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Nurs 6521N Advanced Pharmacology test 1 exam with complete solutions 2024_2025.
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Nurs 6521N Advanced Pharmacology test 1 exam with complete solutions 2024_2025.
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Nurs 6521N Advanced Pharmacology test1 exam with complete solutions 2024/2025
Beta lactamase inhibitors - ANSWER-Clavulanic acid, sulbactam, tazobactam
Unasyn - ANSWER-Ampicillin and sulbactam
Augmentin - ANSWER-Amoxicillin clavulanic acid
Hapten - ANSWER-Drug +plasma protein severe allergic reaction
Mechanisms resistance to beta lactamase - ANSWER-Inactivation by beta
lactamase, mutation trans peptidase target, impaired penetration of drug into
organism, drug effluent pumps
MRSA - ANSWER-Resistant organisms produce PBPs with decreased affinity for
binding beta lactam antibiotics
Impaired penetration of drug into organosm - ANSWER-Absence of porins or
down regulation of porins or porins smaller
Drug efflux pumps - ANSWER-Nonspecific, spit out whatever bacteria doesn't
need, major mechanism MDR
,Prevention of resistance steains - ANSWER-Testing, choose right antibiotic,
complete course therapy, don't use antibiotic when not indicated
Mutidrug resistant organisms - ANSWER-Organisms that are resistant to 1 or
more class of organisms. Drug efflux pumps
Penicillin - ANSWER-Bactericidal
Penicillin adverse effects - ANSWER-GI distress, oral/vaginal candidiasis, rash,
anaphylaxis
Cephalosporins - ANSWER-More stable against beta lactamases, increased range
activity
1st generation cephalosporin - ANSWER-Cefazolin, cephalexin
G+, susceptible beta lactamase
2,3 generations cephalosporins - ANSWER-Broader spectrum,
Increase resistance beta lactamase, increase half life, some cross BBB
4,5 generations cephalosporins - ANSWER-Cefepine, excellent resistance most
beta lactamase, excellent CNS penetration, ceftaroline against MRSA
Adverse reactions cephalosporins - ANSWER-Hypersensitivity, fever, skin
rashes, nephritis, granulocytopenia, hemolytic anemia, anorexia
Cefotetan - ANSWER-Avoid ETOH! Disulfiram like reaction with this
cephalosporins
Treatment for C diff from broad spectrum cephalosporin - ANSWER-Vancomycin,
metrondiszole
, Example monobactam - ANSWER-Aztreonam
IV or IM
Active against G neg only
Tolerated by PCN allergic patiemts
Example carbapenem - ANSWER-Imipenem, IV or IM only
Widest spectrum of any beta lactam, must prescribe with cilastin to inhibit first
pass elimination by renal enzyme dehydropeptidase, low crossreactivity for
PCNs. Good for meningitis, peritonitis in really sick patients
Vancomycin - ANSWER-Cell wall inhibitor but not beta lactam, glycopeptide
structure, best treatment for MRSA and G+. Only use Italy to treat antibiotic
induced colitis, C. difficile and staph entericolitis
Must monitor peak and trough, poorly absorbed po
Vancomyicin - ANSWER-Bacterocidal for G +
Vancomycin - ANSWER-Poor oral bioavailability, 90% GFR eliminated, if renal
impairments can have accumulation.
Vancomycin Adverse Effect - ANSWER-Ototoxicity if given with aminoglycoside!!
Tissue irritation at injection site, chill and fever
Red man syndrome - ANSWER-Vancomycin if Tate of infusion too fast. Histamine
release, hypotension, flush, skin rash. Prevent by 1-2 hr infusion or pretreat with
antihistamine
Advantages vancomycin - ANSWER-Not susceptible to beta lactamase, no PCN
allergy
Classes of protein synthesis inhibitors - ANSWER-Tetracycline, macrolides,
oxazolidinones and aminoglycosides
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