Module 9

Question 1

For some infections PCNs are used w/ aminoglycosides (gentamicin, amikacin). The 2 can be mixed in the same IV solution

Accepted Answer

False

Question 2

Caspofungin IV. The newest class of antifungals• Systemic treatment •Narrow-spectrum antifungal.

Accepted Answer

True

Question 3

Which inhaled Aminoglycoside is Inhaled & is used for Cystic Fibrosis

Accepted Answer

Tobramycin

Question 4

Tetracycline also causes N/V/D. You can take an antidiarrheal instead of notifying the provider if have diarrhea.

Accepted Answer

False

Question 5

How do you treat an anaphylaxis response to penicillin?

Accepted Answer

epinephrine, respiratory support, Monitoring patient for at least 30min after drug injection

Question 6

Penicillin G (IM & IV) is narrow spectrum and most effective against gram + bacteria. what is it used to treat/prevent?

Accepted Answer

Treats meningitis, Prevents syphilis, Prevents Rheumatic, Treats anthrax, Treats gonorrhea

Question 7

D/C Trimethoprim if complete bloodcounts become abnormal

Accepted Answer

True

Question 8

Vaccination is first defense, drug therapy (oseltamivir "tamiflu") is secondary for Influenza

Accepted Answer

True

Question 9

Broad-Spectrum Penicillins

Accepted Answer

Amoxicillin (PO): least likely to produce diarrhea, amoxicillin/clvulonic acid: combines broad spec PCN & betalactamase inhib, Pipercillin (IV): "extended spec" effective against most staph strains

Question 10

Tetracycline side effects

Accepted Answer

turns teeth yellow. NO kids under 8, Avoid in preg & while breastfeeding, Hepatotoxicity, Photosensitivity, Superinfection (C-diff & Candida), Nephrotoxicity

Question 11

ciprofloxacin (fluroquinolone) side effects

Accepted Answer

Has a black box warning that it should not be used as a 1st line drug, Dizziness, HA, Confusion, N/V/D, Phototoxicity, Candida, Tendonitis/tendon rupture (calf/heelpain), C-Diff

Question 12

Carbapenems (Imipenem) should be reserved for patients who cannot be treated with narrow-spectrum drugs

Accepted Answer

True

Question 13

How should you treat C-Diff?

Accepted Answer

Must wash hands, spores resistant to hand sanitizer & temp changes, Metronidazole, Vanco, Stop the antibiotic that caused it

Question 14

What type of drugs have a potential disulfirium effect when mixed with alcohol?

Accepted Answer

Cephalosporins: ceftraixone, cefoxitin, cephalexin

Question 15

Itraconazole: broad spec anti-fungal. Systemic or superficial use. What drug interactions?

Accepted Answer

Digoxin, Sulfonylurea, Fatal dysrhythmias: cisapride, pimozide, dofetilide, quinidine, Warfarin, inhibits drug-metabolizing enzymes & raises levels of other drugs, Space acid-reducing agents, likecimetidine, 1hr prior or 2 hours after dose

Question 16

When taking a Sulfonamide, while rare it is possible that the patient could have allergic reaction to the following meds

Accepted Answer

Glucotrol (Glipizide), a sulfonurea, Loop and Thiazide diuretics(furosemide and HCTZ), a sulfa constituent, celecoxib (Celebrex), a COX 2inhibitor, contains a sulfonamide substitute

Question 17

Nystatin binds to fungal membranes causing contents to leak out=death. Only used for candidiasis. Education?

Accepted Answer

not absorbed by GI system so safe to give orally, Swish & swallow

Question 18

How is Silver Sulfadiazine used?

Accepted Answer

Can cause acidosis(suppresses renal excretion of acid, Can cause blue-green or gray skin-discoloration (do not apply to face), Used for 2nd and 3rd degree burns

Question 19

Rule of thumb: Continue therapy at least one week after symptoms resolve when taking an antifungal agent

Accepted Answer

True

Question 20

Penicillin side effects

Accepted Answer

Hyperkalemia, Allergic response: Maculopapular rash & anaphylaxis), Neurotoxicity (seizures, confusion, hallucinations)

Question 21

If you contract C-Diff from takin a cephalosporin (Ceftriaxone, cefoxitin, cephalexin) what should happen

Accepted Answer

D/C cephalosporin and give Vanco or metronidazole

Question 22

Trimethoprim PO• Suppresses synthesis of tetrahydrofolic acid (like sulfas)• Broad-spectrum. What side effects?

Accepted Answer

Hematologic Effects (only in pts with pre-existing folic acid deficiencies), GI: N/V/epigastric distress, Hyperkalemia (not good if taking ACE, ARB, Aldosterone antagonnist), Rash and Itching

Question 23

Amphotericin B (polyene antibi) that's drug of choice for most systemic mycoses. Broad spec, HIGHLY TOXIC. Side effects?

Accepted Answer

Phlebitis, Hyper & Hypotension, Fever, chills, rigors, nausea, HA, Bone marrow suppression, Nephrotoxicity

Question 24

Some infections-PCNs are used w/ aminoglycosides(gentamicin & amikacin) PCNs in ↑concentration inactivate aminoglycoside

Accepted Answer

True

Question 25

Carbapenems (Imipenem) is a beta-lactam antibiotic. How does it work?

Accepted Answer

Weakens cell wall (lysis & death), Broadest Spectrum (doesn&#x27;t work against MRSA), May interact with valproate (may need additional seizure meds)

Question 26

secondary infection that occurs when normal microbial flora of the body is disturbed because antibiotic kills everything

Accepted Answer

superinfection like Funal & C-Diff

Question 27

Clindamycin-Inhibits protein synthesis, Used for abdom & pelvic infections, gas gangrene, & Group A strep. Side effects?

Accepted Answer

Hypotension & cardiac arrest, Rash, thrombocytopenia, hepatotoxicity, C-diff-can be fatal• NOTIFY MD RIGHT AWAY OF DIARRHEA

Question 28

Oral acyclovir for Herpes is NOT safe to use during pregnancy

Accepted Answer

False

Question 29

Cephalosporins: Ceftriaxone, cefoxitin, cephalexin side effects

Accepted Answer

C-Diff (D/C cephalosporin & give Vanco or metronidazole), Bleeding (interferes with vitamin K), Hemolytic Anemia, Thrombophlebitis, Allergic reaction

Question 30

Most widely used antibiotic in the USA and is the drug of choice for C-Diff, MRSA, and serious infections

Accepted Answer

Vancomycin

Question 31

Ciprofloxacin (fluroquinolone) is a broad spec that is rapidly bactericidal. Tx: UTI infections & anthrax. Pt. Eduation?

Accepted Answer

Take on an empty stomach, Take products with mag, calcium, sucralfate 6hrs before or 2 hrs after.

Question 32

Cephalosporins: Ceftriaxone, cefoxitin, cephalexin function how?

Accepted Answer

Inhibit cell wall synthesis, Beta-lactam drugs, Bactericidal, Broad-spectrum (against gram-positive and negative

Question 33

Monitor kidney function poor excretion can lead totoxicity...Penicillin G dose needs to be reduced

Accepted Answer

True

Question 34

Trimethoprim is a Bacteriostatic or cidal Broad-spectrum drug that works against what?

Accepted Answer

Active against some Gram + bacilli (Staph), Active against most enteric Gram – bacilli

Question 35

General conideration for a penicillin allergy

Accepted Answer

Give PCNs with caution in cephalosporin allergies, an accelerated reaction occurs 1-72 hours": rash, hives, maculopapular, Delayed reaction occurs days to weeks later, Avoid cephalosporins and PCNs if anaphylaxis occurs, Encouraged to wear a med-alert bracelet, An immediate reaction occurs in 2-30 min: anaphylaxis

Question 36

Side effects of Vancomycin

Accepted Answer

Red Man Syndrome (admin over 60 min or more to prevent) Inflamm reaction, Nephrotoxicity ( Dont mix with NSAIDS), Thrombophlebitis (rotate IV sites frequently), Immune-mediated TTP (increase risk for bleeding), Ototoxicity

Question 37

Uncommon life-threatening adverse reactions of acylovir for herpes

Accepted Answer

Neuropathy, Nephrotoxicity (infuse slow, adequate hydration during and 2hrs after), N/V/D

Question 38

Vancomycin (narrow therapeutic range) is not a beta-lactam, used in pts w/PCN allergy. Severe infections. How's it work?

Accepted Answer

Bactericidal (inhibits cell wall synthesis), used against gram-positive bacteria, Narrow Spectrum

Question 39

What can be used to treat the "Amphoterible" side effects of amphotericin B when taking it for a fungus?

Accepted Answer

diphenhydramine, acetaminophen

Question 40

Erythromycin interacts with which drugs?

Accepted Answer

Carbamazepine, Theophylline, Can cause Torsades & QT Prolongation, & N/V/D, Warfarin

Question 41

Sulfamethoxazole PO• Int acting• Reduced risk of renal crystals with adequate hydration. How do you take this med?

Accepted Answer

Only found in combination with trimethoprim, Take with a full glass of water...drink 8-10 glasses of water per day!!, Take with or without food

Question 42

Interferon alpha is for hep B&C: naturally antiviral, immunomodulating, andantineoplastic. May cause flu-like symptoms

Accepted Answer

True

Question 43

Clindamycin is Bacteriostatic, but can be bactericidal if the target organism is sensitive

Accepted Answer

True

Question 44

tetracycline should be given with milk/calcium, antacids, iron supplements, magnesium, zinc to increase absorption

Accepted Answer

False

Question 45

Peak & Trough levels must be checked to ensure safety and efficacy, (metabolism & excretion) when taking Vanco

Accepted Answer

True

Question 46

Aminoglycosides (Gentamicin,Tobramycin, Amikacin) are NOT absorbed by GI tract. Disrupt protein synthesis. Common info?

Accepted Answer

Nephrotoxicity & Ototoxicity, Used primarily to tx Gram (–) bacilli, Bactericidal (rapid death), Effect lasts several hrs aftr serum levels drop, Peaks and troughs are used to monitor therapeutic levels

Question 47

Use caution when mixing Gentamicin, Tobramycin, Amikacin (Aminoglycosides) w/ skeletal muscle relaxants. What can happen

Accepted Answer

respiratory arrest

Question 48

Sulfonamides: Broad Spectrum that are Used against MRSA and chlamydia.

Accepted Answer

Preferred against UTIs: 90% effective against E. Coli, Interacts w/ Warfarin, phenytoin, sulfonylureas...may require reduced dose, Bacteriostatic-inhibit synthesis of tetrahydrofolate (folicacid derivative), Newer sulfonamides produce little risk to kidneys

Question 49

Erythromycin(PO & IV) is a broad-spec drug that inhibits bacterial protein synthesis. Safer antibiotic. Fact about it?

Accepted Answer

Drug of choice against pertussis, Can cause Torsades de Pointes, Bacteriostatic, but can be bactericidal depending on susceptible organisms, Food can decrease absorption• Best to take on empty stomach, Affective against Gram + and Gram –, Can cause N/V/D

Question 50

While taking trimethoprim-sulfamethoxazole what should the patient be told to do?

Accepted Answer

increase fluid intake to 8-10 glass/day

Question 51

When you administer Vanco too fast what can happen?

Accepted Answer

Red man syndrome

Question 52

Erythromycin is excreted primarily in the bile by the liver, making it a good choice for patients with renal impairment

Accepted Answer

True

Question 53

Tetracycline (PO & IV)

Accepted Answer

bacteriostatic, broad spectrum (gram neg & gram pos), only taken on empty stomach w/full glass of water, Can increase Digoxin & Warfarin levels (risk for Dig toxicity & bleeding), Can increase Digoxin & warfarin levels, only used in patients with good renal function

Question 54

How do penicillins work?

Accepted Answer

No direct effects on the cells of the host: SAFEST Antibiotics, disrupt bacterial cell wall, Bactericidal, Active only against bacteria that are undergoing growth and division

Question 55

Avoid cephalosporins and PCNs if anaphylaxis occurs

Accepted Answer

True

Question 56

When taking Ganciclovir for cytomegalovirus you must avoid pregnancy during Tx & 90 days after.

Accepted Answer

True

Module 9

Questions 56

Module 9

Questions 56