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NR 293 Pharm-Exam 1
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NR 293 Pharm-Exam 1 NR 293 Pharm-Exam 1 NR 293 Pharm-Exam 1
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NR 293 Pharm-Exam 1 StudyWhat are the more common categories of antibiotic types?
(Mnemonic: Some People Can Make Quick Angry Tatertots) - ANS Sulfonamides, penicillins,
cephalosporins, macrolides, quinolones, aminoglycosides, tetracyclines.
(Text, pg 604)
What are the 4 most common mechanisms of antibiotic action? - ANS 1). Interference with bacterial
wall synthesis
2). Interference with protein synthesis
3). Interference with replication of nucleic acids
4). Antimetabolite action that disrupts critical metabolic reactions inside the cell
(Text, pg 604)
What should be taken prior to the administration of an antibiotic if possible? - ANS A culture (blood,
sputum, wound, etc.)
-A broad spectrum antibiotic can then be administered following the sample collection (empiric
therapy) until the culture is grown, and can identify the strain of bacterial infection. The antibiotic
can then be switched to a different type that is more specific to the treatment of that particular
infection strain (definitive therapy).
(PP Slide 13)
What is meant by the term "Empiric therapy" in regards to antibiotic therapy? - ANS Treatment of an
infection before specific culture information has been reported or obtained.
(PP Slide 13)
What is meant by "Definitive therapy" in regards to antibiotic therapy? - ANS Antibiotic therapy
tailored to treat organism identified with cultures
(PP Slide 13)
What is meant by "Prophylactic therapy" in regards to antibiotic treatment? - ANS Treatment with
antibiotics to prevent an infection such as those received before and after surgeries and traumatic
injuries.
,What is a therapeutic response to antibiotic therapy? What are some indications of this? - ANS It
means the antibiotic is working correctly. This is indicated by decreases in specific s/s of the noted
infection (fever decreasing, elevated WBC counts returning to normal levels, resolution of redness,
inflammation decrease, drainage cessation, pain reduction)
What is a subtherapeutic response? - ANS S/S of the infection do not improve with antibiotic therapy
What is a superinfection? - ANS This can occur as a result of an antibiotic dropping the levels of the
normal flora, or killing them completely. When these are killed off, other non-normative body flora
begin to grow and cause an infection. (Ex: a vaginal yeast infection)
What is Pseudomembranous colitis? - ANS This is a type of superinfection that tends to have a higher
level of severity. It is better known as Clostridium Difficile, or commonly C. Diff.
-This is brought on by the elimination of normal gut flora which is then replaced by the C.Diff
bacteria.
- The most common s/s is watery foul smelling diarrhea occurring frequently, fever, abdominal pain
and cramping.
What is a secondary infection? - ANS A type of superinfection as well. It occurs when a second
infection closely follows the initial infection, and comes from an external source.
What is meant by "host-factors" in regards to antibiotic therapy? - ANS Important factors that
pertain to the patient specifically. Examples can include age, history, allergies, pregnancy, kidney and
liver function, site of infection, host defense mechanisms (immunocompromisation)
Drugs that cause developmental abnormalities in the fetus of a pregnant woman taking them are
known as what? - ANS Teratogens
Some patients have certain genetic abnormalities that result in various enzyme deficiencies. Name
two of the more common ones. - ANS -Glucose-6-phosphate dehydrogenase (G6PD)
-Slow acetylation
Explain slow acetylation - ANS These type of patients have a physiologic makeup that causes certain
drugs to be metabolized more slowly than usual in a chemical step known as acetylation. This can
lead to toxicity from drug accumulation.
, Explain what may occur if a person is administered antibiotics such as sulfonamides, nitrofurantoin,
or dapsone to a person with G6PD? - ANS Hemolysis (destruction of red blood cells)
Sulfonamides are one of the first drugs used as antibiotics. Although there are many compounds in
this family, only one of them is commonly used in clinical practice. What is it? - ANS
Sulfamethoxazole combined with trimethoprim.
-Commonly known as Bactrim, Septra, or co-trimoxazole. Often abbreviated as SMZ-TMP. It is also
commonly combined with erythromycin (macrolide) for pediatric patients.
-Sulfasalazine is another form which is used to treat ulcerative colitis and RA, but not as an
antibiotic.
What is the mechanism of action of Sulfonamides? - ANS They are bacteriostatic. This means they
don't actually kill the bacteria, but rather inhibit their growth.
-They do this by preventing the bacteria from Folic acid synthesis, which is required for proper
synthesis of purines, one of the chemical components of DNA and RNA.
Are sulfonamides a broad or narrow spectrum antibiotic? - ANS They are broad spectrum and act
against both gram-positive and gram-negative organisms.
What organ is responsible for the elimination of sulfonamide antibiotics? - ANS The Kidneys
-They also tend to have high concentrations in the kidneys, and are therefore often used in the
treatment of UTIs (via Sulfamethoxazole/Trimethoprim)
What are some sulfonamide susceptible organisms or strains of enterobacter species? - ANS -E. Coli
(think UTI)
-Klebsiella spp.
-Proteus mirabilis
-Proteus vulgaris
-Staph aureus
What are two infections that can be treated with Sulfonamides? - ANS -UTI
-Upper respiratory
SMX-TMP is commonly used to treat what? - ANS Outpatient Staphylococcus infections
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