MARYVILLE 615 PHARM EXAM 3 QUESTIONS AND
DETAILED VERIFIED ANSWERS /GRADED A+
/GUARANTEED PASS
1. What factors will place the patient at risk for antibiotic resistance?
- 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?
- 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?
- 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?
- 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?
- 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?
- 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.
DETAILED VERIFIED ANSWERS /GRADED A+
/GUARANTEED PASS
1. What factors will place the patient at risk for antibiotic resistance?
- 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?
- 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?
- 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?
- 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?
- 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?
- 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.
