NR 566 Midterm Study Guide

Contraindications and High-Risk Patients: Understand the conditions or patient populations where certain antibiotics should be avoided.
Examples of Major Antibiotic Drug Classes: Know the commonly used antibiotics in each class (e.g., Penicillins, Cephalosporins, Macrolides).
Monitoring Needs: Be familiar with what needs to be monitored when using specific antibiotics (e.g., kidney function, liver enzymes).
Renal Dosing Adjustments: Identify which antibiotics require dose adjustments in renal impairment and the extent of adjustment (e.g., 25%, 50%).
Patient Education: Provide education on proper use, potential side effects, and when to seek medical attention.
Lifespan Considerations: Understand the safety of antibiotics during pregnancy, breastfeeding, and in pediatric or geriatric populations.
Indications for Use: Know which infections or conditions specific antibiotics are used to treat.

Caution: Patients with allergies to penicillins, cephalosporins, or carbapenems.
Use: Treats infections caused by sensitive bacteria; confirm with culture and sensitivity tests.
Allergy Testing: Skin tests can assess allergy risk; must be done where emergency support is available.
Renal Adjustment: Doses need adjustment for impaired renal function.
Examples of Penicillins:
- Narrow Spectrum Penicillins: Penicillin G, Penicillin V.
- Penicillin-Resistant: Nafcillin, Oxacillin, Dicloxacillin.
- Broad-Spectrum: Ampicillin, Amoxicillin, Piperacillin.
Life Span Considerations: Safe for infants, children, and during pregnancy with caution.
Side Effects: Allergic reactions, pain at injection sites, neurotoxicity at high levels.

Treatment for Different Types of Infections:
- Tinea: Topical or systemic antifungals based on severity.
- Oral Candidiasis: Commonly treated with nystatin or oral fluconazole.
- Aspergillosis: Typically treated with voriconazole; avoid CYP450 inducers like phenobarbital.
Drug Interactions:
- CYP450 Inducers: Increase metabolism of drugs, reducing effectiveness (e.g., Phenobarbital with voriconazole).
- CYP450 Inhibitors: Decrease metabolism, increasing risk of toxicity.
Adverse Reactions/Patient Teaching:
- Itraconazole: Monitor for liver toxicity, gastrointestinal side effects.
- Nucleotide Reverse Transcriptase Inhibitors (NRTIs): Know example drugs like Zidovudine and Didanosine.
Diagnostics & Monitoring for Anthelmintics: Monitor for liver function, CBC.
High-Risk Patients: Identify those at higher risk for adverse effects with specific drugs.
Therapeutic Effects of HIV Therapy: Measure viral load and CD4 count to assess effectiveness.

Glaucoma Treatment:
- Beta Blockers: Know pros and cons, especially in patients with asthma or COPD.
- Treatment for Patients with Asthma/COPD: Prefer alternatives to beta blockers.
Otitis Media & Externa: Understand treatment protocols for bacterial vs. fungal infections.
Acne Treatment:
- Mild: Topical agents like benzoyl peroxide or salicylic acid.
- Moderate: Combination therapy (topicals plus oral antibiotics).
- Severe: Consider isotretinoin or combination therapy.
Eczema Treatment: Recognize complications and appropriate corticosteroid use.
Sunscreen Ingredients: Organic sunscreens should include zinc oxide or titanium dioxide.
Mechanism of Action:
- Expectorants: Help clear mucus from airways.
Adverse Effects & Patient Teaching:
- Montelukast, Intranasal Glucocorticoids, Sympathomimetics: Understand their uses, side effects, and patient education points.
Management of Rebound Congestion: Gradual withdrawal of decongestants.
Biologics in Allergy Treatment: Recognize their role and when they are indicated.

Evaluation of Phentermine/Topiramate: Understand its role in obesity management.
Adverse Effects/Patient Teaching:
- Orlistat: Monitor for gastrointestinal side effects.
- Lorcaserin: Watch for serotonin syndrome.
- Naltrexone/Bupropion: Monitor for mood changes, potential for seizures.
Drug Interactions:
- Orlistat: Can affect absorption of fat-soluble vitamins.
- Lorcaserin: Interacts with other serotonergic drugs.
Role of Topiramate: Used in combination for weight loss; monitor for cognitive effects.
Obesity Stages:
- BMI: Understand the BMI range for each stage and corresponding treatment recommendations.
DEA Schedules: Familiarize with schedules for drugs used to treat obesity (e.g., Phentermine is Schedule IV).