NURS 8024 Pharm Exam 3 (Antimicrobial Part 2) –
Questions With Solutions (A+)
Bacterial protein synthesis inhibitors Right Ans - Clindamycin
Clindamycin Right Ans - Time dependent killing
Inhibits protein synthesis
Bacteriostatic
90% bioavailability
Clindamycin mechanism of resistance Right Ans - Altered target sites
Active efflux (pushes drug out of the cell)
Clindamycin ADE Right Ans - GI upset
Skin rash
Neutropenia
Superinfections such a c diff pseudomembranous
- don't use if patient has history of c diff
Clindamycin indications Right Ans - Gram positive
Prophylaxis of endocarditis in valve patients with PCN allergy
Oxazolidinones Right Ans - New class of bacterial protein synthesis
inhibitors
Time dependent killing
Prevents formation of ribosome complex
Bacteriostatic & Bactericidal against strep
Linezolid Right Ans - Protein synthesis inhibitor
100% bioavailability orally
30% CSF penetration
Linezolid ADE Right Ans - Hematologic
Increased thrombocytopenia risk
Anemia, neutropenia, neuropathy
Optic & peripheral neuropathy
Serotonin syndrome with SSRIs
, Linezolid Indications Right Ans - Gram positive resistant
VRE, HCAP, CAP
Complicated skin & tissue infections
Off label use for TB
No resistance currently
Fluoroquinolones Right Ans - Norfloxacin (1st gen)
Ciprofloxacin & Ofloxacin (2nd gen)
Levofloxacin (3rd gen)
Moxifloxacin & Gemifloxacin (3rd gen respiratory)
Fluoroquinolones are classified by Right Ans - Generations according to
antimicrobial spectra
1st Generation Fluoroquinolone Right Ans - Narrow gram negative
Norfloxacin
2nd Generation Fluoroquinolone Right Ans - Broad- gram negative and
gram positive
Cipro & ofloxacin
3rd generation Fluoroquinolone Right Ans - More gram positive than gram
negative
Levofloxacin
Moxifloxacin
Gemifloxacin
-moxi and gemi are respiratory Fluoroquinolones
Fluoroquinolones MOA Right Ans - Inhibits DNA synthesis
Bactericidal
Concentration dependent killing
Resistance- target sites altered by mutation & change in sensitivity of target
enzymes
Fluoroquinolone ADE Right Ans - GI upset, rash, abnormal LFTs
Prolonged QTc
Tendinitis and tendon rupture (caution in pregnancy)
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