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WorksheetsPharm Final Quiz 4 (Antimicrobial Agents)
Total questions: 105
Worksheet time: 53mins
About ___% of antibiotic prescriptions in 2020 were unnecessary.
30
10
50
70
Older adults and malnourished patients have less resistance to infection.
True
False
What is a potential consequence of overusing anti-infective agents?
Drug resistance
Improved immunity
Faster recovery from all diseases
Decreased risk of infection
Antibacterial agents can either kill bacteria or inhibit bacterial growth.
True
False
Bacteriostatic drugs:
A) Kill bacteria
B) Inhibit bacterial growth
C) Both A and B
D) None of the above
Bactericidal drugs:
A) Kill bacteria
B) Inhibit bacterial growth
C) Both A and B
D) None of the above
Depending on dose, drugs may have both bacteriostatic and bactericidal effects.
True
False
Narrow spectrum antibiotics are primarily effective against ___ type of organism.
one
all
multiple
unknown
Broad spectrum antibiotics are effective against a wide variety of microbes.
True
False
Fill in the blank: Superinfections are common with _______ spectrum antibiotics.
broad
narrow
extended
limited
Which of the following is a common cause of superinfections?
Narrow spectrum antibiotics
Broad spectrum antibiotics
Antivirals
Vaccines
Fill in the blank: Natural flora of the body is _______ by broad spectrum antibiotics.
destroyed
increased
protected
stimulated
Which of the following is NOT a common bacterial superinfection?
A) Yeast infections
B) Clostridium Difficile Colitis
C) Influenza
D) Both A and B
Fill in the blank: Severe cases of Clostridium Difficile Colitis are treated with PO antibiotics such as _______ or vancomycin or FMT.
metronidazole
amoxicillin
azithromycin
ceftriaxone
To prevent superinfections, patients should ingest ________, yogurt, or probiotics.
buttermilk
orange juice
soda
potato chips
Overuse and inappropriate use of antibiotics _______ the emergence of antibiotic resistance.
exacerbates
prevents
delays
eliminates
Which of the following is recommended for effective infection treatment?
Treat contamination, not infection
Target specific pathogens
Avoid selecting correct medications
Ignore infectious disease experts
The use of the strongest agents, such as vancomycin, should be limited to a last resort because:
overuse can lead to antibiotic resistance
they are less effective than weaker agents
they are the cheapest option available
they are always the first line of treatment
Fill in the blank: C&S testing can be done to determine ________.
sensitivity
temperature
pressure
color
When bacteria is 'sensitive' to a drug, what happens to the organism?
The organism is killed or inhibited by the drug.
The organism becomes stronger.
The organism is unaffected by the drug.
The organism multiplies rapidly.
Which of the following is NOT a method to prevent transmission of infection?
Hygiene and isolation precautions
Vaccinations
Limiting invasive devices
Using contaminated samples
Penicillins are effective against which type of bacteria?
Only gram-negative
Most gram-positive and some gram-negative
Only broad spectrum
Only gram-positive
Most gram-negative and some gram-positive
Penicillins/PCNs have a ____ risk of toxicity.
High
Moderate
Low
Unknown
What is the reported incidence of penicillin allergy in the US population?
1-2%
5-10%
15-20%
25-30%
The real incidence of penicillin allergy is likely much ______ than reported.
lower
higher
longer
shorter
Which of the following is NOT an example of a penicillin?
Penicillin G
Amoxicillin
Dicloxacillin
Cephalexin
Methicillin is ________ marketed in the USA.
no longer
widely
recently
commonly
Which of the following statements about resistance to penicillins is correct?
Resistance is rare
Resistance is common
Resistance is never seen
Resistance is only seen in viruses
Staphylococcus aureus is an example of a bacteria that is no longer resistant to which penicillin?
Amoxicillin
Methicillin
Penicillin V
Dicloxacillin
All penicillins, except ________, are absorbed better on an empty stomach.
amoxicillin
penicillin G
cloxacillin
ampicillin
Which penicillin produces a higher rate of adverse GI effects than other penicillins?
Amoxicillin
Ampicillin
Penicillin G
Dicloxacillin
Which antibiotic class is the most commonly used?
Macrolides
Cephalosporins
Penicillins
Tetracyclines
Which statement describes cephalosporins the best?
Broad spectrum, easy administration, safe and effective even at high doses, minimal adverse effects.
Narrow spectrum, high toxicity, frequent dosing required, many drug interactions.
Only effective against viruses, require complex administration, high risk of allergic reactions.
Limited to topical use, ineffective at high doses, cause severe side effects.
Cephalosporins are given for 90% of surgeries prior to incision for what purpose?
Surgical infection prophylaxis
Pain management
Anesthesia induction
Blood clot prevention
The higher the generation number of cephalosporins, the broader the spectrum and the more likely it is to reach cerebrospinal fluid (CSF).
True
False
What percentage of persons allergic to penicillins are also allergic to cephalosporins?
1-8%
10-20%
20-30%
30-50%
If a patient has an anaphylactic history with penicillins, what should be done when administering cephalosporins?
Do trial microdosing instead of full dosage at once.
Administer the full dose immediately.
Ignore the allergy history and proceed as usual.
Switch to a higher generation cephalosporin.
Switch to a different antibiotic class.
Why are superinfections common with cephalosporins?
Due to their broad spectrum nature.
Because they are always given with steroids.
Because they are only effective against viruses.
Because they suppress the immune system directly.
Which of the following is the oldest macrolide antibiotic? (This would be REALLY mean if she put this on the final)
Azithromycin
Clarithromycin
Erythromycin
Penicillin
Macrolides are frequently prescribed if the patient has an allergy to which of the following?
Cephalosporins
Penicillins
Tetracyclines
Sulfa drugs
Erythromycin should be taken with _______.
food
water only
an empty stomach
milk
Azithromycin should be taken 1 hour before or 2 hours after _______.
meals
exercise
sleep
medication
Clarithromycin rarely causes GI side effects and may be taken with or without food.
True
False
Which macrolide antibiotics are considered more expensive?
Erythromycin
Azithromycin and Clarithromycin
Penicillin
Amoxicillin
What serious infection can macrolides cause?
Clostridium Difficile
Pneumocystis Pneumonia
Tuberculosis
Hepatitis B
Azithromycin (Z-Pak) is typically given once daily for how many days?
2-3 days
4-5 days
7-10 days
14 days
The new formulation of azithromycin (Zmax) can be taken in a single dose of _______.
2g
500mg
1g
250mg
Azithromycin is ridiculously over-prescribed, leading to common _______.
resistance
addiction
allergy
deficiency
Which of the following is NOT an example of a fluoroquinolone antibiotic?
Ciprofloxacin
Levofloxacin
Doxycycline
Delafloxacin
Fluoroquinolones are often used for which of the following conditions?
Mild infections
UTIs and pyelonephritis
Viral infections
Fungal infections
Fill in the blank: Fluoroquinolones should NOT be considered first-line treatment for ______ infections.
mild
severe
nosocomial
complicated
Which property is true about fluoroquinolones?
Narrow spectrum
Bacteriostatic
Potent antibiotics
Used for viral infections
Which of the following is NOT an example of a tetracycline antibiotic?
Tetracycline
Doxycycline
Minocycline
Levofloxacin
Fill in the blank: Tetracyclines are known for having one of the ______ spectrums of any class of antibiotics.
broadest
narrowest
weakest
shortest
Which statement is true about tetracyclines?
They are bactericidal
They are bacteriostatic
They are only used for viral infections
They have a narrow spectrum
Fill in the blank: ________ are the drug of choice for Rickettsial diseases (rocky mountain spotted fever, ticks, mites, lice, infected animals).
Tetracyclines
Penicillins
Cephalosporins
Macrolides
Fill in the blank: Tetracyclines are the drug of choice for Chlamydia and ________.
cholera
tuberculosis
influenza
malaria
Fill in the blank: Tetracyclines are the drug of choice for peptic ulcers caused by ________.
Helicobacter Pylori
Escherichia coli
Streptococcus pneumoniae
Staphylococcus aureus
Fill in the blank: Tetracyclines are the drug of choice for acne when used ________ and PO.
topically
intravenously
subcutaneously
rectally
Which of the following is a side effect of tetracyclines?
Photosensitivity
Hypertension
Hyperglycemia
Bradycardia
Tetracyclines are contraindicated in children less than 8 years old due to the risk of irreversible discoloration of permanent teeth.
True
False
Fill in the blank: Tetracyclines MUST be taken on an ________ stomach (EXCEPT doxycycline or minocycline).
empty
full
crowded
heavy
Fill in the blank: Tetracyclines should NOT be given with milk, calcium, antacids, or ________ containing drugs.
iron
potassium
magnesium
zinc
Which minerals bind with tetracyclines and block their absorption?
Calcium and iron
Sodium and potassium
Magnesium and zinc
Copper and selenium
Aminoglycosides are narrow spectrum antibiotics used to treat ______ bacteria.
gram-negative
gram-positive
anaerobic
acid-fast
Which of the following is NOT an example of an aminoglycoside?
Gentamycin
Amikacin
Tobramycin
Penicillin
Aminoglycosides are primarily given by which routes due to poor absorption in the GI tract?
IM or IV
Oral
Subcutaneous
Topical
Why is careful drug dosing important for aminoglycosides?
Because they have a narrow therapeutic window.
Because they are always given orally.
Because they are not absorbed in the intestines.
Because they are used to treat viral infections.
What is the first sign of ototoxicity caused by aminoglycosides?
Tinnitus
Vertigo
Hearing loss
Nausea
Ototoxicity caused by aminoglycosides is largely reversible.
True
False
Which adverse effect of aminoglycosides is associated with excessive trough levels and includes symptoms such as proteinuria, elevated serum creatinine and BUN, and decreased eGFR?
Nephrotoxicity
Ototoxicity
Hepatotoxicity
Agranulocytosis
Sulfonamides are classified as ______ spectrum antibiotics.
broad
narrow
extended
limited
What are two common issues associated with sulfonamides?
Frequent drug reactions and drug resistance
High risk of hypoglycemia and hypertension
Increased risk of viral infections and anemia
Causes hyperthyroidism and weight gain
SATA: What is trimethoprim/Bactrim (sulfamethoxazole/Septra) frequently used for?
UTIs
Herpes Simplex Viruses
Otitis Media
Varicella Zoster
Bronchitis
How much water should a patient drink when taking trimethoprim/Bactrim (sulfamethoxazole/Septra)?
At least 4 oz
At least 6 oz
At least 8 oz
At least 10 oz
Silver sulfadiazine (Silvadene) is a topical agent used to treat _______.
burns
acne
eczema
psoriasis
Metronidazole (Flagyl) is considered both an antibiotic AND an _______ agent.
antiprotozoal
antifungal
antiviral
antihistamine
Which of the following is most commonly used to treat organisms in the GI tract, GU tract, and CNS?
Trimethoprim/Bactrim
Silver sulfadiazine
Metronidazole/Flagyl
Amoxicillin
Metronidazole (Flagyl) can be used to treat trichomoniasis, IBS, and bacterial vaginosis.
True
False
What should be avoided when taking metronidazole (Flagyl) due to the risk of an Antabuse-like reaction?
Dairy products
Alcohol
Sunlight
Caffeine
Tuberculosis (TB) is caused by acid-fast bacillus, _______.
Mycobacterium Tuberculosis
Streptococcus pneumoniae
Escherichia coli
Staphylococcus aureus
Mycobacterium Tuberculosis is a thick-walled bacterium.
True
False
How is tuberculosis transmitted from one person to another?
Through contaminated water
Through droplets dispersed in air
Through direct contact with skin
Through food
Is the worldwide incidence of tuberculosis increasing today?
True
False
Attempts to isolate microorganisms in tuberculosis involve creating walls around them, known as ________.
tubercles
granulomas
nodules
plaques
tumbotrons
What is a key difference in drug therapy for tuberculosis compared to most other infections?
Only one drug is used
Polytherapy is required
Treatment lasts only one week
No drugs are effective
Treatment for tuberculosis must continue for how many months to reach isolated microorganisms in tubercles?
1-2 months
3-6 months
6-24 months
36 months
During tuberculosis treatment, using multiple drugs in different combinations lowers the potential for ________.
resistance
infection
allergy
relapse
Which of the following is NOT an antitubercular agent?
Isoniazid/INH
Rifampin
Amoxicillin
Ethambutol
Treatment for tuberculosis almost ALWAYS includes which two drugs?
INH and rifampin
Penicillin and amoxicillin
Ciprofloxacin and doxycycline
Azithromycin and ceftriaxone
Which of the following meet the criteria for treatment of latent TB?
A) Used for those who have had direct close contact with an active TB patient
B) Used for those who have a positive TB skin test or blood test, but NEGATIVE chest x-ray
C) Both A and B
What are the two treatment options for latent TB?
C) INH alone taken daily for 9 months
B) INH plus rifapentine taken weekly for 3 months
D) Both B and C
A) INH, amoxicillin, and doxycycline for 12 months
E) Both A and B
INH alone is taken daily for how many months for the treatment of latent TB?
9 months
3 months
6 months
12 months
Isoniazid/INH can have negative interactions with _______-rich foods.
Calcium
Potassium
Tyramine
Vitamin B12
Sodium
Prophylactic treatment of TB with INH is _______ in those with liver disease.
recommended
contraindicated
required
avoided if possible
Fungi such as Candida are a part of human normal flora.
True
False
SATA: Select all of the antifungals.
Polyenes
Azoles
Echinocandins
Pyrimidine Analogs
Cephalosporins
Nystatin is ONLY used for ______ infections.
Candida
Aspergillus
Herpes Simplex
Clostridium Difficile
Viruses differ from bacteria because they contain their own DNA and RNA.
True
False
Varicella Zoster viral infections cause _____ in children and ______ in adults.
shingles, chickenpox
shingles, mononucleosis
chickenpox, shingles
chickenpox, Epstein-Barr
Herpes Simplex 1 can affect the genitals.
True
False
The most common cause of lower respiratory infections in infants and children under 2 years old is:
Varicella Zoster
Influenza
Pneumonia
Respiratory Syncytial Virus
The first-line agent for herpes viruses and Varicella Zoster is:
Acyclovir
Vancomycin
Tetracycline
Ribavirin
Ribavirin is the drug of choice for hepatitis ___ when combined with ________.
A, vancomycin
C, interferon
B, interferon
D, vancomycin
Pregnant nurses CANNOT administer ribavirin.
True
False
