NR-566 Advanced Pharmacology for Care of the Family
Midterm Exam
Which patient diagnosed with a urinary tract infection should be hospitalized and prescribed intravenous antibiotics?
Correct Answer:
An older adult man with a low-grade fever, flank pain and an indwelling catheter
An older adult patient with a history of chronic obstructive pulmonary disease (COPD) develops bronchitis. The patient has a temperature of 39.5°C. What action will the provider initially take to assure effective care for this patient?
Correct Answer:
Order an empiric antibiotic while waiting for sputum culture results
When is penicillin not safe to use during pregnancy?
Correct Answer:
During second and third trimester
- / 3
When is it safe to use penicillins during lactation? which drug?
Correct Answer:
amoxicillin
Description: Gram-negative bacillus
Antimicrobial Resistance: Beta-lactamase productionEffective antimicrobials
- those with activity against gram-negative organisms and stable in the
presence of or active against beta-lactamase - Cephalosporins, amoxicillin- clavulanate (Augmentin®), macrolides, respiratory fluoroquinolones [moxifloxacin(Avelox®), levofloxacin (Levaquin®)], tetracyclines including doxycycline
Comments: Common respiratory pathogen with tobacco -related lung disease
Correct Answer:
- Influenza
What are penicillins used for in infants? think disease.
Correct Answer:
Syphilis Meningitis Group A strep
- / 3
Description: Not revealed by gram stain
Antimicrobial Resistance:• Effective antimicrobials - Macrolides, respiratory
fluoroquinolones, tetracyclines including doxycycline• Ineffective antimicrobials - Beta-lactams (cephalosporins and amoxicillin)
Comments: Mostly cough transmitted, often seen in people who have
recently spent extended time in proximity (closed communities-correctional facilities, college dormitories, long-term care facilities)
Correct Answer:
- Pneumoniae
C Pneumoniae
Description: Gram-positive diplococci
Antimicrobial Resistance: Altered protein binding sites in bacterial cell•
Drug-resistant S. pneumoniae (DRSP) factors - recent systemic antimicrobial use (within the past 3-months), age >/= 65 years, alcohol abuse, medical comorbidities, immunosuppressive therapy, or illness • Effective antimicrobials for non-resistant S. pneumoniae Macrolides (azithro, clarithro, erythromycin), standard-dose amoxicillin (1.5-2.5 grams/day), select cephalosporins, tetracyclines including doxycycline• Macrolide use potentially associated with prolonged QT and increased risk for cardiovascular death during use, particularly those with the highest cardiovascular risk. • Preferred antimicrobials for risk of DRSP - high dose amoxicillin (3-4 grams/day), respiratory fluoroquinolones [(moxifloxacin (Avelox®), levofloxacin (Levaquin®)] • Fluoroquinolone use is associated with tendon rupture ri
Correct Answer:
- Pneumoniae
- / 3