NURS 8024 Pharm Test 3 Pt. 1: Questions & Solutions
Narrow spectrum Right Ans - act on a single or limited group of pathogens Extended-spectrum Right Ans - "Efficacy against large numbers of gram positive / gram negative organisms" Broad-spectrum Right Ans - *empiric-presumptive therapy *effective against "broad spectrum" of microbes *unknown pathogen-possible life threatening infection *risk for super infections
Drug entry affected by multiple factors: Right Ans - 1. lipid solubility
- protein binding
- molecular weight
- inflammation
Susceptibility testing Right Ans - -guides antimicrobial therapy -zone of inhibition -predicts minimum inhibitory concentration (MIC); estimate of the drug sensitivity of pathogens Minimum inhibitory concentration (MIC) Right Ans - Interpretation categorizes result as Susceptible, Intermediate, Resistant Susceptible (S) Right Ans - bacterial strain susceptible when pathogen inhibited in vitro by a concentration of drug associated with a high likelihood of therapeutic success Intermediate (I) Right Ans - Sensitivity termed intermediate when concentration of drug associated with uncertain therapeutic effect Resistant (R) Right Ans - bacterial strain considered resistant when concentration of the drug associated with a high likelihood of therapeutic failure Bacteriostatic Right Ans - -inhibits growth or multiplication of bacteria -limits spread of infection - enables immune system to effectively attack pathogen 1 / 2
Bactericidal Right Ans - -kills bacteria -total number of viable organisms decreases Concentration-dependent killing Right Ans - -increase kill rate with increase concentration -once daily dose -aminoglycosides, quinolones Time-dependent killing Right Ans - • bactericidal activity dependent on time serum concentration ↑ MBC predicts efficacy • AUC / MIC ratio • More frequent dosing • lactams, macrolides, vancomycin β Beta lactams (PCN, cephalosporins, and Vanc) Right Ans - Inhibitor of cell wall synthesis Tetracyclines, aminoglycosides, macrolides Right Ans - Inhibitor of protein synthesis MOA of fluoroquinolones Right Ans - Inhibitor of nucleic acid function or synthesis Sulfonamides and Trimethoprim Right Ans - Inhibitors of metabolism Beta-lactam antibiotics Right Ans - -inhibit cell wall synthesis -bactericidal -V common Rx Beta-lactam pharmacokinetics Right Ans - -Time dependent killing -short half life
-IV: 100% bioavailability
-PO: variable absorption rate and degree affected by FOOD
What Beta-lactams can penetrate the CSF? Right Ans - -3rd and 4th generation cephalosporins, aztreonam, meropenem, (parenteral)
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