NURS 5663 Exam 3 Review Comprehensive Resource To Help You Ace Exams Includes Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS Guaranteed Pass First Attempt!! Current Update!!

NURS 5663 Exam 3 Review Comprehensive Resource To Help You Ace Exams Includes Frequently Tested Questions With ELABORATED 100% Correct COMPLETE SOLUTIONS Guaranteed Pass First Attempt!! Current Update!! 1. Different classes of Malaria - Correct Answer: 1. Tissue Schizonticides: Drugs that eliminate developing or dormant liver forms 2. Blood schizonticides: act on erythrocytic parasites 3. Gametocides: kill sexual stages and prevent transmission to mosquitoes 2. Treatment of Malaria - Correct Answer: Use of chloroquine for chemoprophylaxis in areas infested by only chloroquine-sensitive malaria (Hispaniola & Central America west of Panama Canal), Malarone, Mefloquine, or Doxycycline for most other areas. Alternative chemophrophylactic drugs: Primaquine & Tafenoquine 3. Sulfonamides - Correct Answer: 1. Characteristics: oily liquids or crystalline solids that are almost always prepared by the reaction of a sulfonyl chloride with ammonia or an amine, most commonly in the presence of caustic alkali. 2. MOA: Inhibit dihydropteroate synthase and folate production 3. Meds: PO Absorbable: Trimethoprim-sulfamethoxazole, Sulfadiazine + pyrimethamine (treats toxoplasmosis), Sulfadoxine (second line to treat malaria); PO Nonabsorbable: Sulfasalazine (salicylazosulfapyridine (treats IBS)); Topical: Sulfacetamide (second line to treat bacterial conjunctivitis), Mafenide acetate (absorbed from burn sites), Silver sulfasiazine (prevention of infection of burn wounds) 4.Adverse Reactions: Common: fever, skin rashes, exfoliative dermatitis, photosensitivity, urticaria, N/V/D & difficulties with urinary tract (crystalluria, hematuria, or obstruction) Serious: Steven-Johnson syndrome Others: stomatitis, conjunctivitis, arthritis, hematopoietic disturbances (hemolytic or aplastic anemia, granulocytopenia, thrombocytopenia or leukemoid reaction), hepatitis Rarely: polyarteritis nodoas & psychosis 4. Fluoroquinolones - Correct Answer: 1. Characteristics: high oral bioavailability, large volume of distribution, and broad-spectrum antimicrobial activity. 2. MOA: block bacterial DNA synthesis by inhibiting bacterial topoisomerase II (DNA gyrase) and topoisomerase IV 3. Meds: Ciprofloxacin, Delafloxacin, Gemifloxacin, Levofloxacin, Moxifloxacin, Norfloxacin, Olfloxacin, Gatifloxacin (not for sale in US), Enoxacin, Lomefloxacin 4. Adverse Reactions: Common: N/V/D, HA, dizziness, insomnia, skin rash, or abnormal liver function. - Lomefloxacin & Pefloxacin: Photosensitivity - Gatifloxacin, Levofloxacin, Gemifloxacin, & Moxifloxacin: Prolongation of QT interval - Avoid or use with caution in pts with QT interval prolongation or uncorrected hypokalemia - Gatifloxacin: Hyperglycemia in DM pts - May damage growing cartilage, cause arthropathy (not recommended in pts under 18yrs) Serious: Tendinitis Rarely: Aortic dissection or rupture Others: peripheral neuropathy, central neurotoxicities - agitation, impaired memory/attention 5. Macrolides - Correct Answer: - Characteristics: macrocyclic lactone ring (usually containing 14 or 16 atoms) to which deoxy sugars are attached. - MOA: Inhibition of protein synthesis by binding to 50S ribosomal RNA 1. Erythromycin (EES) -Clinical Use: Treats corynebbacterial infections (diphtheria, corynebacterial sepsis, erythrasma), resp, neonatal, ocular, or genital chlamydial infections.Treats Staphylococci & Streptococci.PCN substitute 2. Clarithromycin - Clinical Use: Active against Mycobacterium leprae, Toxopladma gondii, & H. influenzae. Lower incidence of GI intolerance and less frequent dosing then EES. Treats Staphylococci & Streptococci. - Metabolized in liver and partially eliminated in urine 3. Azithromycin - 15-atom lactone macrolide ring compound, derived from EES by addition of methylated nitrogen into the lactone ring. - Clinical Use: active against M avium complex & T gondii. Slightly less active against Staphylococci & Streptococci. Slightly more active against H. Influenzae. Highly active against Chlamydia 4. Fidaxomicin - Clinical Use: Treat Clostridioides difficile infections 5. Ketolides - Semisynthetic, 14-membered ring macrolides, differ from EES by substitution of a 3-keto group for neutral sugar L-Cladinose - Meds: Telithromycin (bacterial PNA -not in US), Solithromycin (not FDA approved) SIDE EFFECTS: Common: Anorexia, N/V/D Acute cholestatic hepatitis (fever, jaundice, imparied liver function) -recover from but hepatitis recurs is readmin. Other: fever, eosinophilia, rash EES inhibit CYP P450 enzymes - increase serum concentration including: theophylline, Warfarin, Cyclosporine, & Methylpresnisoline, PO Digoxin Prolong QT interval d/t effect on potassium channels → leads to rosades depointes arrhythmia Azithromycin - increased risk of cardiac death 6. Beta Lactams: Penicillins - Correct Answer: - Characteristics: A thiazolidine ring is attached to a B-lactam ring that carries a secondary amino group. Structural integrity of the 6-aminopenicillanic acid nucleus is essential for biologic activity of the compunds. 1. PCN (PCN G) - Greatest activity against gram-positive organisms, gram-negative cocci, & non-B-lactamase-producing anaerobes - Clinical Use: Except for Amoxicillin, PO PCNS should be given 1-2 hrs before or after food. PCN G - drug of choice for infections caused by streptococci, meningococci, some enterococci, penicillin-susceptible pneumococci, staphylococci, Treponema pallidum, Clostridium species, Actinomyces. PCN V - only in minor infections. Benzathine PCN & Procaine PCN G - B-hemolytic streptococcal pharyngitis: single dose 2. Antistaphylococcal PCNs (Nafcillin) - resistant to staphylococcal B-lactamases. Active against staphylococci & streptococci - Clinical Use: Except for Amoxicillin, PO PCNS should be given 1-2 hrs before or after food. Infections caused by b-lactamse-producing staphylococci 3. Extended-spectrum PCNs (aminopenicillins & antipseudomonal PCNs) - retain antibacterial spectrum of PCN & have improved activity against gram-negative rods. - Clinical Use: Except for Amoxicillin, PO PCNS should be given 1-2 hrs before or after food. Amoxicillin - PO to treat bacterial sinusitis, otitis, & lower resp tract infections. Ampicillin - effective against susceptible strains of Shigella, infections caused by anaerobes, enterococci, L monocytogenes, & B-lactamase-negative strains of gram-negative cocci & bacilli. Carboxypenicillins, Carbenicillin, & Ticarcillin - not available in US. - MOA: Prevents bacterial cell wall synthesis by binding to and inhibiting cell wall transpeptidases - Adverse Reactions: Rarely: anaphylactic shock, serum sickness - urticaria, fever, joint swelling, angioedem