NUR 334- PHARM EXAM QUESTIONS AND ANSWERS A
+ GRADED
what drug class does gentamicin belong to?
Aminoglycosides
What is the indicated use of aminoglycosides?
- Treat severe infections of the abdomen and urinary tract, hospital acquired
pneumonia, bacteremia, and endocarditis
- serious gram-negative bacterial infections and infections caused by staphylococci
when penicillins or other less toxic drugs are contraindicated
Which antibiotics inhibit protein synthesis?
tetracyclines, macrolides, aminoglycosides
what are the pharmacokinetics of gentamicin?
- absorption: well absorbed IM and IV
- distribution: widely distributed in extracellular fluid, cross placenta, small amount
enters breast milk, poor penetration into CSF
- metabolism and excretion: >90% renal
- half life: 2-4 hr or longer in renal impairment
What drugs fall into the aminoglycoside drug class?
gentamicin, streptomycin, amikacin, neomycin, trobramicin
What are the most common side effects and adverse effects of aminoglycosides
(symptoms associated)?
- ototoxicity: ringing in the ears
- anemia: fatigue, feeling cold, dizziness, pallor
- thrombocytopenia: excessive bruising, petechiae, excessive bleeding
- nephrotoxicity: oliguria, edema, hypertension
What is oliguria?
-Less than 500 cc of urine in 24 hours
-low urine output
What is the concern when a patient is experiencing oliguria?
- impaired renal function possibly due to nephrotoxicity of a med or illness
- can alter the electrolyte balance and fluid balance of the body resulting in
hypo/hypernatremia or hypo/hyperkalemia
What is a broad spectrum antibiotic?
A drug effective against a wide variety of microbial species
when would a narrow spectrum antibiotic be used?
- used for the specific infection when the causative organism is known.
- They will not kill as many of the normal micro organisms in the body as the broad
spectrum antibiotics
What are the common side effects of penicillins?
n/v/d, epigastric distress, pain at IM injection site, phlebitis at IV site, rash
what are the serious adverse reactions associated with penicillin?
CDAD (C. diff diarrhea), hypersensitivity reactions, steven-johnson disease
What two antibiotic classes are people frequently allergic to both of if they have a
known allergy to one?
, penicillins and cephalosporins
What are penicillins used to treat?
strep throat, otitis media, sinusitis, cystitis, and syphilis
what should a nurse do if the peak level of a medication is too high?
monitor for signs of toxicity, give extra fluids and prescribed diuretic to encourage
excretion of excess drug through the kidneys
what is a culture and sensitivity test?
Process of growing isolated organisms and identifying the most effective antibiotic for
treatment
When would a culture and sensitivity test be done?
it is performed when there is an infection that is not responding to broad spectrum
antibiotics and the specific microbe needs to be identified
what is the most commonly prescribes fluoroquinolone?
ciprofloxacin
What are the weird adverse reaction associated with ciprofloxacin?
tendon rupture
What side effect of ciprofloxacin should we know?
photosensitivity
What are some nursing considerations for ciprofloxacin?
reacts with warfarin, should be avoided in pregnancy, don't take with iron, milk, or
antacids
What is the common indicated use for fluoroquinolones?
UTI by gram negative bacteria
What color do gram negative bacteria stain?
pink
what are the signs of superinfection?
fever, perineal itching/pruritis (uti or candida overgrowth), cough (thrush), lethargy,
unusual discharge
which type of bacteria (gram negative or gram positive) is more difficult to kill?
why?
Gram-negative
because they have a hard, protective outer shell
How long should IV acyclovir be infused over?
over 1 hour to prevent kidney damage
what type of drug is zidovudine? indicated use?
- Nucleoside reverse transcriptase inhibitor (NRTI)= ANTIRETROVIRAL
- used to treat HIV; inhibits viral replication which lowers the viral load
what is the first line treatment for UTIs?
bactrim (trimethoprim-sulfamethoxazole)
what is the first step after discovering a med error?
assess the patient!
What are some side effects of tetracyclines?
- Discoloration of child's teeth and skeletal defects if taken by pregnant women or
children who don't have all their adult teeth yet
- photosensitivity and esophagitis
Nursing considerations for tetracyclines
+ GRADED
what drug class does gentamicin belong to?
Aminoglycosides
What is the indicated use of aminoglycosides?
- Treat severe infections of the abdomen and urinary tract, hospital acquired
pneumonia, bacteremia, and endocarditis
- serious gram-negative bacterial infections and infections caused by staphylococci
when penicillins or other less toxic drugs are contraindicated
Which antibiotics inhibit protein synthesis?
tetracyclines, macrolides, aminoglycosides
what are the pharmacokinetics of gentamicin?
- absorption: well absorbed IM and IV
- distribution: widely distributed in extracellular fluid, cross placenta, small amount
enters breast milk, poor penetration into CSF
- metabolism and excretion: >90% renal
- half life: 2-4 hr or longer in renal impairment
What drugs fall into the aminoglycoside drug class?
gentamicin, streptomycin, amikacin, neomycin, trobramicin
What are the most common side effects and adverse effects of aminoglycosides
(symptoms associated)?
- ototoxicity: ringing in the ears
- anemia: fatigue, feeling cold, dizziness, pallor
- thrombocytopenia: excessive bruising, petechiae, excessive bleeding
- nephrotoxicity: oliguria, edema, hypertension
What is oliguria?
-Less than 500 cc of urine in 24 hours
-low urine output
What is the concern when a patient is experiencing oliguria?
- impaired renal function possibly due to nephrotoxicity of a med or illness
- can alter the electrolyte balance and fluid balance of the body resulting in
hypo/hypernatremia or hypo/hyperkalemia
What is a broad spectrum antibiotic?
A drug effective against a wide variety of microbial species
when would a narrow spectrum antibiotic be used?
- used for the specific infection when the causative organism is known.
- They will not kill as many of the normal micro organisms in the body as the broad
spectrum antibiotics
What are the common side effects of penicillins?
n/v/d, epigastric distress, pain at IM injection site, phlebitis at IV site, rash
what are the serious adverse reactions associated with penicillin?
CDAD (C. diff diarrhea), hypersensitivity reactions, steven-johnson disease
What two antibiotic classes are people frequently allergic to both of if they have a
known allergy to one?
, penicillins and cephalosporins
What are penicillins used to treat?
strep throat, otitis media, sinusitis, cystitis, and syphilis
what should a nurse do if the peak level of a medication is too high?
monitor for signs of toxicity, give extra fluids and prescribed diuretic to encourage
excretion of excess drug through the kidneys
what is a culture and sensitivity test?
Process of growing isolated organisms and identifying the most effective antibiotic for
treatment
When would a culture and sensitivity test be done?
it is performed when there is an infection that is not responding to broad spectrum
antibiotics and the specific microbe needs to be identified
what is the most commonly prescribes fluoroquinolone?
ciprofloxacin
What are the weird adverse reaction associated with ciprofloxacin?
tendon rupture
What side effect of ciprofloxacin should we know?
photosensitivity
What are some nursing considerations for ciprofloxacin?
reacts with warfarin, should be avoided in pregnancy, don't take with iron, milk, or
antacids
What is the common indicated use for fluoroquinolones?
UTI by gram negative bacteria
What color do gram negative bacteria stain?
pink
what are the signs of superinfection?
fever, perineal itching/pruritis (uti or candida overgrowth), cough (thrush), lethargy,
unusual discharge
which type of bacteria (gram negative or gram positive) is more difficult to kill?
why?
Gram-negative
because they have a hard, protective outer shell
How long should IV acyclovir be infused over?
over 1 hour to prevent kidney damage
what type of drug is zidovudine? indicated use?
- Nucleoside reverse transcriptase inhibitor (NRTI)= ANTIRETROVIRAL
- used to treat HIV; inhibits viral replication which lowers the viral load
what is the first line treatment for UTIs?
bactrim (trimethoprim-sulfamethoxazole)
what is the first step after discovering a med error?
assess the patient!
What are some side effects of tetracyclines?
- Discoloration of child's teeth and skeletal defects if taken by pregnant women or
children who don't have all their adult teeth yet
- photosensitivity and esophagitis
Nursing considerations for tetracyclines
