Question Bank Review Flashcards
What are some patient counseling advice on Bactrim for toxoplasmosis prophylaxis?
Take with 8oz of water
Medication can increase risk of sunburn
Do not take if you have sulfa allergy
May cause a rash, if it is serious, seek medical help
Which of the following statements is correct regarding nafcillin?
-nafcillin is active against MRSA
-nafcillin is a vesicant
- nafcillin should be dose adjusted in renal impairment
- nafcillin is compatible with NS only
Nafcillin cannot be used in sulfa allergic patient
Nafcillin is a vesicant
If extravasation occurs, use cold packs and hyaluronidase injections
what is an important counseling point to a nurse if ciprofloxacin is to be used for NGT feeds?
- Crush IR cipro in water
- hold feedings 1 hour before and 2 hours after cipro administration
- do not use suspension formulation of cipro because contains oil and will stick to tubing
rifaximin may be used in the management of the following diseases except: A. hepatic encephalopathy B. IBS-D C. recurrent C.Diff D. SBP E. Traveler's diarrhea
D. SBP
rifaximin is an antibacterial agent that is structurally similar to rifampin and used in non-invasive e.coli travelers diarrhea, hepatic encephalopathy risk reduction, and IBS-D. Due to minimal systemic absorption, it is not used in SBP.
Which of the following medication should be avoided in children <8yo to prevent teeth discoloration and growth retardation?
A. telavancin B. minocycline C. telithromycin D. Tinidazole E. Rifaximin
B. minocycline
do not use in children <8yo, pregnant, breast-feeding b/c teeth discoloration and bone growth retardation in children
which of the following statements is correct regarding linezolid?
A. linezolid is associated w/ bone marrow suppression
B. linezolid covers MRSA but not VRE
C. linezolid should be dose adjusted for renal impairment
D. linezolid is a strong CYP1A2 inhibitor
E. linezolid is associated w/ hemolytic anemia in G6PD deficient pts.
linezolid is part of the oxazolidanone family and covers for MRSA AND VRE, does not require renal adjustment and has no significant CYP interactions. Longer txt duration, pt should be monitored for anemia, thrombocytopenia, and leukopenia.
Which of the following covers Vancomycin-resistant E. faecium?
A. Synercid B. Vancocin C. Tygacil D. Invanz E. Avelox
A. Synercid
Tygacil also covers VRE, but not bloodstream VRE infections because as it is a lipophilic drug, it would rapidly distribute to the tissues, resulting in low serum concentrations.
Which of the following best characterizes PD properties of ampicillin/sulbactam?
A. concentration-dependent bacterial killing
B. concentration-above-MIC dependent killing
C. AUC:MIC killing
D. post antibiotic effect for bacterial killing
E. time-dependent bacterial killing
E. time-dependent bacterial killing
maximizing the time >MIC that is why given frequently at q6h than concentration-dependent drugs (e.g. quinolones). Sulbactam is the beta-lactamase inhibitor.
Pg. 374 in RX prep.
How fast should vancomycin be infused?
minimum 1g/hour
Which of the following are common toxicities of Synercid?
A. infusion reactions, electrolyte abnormalities, nephrotoxicity
B. arthralgia/myalgia, nephrotoxicity, neurological disturbances
C. infusion reactions, arthralgia/myalgia, hyperbilirubinemia
D. hyperbilirubinemia, neurological disturbances, arthralgia/myalgia
E. electrolyte abnormalities, nephrotoxicity, infusion reactions
C. infusion reaction, arthralgia/myalgia, hyperbilirubinemia
Which of the following statements regarding cephalosporins is correct?
A. cefazolin is given orally and most effective for mild to moderate gm- foot infections
B. cefixime is the only ceph w/ gm- and enteric anaerobic coverage
C. cephalexin is an oral, 2nd gen ceph that covers gm- and gm+ and is for moderate severity foot infections
D. cefuroxime is a oral 2nd gen ceph that covers gm- and gm+ for mild foot infections
E. cefpodoxime is an IV, 3rd gen ceph with gm- and gm + coverage
D. cefuroxime is a oral 2nd gen ceph with gm- and gm+ coverage for mild foot infections
cefazolin is IV, cefixime is not effective for enteric anaerobes, cephalexin is 1st gen and cefpodoxime is oral 3rd gen. cefuroxime is a 2nd gen ceph that covers, MSSA, streptococcus, and gm- bacteria for mild to moderate foot infections
Which of the following are correct of minocycline? select all that apply.
A. med associated with drug-induced lupus
B. take on empty stomach 1 hr before and 2 hr after
C. may increase sunburn
D. med should be separated when given with antacids
E. no DDIs with this med
A. drug-induced lupus
C. increase sunburn
D. separate from antacids
Do not give in children <8yo, pregnant due to tooth discoloration, bone retardation.
Phosphate binders also reduce absorption.
Which of the following regarding macrobid is correct?
A. med turns urine blue B. dose q6h C. med not absorbed if taken w/ food D. med can be used for pyelonephritis E. med should not be used in crCl <=60mL/min
E. med should not be used in CrCl <=60 mL/min
turns urine brown dosed BID (MacroBID) increased absorption w/ food only used for uncomplicated cystitis contraindicated in CrCl <=60mL/min
Which of the following counseling points of Cipro are not appropriate? A. med can cause confusion B. take 2hr before or 6hr after Maalox C. known to cause muscle aches D. photosensitivity E. monitor glucose if diabetic
C. known to cause muscle aches
does not cause muscle aches, more tendon rupture.
high CNS penetration so CNS toxicity possible, space from antacids, can cause sunburn, can cause hypo or hyperglycemia
select all that apply. Which is true of Zyvox?
A. myelosuppression can occur
B. cleared by kidneys requiring dose adjustment
C. monitor for serotonin syndrome if used with SSRI
D. nephrotoxicity is a common toxicity
E. 1:1 PO:IV
A. myelosuppresion
C. monitor for serotonin syndrome w/ SSRI
E. 1:1 PO:IV
primarily cleared by liver not kidney
MAOI so do not use within 14 days of an SSRI
myelosuppression is a duration related toxicity
IV:PO 1:1 b/cc excellent bioavailability
levofloxacin and azithromycin share which of the following PK properties?
A. lipophiliic agents B. large Vd C. low intracellular concentrations D. excellent tissue penetration E. nephrotoxicity
A lipophilic
B. large Vd
C. excellent tissue penetration
quinolones and macrolides penetrate tissue (needed for lung penetration) and great for atypicals b/c works intracellularly
which of the following are true of sulfamethoxazole/trimethoprim. select all that apply
A. potent hepatic enzyme inducer
B. 1:1 IV:PO
C. excellent against gm +, gm - and OI
D. use with caution in G6PD deficient pts
E. - coombs test indicates hemolytic anemia
B 1:1 IV: PO
C. excellent gm +,-, OI coverage
D. use w/ caution in G6PD deficient pts
potent CYP2C9 inhibitor
partially cleared by kidney so doe adjust for crcl <30mL/min
excellent gm +, - (not pseudomonas), OI coverage
+ coombs test along w/ decreasing Hgb, Hct means hemolytic anemia and Bactrim D/C
Based on which component of Bactrim is a med dosed?
trimethoprim !!!!!!
What medication is a single dose med for bacterial SSTIs? A. vancomycin B. telavancin C. Oritavancin D. tedizolid E. polymixin
C. oritavancin
oritavancin and dalbavancin are lipoglycopeptides similar to vanc and cover MSSA and MRSA. one time dose drugs.
Which organism is consistent w/ gram + cocci in chains?
A. H. influenzae B. MsSA C. acinetobacter baumanii D. staph aureus E. strep. pyogenes
E. strep pyogenes
strep organizes in pair or chains. It is not possible to differentiate MSSA or MRSA on gm stain, only susceptibility testing
which of the following is incorrect regarding daptomycin?
A. exhibits concentration-dependent killing
B. IV formulation incompatible with D5W
C. associated w/ myopathy, rarely rhabdo so monitor creatinine kinase
D. requires dose adjustment for moderate to severe renal impairment
E. oral formulation has excellent bioavailability
E. oral formulation has excellent bioavailability
IV only and only NS
dose adjust crcl<30
CK should be monitored weekly at least
which of the following can interfere w/ coagulation assays? select all that apply A. bactrim B. daptomycin C. linezolid D. oritavancin E. telavancin
B dapto
D. orita
E. tela
unfractionated heparin contraindicated within 5 days (120 hours) of orita b/c false increase in aPTT levels
dapto and tela may increase PT/INR
what is MOA of avelox?
A. inhibit cell wall synthesis
B. bind to 30S to inhibit protein synthesis
C. inhibits DNA topoisomerase
D. inhibits synthesis of Beta (1,3) D-glucan
E. bind to 50S to inhibit protein synthesis
C. inhibit DNA topoisomerase
Which of the following will cover streptococcus, gm - rods and anaerobes? A. ertapenem B. rifaximin C. metronidazole D. fosfomycin E. cipro
A. ertapenem
rifaximin has limited effect to GI
fosfomycin is only for uncomplicated cystitis
cipro does not adequately cover strep
metro has insufficient coverage.
