Georgia College & State University Pharmacology Final
Review Part 1 Questions With Complete Solutions
In addition to having mental health side effects (disorientation,
agitation, memory issues, delirium) and risk of hypoglycemic
coma, what cardiovascular adverse effects are possible and in
what populations should they not be used?
risk of ruptured aorta; avoid in elderly, smokers, HTN, PAD,
Marfans
The FDA says the adverse effects of fluoroquinolones outweigh
the benefits of their use in acute sinusitis, acute bronchitis, and
uncomplicated UTIs. What major GI and systemic adverse
effects can be caused by fluoroquinolones?
bacterial or fungal superinfections and pseudomembranous
colitis
Nuzyra (omadacycline) was FDA approved in a non-inferiorty
trial for community acquired bacterial pneumonia (CABP),
acute bacterial skin and skin structure infections. What is the
major adverse effect of this medication and what are the
symptoms?
intercranial hypertension (pseudotumor cerebri); HA, blurred
vision, papilledema (holds for all tetracycline forms)
Fanconi Syndrome, the result of taking an expired dose of
tetracycline, affects the proximal tubules of the kidney and the
GI system. What symptoms would the provider see?
,polyuria (protein and sugar no longer being taken up by
kidenys), acidosis from leaking bicarb out of urine, and N/V
Tetracyclines should be used with caution in kidney and liver
impairment. It should not be used in pregnancy, lactation, or
children younger than 8 years old. Why?
stains the teeth
What education should be provided to a female patient on oral
birth control who is prescribed tetracycline?
use alternative birth control method while taking the medication;
baby time
Photosensitivity is a huge problem with tetracyclines. In
addition to that, minocycline can have vestibular effects, causing
dizziness. In what population would that be concerning?
in the elderly, due to falls
What is the treatment of choice for Trichomonas Vaginalis?
flagyl (Metronidazole)
Flagyl (metronidazole) has a black box warning for carcinogenic
risk in mice/rats and is not for use in the first trimester of
pregnancy. If you have to give it in pregnancy, what is the dose?
2 gm x 1 dose
Flagyl (metronidazole) must be used with caution in GI
disorders, and kidney and liver disease. In what illness is this
medication contraindicated and why?
myasthenia gravis because of neuromuscular effects
,Flagyl (metronidazole) is generally well tolerated if alcohol is
avoided while taking it. What can happen of alcohol isn't
avoided?
disulfiram reaction; flushing, palpitations, N/V
While vancomycin is no longer considered nephrotoxic if given
alone, what other toxicity can it have and therefore caution must
be used if other meds cause the same problem?
ototoxicity
Adverse reactions to vancomycin include hives, dizziness, rash,
chills, and fever. A major adverse reaction can result from IV
dosing that leads to pruritus, flushing of the head and neck,
hypotension, fainting, tachycardia, N/V, and chills/fever. What
is this adverse reaction, and what is the cause?
Redman Syndrome; histamine mediated phenomena related to
the rate of IV infusion
Because silver sulfadiazine is a sulfa derivative, it must be used
with caution in pregnancy, those less than 2 months old, G6PD,
and sulfur allergy. What part of the body should not have this
applied and why?
the face; skin discoloration can occur
Rifapentine and rifampin turn all secretions red. In addition to
causing neutropenia, leukopenia, and thrombocytopenia, what
other side effects do the TB medications cause?
liver problems (elevations in AST/ALT and jaundice), severe
abd pain, and painful/swollen joints
, All patients starting antitubercular drugs need labs prior to
starting and periodically during treatment (LFTs, BUN/Cr/uric
acid, CBC). What three things is the provider worrying about?
liver, pancytopenia, and gout
Pyrazinamide (PZA) can lead to hepatoxicity and
hyperuricemia. Caution must be used with other medications
that can increase uric acid levels. In addition to LFTs, what
other monitoring would be important while on this medication?
baseline and periodic uric acid levels
Isoniazid induces, inhibits, and is a substrate with weak
serotonin effects but enough to lower the seizure threshold. In
addition to having an MAOI-like reaction, what other side effect
does this medication have and what should the provider do?
peripheral neuropathy; give vitamin B6
The black box warning for isoniazid is for fatal hepatitis that
may occur starting in first 1-3 months, with an increased risk for
women, especially if Black or Hispanic. LFTs need to be drawn
at baseline and monthly, especially if over 35. What education
would the provider give the patient?
must teach signs of hepatitis- jaundice, rash, myalgia, GI
complaints
What must be avoided if a patient is taking isoniazid?
daily alcohol
Review Part 1 Questions With Complete Solutions
In addition to having mental health side effects (disorientation,
agitation, memory issues, delirium) and risk of hypoglycemic
coma, what cardiovascular adverse effects are possible and in
what populations should they not be used?
risk of ruptured aorta; avoid in elderly, smokers, HTN, PAD,
Marfans
The FDA says the adverse effects of fluoroquinolones outweigh
the benefits of their use in acute sinusitis, acute bronchitis, and
uncomplicated UTIs. What major GI and systemic adverse
effects can be caused by fluoroquinolones?
bacterial or fungal superinfections and pseudomembranous
colitis
Nuzyra (omadacycline) was FDA approved in a non-inferiorty
trial for community acquired bacterial pneumonia (CABP),
acute bacterial skin and skin structure infections. What is the
major adverse effect of this medication and what are the
symptoms?
intercranial hypertension (pseudotumor cerebri); HA, blurred
vision, papilledema (holds for all tetracycline forms)
Fanconi Syndrome, the result of taking an expired dose of
tetracycline, affects the proximal tubules of the kidney and the
GI system. What symptoms would the provider see?
,polyuria (protein and sugar no longer being taken up by
kidenys), acidosis from leaking bicarb out of urine, and N/V
Tetracyclines should be used with caution in kidney and liver
impairment. It should not be used in pregnancy, lactation, or
children younger than 8 years old. Why?
stains the teeth
What education should be provided to a female patient on oral
birth control who is prescribed tetracycline?
use alternative birth control method while taking the medication;
baby time
Photosensitivity is a huge problem with tetracyclines. In
addition to that, minocycline can have vestibular effects, causing
dizziness. In what population would that be concerning?
in the elderly, due to falls
What is the treatment of choice for Trichomonas Vaginalis?
flagyl (Metronidazole)
Flagyl (metronidazole) has a black box warning for carcinogenic
risk in mice/rats and is not for use in the first trimester of
pregnancy. If you have to give it in pregnancy, what is the dose?
2 gm x 1 dose
Flagyl (metronidazole) must be used with caution in GI
disorders, and kidney and liver disease. In what illness is this
medication contraindicated and why?
myasthenia gravis because of neuromuscular effects
,Flagyl (metronidazole) is generally well tolerated if alcohol is
avoided while taking it. What can happen of alcohol isn't
avoided?
disulfiram reaction; flushing, palpitations, N/V
While vancomycin is no longer considered nephrotoxic if given
alone, what other toxicity can it have and therefore caution must
be used if other meds cause the same problem?
ototoxicity
Adverse reactions to vancomycin include hives, dizziness, rash,
chills, and fever. A major adverse reaction can result from IV
dosing that leads to pruritus, flushing of the head and neck,
hypotension, fainting, tachycardia, N/V, and chills/fever. What
is this adverse reaction, and what is the cause?
Redman Syndrome; histamine mediated phenomena related to
the rate of IV infusion
Because silver sulfadiazine is a sulfa derivative, it must be used
with caution in pregnancy, those less than 2 months old, G6PD,
and sulfur allergy. What part of the body should not have this
applied and why?
the face; skin discoloration can occur
Rifapentine and rifampin turn all secretions red. In addition to
causing neutropenia, leukopenia, and thrombocytopenia, what
other side effects do the TB medications cause?
liver problems (elevations in AST/ALT and jaundice), severe
abd pain, and painful/swollen joints
, All patients starting antitubercular drugs need labs prior to
starting and periodically during treatment (LFTs, BUN/Cr/uric
acid, CBC). What three things is the provider worrying about?
liver, pancytopenia, and gout
Pyrazinamide (PZA) can lead to hepatoxicity and
hyperuricemia. Caution must be used with other medications
that can increase uric acid levels. In addition to LFTs, what
other monitoring would be important while on this medication?
baseline and periodic uric acid levels
Isoniazid induces, inhibits, and is a substrate with weak
serotonin effects but enough to lower the seizure threshold. In
addition to having an MAOI-like reaction, what other side effect
does this medication have and what should the provider do?
peripheral neuropathy; give vitamin B6
The black box warning for isoniazid is for fatal hepatitis that
may occur starting in first 1-3 months, with an increased risk for
women, especially if Black or Hispanic. LFTs need to be drawn
at baseline and monthly, especially if over 35. What education
would the provider give the patient?
must teach signs of hepatitis- jaundice, rash, myalgia, GI
complaints
What must be avoided if a patient is taking isoniazid?
daily alcohol
