NRSG 245: Pharmacology Final Exam
Questions And 100% Correct Answers.
describe the mechanism of action of penicillins - Answer -weakens the cell wall of bacteria
undergoing growth and division, causing the bacteria to take up excessive water and rupture
-bactericidal: kills bacteria
penicillin can be inactivated by the bacterial enzyme: - Answer beta-lactamase: cleave the
beta-lactam ring
what is the most common cause of drug allergy? - Answer penicillins
what is anaphylaxis? - Answer immediate hypersensitivity reaction characterized by laryngeal
edema, bronchoconstriction, and severe hypotension
what is the primary form of treatment for anaphylaxis? - Answer epinephrine and respiratory
support
how long must a patient be observed after a penicillin injection? - Answer 30 minutes
describe bacterial resistance for cephalosporins (ceftriaxone) - Answer -all cephalosporins
contain the beta-lactam ring for antibacterial activity
-some generations of cephalosporins are susceptible to the enzyme beta-lactamase
name the therapeutic uses of third generation cephalosporins (ceftriaxone) - Answer -broad
spectrum
-drug of choice for meningitis, nosocomial infections caused by gram-negative bacilli resistant to
earlier generation cephalosporin
-neisseria gonorrhoeae
all cephalosporins are eliminated renally except: - Answer ceftriaxone: eliminated hepatically
name the drug interactions of cephalosporin (ceftriaxone) - Answer -probenecid
,name the adverse effects of cephalosporins (ceftriaxone) - Answer -allergic reaction: mild rash
to severe anaphylaxis (should not be given to patients with history of severe reactions to
penicillin)
-bleeding
-GI discomfort: can be reduced by taking medication with food
describe the mechanism of action of vancomycin - Answer -inhibits cell wall synthesis and
promotes bacterial lysis
-bactericidal: kills bacteria
penicillin G is not stable in stomach acid and therefore must be given - Answer parenterally
penicillin V is stable in stomach acid and therefore may be given - Answer orally and taken
with meals
are penicillins broad or narrow spectrum? - Answer narrow: most non-penicillinase-producing
gram positive-bacteria (streptococcus species), gram negative cocci (neisseria species), anerobic
bacteria, and spirochetes (treponema pallidum - sphyilis)
name the adverse effects of penicillins - Answer -allergy
-pain at the site of injection (prolonged but reversible)
-sensory and motor dysfunction - if injected into a peripheral nerve
-neurotoxicity (if blood levels are too high)
which penicillins can only be given IM? - Answer -procaine penicillin G
-benzathine penicillin G
name the drug interactions of penicillins - Answer aminoglycosides (ex. gentamicin): good
interaction, but the two medications must be kept separate in the bloodstream
if a patient has a history of mild allergic reaction to penicillin, what action should be taken? -
Answer consult provider to consider cephalosporin
if a patient has a history of anaphylaxis from penicillins, what actions should be taken? - Answer
, name and describe the 2 forms of broad spectrum penicillin - Answer -ampicillin: same
antimicrobial spectrum as PCN G with increased activity against certain gram-negative bacilli (H.
influenza, E. coli, salmonella)
-amoxicillin: same as ampicillin, but more acid stable and less diarrhea
--both can be inactivated by beta-lactamase
describe a penicillin allergy - Answer anaphylaxis: immediate hypersensitivity reaction
characterized by laryngeal edema, bronchoconstriction, and severe hypotension
what is the primary treatment for anaphylaxis resulting from penicillin? - Answer epinephrine
and respiratory support
how long should patients be observed for after a penicillin injection? - Answer at least 30
minutes
describe the mechanism of action of cephalosporin - Answer -bind to penicillin-binding
proteins (PBPs), disrupt cell wall synthesis, and cause cell lysis
-most effective against cells undergoing active growth and division
-bactericidal: kill bacteria
vancomycin is used to treat ___ infections - Answer severe
name the adverse effects of vancomycin - Answer -renal failure (nephrotoxicity)
-thrombophlebitis
-ototoxicity: rare usually reversible
-histamine reaction: when infused too rapidly, avoided by infusing slowly
describe the symptoms of a histamine reaction - Answer flushing, rash, pruritis, urticaria,
tachycardia, hypotension
describe the mechanism of action of tetracyclines - Answer -suppresses bacteria growth by
inhibiting protein synthesis at the 30s ribosomal subunit
-bacteriostatic: slow bacterial growth
Questions And 100% Correct Answers.
describe the mechanism of action of penicillins - Answer -weakens the cell wall of bacteria
undergoing growth and division, causing the bacteria to take up excessive water and rupture
-bactericidal: kills bacteria
penicillin can be inactivated by the bacterial enzyme: - Answer beta-lactamase: cleave the
beta-lactam ring
what is the most common cause of drug allergy? - Answer penicillins
what is anaphylaxis? - Answer immediate hypersensitivity reaction characterized by laryngeal
edema, bronchoconstriction, and severe hypotension
what is the primary form of treatment for anaphylaxis? - Answer epinephrine and respiratory
support
how long must a patient be observed after a penicillin injection? - Answer 30 minutes
describe bacterial resistance for cephalosporins (ceftriaxone) - Answer -all cephalosporins
contain the beta-lactam ring for antibacterial activity
-some generations of cephalosporins are susceptible to the enzyme beta-lactamase
name the therapeutic uses of third generation cephalosporins (ceftriaxone) - Answer -broad
spectrum
-drug of choice for meningitis, nosocomial infections caused by gram-negative bacilli resistant to
earlier generation cephalosporin
-neisseria gonorrhoeae
all cephalosporins are eliminated renally except: - Answer ceftriaxone: eliminated hepatically
name the drug interactions of cephalosporin (ceftriaxone) - Answer -probenecid
,name the adverse effects of cephalosporins (ceftriaxone) - Answer -allergic reaction: mild rash
to severe anaphylaxis (should not be given to patients with history of severe reactions to
penicillin)
-bleeding
-GI discomfort: can be reduced by taking medication with food
describe the mechanism of action of vancomycin - Answer -inhibits cell wall synthesis and
promotes bacterial lysis
-bactericidal: kills bacteria
penicillin G is not stable in stomach acid and therefore must be given - Answer parenterally
penicillin V is stable in stomach acid and therefore may be given - Answer orally and taken
with meals
are penicillins broad or narrow spectrum? - Answer narrow: most non-penicillinase-producing
gram positive-bacteria (streptococcus species), gram negative cocci (neisseria species), anerobic
bacteria, and spirochetes (treponema pallidum - sphyilis)
name the adverse effects of penicillins - Answer -allergy
-pain at the site of injection (prolonged but reversible)
-sensory and motor dysfunction - if injected into a peripheral nerve
-neurotoxicity (if blood levels are too high)
which penicillins can only be given IM? - Answer -procaine penicillin G
-benzathine penicillin G
name the drug interactions of penicillins - Answer aminoglycosides (ex. gentamicin): good
interaction, but the two medications must be kept separate in the bloodstream
if a patient has a history of mild allergic reaction to penicillin, what action should be taken? -
Answer consult provider to consider cephalosporin
if a patient has a history of anaphylaxis from penicillins, what actions should be taken? - Answer
, name and describe the 2 forms of broad spectrum penicillin - Answer -ampicillin: same
antimicrobial spectrum as PCN G with increased activity against certain gram-negative bacilli (H.
influenza, E. coli, salmonella)
-amoxicillin: same as ampicillin, but more acid stable and less diarrhea
--both can be inactivated by beta-lactamase
describe a penicillin allergy - Answer anaphylaxis: immediate hypersensitivity reaction
characterized by laryngeal edema, bronchoconstriction, and severe hypotension
what is the primary treatment for anaphylaxis resulting from penicillin? - Answer epinephrine
and respiratory support
how long should patients be observed for after a penicillin injection? - Answer at least 30
minutes
describe the mechanism of action of cephalosporin - Answer -bind to penicillin-binding
proteins (PBPs), disrupt cell wall synthesis, and cause cell lysis
-most effective against cells undergoing active growth and division
-bactericidal: kill bacteria
vancomycin is used to treat ___ infections - Answer severe
name the adverse effects of vancomycin - Answer -renal failure (nephrotoxicity)
-thrombophlebitis
-ototoxicity: rare usually reversible
-histamine reaction: when infused too rapidly, avoided by infusing slowly
describe the symptoms of a histamine reaction - Answer flushing, rash, pruritis, urticaria,
tachycardia, hypotension
describe the mechanism of action of tetracyclines - Answer -suppresses bacteria growth by
inhibiting protein synthesis at the 30s ribosomal subunit
-bacteriostatic: slow bacterial growth
