Pharmacology Study Guide: Antibiotics and Antivirals, Exams of Nursing

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NR 565 FINA STUDY GUIDE NEWEST 2024 ACTUAL EXAM

250 + FINAL STUDY GUIDE QUESTIONS AND CORRECT

DETAILED ANSWERS WITH RATIONALES (VERIFIED

ANSWERS) |ALREADY GRADED A+

When aminopenicillins are combined with beta-lactamase inhibitors - correct answer✔✔their spectrum in broadened beta-lactamase inhibitors that can be combined with aminopenicillins - correct answer✔✔clavulanate, sulbactam, & tazobactam Penicillinase-resistant penicillins drugs - correct answer✔✔Nafcillin Oxacillin Cloxacillin Dicloxacillin Methicillin Penicillinase-resistant penicillins active against - correct answer✔✔Streptococcus, MSSA, some coagulase- negative staphylococci, peptostreptococcus Anti-pseudomonal penicillin drugs - correct answer✔✔piperacillin ticarcillin combination:

piperacillin/taxobactam ticarcillin/clavulanate Anti-pseudomonal penicillins active against - correct answer✔✔gram (-) organisms 1st generation cephalosporins drugs - correct answer✔✔Cephradine (Anspor) Cefazolin (ancef) Cefadroxil (Duricef) Cephalexin (keflex) 2nd generation cephalosporins drugs - correct answer✔✔Cefuroxime sodium (Zinacef) Cefuroxime (Ceftin) Cefaclor Cefprozil Cefotetan (Cefotetan) Cefoxitin (Mefoxin) 3rd generation cephalosporins drugs - correct answer✔✔Cefdinir (Omincef) Cefpodoxime (Vantin) Cefotaxime (Celizox) Ceftazidime Fortax) Ceftriaxone (Rocephin) Cedax Cefixime (Suprax)

Pharmacodynamics of cephalosporins - correct answer✔✔inhibit synthesis of bacterial cell wall Fluoroquinolone older drugs - correct answer✔✔cipofloxacin (cipro) norfloxacin (noroxin) ofloacin (flovin) Fluoroquinolones new drugs - correct answer✔✔gemifloxacin (factive) levofloxacin (levaquin) moxifloxacin (avelox) fluoroquinolones active against - correct answer✔✔Gram (-) organisms Pharmacodynamics of fluoroquinolines - correct answer✔✔Interferes with DNA synthesis leading to inability to divide and ultimately, cell death Fluoroquinolones indications - correct answer✔✔PNA sinusitis UTI proctitis bronchitis skin, joint infections Travelers diarrhea (!st line therapy) black box warning for fluoroquinolones - correct answer✔✔tendon rupture

macrolide drugs - correct answer✔✔erythromycin clarithromycin dirithromycin azithromycin telithromycin Pharmacodynamics of macrolides - correct answer✔✔Interferes with steps involves in protein synthesis thereby rendering cell division non-functional macrolides are active against - correct answer✔✔gram (+) organisms & gram (-) organisms Macrolide indications - correct answer✔✔CAP (DOC) legionella PNA (DOC) pertussis chronic bronchitis chlamydia H. pylori Group A Strep mycobacterium avium complex endocarditis prophylaxis Macrolide drug interactions - correct answer✔✔CYP450 & 3A4 inhibitors statins theophylline colchicine carbamazepine

Nitrofurantoin mechanism of action - correct answer✔✔inhibits acetyl co-enzymes Nitrofurantoin active against - correct answer✔✔gram (-) & gram (+) organisms sulfonamide drug interactions - correct answer✔✔sulfonylureas methotrexate cyclosporine hydantoins probenecid thiazide diuretics warfarin nitrofurantoin drug interactions - correct answer✔✔probenecid anticholinergics magnesium salts sulfonamide ADR - correct answer✔✔N/V/D hypersensitivity reactions photosensitivity G6PD deficiency Steven-Johnson syndrome crystals in urine AIDS and sulfonamides - correct answer✔✔AIDs patients are at increased risk for ADRs

Nitrofurantoin ADR - correct answer✔✔cough ADR with G6PD and sulfonamides - correct answer✔✔results in acute hemolytic anemia blood dyscrasias and sulfonamides - correct answer✔✔toxic effects and death Bactrim indications - correct answer✔✔uncomplicated UTI exacerbations of chronic bronchitis MRSA Bactrim drug interactions - correct answer✔✔ACEI ARBs phenytoin warfarin cyclosporine Macrobid indication - correct answer✔✔UTI Clindamycin indications - correct answer✔✔MRSA (1st line therapy in areas where resistance is low) gram (+) cocci (2nd line therapy) endocarditis prophylaxis pneumococcal PNA skin/tissue infections URI/LRI (2nd or 3rd line) Malaria dental infections bacterial vaginosis (off-label)

Rigors flank pain DM, pregnancy, immunocompromised, renal calculi recent d/c from hospital for nursing home 3 or > UTI in past year failed antibiotics within past 4 months resident at ECF Recurrent UTI prevention - correct answer✔✔Bactrim single strength daily at bedtime x 6 months indications for referral to Urologist - correct answer✔✔neonates, children < gross hematuria persistent microscopic hematuria symptoms of obstruction persistent UTIs infection with urea-splitting bacteria symptomatic pregnant patients high fever dehydrated septic Antimycobacterial drugs - correct answer✔✔isoniazid (INH) Rifampin Ethambutol Pyrazinamide Streptomycin

antimycobacterial mechanism of action - correct answer✔✔interferes with lipid &Nucleic acid biosynthesis in growing organisms active TB first phase (initiation phase) drugs - correct answer✔✔2 Months: INH, Rifampin (RIF), pyrazinamide (PZA) and ethambutol (EMB) active TB 2nd phase (continuation) drugs - correct answer✔✔ 4 - 7 months: INH & RIF antiviral drugs: nucleoside analogues - correct answer✔✔Acyclovir (Zovirax), valacyclovir Famciclovir Ganciclovir cidofovir valgancidovir ribavirin Acyclovir (Zovirax) indications - correct answer✔✔HSV- 1 & 2, varicella-zoster virus, EBV, herpes virus 6, CMV, Valacyclovir (Valtrex) indications - correct answer✔✔HSV- 1 & 2, varicella-zoster virus, EBV, herpes virus 6, CMV, famciclovir indications - correct answer✔✔HSV-1 & 2, EBV, Hep B

itraconazole (Onmel) voriconazole (Vfend) Clotrimazole Ketoconazole minonazole terconazole tioconazole Polyene Macrolides drugs - correct answer✔✔amphotericin B nystatin Allylamines Drugs - correct answer✔✔Terbinafine (Lamasil) Naftifine Nuclear acid synthesis inhibitor drugs - correct answer✔✔Flucytosine Azoles mechanism of action - correct answer✔✔reduce erogsterol production by inhibition of the fungal CYP enzyme 14 alpha-demethylase Polyene Macrolides MOA - correct answer✔✔binds to sterol in the fungal cell membrane, altering cell permeability and allowing intracellular components to leak out

Flucytosine mechanism of action - correct answer✔✔Inhibits DNA synthesis by conversion to 5- fluorouracil; inhibits thymidylate synthase. Ketoconazole mechanism of action - correct answer✔✔Inhibits steroid synthesis (inhibits desmolase). fluconazole & posaconazole mechanism of action - correct answer✔✔inhibit fungal CYP450=fungal cell walls weaken itraconazole & voriconazole mechanism of action - correct answer✔✔inhibit formation of ergosterol= increases cell wall permeability=osmotic instability Clotrimazole indications - correct answer✔✔dermatophyte candida albicans oral and vaginal canidasis Ketoconazole indications - correct answer✔✔vulvovaginal candidasis paronychia fungal PNA esophageal candidasis Fluconazole indications - correct answer✔✔candidiasis, cryptococcal meningitis severe systemic infections, vaginal candidasis oropharyngeal candidasis esophageal candidasis

albendazole pyrantel ivermectin Benzimidazoles MOA - correct answer✔✔Interfere with elongation of the microtubules that are responsible for parasitic cellular structure, leading to a disruption of growth and division Pyrantel MOA - correct answer✔✔paralyzes worms to allow expulsion by peristalsis Ivermectin MOA - correct answer✔✔intensifying GABA- mediated signal transduction in peripheral nerves (causing worm paralysis) Mebendazole (Vermox) indications - correct answer✔✔DOC for intestinal & tissue nematodes (roundworm) Nematodes - correct answer✔✔Intestinal and tissue roundworms Cestodes - correct answer✔✔flatworms and tapeworms Trematodes - correct answer✔✔flukes Albendazole (Albenza) indication - correct answer✔✔tissue nematodes: hookworm, trichiasis

giardiasis Pyrantel indications - correct answer✔✔pinworm, trichiasis, hookworms Ivermectin (Stromectol) indications - correct answer✔✔tissue nematodes patient education for albendazole & mebendazole - correct answer✔✔take with a high fat meal patient education for ivermectin - correct answer✔✔take on empty stomach patient education for ibendazole - correct answer✔✔don't use if pregnant; use back of contraceptive Metronidazole (Flagyl), nitazoxanide, & tinidazole - correct answer✔✔used to treat protozoal infections: t. vaginalis G. lambila E. histolytica Metronidazole indications - correct answer✔✔protozoal & bacterial infections Nitazoxanide (Alinia) indications - correct answer✔✔diarrhea caused by G. Lambila & C. parvum

cardinal symptoms of chronic bronchitis which indicate need for antibiotic - correct answer✔✔1.) increased sputum volume 2.) increased sputum purulence 3.) increase dyspnea Tinea corporis (ringworm) treatment - correct answer✔✔terbinafine naftifine butenafine ciclopirox olamine Tinea pedis (athletes foot) treatment - correct answer✔✔terbinafine naftifine butenafine ciclopirox olamine Tinea Capitis (Scalp Ringworm) treatment - correct answer✔✔terbinafine Griseofulvin (1st line therapy) Tinea Cruris (Jock Itch) Treatment - correct answer✔✔naftifine butenafine ciclopirox olamine onychomycosis - correct answer✔✔ciclopirox

1st line treatment for primary and secondary skin infections - correct answer✔✔1st generation Cephalosporins: cephalexin dicoxacillin amoxilcillin/claulanate clindamycin medications and dose to eradicate nasal MRSA - correct answer✔✔intranasal mupirocin: 1/2 tube in each nostril BID x 5 days symptomatic treatment for viral URIs - correct answer✔✔decongestant Tylenol ASA Motrin increase fluid intake cough drops nasal saline spray rest treatment for acute sinusitis - correct answer✔✔amoxicillin with or without clavulanate Antacids MOA - correct answer✔✔Neutralize gastric acid to bring the pH above 3 and inactivate pepsin