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Maryville 615 Pharm Exam III/acuurate and precise answers 2025, Exams of Pharmacology

University of Michigan (UM) - Ann ArborPharmacology

1. What factors will place the patient at risk for antibiotic resistance? - Excessive and inappropriate use of anti-infective agents, over use of broad spectrum antibiotics or any antimicrobial agent, failure to complete the entire course of treatment, administration of antibiotics when pt has a viral infection, and fluroquinolones should be restricted to patients with community acquired pneumonia with comorbidites. Increasing populations of immune-compromised patients. Increase in the number and complexity of invasive medical procedures. Increased survival of patients with chronic disease, multiple medical comorbidities. Daycare of young children. Overcrowding and travel. The leading cause is use of antibiotics age younger than 2 or older than 65 and excessive and inappropriate use of anti-infective agents. 2. What factors place the patient at risk for hypersensitivity reactions with penicillin's and cephalosporins? -

Typology: Exams

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Maryville 615 Pharm Exam III/acuurate and precise
answers 2025
1. What factors will place the patient at risk for antibiotic resistance? - Excessive and
inappropriate use of anti-infective agents, over use of broad spectrum antibiotics or any
antimicrobial agent, failure to complete the entire course of treatment, administration of
antibiotics when pt has a viral infection, and fluroquinolones should be restricted to patients
with community acquired pneumonia with comorbidites.
Increasing populations of immune-compromised patients. Increase in the number and
complexity of invasive medical procedures. Increased survival of patients with chronic disease,
multiple medical comorbidities. Daycare of young children. Overcrowding and travel. The
leading cause is use of antibiotics age younger than 2 or older than 65 and excessive and
inappropriate use of anti-infective agents.
2. What factors place the patient at risk for hypersensitivity reactions with penicillin's and
cephalosporins? - Cross sensitivity due to the fact that each class contains a beta-lactam
ring, the beta lactam ring also has a cross resistance, since its vulnerable to beta lactamase
producing organisms, a patient has a risk of developing a reaction within 2-30 minutes after
administration of the medication.
Hx of serious hypersensitivity reaction (anaphylaxis, serum sickness, exfoliative dermatitis,
hemolysis or other blood dyscrasia) to PCN. Alsoallergic reaction to cephalosporin's, imipenem,
or beta-lactamase inhibitors may contraindicate use of PCN.
3. What are the safest antibiotics to prescribe to a woman who is pregnant? - PCN is the
safest drug to prescribe to pregnant women, augmentin in pregnant women for UTI's,
sulfonamides and penicillinase resistant PCN's should be avoided in late pregnancy due to the
displacement of billirubin from the plasma proteins of the newborn causing new born canictaris
(sp?)
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Maryville 615 Pharm Exam III/acuurate and precise

answers 2025

  1. What factors will place the patient at risk for antibiotic resistance? - Excessive and inappropriate use of anti-infective agents, over use of broad spectrum antibiotics or any antimicrobial agent, failure to complete the entire course of treatment, administration of antibiotics when pt has a viral infection, and fluroquinolones should be restricted to patients with community acquired pneumonia with comorbidites. Increasing populations of immune-compromised patients. Increase in the number and complexity of invasive medical procedures. Increased survival of patients with chronic disease, multiple medical comorbidities. Daycare of young children. Overcrowding and travel. The leading cause is use of antibiotics age younger than 2 or older than 65 and excessive and inappropriate use of anti-infective agents.
  2. What factors place the patient at risk for hypersensitivity reactions with penicillin's and cephalosporins? - Cross sensitivity due to the fact that each class contains a beta-lactam ring, the beta lactam ring also has a cross resistance, since its vulnerable to beta lactamase producing organisms, a patient has a risk of developing a reaction within 2-30 minutes after administration of the medication. Hx of serious hypersensitivity reaction (anaphylaxis, serum sickness, exfoliative dermatitis, hemolysis or other blood dyscrasia) to PCN. Alsoallergic reaction to cephalosporin's, imipenem, or beta-lactamase inhibitors may contraindicate use of PCN.
  3. What are the safest antibiotics to prescribe to a woman who is pregnant? - PCN is the safest drug to prescribe to pregnant women, augmentin in pregnant women for UTI's, sulfonamides and penicillinase resistant PCN's should be avoided in late pregnancy due to the displacement of billirubin from the plasma proteins of the newborn causing new born canictaris (sp?)

Amoxicillin, Ampicillin, Clindamycin, Erythromycin, and PCN

  1. What patient teaching will you provide to a patient who is experiencing non-infectious diarrhea related to antibiotic administration? - Increase fluids, consume plain yogurt, Donagel for second line therapy, and avoid anti-peristalsis agents that promote the retention of toxins. If diarrhea is severe notify prescriber, for mild diarrhea use a absorbent anti-diarrheal one that contains Attapuligite (donnagel), avoid using antiperistaltic agents that can cause to retain toxins, if diarrhea contains blood pus or mucous call prescriber.
  2. According to the American College of Cardiology and the American Heart Association, what are the guidelines related to prophylactic antibiotics prior to a dental appointment? - Prophylactic antibiotic therapy is for patients with prosthetic heart valves, previous infected endocarditis, certain patients with congenital heart disease, cardiac transplant with valve regurgitation with the dental procedures who have the manipulation with gingival tissue. Pts with congenital heart disease require prophylaxis unrepaired cyanotic congenital heart disease, completely repaired heart disease and with prosthetic material require treatment in the first 6 months after repair, anyone out of the 6 month repair range doesn't require prophylactic treatment. PCN s, if allergic: zithromycin or clarithromycin single dose of 500mg for adults or 15mg/kg for children 1 hour before.
  3. A patient is taking a fluoroquinolone; what are the most serious adverse effects? - Fatal hypersensitivity reaction, Steven Johnson syndrome, and other adverse effects, psudomembrenous colitis and black box warning of tendon rupture. Tendon rupture, very dangerous drug to give, reactions with first dose, steven-johnson syndrome, hypersensitivity reactions (anaphylaxis), pseudomembrenous colitis (c.diff), photosensitivity or photo toxicity (especially with lomefloxacin and sparfloxcin), and dizziness.
  1. What medication will cause a pseudotumor cerebri (benign intracranial hypertension)? - Tetracycline, patients should stop taking tetracycline and contact a healthcare provider if HA, blurred vision develops they are s/s of pseudotumor cerebri. Tetracycline. Symptoms: HA, blurred vision, bulging fontanels
  2. What vitamin will decrease peripheral neuropathy in patients taking isoniozide for TB? - Pyridoxine (B6). Especially when given with INH
  3. What lab values should be assessed when administering valacyclovir? - BUN, Cr, at the beginning of therapy and sporadically throughout therapy. Assess renal function, BUN, and serum creatinine
  4. What patient education related to the patient's diet should be provided for a patient taking valacyclovir? - Valcyclovir is a nucleoside analog and can be taken without regards to meals; food doesn't affect absorption and should be administered with a full glass of water. Antineoplastic agent's fluroquinelones is decreased, cimitadine interferes with the elimination of fluriquinolones, cyclosporine increases nephrotoxic effects, glucocorticoids increase the risk of tendon rupture, theophylline decreases the clearance and toxicity of theophylline. Taken with full glass of water. Food doesn't matter.
  5. When should oseltamivir phosphate be prescribed? - W/in 48 hours if the onset of s/s
  6. What are the most common drug interactions with levofloxacin? - Antacids interfere with GI absorption and decrease serum levels, anti-coagulants affect the anticoagulant therapy thus increasing anticoagulant affects.

NSAIDs: CNS stimulation and seizures. Anti-diabetics: Blood sugar could go up or down. Levaquin & NSAIDs: something serious you must watch for. Coumadin & Levaquin (and all drugs from same class): interaction.

  1. What are the recommended doses for treatment of infections with lincosamides? - Serious bacterial infections in adult's 150-180mg q6h, Children 8-16mg/kg/day in 3- 4 divided doses. Severe bacterial infection 300-450 mg q6h, Children 16-20 mg/kg/day in 3- 4 doses. Endocarditis prophylaxis 2g one hour before procedure, children 20mg/kg one hour before procedure, malaria treatment 900mg TID x 3 days, in children 6.7-7.3 mg/kg TID x 3 days. Bacterial vaginosis in pregnant women 300mg BID x7 days. Pneumocistis carni pneumonia 1200- 1800mg/day in divided doses with 15-30mg of primoquine daily. Toxoplasmosis of CNS treatments 1200-2400mg/day in divided doses with 50-100mg of primethomine daily. Oditigenic infections 300-400mh q6h for 3-5 days, children 20mg/kg/day divided into 3-4 doses. Adults: Initial dose: 150-300mg PO q6h. Severe bacterial infections: 300-450mg PC q6h. Ondogenic (dental infections): 300-4510mg PO q6h x3-5 days. Malaria treatment: 900mg PO TID x 3 days. Endocarditis prophylaxis: 2g PO 1hr before procedure. Pneumocyctitiscarnii pneumonia: 1200-1800mg PO every day in divided doses with 15-30mg of Primaquine. Toxoplasmosis of CNS treatment: 1200-2400mg every day in divided doses with 50-100mg of pyrimethanine. Children: Initial dose: 8-16mg/kg/day in 3-4 equal doses. Severe bacterial infections: 16-20 mg/kg/day in 3-4 equal doses. Malaria treatment: 6.7-7.3mg/kg TID for 3 days. Endocarditis prophylaxis: 20mg/kg 1 hr before procedure. Clindamycin for bacterial vaginosis is safe for pregnant.
  2. What is the recommended treatment for H.pylori in peptic ulcer disease? - Clarithromycin, tetracycline, amoxicillin, levofloxacin, metranydazole, can be given in triple drug regimen or quadruple drug regimen Clarithromycin, metronidazole, and PPI
  3. A patient is administered gentamicin and complains of sudden hearing loss. What should the nurse do? - D/c medication and notify the physician

Cross-allergenicity between sulfonamide antibiotics and other drugs containing a sulfonamide.

  1. What is the course of treatment with doxycycline for the treatment of Lyme disease? - First line therapy, doxycycline 100 mg BID, erythema migrins 14-21 days, mild cardiac involvement 21 days, arthritis 28 days, isolated facial paralysis 21-28 days. Use amoxicillin if pregnant and for children under the age of 8. Lyme disease and doxycycline: time of treatment (duration): doxycycline 100mg BID 14-28 days. Duration varies by presenting symptoms: early erythema migrans 14-21 days, mild cardiac involvement 21 days, arthritis 28 days, and isolated facial paralysis 21- 2 8 days. Big culprit for interaction with BCP.
  2. Differentiate between oral and parenteral vancomycin - Oral vanc is administered for C. diff, however metranidozole should be used first. Vanc is bactericidal for gram (+) organisms streptococci, pneumococci, corneabacter, listeria, lacto bacilli, ectenomiaciese and clostridium. Parenteral administration, assess the RF and WBC for inflammatory responses. IV formulation is used to treat gram (+) bacterial infections. PO formulation is poorly absorbed and is typically only used in the treatment of C-diff colitis. This medication shouldn't be included in an IV to PO therapy conversion program.
  3. What are the adverse effects of ethambutol? - GI s/s, but most serious s/s is optic neuritis which is dose related, decrease visual acuity, red/green color blindness, diminished visual fields, loss of vision, test vision before and throughout treatment. Increased uric acid level, transient impairment of liver function, infrequent peripheral neuropathy. Optic neuritis (most serious and appears dose related), decreased visual acuity, red/green color blindness, diminished visual fields, and sometimes loss of vision. GI disturbance, precipitation of gouty arthritis r/t increased uric acid levels, impairment of liver function, infrequent peripheral neuropathy.
  1. What are the adverse effects of pyrazinamide? - Hepatotoxicity, hyperuricemia precipitating gout arthritis Dose related hepatotoxicity, most likely in black and Hispanic women, women of postpartum, and patients over 50. Hyperuricemia often because the drug inhibits the excretion of urates. Hyperuricemia is often asymptomatic, but may precipitate acute gouty arthritis (baseline serum uric acid levels should be drawn).
  2. For what is rifampin prescribed? - Bactericidal against mycobacterium, gonorrhea, staphylococcus, mycobacterium lepirae, MAC, H. influenza and meningitis. Bactericidal against susceptible mycobacterium, gonorrhea, staphylococcus, mycobacterium leprae (cause of leprocy), H flu type B, post contact after meningitis outbreak.
  3. What are the adverse effects of isoniazid (INH)? - Hepatotoxicity, numbness and tingling in the extremities, patients predisposed to this ADR are those who are slow acelylators, pregnant women, older adults, diabetics, and patients with chronic liver disease, ETOH, vit B prevents the development of peripheral neuropathy. Hepatotoxicity, blood dysacrasias, metabolic acidosis, gynecomastia, hypocalcemia related to altered vit D metabolism, anemias, thrombocytopenia.
  4. How should you administer the nucleoside analogues? - Taken without regards to meals and food doesn't alter their absorption. They come in oral, parenteral, and topical. Most are given orally. The nucleoside analogues can all be taken without regard to meals, because food doesn't alter absorption. All forms should be taken with a full glass of water.

risks to the fetus. Systemic absorption following topical application is low; however caution is advised when prescribing to breastfeeding women. Contraindicated in children younger than 2 years.

  1. What is hypochlorhydria? - Presence of an abnormally small amount of hydrochloric acid in the stomach. Absent or low production of gastric acid in the stomach. Ketoconazole is pH dependent. If given ketaconozole for candidiasis, take it with acidic drinks.
  2. What lab values should be monitored when administering antifungal agents? - AST, ALT, alkaline phosphatase and billirubin. Monitor prior to therapy and monitor monthly for 3- 4 months and frequently thereafter. Hepatic function, AST, ALT, alkaline phosphatase, bilirubin, monitored prior to initiation of therapy monthly for 3-4 months and frequently thereafter during treatment. Even the modest elevations in liver enzymes require discontinuation of ketoconazole. Therapeutic response should be evaluated at 6-8 weeks after initiation of drug therapy for tinea infections, 4-6 months for fingernail onychomosis, and 8-9 months for toenail mycoses.
  3. Identify which antihelmintic is used to treat parasitic worms. - Pin worm enterobyus vermicularus, administer pyrental pamoate. Whip worm pyrental, allendazole, mabendazole. Escerase lambre (round worm) mebendazole. Hook worm give pyrantal, allendazole, mabendazole. Mebendazole: Inhibits the formation of the worm's microtubules and irreversibly blocks uptake depleting endogenous glycogen storage, the worm starves to death. Thiabendazole: suppresses the production of egg or larvae and their subsequent development. Albendazole: Inhibits tubulin polymerization, resulting in loss of cytoplasmic microtubules. Pyrantel: is a depolarizing neuromuscular blocking agent that creates spastic paralysis in the worm, it also inhibits cholinesterases. Ivermectin (stromectol): Increases permeability of the cell membrane, resulting in loss of extracellular calcium and increase in intracellular calcium and also producing massive

contractions and paralysis of the worm's neuromusculature. Drugs of choice for treating intestinal nematodes includes: mebendazole, pyrantel, and thiabendazole. Tissue nematodes are best treated with mebendazole, thiabendazole, albendazole, or ivermectin.