Exam 2: Antibiotics-Notable Adverse Events

Question 1

What are the two MAIN adverse events associated with the Erythromycin’s Clarithromycin and Azithromycin?

Answer 1

1.Liver disease 2.Altering the QT interval of the heart

Question 2

What dental drug is most counter indicated for use with Clarithromycin and Azithromycin?

Answer 2

The VASOCONSTRICTOR epinephrine, it will alter the QT interval of the heart

Question 3

What are the 4 major classes of drugs that can PROLONG the QT interval of the heart?

Answer 3

Fluoroqunione, Macrolide, Azole antifungals, and Epinephrine

Question 4

For Pedo antibiotic Rx: must calculate dose based on ___/___ body weight.

Answer 4

mg drug/ kg of body weight

Question 5

As discussed before Tetracyclines chelate to divalent cations, to wait a minimum of ___ hours between eating dairy and taking tetracycline.

Answer 5

2 hours

Question 6

Why are oral contraceptives weakened when on antibiotics? What do you recommend? BUT most have been cleared of this accusation EXCEPT WHICH DRUG?

Answer 6

Oral contraceptives are prodrugs that need gut bugs to produce the estrogen needed to stop pregnancy. Double up on protection….Rifapin for TB

Question 7

What happens to the Pt’s blood when they are taking warfarin and antibiotics?

Answer 7

it becomes very thin! (no more Vitamin K to compete with warfarin!)

Question 8

Dangerous drug interaction with Metronidazole…avoid drinking EtOH and _______ for at least 3 days after.

Answer 8

propylene glycol

Question 9

Our RED FLAG drugs are Macrolides AND _______.

Answer 9

AZOLE antifungals

Question 10

Each year in the United States, at least ___ million people become infected with bacteria that are resistant to antibiotics

Answer 10

2

Question 11

C. difficile causes deadly diarrhea and kills

at least _______ people each year!

Answer 11

14,000

Question 12

Most deaths related to antibiotic resistance occur from drug-resistant infections picked up in _______ settings :(

Answer 12

health care

Question 13

___% of hospital-squired infections are caused by drug resistant micro organisms

Answer 13

60%

Question 14

What are the two ways a bug can become genetically resistant?

Answer 14

Chromosomal mutations and exchange of genetic material

Question 15

Once a resistant bug has changed its DNA, what are the 3 ways it shows up?

Answer 15

1. inactivate drugs 2.prevent the uptake of the drug 3.active drug efflux out of the cell!

Question 16

MRSA is observed with increasing frequency in persons with no links to _______ systems…here it comes!

Answer 16

healthcare

Question 17

Resistant bacteria can be transmitted to humans through ______.

Answer 17

Foods…thanks Tyson chicken

Question 18

Trends in resistance: Emerging among some ______, particularly those _____ that cause infections in transplant patients with weakened immune systems….Observed with some of the drugs used to treat _____ infections and influenza…Documented with drugs used to treat ______ infections…Developed to a variety of other parasites

Answer 18

fungi…fungi…HIV…malaria

Question 19

What two bugs are URGENT threat level?

Answer 19

C Diff, N Gonorrhoeae (NO MRSA!!)

Question 20

What threat level is MRSA?

Answer 20

Serious (in between urgent and concerning)

Question 21

__________: Coordinated interventions designed to improve and measure the appropriate use of antimicrobials by promoting the selection of the optimal antimicrobial drug regimen, dose, duration of therapy, and route of administration.

Answer 21

Antibiotic Stewardship

Question 22

What is the agency in charge of optimizing the use of antimicrobial therapy?

Answer 22

HA APRIL FOOLS! there is none.

Question 23

The _______ supports broad implementation of antimicrobial stewardship programs across all health care settings.

Answer 23

Infectious Diseases Society of Amurrica (IDSA)

Question 24

Up to ____% of all the antibiotics prescribed are not needed or are not prescribed appropriately

Answer 24

50%…Holy Cow!

Question 25

The four ways to reduce antibiotic resistance: 1. Give an adequate _____ 2. Take for an adequate _______ 3. Avoid repeated administration 4. Avoid ______ administration

Answer 25

dose…duration…topical (interesting)