lOMoAR cPSD| 66549320
NR566 Midterm Study Guide
Be familiar with the interactive activities throughout course modules. You could see
variations of those same questions on your exams.
Week 1
• Community Acquired Pneumonia (CAP) o Common pathogens: Predominant organisms
in CAP depends on the age and overall health of the patient. Streptococcus pneumoniae
is the most common causative organism. Others include atypical bacteria (mycoplasma
pneumoniaeolder children and young adults) or viruses (influenza or RSV)
Smokers (H. influenzae)
Cystic fibrosis (Pseudomonas aeruginosa)
Immunocompromised (Pneumocystitis carini) o First line
treatment for previously healthy adults: Amoxicillin (PCN), Doxycycline and
Macrolides (Azithromycin)
What to give if first drug didn’t work: Levaquin (Fluroquinolones)
o Treatment for M. Pneumoniae in pediatric patient (Specific/example antibiotic
from drug class will be provided) Macrolides, Azithromycin, Erythromycin
o Treatment of CAP in pregnancy: Macrolide, tetracycline (avoid in Preg), PCN,
cephalosporin, erythromycin is safe in pregnancy.
o If someone has been treated with an antibiotic in the previous 90 days of
contracting CAP, a quinolone would be a prudent choice to prescribe: Floxacin
Be familiar with drug examples within the antibiotic classes.
o Treatment of chlamydial pneumonia in infant (options will include dose, but if you
know the correct drug, the dose will come with it on the exam so no need to
memorize dose): Erythromycin 12.5mg/kg PO QID x 14 days
• Broad vs narrow spectrum agents: Broad - active against a wide variety of microbes.
Narrow - active only against a few species of microorganisms.
o When to use which one: Broad - Gram + Cocci and Gram - Bacilli. Narrow -
Gram + Cocci, Gram - bacilli, gram - aerobes, mycobacterium TB
• Empiric antibiotics o What are they: Ciprofloxacin, Trimethoprim/Sulfamethoxazole,
Amoxicillin o When to prescribe: If pt has severe infection and may need to initiate
treatment before test results are available. Drug selection is based on clinical eval and
knowledge of microbes that are most likely causing the infection.
• Clostridium difficile associated diarrhea o How to treat: Stop prior abx and start
Vancomycin or Fidaxomicin o Drug class known for ALL drugs in class to promote
development of C. Diff. : Bacteriostatic Inhibitors
• One question from article in required reading list:
o Ungureanu, G., Alexa, I.-D., & Ungureanu, M.-C. (2018). Unnecessary Medicine,
an Issue with Major Ethical Implications. Internal Medicine / Medicina Interna,
15(5), 65–74.
https://www.stuvia.com/user/performance
, lOMoAR cPSD| 66549320
NR566 Midterm Study Guide
• Penicillin o Cross-sensitivity reactions with which drug classes: Cephalosporins o
Prescribing in pregnant patients: No controlled studies; No second or third trimester fetal
risk p.666 Green Box
• Cephalosporins
o Patient education needed: Do not take it if allergic to PCN. Interacts with Alcohol,
vit K, clotting factors. Increases risks of C-Diff so check stools.
o Prescribing in pregnant patients: Safe
• Tetracyclines o Patient education needed: Discoloration of teeth. Avoid prolonged sun
exposure, C-Diff, Renal and Hepatotoxicity. Do not take with calcium, milk, iron, mag
containing Laxative, and most antacids. Effects GI tract n/v/d. Reactions can decrease if
taken with meals.
o Prescribing in pregnant patients: Fetal harm. Suppress growth of long bones
• Macrolides
o Patient education needed: Can cause QT prolongation risk for torsades de
pointes. GI effects n/v/d.
• Aminoglycosides
o Patient education needed: Serious toxicity to inner ear (H/A, nausea, dizziness,
tinnitus, and vertigo). And toxicity to kidneys.
• Sulfonamides
o Patient education needed: Complete prescription course. Drink 8-10 glasses of
water to decrease risk of crystalluria. Apply sunscreen and avoid prolonged
sunlight exposure. o Prescribing in pregnant patients: Birth defects 1st trimester.
Near term can cause Kernicterus.
• Gentamicin
o Renal adjustments: Renal toxic
Week 2
• How to treat tinea capitis (don’t need specific drug or dose, focus on drug classes): Oral
griseofulvin x 8-10 weeks(antifungal). However, oral terbinafine taken for only two to four
weeks, maybe more effective.
• Specific drug to treat aspergillosis: Voriconazole
• Anthelmintic drugs o Which ones carry risk for hypotension with patients on
antihypertensives? Ivermectin and Moxidectin o Which ones can cause bone marrow
suppression and liver impairment? Albendazole, Mebendazole o Which is generally safe
to give without obtaining baseline data? Pyrantel Pamoate o Safe for use in pregnancy:
WHO states mebendazole, albendazole, and pyrantel pamoate in the second, third
trimesters, but not the first trimester and does not
recommend the use of Ivermectin and diethylcarbamazine as treatment for
women who are pregnant.
• HIV Medications o Risks with didanosine: pancreatitis
https://www.stuvia.com/user/performance
NR566 Midterm Study Guide
Be familiar with the interactive activities throughout course modules. You could see
variations of those same questions on your exams.
Week 1
• Community Acquired Pneumonia (CAP) o Common pathogens: Predominant organisms
in CAP depends on the age and overall health of the patient. Streptococcus pneumoniae
is the most common causative organism. Others include atypical bacteria (mycoplasma
pneumoniaeolder children and young adults) or viruses (influenza or RSV)
Smokers (H. influenzae)
Cystic fibrosis (Pseudomonas aeruginosa)
Immunocompromised (Pneumocystitis carini) o First line
treatment for previously healthy adults: Amoxicillin (PCN), Doxycycline and
Macrolides (Azithromycin)
What to give if first drug didn’t work: Levaquin (Fluroquinolones)
o Treatment for M. Pneumoniae in pediatric patient (Specific/example antibiotic
from drug class will be provided) Macrolides, Azithromycin, Erythromycin
o Treatment of CAP in pregnancy: Macrolide, tetracycline (avoid in Preg), PCN,
cephalosporin, erythromycin is safe in pregnancy.
o If someone has been treated with an antibiotic in the previous 90 days of
contracting CAP, a quinolone would be a prudent choice to prescribe: Floxacin
Be familiar with drug examples within the antibiotic classes.
o Treatment of chlamydial pneumonia in infant (options will include dose, but if you
know the correct drug, the dose will come with it on the exam so no need to
memorize dose): Erythromycin 12.5mg/kg PO QID x 14 days
• Broad vs narrow spectrum agents: Broad - active against a wide variety of microbes.
Narrow - active only against a few species of microorganisms.
o When to use which one: Broad - Gram + Cocci and Gram - Bacilli. Narrow -
Gram + Cocci, Gram - bacilli, gram - aerobes, mycobacterium TB
• Empiric antibiotics o What are they: Ciprofloxacin, Trimethoprim/Sulfamethoxazole,
Amoxicillin o When to prescribe: If pt has severe infection and may need to initiate
treatment before test results are available. Drug selection is based on clinical eval and
knowledge of microbes that are most likely causing the infection.
• Clostridium difficile associated diarrhea o How to treat: Stop prior abx and start
Vancomycin or Fidaxomicin o Drug class known for ALL drugs in class to promote
development of C. Diff. : Bacteriostatic Inhibitors
• One question from article in required reading list:
o Ungureanu, G., Alexa, I.-D., & Ungureanu, M.-C. (2018). Unnecessary Medicine,
an Issue with Major Ethical Implications. Internal Medicine / Medicina Interna,
15(5), 65–74.
https://www.stuvia.com/user/performance
, lOMoAR cPSD| 66549320
NR566 Midterm Study Guide
• Penicillin o Cross-sensitivity reactions with which drug classes: Cephalosporins o
Prescribing in pregnant patients: No controlled studies; No second or third trimester fetal
risk p.666 Green Box
• Cephalosporins
o Patient education needed: Do not take it if allergic to PCN. Interacts with Alcohol,
vit K, clotting factors. Increases risks of C-Diff so check stools.
o Prescribing in pregnant patients: Safe
• Tetracyclines o Patient education needed: Discoloration of teeth. Avoid prolonged sun
exposure, C-Diff, Renal and Hepatotoxicity. Do not take with calcium, milk, iron, mag
containing Laxative, and most antacids. Effects GI tract n/v/d. Reactions can decrease if
taken with meals.
o Prescribing in pregnant patients: Fetal harm. Suppress growth of long bones
• Macrolides
o Patient education needed: Can cause QT prolongation risk for torsades de
pointes. GI effects n/v/d.
• Aminoglycosides
o Patient education needed: Serious toxicity to inner ear (H/A, nausea, dizziness,
tinnitus, and vertigo). And toxicity to kidneys.
• Sulfonamides
o Patient education needed: Complete prescription course. Drink 8-10 glasses of
water to decrease risk of crystalluria. Apply sunscreen and avoid prolonged
sunlight exposure. o Prescribing in pregnant patients: Birth defects 1st trimester.
Near term can cause Kernicterus.
• Gentamicin
o Renal adjustments: Renal toxic
Week 2
• How to treat tinea capitis (don’t need specific drug or dose, focus on drug classes): Oral
griseofulvin x 8-10 weeks(antifungal). However, oral terbinafine taken for only two to four
weeks, maybe more effective.
• Specific drug to treat aspergillosis: Voriconazole
• Anthelmintic drugs o Which ones carry risk for hypotension with patients on
antihypertensives? Ivermectin and Moxidectin o Which ones can cause bone marrow
suppression and liver impairment? Albendazole, Mebendazole o Which is generally safe
to give without obtaining baseline data? Pyrantel Pamoate o Safe for use in pregnancy:
WHO states mebendazole, albendazole, and pyrantel pamoate in the second, third
trimesters, but not the first trimester and does not
recommend the use of Ivermectin and diethylcarbamazine as treatment for
women who are pregnant.
• HIV Medications o Risks with didanosine: pancreatitis
https://www.stuvia.com/user/performance
