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Pharm Lecture 1 - Heme/Onc

Total questions: 61

Worksheet time: 37mins

Name
Class
Date
1.

What other antibiotics have good oral bioavailability?

a)

Azithromycin

b)

Levofloxacin

c)

TMP/SMX

d)

Vancomycin

e)

Clindamycin

2.

What other drug classes also cause photosensitivity?

a)

Penicillins

b)

Clindamycin

c)

Fluoroquinolones

d)

Macrolides

e)

Metronidazole

3.

What other medication requires evaluation of serum drug levels to ensure the drugs is in a safe "therapeutic range"?

a)

Daptomycin

b)

Trimethroprim/Sulfamethoxazole

c)

Azithromycin

d)

Vancomycin

e)

Oritavancin

4.

Doxycycline is associated with which adverse effect?

a)

Cardiac arrhythmias

b)

Ototoxicity

c)

Photosensitivity

d)

New onset seizures

5.

Review Q! Which other antimicrobials were also associated with photosensitvity?

a)

TMP/SMX

b)

Ciprofloxacin

c)

Ampicillin

d)

Vancomycin

e)

Metronidazole

6.

Identify all drug classes that contains 1 or more agents that can be used to treat MRSA when given orally.

a)

Tetracyclines

b)

Lincosamides (clindamycin)

c)

Oxazolidinones

d)

Sulfa antimicrobials

e)

Fluoroquinolones

7.

What is the mechanism of action for doxycycline?

a)

Damage to DNA via creation of free radicals leading to cell death

b)

Bind to ribosomes preventing protein synthesis

c)

Inhibit cross-linking of peptidoglycan in the cell wall causing autolysis

d)

Inhibition of folate synthesis

8.

The pharmacodynamic properties of tobramycin are ________ and ________

a)

time dependent

b)

concentration dependent

c)

AUC/MIC dependent

d)

bacteriostatic

e)

bactericidal

9.

Similar to vancomycin, aminoglycosides also required therapeutic drug monitoring with serum drug levels collected at specific time points.

a)

True

b)

False

10.

Why should aminoglycosides be avoided in pregnancy?

a)

Neural tube defects

b)

Tooth and bone abnormalities

c)

In utero ear or kidney damage

d)

Hemolytic anemia

11.

What test is required for toxicity monitoring in patients receiving aminoglycosides?

a)

Creatine kinase (CK)

b)

EKG

c)

Serum creatinine (SCr)

d)

Platelets

12.

Aminoglycosides are used in combination therapy with ______ for treatment of gram-negative and gram-positive infections.

a)

fluoroquinolones

b)

macrolides

c)

beta-lactams

d)

sulfa antimicrobials

13.

Review Q! There is only 1 antibacterial that should be used clinically on its own (no combo therapy) for treatment of both MRSA and Pseudomonas. Which one?

a)

TMP/SMX

b)

Clindamycin

c)

Doxycycline

d)

Delafloxacin

e)

Azithromycin

14.

Aminoglycosides

a)

Doxycycline

b)

Minocycline

c)

Gentamicin

d)

Tobramycin

e)

Amikacin

15.

2nd generation Tetracyclines

a)

Doxycycline

b)

Minocycline

c)

Gentamicin

d)

Tobramycin

e)

Amikacin

16.

Route of administration for Doxycycline

a)

PO

b)

IV

c)

Syrup

d)

Inhaled

17.

Route of administration for Gentamicin and Amikacin

a)

PO

b)

IV

c)

Syrup

d)

Inhaled

18.

Route of administration for Tobramycin

a)

PO

b)

IV

c)

Syrup

d)

Inhaled

19.

Route of administration for Minocycline

a)

PO

b)

IV

c)

Syrup

d)

Inhaled

20.

Route of administration for Tetracycline (the drug)

a)

PO

b)

IV

c)

Syrup

d)

Inhaled

21.

The pharmacodynamic properties of tetracyclines are ________ and ________

a)

time dependent

b)

concentration dependent

c)

AUC/MIC dependent

d)

bacteriostatic

e)

bactericidal

22.

Which drug class was commonly used in agriculture in the 2000s and lead to an increase in antimicrobial resistance in human infections?

a)

Tetracyclines

b)

Aminoglycosides

23.

Pregnancy/Lactation concern for fetal abnormalities --> teeth and bone abnormalities

a)

Tetracyclines

b)

Aminoglycosides

24.

Children/Neonates concern in less than 8 years old due to tooth discoloration

a)

Tetracyclines

b)

Aminoglycosides

25.

Pregnancy/lactation concern for fetal harm --> kidneys and ears

a)

Tetracyclines

b)

Aminoglycosides

26.

Elderly concern for nephrotoxicity

a)

Tetracyclines

b)

Aminoglycosides

27.

Doxycycline and Minocycline gram pos coverage:

a)

MSSA

b)

MRSA

c)

Strep sp

d)

Enterococcus Faecalis

e)

Coagulase neg staph

28.

Doxycycline and Minocycline gram neg coverage:

a)

enterobactericae

b)

acinetrobacter

c)

haemphilus influenzae

d)

morganella

e)

pseudomonas

29.

Doxycycline and Minocycline DOES NOT have coverage for:

a)

proteus

b)

providencia

c)

acinetrobacter

d)

morganella

e)

pseudomonas

30.

Tetracycline (the drug) does not have coverage for:

a)

MSSA

b)

MRSA

c)

Strep sp

d)

Enterococcus Faecalis

31.

Drug of choice for Rickettsia rickettsia (RMSF) and Borrelia burgdorferi (Lyme Disease):

a)

Doxycycline

b)

Minocycline

c)

Tetracycline (the drug)

d)

Tobramycin

e)

Amikacin

32.

Doxycycline is used to treat RMSF in children regardless of tooth discoloration concern.

a)

True

b)

False

33.

Common adverse effects in Doxycycline and Minocycline

a)

photosensitvity

b)

tooth discoloration

c)

GI

d)

esophagitis

e)

hepatotoxicity

34.

Rare, but potentially serious, adverse effects in Doxycycline and Minocycline

a)

hepatologic abnormalities

b)

acute pancreatitis

c)

intracranial HTN

d)

Fanconi syndrome

e)

skin pigmentation

35.

Fanconi syndrome is a rare, but serious, adverse effect and is defined as:

a)

severe HA and visual disturbances

b)

potentially fatal renal tubular failure

c)

highly toxic to kidneys

d)

hearing loss, vertigo

36.

When does Fanconi syndrome occur?

a)

with expired medications, in tetracyclines (and especially in tetracycline the drug)

b)

without drug level monitoring, in tetracyclines (and especially in tetracycline the drug)

c)

with expired medications, in aminoglycosides (and especially tobramycin)

d)

without drug level monitoring in aminoglycosides (and especially tobramycin)

37.

Top 200 drug

a)

Doxycycline

b)

Minocycline

c)

Gentamicin

d)

Tobramycin

e)

Amikacin

38.

Tetracyclines

a)

hepatic metabolism, but no drug interactions

b)

hepatic metabolism, but many drug interactions

c)

renal metabolism, but no drug interactions

d)

renal metabolism, but many drug interactions

39.

How can someone avoid esophagitis in tetracyclines?

a)

Take with food

b)

Take with full glass of water

40.

Tetracyclines

a)

mostly fecal/bile excretion

b)

100% renal excretion

41.

IV aminoglycosides

a)

mostly fecal/bile excretion

b)

100% renal excretion

42.

Which drug class has a potent post-abx effect?

a)

Tetracyclines

b)

IV Aminoglycosides

43.

Which drug class has excellent body fluid distribution?

a)

Tetracyclines

b)

IV Aminoglycosides

44.

Adverse effects of IV Aminoglycosides include:

a)

nephrotoxicity

b)

otoxicity

c)

hepatoxicity

d)

Fanconi syndrome

e)

hypersensitivity

45.

Bioterroism alternative to Ciprofloxacin

a)

Doxycycline

b)

Minocycline

c)

Tetracycline (the drug)

d)

Tobramycin

e)

Amikacin

46.

Rhinosinusitis, preferred over oral cephalosporin

a)

Doxycycline

b)

Minocycline

c)

Tetracycline (the drug)

d)

Tobramycin

e)

Amikacin

47.

MRSA, oral agent option for skin and bone infections

a)

Doxycycline

b)

Minocycline

c)

Tetracycline (the drug)

d)

Tobramycin

e)

Amikacin

48.

Pneumonia, 2nd line for atypical coverage

a)

Doxycycline

b)

Minocycline

c)

Tetracycline (the drug)

d)

Tobramycin

e)

Amikacin

49.

Nephrotoxicity adverse effect in IV aminoglycosides is (select all that apply):

a)

highly toxic to kidneys

b)

needs drug level monitoring

c)

reversible and preventable

d)

often irreversible

e)

hearing loss and vertigo

50.

Otoxicity adverse effect in IV aminoglycosides is (select all that apply):

a)

highly toxic to kidneys

b)

needs drug level monitoring

c)

reversible and preventable

d)

often irreversible

e)

hearing loss and vertigo

51.

Gram negative coverage for IV Aminoglycosides includes:

a)

enterobacteriaceae

b)

pseudomonas

c)

acinetrobacter

d)

Haemophilus influenzae

52.

Which IV Aminoglycosides are best for Gram negative coverage?

a)

Tobramycin

b)

Amikacin

c)

Gentamicin

53.

Which IV Aminoglycosides can only be used for Gram positive coverage?

a)

Tobramycin

b)

Amikacin

c)

Gentamicin

54.

IV Aminoglycoside gram negative coverage requires...

a)

IV combo therapy

b)

synergy with beta-lactams or vanco

55.

IV Aminoglycoside gram positive coverage requires...

a)

IV combo therapy

b)

synergy with beta-lactams or vanco

56.

Gram positive coverage for IV Aminoglycosides includes:

a)

streptococcus

b)

enterococcus

c)

MSSA

d)

MRSA

57.

Doxycycline and Minocycline coverage also includes:

a)

Protozoa

b)

Spirochetes

c)

Anaerobes

d)

Atypicals

e)

None of the above

58.

IV Aminoglycosides coverage also includes:

a)

Protozoa

b)

Spirochetes

c)

Anaerobes

d)

Atypicals

e)

None of the above

59.

Which aminoglycoside can be used in Cystic Fibrosis and ventilator patients?

[Aminoglycosides: non-systemic clinical uses]

a)

Tobramycin

b)

Amikacin

c)

Kanamycin

d)

Neomycin

60.

Which aminoglycoside can be used for wound irrigation?

[Aminoglycosides: non-systemic clinical uses]

a)

Tobramycin

b)

Amikacin

c)

Kanamycin

d)

Neomycin

61.

Which aminoglycoside can be used for cream and ointments?

[Aminoglycosides: non-systemic clinical uses]

a)

Tobramycin

b)

Amikacin

c)

Kanamycin

d)

Neomycin

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