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💊 Famakoloji · Leson 6 sou 6 · 7 min

Klas Medikaman dapre Sifiks ak Efè Segondè ki Defini Chak

Drug Classes by Suffix and the Side Effect That Defines Each

🔤 Ou pap janm memorize tout medikaman. Ou ka memorize fen yo. '-mycin' oswa '-micin' sou yon aminoglycoside vle di zòrèy ak ren. '-floxacin' vle di tandon. '-pril' vle di tous. Sifiks la se kle repons lan.

🔤 You will never memorize every drug. You can memorize endings. '-mycin' or '-micin' on an aminoglycoside means ears and kidneys. '-floxacin' means tendons. '-pril' means cough. The suffix is the answer key.

💡 Ide prensipal

Sifiks la di klas la; klas la di efè segondè a. Cultures anvan antibyotik, fini tretman an, mande ki reyaksyon alèjik la te ye.

Suffix tells the class; class tells the side effect. Cultures before antibiotics, finish the course, ask what the allergic reaction was.

🧠 Poukisa sa enpòtan

AMINOGLYCOSIDE (gentamicin, tobramycin): ototoksik ak nefrotoksik; siveye nivo pik ak nivo minimòm yo, creatinine ak odisyon. Se pa tout -mycin ki yon aminoglycoside: macrolide tankou azithromycin ak erythromycin sitou pwovoke pwoblèm GI ak pwolongasyon QT. FLUOROQUINOLONE (-floxacin): kraze tandon, sitou ak corticosteroid ak lakay granmoun aje; fotosansiblite. TETRACYCLINE: fotosansiblite, dan dekolore, kidonk yo pa pou timoun anba 8 an oswa pandan gwosès; evite pwodwi let ak antiasid. VANCOMYCIN: perfize pandan omwen 60 minit pou anpeche reyaksyon perfusion vancomycin (gratèl ak woujè nan figi, kou ak pati anwo kò a); siveye nivo medikaman an (nivo minimòm yo, oswa dòz gide pa AUC nan famasi) ak fonksyon ren an. PENICILLINS ak CEPHALOSPORINS: alèji kwaze; mande ki reyaksyon an te ye, pa sèlman 'alèji'. Pran CULTURES anvan premye dòz antibyotik la lè sa pa retade terapi a; nan sepsis yo sispèk, pran yo rapidman men pa kenbe antibyotik yo pandan w ap tann cultures yo (objektif: antibyotik nan 1 èdtan). Anseye pasyan yo pou yo fini tout tretman an. STATIN (-statin): doulè nan misk ak rhabdomyolysis; yo cheke anzim fwa anvan yo kòmanse epi jan sa nesesè; yo pran simvastatin nan aswè, atorvastatin a nenpòt lè nan jounen an. INIBITÈ ACE (-pril): tous, anjyodèm, ipèkalemi. ARB (-sartan). BLOKÈ BETA (-olol). BLOKÈ KANAL KALSYÒM (-dipine): edèm, entèraksyon ak chadèk. INIBITÈ PONP PWOTON (-prazole): risk frakti alontèm ak C. diff. CORTICOSTEROID (-sone): ipèglisemi, maske enfeksyon, osteyopowoz, pa janm sispann brèsk, pran ak manje. NSAIDs: senyen GI, blesi nan ren, evite ak antikoagilan. DYERETIK ANS (furosemide): ipokalemi, ototoksisite ak pouse IV rapid; SA KI EPAYE POTASYÒM (spironolactone): ipèkalemi, kidonk pa gen sipleman potasyòm oswa ranplasan sèl.

AMINOGLYCOSIDES (gentamicin, tobramycin): ototoxic and nephrotoxic; monitor peak and trough levels, creatinine and hearing. Not every -mycin is an aminoglycoside: macrolides such as azithromycin and erythromycin mainly cause GI upset and QT prolongation. FLUOROQUINOLONES (-floxacin): tendon rupture, especially with corticosteroids and in older adults; photosensitivity. TETRACYCLINES: photosensitivity, tooth discoloration, so not for children under 8 or pregnancy; avoid dairy and antacids. VANCOMYCIN: infuse over at least 60 minutes to prevent vancomycin infusion reaction (itching and redness of the face, neck and upper body); monitor drug levels (troughs, or AUC-guided dosing by pharmacy) and kidney function. PENICILLINS and CEPHALOSPORINS: cross-allergy; ask about reactions, not just 'allergies'. Obtain CULTURES before the first antibiotic dose when this does not delay therapy; in suspected sepsis, draw them quickly but do not hold antibiotics while waiting for cultures (goal: antibiotics within 1 hour). Teach clients to finish the entire course. STATINS (-statin): muscle pain and rhabdomyolysis; liver enzymes checked before starting and as needed; simvastatin is taken in the evening, atorvastatin at any time of day. ACE INHIBITORS (-pril): cough, angioedema, hyperkalemia. ARBS (-sartan). BETA BLOCKERS (-olol). CALCIUM CHANNEL BLOCKERS (-dipine): edema, grapefruit interaction. PROTON PUMP INHIBITORS (-prazole): long-term fracture and C. diff risk. CORTICOSTEROIDS (-sone): hyperglycemia, infection masking, osteoporosis, never stop abruptly, take with food. NSAIDs: GI bleeding, kidney injury, avoid with anticoagulants. LOOP DIURETICS (furosemide): hypokalemia, ototoxicity with rapid IV push; POTASSIUM-SPARING (spironolactone): hyperkalemia, so no potassium supplements or salt substitutes.

🏥 Nan lavi reyèl

🦵 Yon moun 70 an sou prednisone kòmanse levofloxacin pou nemoni epi twa jou apre li rapòte yon doulè byen file nan do cheviy li. Enfimyè a rekonèt yon fluoroquinolone plis yon corticosteroid kòm yon risk pou kraze tandon, li anpeche pasyan an mache sou li epi li avèti founisè a. Rekonèt sifiks la te kenbe sa deskripsyon pasyan an pou kont li pa ta kenbe.

🦵 A 70-year-old on prednisone starts levofloxacin for pneumonia and three days later reports a sharp pain in the back of the ankle. The nurse recognizes a fluoroquinolone plus corticosteroid as a tendon rupture risk, stops the client from walking on it and notifies the provider. Suffix recognition caught what the client's description alone would not have.

📌 Sa pou retni

  • -mycin aminoglycoside: zòrèy ak ren; -floxacin: tandon; tetracycline: dan ak solèyAminoglycoside -mycins: ears and kidneys; -floxacin: tendons; tetracycline: teeth and sun
  • Cultures anvan premye dòz la; fini tretman anCultures before the first dose; finish the course
  • Spironolactone: pa gen sipleman potasyòm; furosemide: veye potasyòm baSpironolactone: no potassium supplements; furosemide: watch for low potassium

📖 Tèm nan leson sa a

-OLOL (beta blockers): Yon non jenerik ki fini an -olol (metoprolol, atenolol, propranolol) se yon beta blocker: tcheke puls la, rete l pou yon vitès kè anba 60, epi pa janm rete l sibit.

-PRIL (ACE inhibitors): Yon non jenerik ki fini an -pril (lisinopril, enalapril, captopril) se yon ACE inhibitor: siveye yon tous sèk, tcheke potasyòm, epi trete angioedema kòm yon ijans.

-SARTAN (angiotensin receptor blockers, blokè reseptè anjyotansin) (-SARTAN (angiotensin receptor blockers)): Yon non jenerik ki fini an -sartan (losartan, valsartan) se yon angiotensin receptor blocker: altènatif ACE inhibitor a san tous la, ak menm avètisman potasyòm ak gwosès yo.

-STATIN (medikaman kolestewòl) (-STATIN (cholesterol drugs)): Yon non jenerik ki fini an -statin (atorvastatin, simvastatin) bese kolestewòl: pran simvastatin nan aswè (atorvastatin nenpòt lè), rapòte doulè nan misk (rhabdomyolysis), epi tcheke anzim fwa anvan yo kòmanse.

Inibitè ACE (-pril) (ACE inhibitors (-pril)): Bese tansyon epi pwoteje kè a ak ren yo nan ensifizans kadyak ak dyabèt; efè ki defini yo se yon tous sèk, potasyòm wo ak anjyoedèm (sispann medikaman an epi pwoteje vwa respiratwa a), epi yo pa janm bay yo nan gwosès.

Blokè reseptè anjyotansin (-sartan) (Angiotensin receptor blockers (-sartan)): Altènatif inibitè ACE a pou yon pasyan ki te devlope tous la; yo toujou ogmante potasyòm epi yo ka lakòz anjyoedèm, kidonk tcheke potasyòm ak kreyatinin, epi yo kontr-endike nan gwosès.

Diiretik loop ak thiazide (Loop and thiazide diuretics): Furosemide ak hydrochlorothiazide toude gaspiye potasyòm, kidonk tcheke nivo a, peze pasyan an chak jou epi bay dòz la nan maten; pouse furosemide IV dousman pou pwoteje tande a, epi atann thiazide yo ogmante glikoz, asid irik ak kalsyòm.

Diiretik ki epay potasyòm (Potassium-sparing diuretics): Spironolactone ak fanmi li yo kenbe potasyòm, kidonk danje a se ipèkalemi; anseye pasyan an sote sipleman potasyòm ak ranplasman sèl, veye nivo a ak inibitè ACE oswa ARB, epi atann sansiblite tete ak spironolactone.

Statin (-statin) (Statins (-statin)): Bese kolestewòl pou anpeche kriz kadyak ak konjesyon serebral; anseye pasyan an rapòte doulè misk ki pa eksplike oswa pipi fonse (rhabdomyolysis), tcheke anzim fwa, pran simvastatin nan aswè, evite ji chadèk, epi sispann yo nan gwosès.

Metformin: Medikaman premye liy pou dyabèt type 2 ki pa lakòz ipoglisemi pou kont li; avètisman nan bwat la se asidoz laktik, kidonk yo kenbe li pou ensifizans ren, maladi grav ak kontrast yode dapre òd (rekòmanse ozanviwon 48 èdtan apre si fonksyon ren an estab).

Medikaman sulfonylureas (glipizide, glyburide, glimepiride) (Sulfonylureas (glipizide, glyburide, glimepiride)): Peze ensilin soti nan pankreya a, kidonk ipoglisemi se risk ki defini a, pi mal kay granmoun aje, ak repa rate, alkòl oswa maladi ren; pran yo anvan dejene, anseye siy yo ak règ 15 la, epi atann kèk pran pwa.

Inibitè SGLT2 (-gliflozin) (SGLT2 inhibitors (-gliflozin)): Fè ren yo jete glikoz nan pipi a, sa ki ede tou ensifizans kadyak ak maladi ren; atann enfeksyon ledven jenital, enfeksyon pipi ak dezidratasyon, veye asidosetoz menm ak glikoz nòmal, epi kenbe yo omwen 3 jou anvan operasyon dapre òd.

Agonis reseptè GLP-1 (-glutide, -tide) (GLP-1 receptor agonists (-glutide, -tide)): Enjeksyon chak semèn oswa chak jou (semaglutide, liraglutide, tirzepatide) ki bese glikoz ak pwa lè yo diminye apeti epi ralanti lestomak la; kè plen atann, gwo doulè vant sijere pankreatit, gen yon avètisman nan bwat pou timè selil C tiwoyid, epi anestezi dwe konnen paske lestomak plen an riske aspirasyon.

Inibitè ponp pwoton (-prazole) ak blokè H2 (Proton pump inhibitors (-prazole) and H2 blockers): Koupe asid lestomak pou reflux ak ilsè; PPI yo pran 30 a 60 minit anvan dejene epi ak itilizasyon lontan ogmante risk frakti, Clostridioides difficile ak magnesium oswa B12 ba, pandan famotidine se blokè H2 ki pi lejè a ki ka konfonn granmoun aje.

Sucralfate: Fòme yon pat ki kouvri yon ilsè pou li ka geri; bay li sou lestomak vid 1 èdtan anvan repa ak lè dòmi, separe li ak lòt medikaman pa ozanviwon 2 èdtan paske li mare yo, epi atann konstipasyon.

Penicillin ak cephalosporin (Penicillins and cephalosporins): Fanmi antibyotik ki pi komen yo ak kòz ki pi komen alèji medikaman, ak kèk reyaktivite kwaze ant yo; mande ki reyaksyon pase a te ye, pa sèlman si gen youn, fè kilti anvan premye dòz la, epi rapòte dyare grav kòm Clostridioides difficile posib.

Vancomycin: Medikaman IV pou MRSA ak medikaman oral pou Clostridioides difficile; enfize chak dòz sou omwen 60 minit pou anpeche reyaksyon enfizyon vancomycin (woujè, gratèl ak ipotansyon), epi pwoteje ren yo ak zòrèy yo lè ou swiv nivo trough oswa AUC ak kreyatinin.

Antibyotik aminoglycosides (gentamicin, tobramycin, amikacin) (Aminoglycosides (gentamicin, tobramycin, amikacin)): Antibyotik IV pwisan pou enfeksyon gram-negatif grav ki gen avètisman nan bwat yo se domaj ren, pèt tande ak feblès newomiskilè; trase nivo pik ak trough alè, swiv kreyatinin ak pwodiksyon pipi, epi rapòte bri nan zòrèy oswa vètij imedyatman.

Fluoroquinolones (-floxacin): Antibyotik laj ak avètisman nan bwat pou kraze tandon (pi mal ak esteroyid, granmoun aje), domaj nè pèmanan, konfizyon ak agravasyon myasthenia gravis; sispann pou doulè tandon, bay dòz 2 èdtan anvan oswa 6 èdtan apre antiasid, pwodwi letye, kalsyòm, fè oswa zenk, epi siveye glikoz nan dyabèt.

Tetracyclines (doxycycline, minocycline): Antibyotik pou akne, maladi Lyme ak nemoni atipik ki tache dan k ap devlope, kidonk yo evite yo nan gwosès ak kay timoun anba 8 (eksepte kou doxycycline kout); pran ak yon vè dlo plen pandan ou kanpe dwat, lwen pwodwi letye, antiasid ak fè, epi itilize pwoteksyon kont solèy.

Antibyotik macrolides (azithromycin, erythromycin, clarithromycin) (Macrolides (azithromycin, erythromycin, clarithromycin)): Antibyotik pou enfeksyon respiratwa ak enfeksyon seksyèlman transmisib epi chwa abityèl nan alèji penicillin; yo deranje lestomak la, pwolonje entèval QT la (tcheke lòt medikaman QT), epi erythromycin ak clarithromycin ogmante nivo warfarin, statin ak lòt medikaman fwa a elimine.

Metronidazole: Trete enfeksyon anaerobik, trichomoniasis ak vajinoz bakteryèn, ak Clostridioides difficile lejè sèlman lè vancomycin oral oswa fidaxomicin pa disponib; pa alkòl pandan tretman oswa 3 jou apre (woujè, vomisman, maltèt), atann gou metalik ak pipi fonse, epi rapòte angoudisman oswa pikotman nan men oswa pye.

Trimethoprim-sulfamethoxazole (TMP-SMX): Antibyotik sulfa pou enfeksyon pipi ak nemoni Pneumocystis; sispann pou nenpòt gratèl paske li ka vin sendwòm Stevens-Johnson, pouse likid pou kenbe kristal yo deyò ren yo, veye potasyòm ak konte san, itilize pwoteksyon kont solèy, epi atann li ogmante INR sou warfarin.

Medikaman tibèkiloz (isoniazid, rifampin) (Tuberculosis drugs (isoniazid, rifampin)): Mwa terapi konbine kote isoniazid domaje fwa a ak nè yo (bay pyridoxine, evite alkòl, rapòte pipi fonse oswa angoudisman) epi rifampin fè pipi, swe ak dlo nan je vin zoranj epi fè kontraseptif oral yo echwe; yon pasyan pa enfektye ankò apre twa echantiyon krache negatif.

Acyclovir ak valacyclovir (Acyclovir and valacyclovir): Antiviral diminye epidemi men yo pa geri anyen; kòmanse nan premye pikotman oswa nan 24 èdtan apre blesi pou herpes simplex ki repete ak nan 72 èdtan apre gratèl pou zona; enfize dòz IV sou omwen yon èdtan ak anpil likid kont kristal ren; tcheke kreyatinin.

Tacrolimus ak cyclosporine (Tacrolimus and cyclosporine): Medikaman anti-rejè transplantasyon yo pran pou tout lavi ak nivo trough pou gide dòz la; toude domaje ren yo epi ogmante tansyon, potasyòm ak risk enfeksyon, tacrolimus ajoute tranbleman ak dyabèt, cyclosporine ajoute depase jansiv ak kwasans cheve, epi chadèk ogmante nivo yo.

Medikaman gout (allopurinol, colchicine) (Gout drugs (allopurinol, colchicine)): Allopurinol anpeche atak gout men li pa ka trete youn epi yo sispann li nan premye gratèl la (risk Stevens-Johnson); colchicine trete kriz egi a epi yo sispann li pou dyare oswa vomisman, premye siy toksisite li yo; toude mande 2 a 3 lit likid pa jou.

Tamsulosin ak finasteride (Tamsulosin and finasteride): De medikaman pwostat komen: tamsulosin detann soti vesi a men li lakòz vètij ortostatik (pran li 30 minit apre menm repa a epi di chirijyen je a anvan operasyon katarak), pandan finasteride retresi pwostat la sou 6 mwa epi fanm ansent pa dwe manyen li.

Kontraseptif oral konbine (Combined oral contraceptives): Grenn estrogen-progestin ki anpeche gwosès men ogmante risk boul, kidonk fimè ki pi wo pase 35 ak nenpòt moun ki gen yon istwa boul pa ka pran yo; anseye ACHES (doulè vant, doulè pwatrin, maltèt, chanjman je, gwo doulè janm) kòm rezon pou rele, epi ke rifampin fè yo echwe.

✅ Teste tèt ou

Yon pasyan k ap resevwa gentamicin IV rapòte zòrèy li kònen. Ki aksyon ki pi enpòtan?A client receiving IV gentamicin reports ringing in the ears. Which action is most important?
  1. Rasire pasyan an ke sa a pase vitReassure the client that this is temporary
  2. Ogmante vitès perfusion an pou fini pi vitIncrease the infusion rate to finish sooner
  3. Rapòte rezilta a epi atann yo kenbe medikaman an epi cheke nivo yoReport the finding and expect the drug to be held and levels checked
  4. Bay yon antihistaminikAdminister an antihistamine

Repons: C · Rapòte rezilta a epi atann yo kenbe medikaman an epi cheke nivo yo

Kònen nan zòrèy se siy ototoksisite, ki ka vin pèmanan. Yo dwe evalye nivo aminoglycoside ak fonksyon ren an.

Tinnitus signals ototoxicity, which can become permanent. Aminoglycoside levels and renal function must be evaluated.

Yon pasyan k ap pran spironolactone mande sou itilizasyon yon ranplasan sèl. Kisa enfimyè a ta dwe anseye?A client taking spironolactone asks about using a salt substitute. What should the nurse teach?
  1. Yo amelyore efè medikaman anThey improve the drug's effect
  2. Evite yo; yo gen potasyòmAvoid them; they contain potassium
  3. Ranplasan sèl se yon chwa ki bon pou lasanteSalt substitutes are a healthy choice
  4. Itilize yo sèlman nan dineUse them only at dinner

Repons: B · Evite yo; yo gen potasyòm

Dyeretik ki epaye potasyòm plis ranplasan sèl ki gen potasyòm ka pwovoke ipèkalemi danjere. Rele ranplasan sèl yon chwa ki bon pou lasante rate fèt ke yo ranplase sodium ak potasyòm, menm elektwolit medikaman sa a deja kenbe a.

Potassium-sparing diuretics plus potassium-containing salt substitutes can cause dangerous hyperkalemia. Calling salt substitutes a healthy choice misses that they replace sodium with potassium, the very electrolyte this drug already holds on to.

Poukisa yo pran cultures san anvan premye dòz yon antibyotik, lè sa pa pwovoke okenn reta, lakay yon pasyan yo sispèk gen sepsis?Why are blood cultures drawn before the first dose of an antibiotic, when this causes no delay, in a client with suspected sepsis?
  1. Antibyotik yo entèfere ak pran san anAntibiotics interfere with the blood draw
  2. Antibyotik la ka siprime kwasans bakteri epi anpeche yo idantifye òganis laThe antibiotic can suppress bacterial growth and prevent identifying the organism
  3. Se yon egzijans pou faktirasyonIt is a billing requirement
  4. Cultures yo valab sèlman lè pasyan an gen lafyèvCultures are only valid when the client is febrile

Repons: B · Antibyotik la ka siprime kwasans bakteri epi anpeche yo idantifye òganis la

Kòmanse antibyotik anvan ka pwodui cultures fo-negatif, sa kite òganis la ak sansiblite li yo enkoni. Yo pran cultures rapidman, men yo pa retade antibyotik nan sepsis yo sispèk pandan y ap tann yo. Antibyotik pa entèfere ak pran san an li menm; pwoblèm lan se sa ki pral oswa ki pap grandi nan culture la apre.

Starting antibiotics first can produce false-negative cultures, leaving the organism and its sensitivities unknown. Cultures are drawn quickly, but antibiotics in suspected sepsis are not delayed waiting for them. Antibiotics do not interfere with the blood draw itself; the problem is what will or will not grow in the culture afterward.

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