Week 2 Exam: NR566 / NR 566 (Latest 2026 / 2027) Advanced Pharmacology for Care of the Family | Questions & Answers | Grade A | 100% Correct – Chamberlain

Week 2 Exam: NR566 / NR 566 (Latest 2026 / 2027) Advanced Pharmacology for Care of the Family | Questions & Answers | Grade A | 100% Correct – Chamberlain Question: Penicillin is also known as a _____ ______ abx: Answer disrupts cell wall, like all beta lactams beta lactam Question: Penicillins weaken ___________ cell wall, causing bacteria to take up hella water ---- bursts Penicillins weaken cell wall by inhibiting ______________, an enzyme that strengthens bacterial cell wall Answer bacterial transpeptidase Question: Penicillins are only active against bacteria that are undergoing ___________ and ______________ Answer growth division Question: bacterial resistance in penicillins is determined by 3 factors: 1. ___________ of penicillins by bacterial enzymes 2. production of penicillin binding proteins that have a ___ affinity for penicillins 3. inability of ___________ to reach their targets Answer inactivation low penicllins Question: describe gram negative penicillin activity: only certain penicillins like ___________ are able to cross it to reach penicillin binding protein on cytoplasmic membrane there are 3 layers: lasmic membrane 2. _____ cell wall 3. additional outer membrane Answer ampicillin thin Question: the main difference in Pen G and Pen V is ______ __________ Pen _ is stable in the stomach, Pen _ is not. acid stability Answer V G Question: Pen _ can be given PO, with meals Answer V Question: Cephalosporins are _______________, they bind to penicillin binding proteins, disrupt cell wall synthesis, and activate __________, -- cell death Answer bactericidal autolysins Question: Cephalosporins are most effective against cells undergoing _________ and _________ Answer growth division Question: __________ and ____________ induce alcohol intolerance if pt were to drink alcohol while on either abx, they could have a ________-like reaction, dangerous! s/s: HoTN, ________, HA Answer cefazolin; cefotetan disulfram; palpitations (cephalosporins) Question: ____________, ______________, and _____________ can increase bleeding because they have a side chain that interfere with vitamin __ metabolism stopping __________ factor from forming Cefotetan, cefazolin, ceftriaxone Answer vitamin K clotting be careful using meds with other drugs that promote bleeding ex: warfarin, digoxin, NSAIDs, antiplatelets Question: The nucleus of the cephalosporins bacteria has ____ ________, which is required for antibacterial activity Answer beta lactam Question: Carbapenem is a _____ ________ antibiotic that binds to two _____, ___________ cell wall -- cell death Answer beta lactam Question: PBPs (penicillin binding proteins) Answer weakening Question: list 3 meds under Carbapenems: 1. i 2. m 3. e Answer imipenem meropenem ertapenem Question: only use __________ when pt can't be treated with a more narrow spectrum abx can only be given via __, not well absorbed in GI tract Answer carbapenems IV can effectively penetrate gram negative cell envelope Question: decrease ________________ in pts with renal impairment Answer carbapenems Question: Carbapenems are excreted renally, but when given alone it is deactivated by ____________, an enzyme in kidneys to increase urinary elimination of _____________, the abx is given with________ a dipeptidase inhibitor Answer dipeptidase carbapenems cilastin Question: ___________ is the most used abx, often used to tx ______, C. diff and serious infections in pts allergic to penicillin Answer vancomycin MRSA Question: Vancomycin ___________ cell wall synthesis --- cell death Answer inhibits Question: Does Vancomycin interact with PBPs? If it does, how does it work? if not, how does it work? Answer NO it stops synthesis by binding to molecules that serve as precursors for cell wall biosynthesis Vancomycin is used for ________ C. diff infection, not _________ Answer severe; mild C. diff, a gram ___ spore forming anerobic infection, often happens after ______________ use that ____ normal gut flora, allowing C. diff to flourish Answer positive antibiotic kills what abx are often the cause of C.diff? 1. 2. 3. Answer 1. clindamycin 2. fluoroquinolones 3. 2nd and 3rd gen cephalosporins C. diff is passage of ____ or more unformed stool in 24 hours and a positive C diff test Answer 3 risk factors for getting C.diff is tx with ___________, especially old people taking it. ___________ hospitalization, GI surgery, _________________ check ____ and serum _________ Answer antibiotics prolonged immunosuppression WBC, creatinine initial C diff dx should be treated with PO _____________ or ____________. but if infection is fulminant: toxic megacolon, HoTN, shock, give PO ___________________ vancomycin; fidaxomicin vancomycin the primary major side effect of Vancomycin is _______ __________, risk is dose related, and is increased by use of other _____________ drugs renal toxicity nephrotoxic to decrease renal risk, ___________ trough levels shouldn't be greater than what's needed if kidney damage develops, indicated by ____ % increase in ___________, decrease dose vancomycin 50 %; creatinine Tetracyclines are a ________ spectrum abx, and stop bacterial growth by binding to ____ ribosomal subunit and stop tRNA from binding to mRNA- ribosome complex examples of tetracyclines are: 1. d 2. t 3. e broad 30 S 1. doxycycline 2. tetracycline 3. eravacycline Tetracyclines are _____________ selective toxicity of tetracyclines comes from poor ability to cross _______________ cell membranes bacteriostatic mammalian Tetracycline should not be given with 1: i 2. 3. c 4. M 5 most ___________ because they contain ___________, ___________ or both 1. iron 2. milk products 3. calcium sium containing laxatives 5. antacids; magnesium; aluminum _____ tetracyclines increase ____ sensitivity all; skin teach: avoid prolonged exposure to sun, wear protective clothing, use sunscreen! ____________ should not be used in kids8 y/o because it can what tetracyclines it can permanently discolor teeth can a pregnant/breastfeeding pt take tetracycline? NO it pt taking_____________ develops diarrhea, notify NP because it can indicate a potentially ____-____________ _____________ tetracycline life-threatening superinfection high dose of ____________ IV therapy can cause severe _______ damage tetracycline liver Macrolides are ______ spectrum abx that inhibit _________ ___________ list three examples: 1. e 2. a 3. c broad protein synthesis erythromycin azithromycin clarithromycin Main adverse effects of macrolides is that they can cause sudden cardiac death from ___ ______________ due to combining med with _____, azoles, CYP3A4 inhibitors and Ca channel blockers QT prolongation PIs GI adverse effects of _____________ are N/V/D and ________ _____. take ______________ with meals but in form that's unaffected by food! macrolides epigastric pain erythromycin Clindamycin binds to ___ subunit of bacterial ribosomes and stops _______ _____________ 50S protein synthesis do NOT give erythromycin with ________________, may antagonize each other's effects clindamycin ________________ works as an alternative to penicillin often used for ___________ infections outside CNS. does not cross BBB clindamycin anaerobic _____________ can cause potentially fatal c. diff diarrhea. pt should notify NP if diarrhea develops clindamycin if pt taking ____________ has 5 watery stools: pt should notify NP and DC if pt dx with superinfection w/ C. diff diarrhea, ___________ medication! tx with _______ and ___________. clindamycin discontinue fluid and electrolytes. do NOT give meds that can slow gastric motility ex: opioids, anticholinergics Don't give clindamycin with ____________ and ___________. their binding sites overlap, antagonize each other's effects erythromycin chloraphenicol do not give meds at the same time! Aminoglycosides are _____________ abx used against aerobic gram negative bacilli bactericidal Aminoglycosides, a ________ spectrum abx, binds to ____ ribosomal subunit causing inhibition of protein synthesis, premature protein synthesis termination and production of abnormal proteins narrow 30 S list 3 examples of aminoglycosides: 1. a 2. g 3.t amikacin gentamicin tobramycin resistance in aminoglycosides happen DT production of __________ that can inactivate them ______________ are only reserved for infections that are unresponsive to other _______________ enzymes amikacin aminoglycosides _____________ are ototoxic, hepatotoxic, and nephrotoxic aminoglycosides risk for ototoxicity when taking ____________ increases DT: ______ impairment concurrent use of _____ __________ excessive ________________ use, 10 days aminoglycoside renal loop diuretics aminoglycoside ototoxcity happens when taking ______________ DT excessive ________ levels, impairing hearing and balance 1st sign of ototoxicity is ________- __________ ____________, irreversible 1 st sign of imbalance is ___, lasts for 1-2 days then vertigo, dizziness aminoglycosides trough high-pitched ringing HA Nephrotoxicity when taking _______________ is increased in pts getting a ____ dose, _____________ use, and preexisting _________ impairment aminoglycosides high prolonged renal most significant consequence of renal damage is accumulation of __________ leading to more ____ damage and ototoxicity aminoglycosides renal nephrotoxic drugs like aspirin, ______________________ _, vancomycin, ______ and cyclosporine can increase risk for renal damage when given concurrently with ______________ amphotericin B NSAIDs aminoglycosides ____________ can also inhibit ________________- transmission leading to flaccid paralysis and fatal __________________ depression aminoglycosides neuromuscular respiratory ________________ and aminoglycosides are used frequently together to enhance bacterial kill. effective because ______________ disrupts cell wall, helping ________________ to site of action penicillin penicillin aminoglycoside ____________ and _____________ are also given with aminoglycosides to enhance bacterial kill vancomycin cephalosporins Trimethoprim suppresses ___________ synthesis, can be both bacteriostatic and bactericidal only approved for initial treatment of acute ______________ ___ DT susceptible bacteria tetrahydrofolate uncomplicated UTIs Sulfonamides are used for ______ ____ treatment, not used often because newer abx are less toxic and _____________ resistance development acute UTI sulfonamide to decrease RF renal damage, adults taking ____________ need daily UO of _____ml, drink 8 10 glasses of water daily! for pts with CrCl of ___-__ ml/minute, prescribe ____ of the typical dose sulfonamides 1200ml 15-30 ml/min 1/2 Methenamine is a prodrug that breaks down into __________ and _____________ urine must be acidic, ____ for formaldehyde to be released ammonia; formaldehyde 5.5 _____________ can be ineffective against _________ tract infections because there's not enough time for _____________ to form as drug passes through Methenamine upper formaldehyde does Methenamine prevent against CAUTIs? NO don't give methenamine with drugs that __________ urine pH, they _____ formaldehyde release increase stop dont take alkalinizing meds ____________ do not go with formaldehyde. when combined, these 2 elements form an __________ complex increasing RF ______ ______ injury from crystalluria sulfonamides insoluble urinary tract ________________ is the first choice of tx for uncomplicated cystitis and ______, lower UTIs adverse effects are GI, ___________, hematologic, and ____________ nitrofurantoin acute pulmonary hepatoxic most frequent GI side effects for nitrofurantoin are __________ and N/V/D can be decreased if taken with ______ or food, or __________ dose anorexia milk; decrease acute ______________ reactions to nitrofurantoin are most common; manifestations are fever, cough, ___________ infiltrates. resolve _-_ days after DC med subacute: rare, ___________ lung damage, cough, malaise. s/s regress _____ to ________ after DC med pulmonary alveolar 2-4 permanent weeks to months _____________ anemia may occur in infants if mom was on nitrofurantoin and babies with _____ deficiency other hematologic problems that can occur: agranulocytosis, ___________ and megaloblastic anemia hemolytic; G6PD leukopenia peripheral neuropathy in pts taking ___________ is most likely to occur in pts with _______ impairment or taking med chronically to decrease risk for ______________, pts need periodic liver function test. DC if hepatotoxicity develops nitrofurantoin renal hepatotoxicity if pregnant pt takes __________ theres an increased risk for neonatal ___________ if med taken within last __ days of gestation contraindicated in pregnant pts at term (38-42 weeks) DT risk for __________ anemia, birth defects like cleft lip and palate, ______ septal defects, absence of 1 or both _____ nitrofurantoin jaundice 30 hemolytic atrial eyes What does candidiasis mean? yeast What does aspergillosis mean? mold or fungus Amphotericin B is what type of antibiotic? broad spectrum What is the black box warning for Amphotericin B? Use in life threatening infections only How is Amphotericin administered? IV only What is recommended before using Amphotericin B? Test dose What are infusion reactions for Amphotericin B? Fever, chills, nausea What do we use to premedicate before the use of Amphotericin B? Acetaminophen plus diphenhydramine What is common with infusions when using Amphotericin B? Phlebitis How is Amphotericin B used? Life threatening situations daily or every other day for 6-8 weeks What type of antibiotics are "Azoles"? Broad spectrum anifungals What does the medication class "Azoles" inhibit? CYP450 How are the medication class of "Azoles" given IV or PO What is the black box warning for Ketoconazole? rare fatal hepatic necrosis. Contraindicated with drugs that prolong QT interval Is Ketoconazole well tolerated? Yes How can Fluconazole (Diflucan) be given? Orally or superficial fungal infections daily for 3 weeks to 3 months What is prescribed for tinea capitis - scalp? Oral Griseofulvin for 8-10 weeks What is tinea capitis - scalp? Ringworm What is candida - mouth? Thrush What do we prescribe for candida? Topical Nystatin Oral fluconazole What is tinea corporis - skin? Ringworm What do we prescribe for tinea corporis - skin? Topical terbinafine What is candida - vagina? Vaginal yeast infection What do we prescribe for candida- vagina? Topical miconazole Oral fluconazole What is onychomycosis - nail? Nail fungus What do we prescribe for onychomycosis - nail? Oral terbinafine topical efinaconazole What is tinea pedis - foot? Athletes foot What do we prescribe for tinea pedis? Topical terbinafine Jerri is a 22-year-old who is 10 weeks pregnant. She presents with symptoms of a vaginal yeast infection. Her treatment should include Topical Miconazole Ted is a 44-year-old who is s/p appendectomy. He calls the office with complaints of a white coating on his tongue and painful swallowing. His treatment should include Nystatin Bill is a 65-year-old who complains of thickening and discoloration of his toenails. He has tried over-the-counter nail fungus treatments without success. His treatment should include oral terbinafine Eric is a 19-year-old who presents with itching and scaly skin between his toes. He has never experienced this before. His treatment should include topical terbinafine Bev is a 56-year-old with diabetes who presents with symptoms of a vaginal yeast infection. This is her third infection this year. Her treatment should include Oral fluconizole Anthelmintics medication are effective in treating what? parasitic infections What medications are given for Pinworms? Single dose of Mebendazole Pyrantel pamoate Albendazole What medications are given for whipworms? Mebendazole Pyrantel pamoate Albendazole What medications are given for roundworms? Mebendazole What medications are given for hookworms? Mebendazole Pyrantel pamoate Albendazole What medications are given for threadworms? Ivermectin thiabendazole What medications are given for scabies? Off label ivermectin in immunocompromised patients What are the ADRs for mebendazole? May cause transient neutropenia What are the ADRs for Ivermectin? Mazzotti reaction ever, urticaria, swollen and tender lymph nodes, tachycardia, hypotension, arthralgias