MARYVILLE 615
PHARM EXAM III
1. What factors will place the patient at risk for antibiotic resistance? - CORRECT ANSWER -
Excessive and inappropriate use of anti-infective agents, over use of broad spectrum
antibiotics or any antimicrobial agent, failure to complete the entire course of treatment,
administration of antibiotics when pt has a viral infection, and fluroquinolones should be
restricted to patients with community acquired pneumonia with comorbidites.
Increasing populations of immune-compromised patients. Increase in the number and
complexity of invasive medical procedures. Increased survival of patients with chronic
disease, multiple medical comorbidities. Daycare of young children. Overcrowding and
travel. The leading cause is use of antibiotics age younger than 2 or older than 65 and
excessive and inappropriate use of anti-infective agents.
2. What factors place the patient at risk for hypersensitivity reactions with penicillin's and
cephalosporins? - CORRECT ANSWER -Cross sensitivity due to the fact that each class
contains a beta-lactam ring, the beta lactam ring also has a cross resistance, since its
vulnerable to beta lactamase producing organisms, a patient has a risk of developing a
reaction within 2-30 minutes after administration of the medication.
Hx of serious hypersensitivity reaction (anaphylaxis, serum sickness, exfoliative dermatitis,
hemolysis or other blood dyscrasia) to PCN. Alsoallergic reaction to cephalosporin's,
imipenem, or beta-lactamase inhibitors may contraindicate use of PCN.
3. What are the safest antibiotics to prescribe to a woman who is pregnant? - CORRECT
ANSWER -PCN is the safest drug to prescribe to pregnant women, augmentin in pregnant
women for UTI's, sulfonamides and penicillinase resistant PCN's should be avoided in late
pregnancy due to the displacement of billirubin from the plasma proteins of the newborn
causing new born canictaris (sp?)
, Amoxicillin, Ampicillin, Clindamycin, Erythromycin, and PCN
4. What patient teaching will you provide to a patient who is experiencing non-infectious
diarrhea related to antibiotic administration? - CORRECT ANSWER -Increase fluids, consume
plain yogurt, Donagel for second line therapy, and avoid anti-peristalsis agents that promote
the retention of toxins.
If diarrhea is severe notify prescriber, for mild diarrhea use a absorbent anti-diarrheal one
that contains Attapuligite (donnagel), avoid using antiperistaltic agents that can cause to
retain toxins, if diarrhea contains blood pus or mucous call prescriber.
5. According to the American College of Cardiology and the American Heart Association,
what are the guidelines related to prophylactic antibiotics prior to a dental appointment? -
CORRECT ANSWER -Prophylactic antibiotic therapy is for patients with prosthetic heart
valves, previous infected endocarditis, certain patients with congenital heart disease, cardiac
transplant with valve regurgitation with the dental procedures who have the manipulation
with gingival tissue. Pts with congenital heart disease require prophylaxis unrepaired
cyanotic congenital heart disease, completely repaired heart disease and with prosthetic
material require treatment in the first 6 months after repair, anyone out of the 6 month
repair range doesn't require prophylactic treatment.
PCN s, if allergic: zithromycin or clarithromycin single dose of 500mg for adults or 15mg/kg
for children 1 hour before.
6. A patient is taking a fluoroquinolone; what are the most serious adverse effects? -
CORRECT ANSWER -Fatal hypersensitivity reaction, Steven Johnson syndrome, and other
adverse effects, psudomembrenous colitis and black box warning of tendon rupture.
Tendon rupture, very dangerous drug to give, reactions with first dose, steven-johnson
syndrome, hypersensitivity reactions (anaphylaxis), pseudomembrenous colitis (c.diff),
photosensitivity or photo toxicity (especially with lomefloxacin and sparfloxcin), and
dizziness.
PHARM EXAM III
1. What factors will place the patient at risk for antibiotic resistance? - CORRECT ANSWER -
Excessive and inappropriate use of anti-infective agents, over use of broad spectrum
antibiotics or any antimicrobial agent, failure to complete the entire course of treatment,
administration of antibiotics when pt has a viral infection, and fluroquinolones should be
restricted to patients with community acquired pneumonia with comorbidites.
Increasing populations of immune-compromised patients. Increase in the number and
complexity of invasive medical procedures. Increased survival of patients with chronic
disease, multiple medical comorbidities. Daycare of young children. Overcrowding and
travel. The leading cause is use of antibiotics age younger than 2 or older than 65 and
excessive and inappropriate use of anti-infective agents.
2. What factors place the patient at risk for hypersensitivity reactions with penicillin's and
cephalosporins? - CORRECT ANSWER -Cross sensitivity due to the fact that each class
contains a beta-lactam ring, the beta lactam ring also has a cross resistance, since its
vulnerable to beta lactamase producing organisms, a patient has a risk of developing a
reaction within 2-30 minutes after administration of the medication.
Hx of serious hypersensitivity reaction (anaphylaxis, serum sickness, exfoliative dermatitis,
hemolysis or other blood dyscrasia) to PCN. Alsoallergic reaction to cephalosporin's,
imipenem, or beta-lactamase inhibitors may contraindicate use of PCN.
3. What are the safest antibiotics to prescribe to a woman who is pregnant? - CORRECT
ANSWER -PCN is the safest drug to prescribe to pregnant women, augmentin in pregnant
women for UTI's, sulfonamides and penicillinase resistant PCN's should be avoided in late
pregnancy due to the displacement of billirubin from the plasma proteins of the newborn
causing new born canictaris (sp?)
, Amoxicillin, Ampicillin, Clindamycin, Erythromycin, and PCN
4. What patient teaching will you provide to a patient who is experiencing non-infectious
diarrhea related to antibiotic administration? - CORRECT ANSWER -Increase fluids, consume
plain yogurt, Donagel for second line therapy, and avoid anti-peristalsis agents that promote
the retention of toxins.
If diarrhea is severe notify prescriber, for mild diarrhea use a absorbent anti-diarrheal one
that contains Attapuligite (donnagel), avoid using antiperistaltic agents that can cause to
retain toxins, if diarrhea contains blood pus or mucous call prescriber.
5. According to the American College of Cardiology and the American Heart Association,
what are the guidelines related to prophylactic antibiotics prior to a dental appointment? -
CORRECT ANSWER -Prophylactic antibiotic therapy is for patients with prosthetic heart
valves, previous infected endocarditis, certain patients with congenital heart disease, cardiac
transplant with valve regurgitation with the dental procedures who have the manipulation
with gingival tissue. Pts with congenital heart disease require prophylaxis unrepaired
cyanotic congenital heart disease, completely repaired heart disease and with prosthetic
material require treatment in the first 6 months after repair, anyone out of the 6 month
repair range doesn't require prophylactic treatment.
PCN s, if allergic: zithromycin or clarithromycin single dose of 500mg for adults or 15mg/kg
for children 1 hour before.
6. A patient is taking a fluoroquinolone; what are the most serious adverse effects? -
CORRECT ANSWER -Fatal hypersensitivity reaction, Steven Johnson syndrome, and other
adverse effects, psudomembrenous colitis and black box warning of tendon rupture.
Tendon rupture, very dangerous drug to give, reactions with first dose, steven-johnson
syndrome, hypersensitivity reactions (anaphylaxis), pseudomembrenous colitis (c.diff),
photosensitivity or photo toxicity (especially with lomefloxacin and sparfloxcin), and
dizziness.
