Vancomycin and Drug Drug Interactions

Vancomycin has adverse reactions when used with some medications. You must wait several hours before giving vancomycin to a patient who has received oral cholestyramine (Questran) or colestipol (Colestid) because these medications lower the therapeutic effect of vancomycin. Also avoid giving vancomycin if the patient has taken any aminoglycosides because they increase the potential for ototoxicity (ear) and nephrotoxicity (kidney). If the patient receives vancomycin and aminoglycosides, then...

Loop Or Highceiling Diuretics

Loop or high-ceiling diuretics act on the ascending loop of Henle by inhibiting chloride transport of sodium into the circulation. Sodium, potassium, calcium, and magnesium are lost. Loop or high-ceiling diuretics have little effect on blood sugar, but increase the uric acid level. Loop or high-ceiling diuretics are potent and cause marked depletion of water and electrolytes. They are more potent than thiazides and two to three times more effective when inhibiting reabsorption of sodium....

Diuretics

Diuretics lower blood pressure and decrease peripheral and pulmonary edema in congestive heart failure and renal or liver disorders by inhibiting sodium and water reabsorption from the kidney tubules resulting in increased urine flow (diuresis). Most sodium and water reabsorption occurs throughout the renal tubular segments. Diuretics affect one or more of these segments. Every one and one-half hours the kidneys (glomeruli) clean the body's extracellular fluid (ECF). Small particles such as...

Antidiarrhea

Diarrhea is defined as frequent liquid stools that can be caused by foods, fecal impaction, bacteria (Escherichia coli, Salmonella), virus (parvovirus, rotavirus), toxins, drug reaction, laxative abuse, malabsorption syndrome caused by lack of digestive enzymes, stress and anxiety, bowel tumor, and inflammatory bowel disease such as ulcerative colitis or Crohn's disease. Diarrhea can be mild (lasting one bowel movement) or severe (lasting several bowel movements). Intestinal fluids are rich in...

Psoriasis

Psoriasis is a chronic skin disorder characterized by erythematous papules and plaques covered with silvery scales appearing on the scalp, elbows, palms of the hands, knees, and soles of the feet. This is caused by an accelerated growth of epidermal cells more than five times its normal rate. Less than 3 of the population of the United States is affected by psoriasis. More caucasians are affected than African-Americans and onset occurs between 10 and 30 years old. Patients who have psoriasis...

Steppedcare Treatment

The prescribed method of treating hypertension begins with a nonpharmacolog-ical approach such as lifestyle changes losing weight, reducing sodium intake, limiting alcohol intake, smoking cessation, and increasing physical activity. If blood pressure remains elevated, then treatment moves to the next step. The patient is administered diuretics or beta-blockers. If blood pressure still remains high, then the dose of diuretics or beta-blockers is increased or a calcium channel blocker, ACE...

Drugs And The Thyroid Gland

The thyroid gland secretes two hormones that regulate protein synthesis, enzyme activity, and stimulate mitochondrial oxidation. These are thyroxine (T4) and triiodothyronine (T3). The thyroid gland secretes 20 of the circulating T3. The remaining 80 comes from degradation of T4 hormone. Approximately 40 of T4 is degraded and becomes T3. T3 and T4 are carried in the blood by thyroxine-binding globulin (TBG) and albumin, which protects the hormones from being degraded. T3 is more potent than T4....

Drug Action and Drug Interactions

Just give me the magic pill to make me normal again. You probably said something like that the last time you felt under the weather and your home remedies didn't make you feel better. You might have even reached the point when you'd welcome an injection of a miracle drug if it would get you back on your feet quickly. Drugs aren't miracles and have nothing to do with magic although you might think differently when your nose is running, eyes watering, and you feel rotten all over. A drug is a...

Chronic Bronchitis

Chronic bronchitis is an inflammation of the bronchi that persists for a long period of time or repeatedly occurs. It is a form of COPD. Smoking is the main cause for bronchitis. Second-hand smoke may also cause chronic bronchitis. Air pollution, infection, and allergies make it worse. Patients who develop chronic bronchitis have excess mucous production that irritates the bronchial causing the patient to have a persistent productive cough. Patients exhibit a gurgling lung sound (rhonchi) both...

Stimulants contact or irritants

Stimulant laxatives increase peristalsis by irritating sensory nerve endings in the intestinal mucosa. Stimulant laxatives include those containing phenolphthalein (Ex-Lax, Feen-A-Mint, Correctol), bisacodyl (Dulcolax), cascara sagrada, senna (Senokot), and castor oil (purgative). Bisacodyl and phenolphthalein are two of the most frequently used and abused laxatives because they can be purchased over-the-counter. Results occur in 6 to 12 hours. Stimulant laxatives such as bisacodyl are used to...

Antifungal Drugs antimycotic drugs

These drugs are used to treat two types of fungal infections 1. Superficial fungal infections of skin or mucous membrane. 2. Systemic fungal infections of the lung or central nervous system. The conditions may be mild such as tinea pedis (ahtlete's foot), or severe as in pulmonary conditions or meningitis. Fungi, such as Candida spp. (yeast), are normal flora of mouth, skin, intestine, and vagina. Candidiasis might be an opportunistic infection when the defense mechanisms are impaired....

Warts

A wart is a benign lesion characterized as a hard, horny nodule that may appear anywhere on the body, but particularly on the hands and feet. Warts are removed by freezing, electrodesiccation, or surgical excision. Salicyclic acid, podophyllum resin, and cantharidin are three medications commonly used to remove warts. Salicylic acid promotes desquamation. However, salicylic acid is also absorbed through the skin and can result in salicylism (toxicity). Podophyllum resin is used to remove...

Osmotics saline

Osmotic laxatives (hyperosmolar) are salts or saline products, lactulose, and glycerin. The saline products are composed of sodium or magnesium, and a small amount is systemically absorbed. They pull water into the colon and increase water in the feces to increase bulk, which stimulates peristalsis. Saline cathartics cause a semiformed-to-watery stool depending on dose. However, they are contraindicated for patients who have congestive heart failure. Osmotic laxatives contain three types of...

Bronchodilator

Bronchodilators relax smooth muscles around the bronchioles restoring airflow to the lungs. Sympathomimetics are bronchodilators that increase the production of cyclic AMP, causing dilation of the bronchioles by acting as adrenergic agonistic. Some sympathomimetics are selective to particular adrenergic receptors, which are referred to as alpha1, beta2 and beta2-adrenergic. Other sympathomimetics are non-selective sympathomimetic that affect all types of adrenergic receptor sites. Epinephrine...

Inflammation

Disease-Modifying Antirheumatic Drugs (DMARDs) Note All of these tables are available on the book's Web site Alpha Adrenergic Agonist Nasal Decongestant Leukotrine Modifiers and LT Synthesis Inhibitors Ergot Alkaloids and Related Compounds IV Sedative-Hypnotic Barbiturates and Others Inhalation and Intravenous Anesthetics Anticholinergic-Antiparkinsonism Drugs Cholinesterase Inhibitor Indirect Cholinergic Anxiolytics, Skeletal Muscle Relaxant, Anticonvulsant Depolarizing Muscle Relaxants...

Oral Antidiabetics

Oral antidiabetic drugs such as sulfonylureas are administered to patients who have Type 2 diabetes mellitus to stimulate beta cells to secrete insulin. This results in an increase in insulin cell receptors, enabling cells to bind to insulin during glucose metabolism. Sulfonylureas are chemically related to sulfonamides but lack antibacterial activity. Sulfonylureas are classified as first- and second-generation drugs and each generation is divided into short-acting, intermediate-acting, and...

Central Nervous System Stimulants

Medication is given to stimulate the central nervous system in order to induce a therapeutic response. These include medications that treat narcolepsy, attention deficit disorder (ADD), obesity, and reversal of respiratory distress. There are four major groups of medications that stimulate the central nervous system. These are amphetamines, caffeine, analeptics, and anorexiants. Amphetamines stimulate the cerebral cortex of the brain. Caffeine also stimulates the cerebral cortex and stimulates...

Inhalation Route

The inhalation route is used to have the patient inhale the medication using an inhaler. This is a common route used to administer bronchodilators to patients with breathing problems such as asthma, pneumonia, and chronic obstructive pulmonary disease. The medication enters the lower respiratory tract where it is rapidly absorbed in the bronchioles providing the patient with relief from bronchospasms, wheezing, asthma, or allergic reactions. Inhalation is used to deliver antibiotics, steroids...

Topical Anesthetic Agents

Topical anesthetic agents (see chart) are solutions, liquid sprays, ointments, creams, and gels that are applied to mucous membranes, broken or unbroken skin surfaces, and burns to decrease the sensitivity of nerve endings in the affected area. The first topical anesthetic agent was TAC, which is a combination of tetra-caine, adrenaline (epinephrine), and cocaine, and was used for face and scalp lacerations. A version of TAC called LET is used today. LET is a combination of lidocaine,...

Dermatitis

Dermatitis is a skin eruption that is caused by medications (drug-induced dermatitis) or by a chemical agent coming in touch with the skin (contact dermatitis). Drug-induced dermatitis is characterized by skin lesions that can be a rash, urticaria, papules, vesicles or life-threatening skin eruptions such as erythema multiforme (red blisters over a large portion of the body) or Stevens-Johnson syndrome (large blisters in the oral and anogenital mucosa, pharynx, eyes, and viscera). As a result...

Alopecia Male Pattern Baldness

Alopecia occurs when the hair shaft is lost and the hair follicle cannot regenerate. This results in permanent hair loss. Alopecia is associated with a familial history and the aging process. Some patients experience alopecia earlier than others. Some medications can cause temporary alopecia. These include anticancer (antineoplastic) agents, gold salts, sulfonamides, anticonvulsants, aminoglyco-sides, and nonsteroideal antiflammatory drugs (NSAIDs) such as indomethacin. Table 20-2. Topical...

Migraine Headaches

Migraines are a debilitating neurovascular disorder that affects 28 million people over the age of 11. The cause of migraines is not clearly understood although research indicates the expansion of blood vessels and the release of certain chemicals such as dopamine and serotonin causes inflammation and pain. Dopamine and serotonin are found normally in the brain. A migraine can occur if an abnormal amount of these chemicals are present or if the blood vessels are unusually sensitive to them....

Nursing Diagnosis

The nurse develops a nursing diagnosis after analyzing information gained from assessing the patient. A nursing diagnosis is a statement that describes the patient's actual or potential response to a health problem that the nurse is licensed and competent to treat. The North American Nursing Diagnosis Association NANDA developed a guide used by many nurses to arrive at a nursing diagnosis. A physician or advanced practitioner uses the medical diagnosis to prescribe a treatment for combating the...

Impact of Cultural Influences in Drug Administration

The cultural background of the patient and of the patient's family can impact the administration of medication. Cultural influences are learned values, beliefs, customs, and behavior. These influences include the patient's belief about health such as What healthcare can do for the patient The patient's susceptibility to disease The benefits of taking steps to prevent disease What makes a patient seek healthcare What makes a patient follow healthcare guidelines For example, a patient who is a...