Pharmacology (Chapter 17/TEST REVIEW)

Contraindications of penicillin?

History of serious allergy (*anaphylaxis,* hives). Administration of antihistamines with penicillin will not prevent hypersensitivity reactions.

Medication is no longer effective against a particular organism

Resistance

Interactions of macrolides?

Warfarin (may prolong *prothrombin time* and *bleeding*) Can cause abnormal, potentially fatal, cardiac arrhythmias when combined with calcium channel blockers, antiarrhythmic agents, antifungals, and quinolones

*Quinolones* are *contraindicated* for patients with: a. cardiac disease b. blood dyscrasias c. hearing loss d. allergies to penicillin

a. cardiac disease

Which of the following medications would NOT be classified as an *antiviral?* a. Ayclovir b. Rifampin c. Valtrex d. Tamiflu

b. Rifampin

Which of the following *contraindications* or warnings is appropriate for *tetracycylines?* a. avoid use in patients with seizure disorders b. avoid exposure to direct sunlight c. not for use in patients with urinary obstruction d. not for use in diabetics or asthmatics

b. avoid exposure to direct *sunlight*

*Side effects*related to the use of *tetracyclines* include nausea, vomiting, and diarrhea in addition to which of the following signs and/or symptoms? a. abdominal pain, colitis, crystalluria, and phototoxicity b. discolored teeth and retarded bone growth in fetus or young children c. blood dyscrasias and hepatic toxicity with jaundice d. lower extremity weakness

b. discolored teeth and retarded bone growth in fetus or young children

Which of the following *side effects* occur in MOST patients, at least to some degree, who are receiving *amphotericin B?* a. hepatic abnormalities b. nephrotoxicity c. photosensitivity d. hypokalemia

b. nephrotoxicity

Side effects of clindamycin?

nausea, vomiting, *diarrhea*, and colitis rash, pruritis, fever, and occasionally anyaphylaxis local effects

Antibiotic that is effective against a large variety of organisms

*Broad*-spectrum

Interactions of cephalosporins?

*Disulfiram-like* reactions (flushing, tachycardia, shock) with *alcohol* ingestion and cefotetan

Interactions of aminoglycosides?

*Interferes* with other ototoxic drugs. General anesthetics or neuromuscular blocking agents (can cause respiratory paralysis). Antiemetics (may mask symptoms of ototoxicity)

Side effects of Metronidazole (Flagyl)?

*Metallic* taste Dark urine (common but harmless) Avoid alcohol during and 48 hours after treatment

Side effects of Nystatin?

*RARE* but may occasionally include nausea, vomiting, diarrhea with high oral doses.

What is the most significant side effect of Ribavirin?

*Respiratory* complications Hypotension and cardiac arrest

If you get a hypersensitivity reaction, what should you do?

*Stop* the drug!

A new infection as a result of killing the normal flora

*Super*infection

Interactions of tetracyclines?

*antacids, calcium supplements, or magnesium laxatives *iron preparations *dairy products *oral contraceptives

Test to identify the causative organism and the specific medication to which it is sensitive

Culture and Sensitivity

Side effects of sulfonamides?

Are numerous and sometimes *serious,* especially in AIDS patients Hypersensitivity reaction (can be *fatal*) Renal damage with crystalluria and hematuria Blood dyscrasias Hepatic toxicity with jaundice

(T or F) Antiviral agents do not have a problem with resistance; resistance only occurs with antibiotics

False

(T or F) Streptomycin should always be administered intravenously

False

(Tor F) Severe side effects are usually rare when administering amphotericin B

False

Ribaviran is a drug with the broadest spectrum of antiviral activity. It is used via nasal or oral inhalation. Because of the potential risk of the medication being "in the air" who should avoid contact with infants or young children receiving this medication?

Health care practitioners and visitors who are *pregnant* or lactating.

An infection as a result of a weakened immune system

Opportunistic infections

Side effects of *cephalosporins?*

Hypersensitivity, anaphylaxis (especially in those allergic to penicillin) Abnormal bleeding.

Contraindications of cephalosporins?

Known allergies, especially to PENICILLIN. Prolonged use leading to superinfections or severe colitis (Clostridium difficile/C.Diff.)

Side effects of quinolones?

Possible *cartilage or tendon damage* Phototoxicity Crystalluria

Side effects of *macrolides?*

Side effects are rare but, common *GI* side effects are to be expected.

Contraindications of aminoglycosides?

Tinnitus, vertigo, and high-frequency hearing loss

(T or F) Resistance to drugs may develop when they have been used too frequently

True

Tamiflu and Relenza are indicated for the treatment of uncomplicated acute illness due to influenza types A and B. When should they be taken?

Within 48 hours of the onset of the symptoms

*Side effects* of the *aminoglycosides* MOST LIKELY include which of the following signs and/or symptoms? a. nephrotoxicity, ototoxicity b. blood dyscrasias c. anorexia, abdominal cramps d. superinfections

a. nephrotoxicity, ototoxicity

A life-threatening *interaction* of *quinolones* may occur when administered with: a. theophylline b. Ca, Mg, Fe, Zn c. sucralfate d. antacids

a. theophylline

Which of the following *side effects* are related to the use of *isoniazid (INH) and *rifampin (Rifadin)?* a. weakness of extremities, hepatic toxicity, and *red-orange colored excretions* b. optic neuritis, dermatitis, pruritis, and joint pain c. gout and GI disturbances d. ototoxicity and nephrotoxicity

a. weakness of extremities, hepatic toxicity, and *red-orange colored excretions*

Patients taking antibiotics should be instructed to take medication: a. with a full glass of water on an empty stomach b. with fruit juice c. with antacids if stomach irritation occurs d. only until symptoms disappear

a. with a full glass of water on an empty stomach

Which of the following *contraindications* most likely refer to the use of *macrolide* a. tinnitus and reduced renal function b. known allergies to penicillins; pregnant or nursing women c. alcoholism and hypertension d. high-frequency hearing loss

c. *alcoholism* and hypertension

**Side effects* of *pyrazinamide (PZA)* can include: a. red-orange colored excretions b. optic neuritis, malaise, fever, and confusion c. *hepatic* toxicity, hypersensitivity, and GI disturbances d. ototoxicity and nephrotoxicity

c. hepatic toxicity, hypersensitivity, and GI disturbances

Which of the following class of *antibiotics* is considered to be *LEAST* toxic? a. penicillins b. aminoglycosides c. macrolides d. cephalosporins

c. macrolides

*Sulfonamides* should be used cautiously or not at all in patients with: a. a history of AIDS b. urinary tract infections c. multiple allergies d. toxoplasmosis

c. multiple *allergies*

*Side effects* of *vancomycin* may include: a. colitis, rash, pruritis, and occasional anaphylaxis b. abdominal pain, nausea, vomiting, anorexia, metallic taste, and dark urine c. ototoxicity, nephrotoxicity, and *pseudomembranous colitis* d. impaired renal function, lethargy, tremors, and photosensitivity

c. ototoxicity, nephrotoxicity, and *pseudomembranous colitis*

*Contraindications* for use of *vancomycin* include: a. GI, hepatic, or renal disease b. history of blood dyscrasia c. pregnancy and lactation d. renal disease and dehydration

c. pregnancy and lactation

Considerations for patients who are receiving *ribavirin* include: a. avoiding its use in patients with seizure and cardiovascular disorders b. not for use in patients with asthma and COPD c. preventing patient's exposure to pregnant and lactating patients d. none of the above

c. preventing patient's exposure to pregnant and lactating patients

*Side effects* of the *penicillins* MORE LIKELY include which of the following signs and/or symptoms? a. ototoxicity b. blood dyscrasias c. anorexia d. hypersensitivity reactions and superinfections

d. hypersensitivity reactions and superinfections

*Acyclovir* is *contraindicated* in which of the following patient populations? a. hepatic disease b. alcoholics and pregnant women c. older adults d. nursing mothers

d. nursing mothers

*Side effects* of *streptomycin* can include: a. numbness, weakness of extremities, and red-orange colored excretions b. optic neuritis, confusion, and joint pain c. hepatic toxicity, hypersensitivity, and GI disturbances d. ototoxicity and nephrotoxicity

d. ototoxicity and nephrotoxicity