Study Outline for MEN Pharmacology
Updated February 13, 2025
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Exam 3:
Infectious Diseases; GU; Gender Affirming Therapies; Pain Management
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General Info for antimicrobials (Antibiotics, Antifungals, Antivirals)
How drug is eliminated? Need to adjust?
Know when a drug is DOC
Know which drugs are antibiotics v. antivirals v. antifungals v. antiTB
AEs (serious / common), NIs, DDIs (especially absorption-related)
Nursing implications (outlined in both slides and end of each chapter in the book)
Other: individual variation, safety, dosage forms
Antimicrobial basics
 Broad spectrum v. narrow spectrum
 Antimicrobial resistance
o Innate or acquired
o Extended hospitalization, morbidity, mortality
o Use of antimicrobials promotes emergence of drug resistant organisms because makes
favorable conditions for organisms that are resistant to flourish.
o Broad spectrum cause more resistance, amount of use, healthcare associated infections,
superinfection ( new infection from killing off something else)
 Dosing considerations (e.g., which drugs are renally eliminated?)
o Weight
o Drug penetration
o Bioavailability based on route
o Adherence
o How eliminated (older adults)
 Methods to maximize adherence
Antibiotics
Medications
- Beta-lactams (group 1)
o Penicillin G aqueous, Penicillin G benzathine or Penicillin G procaine, Penicillin VK (oral)
 Syphallis DOC
o Cephalosporins: Cephalexin po, Cefazolin IV
o Carbapenems: imipenem-cilastatin
- Vancomycin – PO v. IV forms; vancomycin infusion reaction (group 3)
o DOC hospital acquired MRSA
o Use for Cdiff (usually better than metronidazole)
- Tetracycline (group 2)
- Macrolides: erythromycin (group 2)
- Aminoglycosides: gentamicin (group 3) (IV only)
- Sulfonamides: trimethoprim/sulfamethoxazole (TMP/SMX)
- Fluoroquinolones: ciprofloxacin (group 2)
- Clindamycin (group 3)
- Metronidazole (group 3)
o DOC C diff (GI tract)
Study Outline for MEN Pharmacology
Updated February 13, 2025
General Concepts:
- AEs
- Drug level monitoring: Peaks & Troughs (if applicable); how to draw, why this is important,
which drugs need levels monitored
o Gento and vancomycin
- DDIs: especially absorption-related or metabolism with critical/narrow therapeutic index drugs
(e.g., warfarin, cyclosporine)
- NIs: administration/education/monitoring
Antivirals
Medications
- Acyclovir (VZV; HSV)
- Ganciclovir (CMV)
- Oseltamivir (Influenza)
- COVID is not on exam
General Concepts
- Use for each antiviral agent
- AEs
- NIs – what does nurse need to do to ensure safety and efficacy?
Antifungals
Medications
- Polyene Antifungals
o Conventional Amphotericin B
o Liposomal Amphotericin B (Ambisome)
o Nystatin (superficial infections)
- Azoles
o Itraconazole, fluconazole
o Clotrimazole/itraconazole (superficial infections)
General Concepts:
- Differences between conventional & liposomal amphotericin B
- AEs
- NIs – what does nurse need to do to ensure safety and efficacy?
Tuberculosis
Medications (RIPE)
- Isoniazid
- Rifampin
- Pyrazinamide
- Ethambutol
General Concepts
- How is TB different from other infections?
- Drug resistance concerns
- How TB is treated (induction, continuation, DOT)
- Important AEs for each drug
- NIs: what does nurse need to do to ensure safety and efficacy?
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Study Outline for MEN Pharmacology
Updated February 13, 2025
Antiretrovirals for HIV
Medications
- NRTIs: abacavir; zidovudine
- NNRTIs: efavirenz
- PIs: darunavir
- PK Boosters: ritonavir, cobicistat
- INSTIs: raltegravir
- PrEP: tenofovir/emtricitabine (Truvada; Descovy)
General Concepts
- How is HIV different from other infections?
- Drug resistance/treatment/monitoring principles for HIV
- What’s the importance of food?
- AEs, DDIs
Immunologics
Medications:
- Methotrexate (nonbiologic DMARD - chemotherapy agent)
- Etanercept (biologic DMARD)
- Cyclosporine
General Concepts
- Use
- AEs & NIs
- SAFETY ISSUES
- Individual variation
- General principles related to use of chemo agents (e.g., methotrexate)
Vaccines
Medications (prototype vaccines below)
- Influenza vaccine (all types)
- Pneumococcal polysaccharide vaccine (PPSV23)
- Rabies vaccine and immune globulin
General Concepts
- Immunity
o “Herd” immunity
o Active (natural, vaccination) vs. passive immunization (maternal, immune globulin)
- Live v. Inactivated/subunit/other
o Advantages & disadvantages
- True contraindications v conditions where pt may/may not get vaccine
- Adverse effects of vaccines in general and specific vaccines reviewed
- Nursing implications for vaccines (in general)
Pain Management
Medications
- Nonopioids
o Aspirin
o Ibuprofen
o Celecoxib
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Study Outline for MEN Pharmacology
Updated February 13, 2025
o Acetaminophen
- Opioids
o Morphine
o Methadone (Exam 4)
o Fentanyl
o Hydromorphone (Dilaudid)
o Naloxone – reversal agent
o Agents to avoid (Meperidine, Codeine)
- Gout
o Allopurinol
o Colchicine
- Headache
o Sumatriptan
General Concepts
- How do opioids differ from non-opioids?
- How do drugs within class differ from each other?
- Max doses for ibuprofen and acetaminophen
- All antidotes
- AEs, NIs, individual variation, & DDIs
- Pain and sedation practice problems calculations and using pasero pain scale
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