NR566 FINAL EXAM SCRIPT COMPLETE
QUESTIONS AND CORRECT ANSWERS
WITH ACCURATE RATIONALES GRADED
A+
⩥ Tetracycline MOA
Answer: -bacterial growth by inhibiting protein synthesis
-bind to the 30S ribosomal subunit and thereby inhibit binding of
transfer RNA to the messenger RNA-ribosome complex
⩥ What is doxycycline and minocycline used for?
Answer: periodontal disease
⩥ What education for doxycycline and minocycline should we give our
patients?
Answer: Avoid calcium/iron supplements, antacids, magnesium/milk
products as will chelate drug into nonabsorbable form
Adverse effects:
-irritate GI tract
-discolor teeth (avoid <8yrs old)
,-superinfection
-hepatic/renal toxicity
-sunburn easily
-diarrhea may indicate a potentially life-threatening -superinfection of
the bowel
-high-dose intravenous therapy has been associated with -severe liver
damage
⩥ Should tetracycline be renal dosed?
Answer: patients with kidney disease should not use these drugs
⩥ What medication when administered with tetracycline need close
blood level monitoring
Answer: -can increase digoxin levels through increasing absorption in
the GI tract
-increase international normalized ratio (INR) levels by altering the
vitamin K−producing flora in the gut
-patients on digoxin or warfarin should undergo careful drug level
monitoring
⩥ What are names of medications under Macrolids class?
Answer: azithromycin and clarithromycin—are derivatives of
erythromycin
,⩥ Erythromycin MOA
Answer: binds to the 50S ribosomal subunit and thereby blocks the
addition of new amino acids to the growing peptide chain
⩥ Which CYP450 enzyme is erythromycin metabolized by?
Answer: eliminated primarily by hepatic mechanisms, including
metabolism by CYP3A4
⩥ What is the most serious potential adverse effect of erythromycin?
Answer: sudden cardiac death from QT prolongation
⩥ Due to the inhibition of hepatic cytochrome P450 drug metabolizing
enzymes, which drugs have the potential for elevated blood levels when
taken with erythromycin?
Answer: -theophylline and warfarin
-shouldn't be combined with verapamil, diltiazem, HIV protease
inhibitors, and azole antifungal drugs
⩥ What can clindamycin promote that can be fatal?
Answer: severe C-diff, a condition that can be fatal
⩥ Clindamycin MOA
Answer: binds to the 50S subunit of bacterial ribosomes and thereby
inhibits protein synthesis
, ⩥ Clindamycin can be used as an alternative to what?
Answer: penicillin
⩥ What do we need to be aware of in our female patients of child
bearing age with clindamycin?
Answer: may decrease oral contraceptive activity
⩥ Clindamycin is the drug of choice for what infections?
Answer: -severe group A streptococcal infection
-gas gangrene
⩥ Linzeolidis active against what multi-drug resistant gram positive
pathogens?
Answer: vancomycin-resistant enterococci (VRE) and methicillin-
resistant Staphylococcus aureus (MRSA)
⩥ What are the serious potential adverse effects of Linzeolid?
Answer: -reversible myelosuppression
-manifesting as anemia
-leukopenia
-thrombocytopenia
-pancytopenia
QUESTIONS AND CORRECT ANSWERS
WITH ACCURATE RATIONALES GRADED
A+
⩥ Tetracycline MOA
Answer: -bacterial growth by inhibiting protein synthesis
-bind to the 30S ribosomal subunit and thereby inhibit binding of
transfer RNA to the messenger RNA-ribosome complex
⩥ What is doxycycline and minocycline used for?
Answer: periodontal disease
⩥ What education for doxycycline and minocycline should we give our
patients?
Answer: Avoid calcium/iron supplements, antacids, magnesium/milk
products as will chelate drug into nonabsorbable form
Adverse effects:
-irritate GI tract
-discolor teeth (avoid <8yrs old)
,-superinfection
-hepatic/renal toxicity
-sunburn easily
-diarrhea may indicate a potentially life-threatening -superinfection of
the bowel
-high-dose intravenous therapy has been associated with -severe liver
damage
⩥ Should tetracycline be renal dosed?
Answer: patients with kidney disease should not use these drugs
⩥ What medication when administered with tetracycline need close
blood level monitoring
Answer: -can increase digoxin levels through increasing absorption in
the GI tract
-increase international normalized ratio (INR) levels by altering the
vitamin K−producing flora in the gut
-patients on digoxin or warfarin should undergo careful drug level
monitoring
⩥ What are names of medications under Macrolids class?
Answer: azithromycin and clarithromycin—are derivatives of
erythromycin
,⩥ Erythromycin MOA
Answer: binds to the 50S ribosomal subunit and thereby blocks the
addition of new amino acids to the growing peptide chain
⩥ Which CYP450 enzyme is erythromycin metabolized by?
Answer: eliminated primarily by hepatic mechanisms, including
metabolism by CYP3A4
⩥ What is the most serious potential adverse effect of erythromycin?
Answer: sudden cardiac death from QT prolongation
⩥ Due to the inhibition of hepatic cytochrome P450 drug metabolizing
enzymes, which drugs have the potential for elevated blood levels when
taken with erythromycin?
Answer: -theophylline and warfarin
-shouldn't be combined with verapamil, diltiazem, HIV protease
inhibitors, and azole antifungal drugs
⩥ What can clindamycin promote that can be fatal?
Answer: severe C-diff, a condition that can be fatal
⩥ Clindamycin MOA
Answer: binds to the 50S subunit of bacterial ribosomes and thereby
inhibits protein synthesis
, ⩥ Clindamycin can be used as an alternative to what?
Answer: penicillin
⩥ What do we need to be aware of in our female patients of child
bearing age with clindamycin?
Answer: may decrease oral contraceptive activity
⩥ Clindamycin is the drug of choice for what infections?
Answer: -severe group A streptococcal infection
-gas gangrene
⩥ Linzeolidis active against what multi-drug resistant gram positive
pathogens?
Answer: vancomycin-resistant enterococci (VRE) and methicillin-
resistant Staphylococcus aureus (MRSA)
⩥ What are the serious potential adverse effects of Linzeolid?
Answer: -reversible myelosuppression
-manifesting as anemia
-leukopenia
-thrombocytopenia
-pancytopenia
