OPEN BOOK QUIZ WEEK 1 QUESTIONS
AND ANSWERS
k carbapenems: high risk pt - pts using valproate to control seizures should be placed on imipenem
Vancomycin: high risk pts - use caution in pts with renal impairment
cephalosporin: high risk pts - contraindicated for pts with a hx of allergic reactions to this drug class or
severe reactions to penicillin
Tetracyclines: high risk pts - contraindicated in pregnant women and in children younger than 8 years
macrolides: high risk pts - use caution in pts w/ QT prolongation
Aminoglycosides: high risk pt - used w/ caution in pts with renal impairment, hearing impairment, and
those receiving ototoxic and nephrotoxic drugs
trimethoprom-sulfamethoxazole: high risk pts - contraindicated for nursing mothers, pregnant women in
the first trimester and infants younger than 2 months
Trimethoprim should be avoided with patients with what deficiency? - Folate: manifested as
megaloblastic anemia
Uti med- trimethoprim sulfamethoxazole contraindicated in which population? - early infancy
UTI med: Nitrofurantoin
contraindicated in which population? - 3rd trimester & older adults with renal impairment
Uti med- fluroquinolones
contraindicated in which population? - throughout pregnancy
Pregnancy concern: Cephalosporin - all appear to be safe for use in pregnancy
Pregnancy concern: Penicillins - Althought there are no-well controlled studies in pregnant women,
evidence we do have suggests there is no second or third trimester fetal risk
Pregnancy Concern: Tetracycline - animal studies reveal that these drugs can cause fetal harm in
pregnancy. Thus this class should be avoided during pregnancy
Pregnancy concern: Aminoglycosides - there is evidence that use of this drug class in pregnancy can
harm the fetus so they should not be used
Pregnancy concern: Sulfonamides - systemic drugs in this class may cause birth defects, especially if
taken during the first trimester. If taken near term, the infant my develop kernicterus
narrow-spectrum: pencillinase sensitive - Penicillin G
, Penicillin V
narrow-spectrum: penicillinase-resistant - Nafcillin
Oxacillin
Dicloxacillin
Broad spectrum-penicillin - ampicillin
amoxicillin
Extended-spectrum penicillin - Piperacillin
Breastfeeding: Cephalosporin - generally not expected to cause adverse effects in breasted infants
Breastfeeding: Amoxicillin - safe for use in breastfeeding mothers
Breastfeeding: Penicillin - data are lacking regarding transmission of some drugs in this class from mother
to infant through breast milk
Breastfeeding: Tetracyclines - should be avoided by breastfeeding women due to possible staining of
teeth in breast fed infant
Breastfeeding: Sulfonamides - secreted in breast milk.
breastfeeding women on these drugs should be warned that breastfeeding an infant younger than 2
months can cause kernicterus
Breastfeeding: Gentamycin - probably safe to use during lactation. There is limited info regarding its use
in this way
what baseline/data is needed to prescribe trimethoprim/sulfamethoxazole - establish an infection
appropriate for this drug class exists
-complete blood count with white cell diff/ for prolonged therapy
-renal function if there is concern in may be compromised
In pts w/ a creatinine clearance of 15-30mL/min taking Bactrim, how should dosing be adjusted -
reduced by 50%
What is the causative agent for acute otitis media - Streptococcus pneumoniae
Which antibiotics classes should have a culture and sensitivity prior to prescribing and which ones do
not?
Culture - Penicillins
Vanc
Carbapenems
Cephalosporin
AND ANSWERS
k carbapenems: high risk pt - pts using valproate to control seizures should be placed on imipenem
Vancomycin: high risk pts - use caution in pts with renal impairment
cephalosporin: high risk pts - contraindicated for pts with a hx of allergic reactions to this drug class or
severe reactions to penicillin
Tetracyclines: high risk pts - contraindicated in pregnant women and in children younger than 8 years
macrolides: high risk pts - use caution in pts w/ QT prolongation
Aminoglycosides: high risk pt - used w/ caution in pts with renal impairment, hearing impairment, and
those receiving ototoxic and nephrotoxic drugs
trimethoprom-sulfamethoxazole: high risk pts - contraindicated for nursing mothers, pregnant women in
the first trimester and infants younger than 2 months
Trimethoprim should be avoided with patients with what deficiency? - Folate: manifested as
megaloblastic anemia
Uti med- trimethoprim sulfamethoxazole contraindicated in which population? - early infancy
UTI med: Nitrofurantoin
contraindicated in which population? - 3rd trimester & older adults with renal impairment
Uti med- fluroquinolones
contraindicated in which population? - throughout pregnancy
Pregnancy concern: Cephalosporin - all appear to be safe for use in pregnancy
Pregnancy concern: Penicillins - Althought there are no-well controlled studies in pregnant women,
evidence we do have suggests there is no second or third trimester fetal risk
Pregnancy Concern: Tetracycline - animal studies reveal that these drugs can cause fetal harm in
pregnancy. Thus this class should be avoided during pregnancy
Pregnancy concern: Aminoglycosides - there is evidence that use of this drug class in pregnancy can
harm the fetus so they should not be used
Pregnancy concern: Sulfonamides - systemic drugs in this class may cause birth defects, especially if
taken during the first trimester. If taken near term, the infant my develop kernicterus
narrow-spectrum: pencillinase sensitive - Penicillin G
, Penicillin V
narrow-spectrum: penicillinase-resistant - Nafcillin
Oxacillin
Dicloxacillin
Broad spectrum-penicillin - ampicillin
amoxicillin
Extended-spectrum penicillin - Piperacillin
Breastfeeding: Cephalosporin - generally not expected to cause adverse effects in breasted infants
Breastfeeding: Amoxicillin - safe for use in breastfeeding mothers
Breastfeeding: Penicillin - data are lacking regarding transmission of some drugs in this class from mother
to infant through breast milk
Breastfeeding: Tetracyclines - should be avoided by breastfeeding women due to possible staining of
teeth in breast fed infant
Breastfeeding: Sulfonamides - secreted in breast milk.
breastfeeding women on these drugs should be warned that breastfeeding an infant younger than 2
months can cause kernicterus
Breastfeeding: Gentamycin - probably safe to use during lactation. There is limited info regarding its use
in this way
what baseline/data is needed to prescribe trimethoprim/sulfamethoxazole - establish an infection
appropriate for this drug class exists
-complete blood count with white cell diff/ for prolonged therapy
-renal function if there is concern in may be compromised
In pts w/ a creatinine clearance of 15-30mL/min taking Bactrim, how should dosing be adjusted -
reduced by 50%
What is the causative agent for acute otitis media - Streptococcus pneumoniae
Which antibiotics classes should have a culture and sensitivity prior to prescribing and which ones do
not?
Culture - Penicillins
Vanc
Carbapenems
Cephalosporin
