NURS 5334 Pharm: Antimicrobial Recall Quiz –
Questions And Answers (Complete Set) What are the main causative gram + organisms? Right Ans - Staph, Strep, and Enterococcus the rest are G- Known causative organisms of Otitis Media? Right Ans - Strep pneumoniae,
- flu, M catarrhalis, viral
Known causative organisms of sinusitis? Right Ans - Strep pneumoniae, S aureus, f. flu, klebsiella, mycoplasma, chlamydia, and legionella Known causative organisms of Diarrhea? Right Ans - salmonella, shigella, campylobacter, e coli, c diff, bacteroides fragilis Known causative organisms of UTI? Right Ans - e coli, proteus mirabilis, klebiella, stpah saphrophyticus Known causative organisms of skin infections? Right Ans - strep, staph Known causative organisms of intra-abdominal infections? Right Ans - e coli, klebsiella, Enterobacter, proteus Bactericidal vs bacteriostatic? Right Ans - kills vs weakens What spectrum of abx do you start off with? Right Ans - narrow, ALWAYS What is the minimum bactericidal concentration (MBC)? Right Ans - lowest concentration of an antibacterial agent required to kill a certain bacteria What is the minimum inhibitory concentration? Right Ans - lowest concentration of an antimicrobial agent that will inhibit the visible growth of a microorganism after overnight incubation (in vitro) What is an antibiogram? Right Ans - chart of local resistance patterns to antibiotics 1 / 3
When is combination therapy appropriate? Right Ans - febrile, leukopenic pt, infections w/ multiple pathogens, synergism, TB, and HIV Abx to use with caution Right Ans - aminoglycosides, vancomycin, clindamycin, gentamycin, imipenem, Cilastatin, trimethoprim, nitrofurantoin Abx contradicted in pregnancy- Chloramphenicol Right Ans - grey baby syndrome Abx contradicted in pregnancy- Erythromycin estolate Right Ans - cholestatic hepatitis in mother Abx contradicted in pregnancy- Tetracycline Right Ans - limb abnormalities, dental staining, decrease in bone growth Abx contradicted in pregnancy- Fluoroquinolones Right Ans - abnormalities in cartilage Abx contradicted in pregnancy- TMP/SMX Right Ans - hemolysis, increased risk of kernicterus In what pts should you NOT used TMP/SMX to treat infections (BESIDES PREGNANT WOMEN)? Right Ans - pts with G6PD deficiency What abx are excreted renally? Right Ans - Amionglycosides, cephalosporins, imipnem, fluoroquinolones, pnc, trimethoprim, tetracycline, vancomycin What abx are excreted hepatically? Right Ans - Cefoperazone, chloramphenicol, doxycycline, erythromycin, metronidazole, nafcillin, rifampin, sulfamethoxazole Oral drugs used to tx MRSA Right Ans - TMP/SMX, clindamycin, doxycycline, linezolid, tedizolid Induration of > or equal to 5mm is considered positive in this population Right Ans - HIV pts 2 / 3
Induration of > or equal to 10mm is considered positive in this population Right Ans - recent immigrants (within last 5 years) from countries with high TB prevalence Induration of > or equal to 15mm is considered positive in this population Right Ans - pts at no known risk for TB How is latent TB dx? Right Ans - a positive TB results and a medical evaluation that does not indicate TB disease What are the first 4 meds to tx TB? Right Ans - isoniazid, rifampin, ethambutol, and pyrazinamide What is multidrug resistant TB? Right Ans - TB resistant to both isoniazid and rifampin What is extremely resistant TB? Right Ans - TB resistant to isoniazid, rifampin, all fluoroquinolones, and at least one injectable second line drug What is an important teaching for patients taking isoniazid for TB? Right Ans - adverse effect of this treatment is peripheral neuropathy, which can be reversed with pyridoxine What is an important teaching for patients taking rifampin for TB? Right Ans - it can change the color of body fluids to reddish/orange Which TB med can decrease vision? Right Ans - Ethambutol How do PNC and cephalosporins work? Right Ans - by weaking the cell wall and promoting lysis and death How does bacterial resistance develop with PNC? Right Ans - production of PNC binding proteins that have low affinity for PNC, inability of PNC to reach their target, and inactivation of PNC by bacterial enzymes Pt dx with streph throat and has an anaphylactic allergy to PNC, which abx should you prescribe? Right Ans - azithromycin
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