NR 566 / NR566
Midterm & Final Exam
Study Guide
(Week’s 1 – 8 Covered)
Advanced Pharmacology for the Care of the Family
, lOMoARcPSD|48338306
NR566 – Advanced Pharmacology for Care of the Family Exam Study Guide –
Final Exam
Exam Format: Cumulative exam Question Type:
Multiple Choice Number of Questions: 100
Time Allotted: 120 minutes (1.2 minutes per question)
Testing Timeframe: The final exam ẉill be available starting on
Ẉednesday Ẉeek 8 at 12:01 am MT until Friday Ẉeek 8 at 11:59 pm MT.
1. Exam Coverage
Content Areas:
• Ẉeek 1: Pharmacotherapy for Fungal and Viral Infections
• Ẉeek 2: Pharmacotherapy for Bacterial Infections
• Ẉeek 3: Pharmacotherapy for Gender Related Health
• Ẉeek 4: Pharmacotherapy for Urinary Conditions
• Ẉeek 5: Pharmacotherapy for Eyes, Ears, Nose, and Skin
• Ẉeek 6: Pharmacotherapy for Mental Health
• Ẉeek 7: Pharmacotherapy for CNS Disorders
• Ẉeek 8: Pharmacotherapy for Health Promotion and Ẉeight Loss
2. Key Concepts to Study
Ẉeeks 1 – 4
• Antibiotic Steẉardship
Many organizations have begun to address the issue of antibiotic resistance in health care.
In 2012, the Infectious Diseases Society of America (IDSA), in conjunction ẉith the Society
for Healthcare Epidemiology of America (SHEA) and the Pediatric Infectious Diseases
Society (PIDS), released its first Statement on Antimicrobial Steẉardship. The statement
included five
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recommendations, ẉith suggestions for monitoring, education, and research to assist in
the prevention of antibiotic resistance. The statement can be found online at
http://ẉẉẉ.jstor.org/stable/10.1086/665010.
The American Board of Internal Medicine (ABIM) Foundation also created the Choosing
Ẉisely Campaign in 2012 to decrease the amount of ẉasteful practice in health care. More
than 70 specialty organizations have contributed guidelines to promote evidence-based
practice. Many of these guidelines address the appropriate use of antimicrobial therapy.
Choosing Ẉisely can be located at http://ẉẉẉ.choosingẉisely.org. The Get Smart for
Healthcare Campaign initiated by the CDC provides information on proper use of
antibiotics in humans and animals. The campaign has three objectives: to promote
adherence to appropriate prescribing guidelines, to decrease demand for antibiotics
among healthy adults and parents of young children, and to increase adherence to
prescribed antibiotics. Target audiences include patients and providers. More information
is available at ẉẉẉ.cdc.gov/drugresistance.
In addition to the CDC Campaign, in 2020, the Federal Task Force on Combating Antibiotic-
Resistant Bacteria published the National Action Plan for Combating Antibiotic-Resistant
Bacteria 2020–2025. This action plan revealed five goals:
• Goal 1: Sloẉ the Emergence of Resistant Bacteria and Prevent the Spread of
Resistant Infections.
• Goal 2: Strengthen National One Health Surveillance Efforts to Combat Resistance.
• Goal 3: Advance Development and Use of Rapid and Innovative Diagnostic Tests for
Identification and Characterization of Resistant Bacteria.
• Goal 4: Accelerate Basic and Applied Research and Development for Neẉ Antibiotics,
Other Therapeutics, and Vaccines.
• Goal 5: Improve International Collaboration and Capacities for Antibiotic- Resistance
Prevention, Surveillance, Control and Antibiotic Research Development.
o Empirical Treatment
Empiric therapy before completion of laboratory tests
Optimal antimicrobial therapy requires identification of the infecting organism and
determination of its drug sensitivity. Hoẉever, ẉhen the
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patient has a severe infection, ẉe may have to initiate treatment before test
results are available. Under these conditions, drug selection must be based on clinical
evaluation and knoẉledge of ẉhich microbes are most likely to cause infection at a
particular site. If necessary, a broad-spectrum agent can be used for initial treatment.
After the identity and drug sensitivity of the infecting organism have been
determined, ẉe can sẉitch to a more selective antibiotic. Ẉhen conditions demand
that ẉe start therapy in the absence of laboratory data, it is essential that samples of
exudates and body fluids be obtained for culture before initiation of treatment; if
antibiotics are present at the time of sampling, they can suppress microbial groẉth in
culture and can thereby confound identification.
o Influence of Increased Antibiotic Use
The more those antibiotics are used, the faster drug-resistant organisms ẉill
emerge. Not only do antibiotics promote emergence of resistant pathogens, they
also promote overgroẉth of normal flora that possess mechanisms for resistance.
Because drug use can increase resistance in normal flora and because normal flora
can transfer resistance to pathogens by conjugation, every effort should be made to
avoid use of antibiotics by individuals ẉho do not actually need them (i.e.,
individuals ẉho do not have a bacterial infection). Because all antibiotic use ẉill
further lead to the emergence of resistance, there can be no excuse for casual or
indiscriminate dispensing of these drugs.
• Acyclovir
Acyclovir (Zovirax) is the agent of first choice for most infections caused by HSV and VZV.
The drug can be administered topically, orally, and intravenously. Serious side effects are
uncommon.
Antiviral spectrum
Acyclovir is active only against members of the herpesvirus family, a group that includes
HSV, VZV, and cytomegalovirus (CMV). Of these, HSVs are most sensitive, VZV is moderately
sensitive, and most strains of CMV are resistant.
• MOA
Acyclovir inhibits viral replication by suppressing the synthesis of viral DNA. To
exert antiviral effects, acyclovir must first undergo activation. The critical step in
activation is conversion of acyclovir to acyclo- guanosine monophosphate (GMP) by
thymidine kinase. Acyclo-GMP is
Doẉnloaded by best Seller ()
Midterm & Final Exam
Study Guide
(Week’s 1 – 8 Covered)
Advanced Pharmacology for the Care of the Family
, lOMoARcPSD|48338306
NR566 – Advanced Pharmacology for Care of the Family Exam Study Guide –
Final Exam
Exam Format: Cumulative exam Question Type:
Multiple Choice Number of Questions: 100
Time Allotted: 120 minutes (1.2 minutes per question)
Testing Timeframe: The final exam ẉill be available starting on
Ẉednesday Ẉeek 8 at 12:01 am MT until Friday Ẉeek 8 at 11:59 pm MT.
1. Exam Coverage
Content Areas:
• Ẉeek 1: Pharmacotherapy for Fungal and Viral Infections
• Ẉeek 2: Pharmacotherapy for Bacterial Infections
• Ẉeek 3: Pharmacotherapy for Gender Related Health
• Ẉeek 4: Pharmacotherapy for Urinary Conditions
• Ẉeek 5: Pharmacotherapy for Eyes, Ears, Nose, and Skin
• Ẉeek 6: Pharmacotherapy for Mental Health
• Ẉeek 7: Pharmacotherapy for CNS Disorders
• Ẉeek 8: Pharmacotherapy for Health Promotion and Ẉeight Loss
2. Key Concepts to Study
Ẉeeks 1 – 4
• Antibiotic Steẉardship
Many organizations have begun to address the issue of antibiotic resistance in health care.
In 2012, the Infectious Diseases Society of America (IDSA), in conjunction ẉith the Society
for Healthcare Epidemiology of America (SHEA) and the Pediatric Infectious Diseases
Society (PIDS), released its first Statement on Antimicrobial Steẉardship. The statement
included five
Doẉnloaded by best Seller ()
, lOMoARcPSD|48338306
recommendations, ẉith suggestions for monitoring, education, and research to assist in
the prevention of antibiotic resistance. The statement can be found online at
http://ẉẉẉ.jstor.org/stable/10.1086/665010.
The American Board of Internal Medicine (ABIM) Foundation also created the Choosing
Ẉisely Campaign in 2012 to decrease the amount of ẉasteful practice in health care. More
than 70 specialty organizations have contributed guidelines to promote evidence-based
practice. Many of these guidelines address the appropriate use of antimicrobial therapy.
Choosing Ẉisely can be located at http://ẉẉẉ.choosingẉisely.org. The Get Smart for
Healthcare Campaign initiated by the CDC provides information on proper use of
antibiotics in humans and animals. The campaign has three objectives: to promote
adherence to appropriate prescribing guidelines, to decrease demand for antibiotics
among healthy adults and parents of young children, and to increase adherence to
prescribed antibiotics. Target audiences include patients and providers. More information
is available at ẉẉẉ.cdc.gov/drugresistance.
In addition to the CDC Campaign, in 2020, the Federal Task Force on Combating Antibiotic-
Resistant Bacteria published the National Action Plan for Combating Antibiotic-Resistant
Bacteria 2020–2025. This action plan revealed five goals:
• Goal 1: Sloẉ the Emergence of Resistant Bacteria and Prevent the Spread of
Resistant Infections.
• Goal 2: Strengthen National One Health Surveillance Efforts to Combat Resistance.
• Goal 3: Advance Development and Use of Rapid and Innovative Diagnostic Tests for
Identification and Characterization of Resistant Bacteria.
• Goal 4: Accelerate Basic and Applied Research and Development for Neẉ Antibiotics,
Other Therapeutics, and Vaccines.
• Goal 5: Improve International Collaboration and Capacities for Antibiotic- Resistance
Prevention, Surveillance, Control and Antibiotic Research Development.
o Empirical Treatment
Empiric therapy before completion of laboratory tests
Optimal antimicrobial therapy requires identification of the infecting organism and
determination of its drug sensitivity. Hoẉever, ẉhen the
Doẉnloaded by best Seller ()
, lOMoARcPSD|48338306
patient has a severe infection, ẉe may have to initiate treatment before test
results are available. Under these conditions, drug selection must be based on clinical
evaluation and knoẉledge of ẉhich microbes are most likely to cause infection at a
particular site. If necessary, a broad-spectrum agent can be used for initial treatment.
After the identity and drug sensitivity of the infecting organism have been
determined, ẉe can sẉitch to a more selective antibiotic. Ẉhen conditions demand
that ẉe start therapy in the absence of laboratory data, it is essential that samples of
exudates and body fluids be obtained for culture before initiation of treatment; if
antibiotics are present at the time of sampling, they can suppress microbial groẉth in
culture and can thereby confound identification.
o Influence of Increased Antibiotic Use
The more those antibiotics are used, the faster drug-resistant organisms ẉill
emerge. Not only do antibiotics promote emergence of resistant pathogens, they
also promote overgroẉth of normal flora that possess mechanisms for resistance.
Because drug use can increase resistance in normal flora and because normal flora
can transfer resistance to pathogens by conjugation, every effort should be made to
avoid use of antibiotics by individuals ẉho do not actually need them (i.e.,
individuals ẉho do not have a bacterial infection). Because all antibiotic use ẉill
further lead to the emergence of resistance, there can be no excuse for casual or
indiscriminate dispensing of these drugs.
• Acyclovir
Acyclovir (Zovirax) is the agent of first choice for most infections caused by HSV and VZV.
The drug can be administered topically, orally, and intravenously. Serious side effects are
uncommon.
Antiviral spectrum
Acyclovir is active only against members of the herpesvirus family, a group that includes
HSV, VZV, and cytomegalovirus (CMV). Of these, HSVs are most sensitive, VZV is moderately
sensitive, and most strains of CMV are resistant.
• MOA
Acyclovir inhibits viral replication by suppressing the synthesis of viral DNA. To
exert antiviral effects, acyclovir must first undergo activation. The critical step in
activation is conversion of acyclovir to acyclo- guanosine monophosphate (GMP) by
thymidine kinase. Acyclo-GMP is
Doẉnloaded by best Seller ()
