinase Activation
Indications
Herpes Simplex Virus (HSV)
Varicella Zoster Virus (VZV)
Side Effects (Oral)
Headache
GI Distress
Side Effects (IV)
CNS Toxicity
Nephrotoxicity (Crystalline Nephropathy)
Considerations
Prevents Recurrent Episodes
Slow IV Infusion
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2 mins
Ganciclovir
Indications
Cytomegalovirus (CMV)
Immunocompromised
Mechanism
Guanosine Analog
Disrupts DNA Synthesis
Inhibits Viral DNA Polymerase
Side Effects
Hematologic Effects
Nephrotoxicity
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1 min

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