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Questions And Answers 2025
What blood values should be monitored with carbamazepine (Tegretol)? P. 236-237 - correct answer ✅CBC for agranulosytosis (leukopenia/ neutropenia), BMP, and liver function tests, monitored at baseline prior to administration and followed throughout treatment What is the pharmacodynamics of carbamazepine (Tegretol)? P. 235
correct answer ✅Carbamazepine depresses transmission in the nucleus ventralis anterior of the thalamus. This area is associated with the spread of seizure discharge. Exact mechanism of action not known but may work by slowing sodium influx to the cortical neurons thus slowing the spread of abnormal neuron activity. What should families be taught regarding the monitoring of seizure activity? - correct answer ✅Seizure triggers, when to contact the physician, how to take medications properly and that medication needs may change with patient growth (kids), need for monitoring blood levels, signs of adverse drug reactions What electrolyte imbalance is noted with the administration of topiramate (Topamax)? P. 239 - correct answer ✅Topiramate is a carbonic anhydrase inhibitor used for seizures and migraines. This can increase bicarb loss (via the
Questions And Answers 2025
kidneys) which decreases serum bicarb levels. The result is hyperchloremic metabolic acidosis. What is the pregnancy category for valproate? - correct answer ✅Pregnancy category D (FDA dropped Pregnancy category designations June 2015) What instructions will you provide to a woman who wants to get pregnant and has a seizure disorder controlled with valproate? P. 278-279 - correct answer ✅She should be advised to speak with her neurologist before trying to get pregnant. Valproate is a known teratogen (it can lead to neural tube defects), but may be taken after the first trimester if needed. What are the precautions and contraindications for the tricyclic antidepressants? P. 245-246 - correct answer ✅Contraindicated with cardiovascular disorders (Direct alpha adrenergic blocking effect and quinidine like effect on the myocardium). Use with caution in those with glaucoma, prostatic hypertrophy, or urinary incontinence. Do not use in combination with MAOIs. Two week washout period. Use with extreme caution in pregnancy. Most significant risk is cardiac conduction disorder mostly in peds and elderly. May develop sinus tachycardia due to slowing of depolarization of the cardiac muscle
Questions And Answers 2025
correct answer ✅Patients should be counseled that it may take as long as 3 to 4 weeks for maximum therapeutic benefits. When are buspirone (Buspar) and an SSRI combined? P. 217 - correct answer ✅Buspirone can be used as the sole pharmacotherapeutic agent for anxiety. Used together for treatment-resistant depression because of the combined serotonergic mechanisms What type of diet is recommended with the administration of lithium? P. 278 - correct answer ✅Patients must maintain a consistent, adequate salt intake and avoid dehydration. What are the main side effects of each of each class of antidepressants? P. 245-255 - correct answer ✅TCAs-anticholinergic effects, cardiac, weight gain. SSRI-nausea and vomiting, headache, light-headedness, dizziness, anxiety and agitation, dry mouth, increased sweating, weight changes, serotonin syndrome. SSNIs-headache, somnolence, dizziness, insomnia, nervousness, nausea, dry mouth, constipation, and abnormal ejaculation; decreased appetite and weight loss. Norepinephrine reuptake inhibitors (NRIs)- nausea, vomiting, insomnia, fatigue, weight loss, somnolence, nervousness, dry mouth, blurred vision, diarrhea, and constipation. MAOIs -
Questions And Answers 2025
insomnia, anxiety, anticholinergic effects, dizziness, headaches, restlessness, and hypotension What receptors do the benzodiazepines act on? P. 267 - correct answer ✅GABA receptors What factors will place the patient at risk for antibiotic resistance? P. 692-693 - correct answer ✅Bacteria can undergo genetic mutations or acquire resistance. Excessive or Inappropriate use (ex, viral use). Over-use of broad spectrum antibiotics. Not completing course of therapy What factors place the patient at risk for hypersensitivity reactions with penicillins and cephalosporins? P. 695-709 - correct answer ✅Each class contains a Beta-lactam ring. What are the safest antibiotics to prescribe to a woman who is pregnant? P. 705-708 - correct answer ✅Most penicillins (Amoxicillin, Amox-Clav), and cephalosporins are considered safe pregnancy. Tetracyclines (doxycycline and minocycline) and quinolones should be avoided with pregnancy.
Questions And Answers 2025
or the periapical region of teeth or perforation of the oral mucosa: Patients with prosthetic cardiac valves or prosthetic material used for cardiac valve repair. Patients with previous infective endocarditis. Patients with congenital heart defect (CHD). Unrepaired cyanotic CHD, including palliative shunts and conduits. Completely repaired congenital heart defect repaired with prosthetic material or device, whether placed by surgery or by catheter intervention, during the first 6 months after the procedure. Repaired CHD with residual defects at the site or adjacent to the site of a prosthetic patch or prosthetic device (both of which inhibit endothelialization). Cardiac transplant recipients with valve regurgitation due to a structurally abnormal valve. What patient teaching will you provide to a patient who is experiencing non- infectious diarrhea related to antibiotic administration? P. 695 - correct answer ✅Increase fluids , Fresh yogurt in restoring good flora in the GI system , Donnagel-(attapulgite is an absorbent), Anitperistaltic agent not recommended (retain toxins) A patient is taking a fluoroquinolone; what are the most serious adverse effects? P. 721 - correct answer ✅Tendonitis and tendon rupture , C. diff infection, Hypersensitivity reactions, Stevens-Johnsons Syndrome (Rash eyes, nose, mouth, genitals- skin dies and heals after rash)
Questions And Answers 2025
What population should not be administered tetracycline and why? P. 753 - correct answer ✅Pregnancy (in addition to affecting tooth development, tetracycline use has been associated with retardation of skeletal development and reduced bone growth), Lactation, Children less than 8 years, Renal or hepatic impairment What is the mechanism of action of tetracyclines? - correct answer ✅Tetracycline antibiotics are protein synthesis inhibitors, inhibiting the binding of aminoacyl-tRNA to the mRNA- ribosome complex. They do so mainly by binding to the 30S ribosomal subunit in the mRNA translation complex. What are the most common drug interactions with the fluoroquinolone levofloxacin (Levaquin)? - correct answer ✅Levofloxacin should not be used with NSAIDs, concurrent use increases CNS stimulation and seizures, Antacids- interfere with GI absorption, resulting in decreased serum levels, Anticoagulants- anticoagulant effect is increased, Antineoplastic agents- fluoroquinolone is decreased, Cimetidine- interferes with elimination of fluoroquinolone, Cyclosporins-increase nephrotoxic effects, Glucocorticoids- increase risk of tendon rupture, Theophylline- decreased clearance of theophylline and toxicity
Questions And Answers 2025
Differentiate between oral and parenteral vancomycin. P. 758-759 - correct answer ✅Parenteral: bactericidal for GP organisms, MRSA, monitor renal function. systemic therapy. Oral: pseudomembranous colitis, or c-diff, not absorbed, (metronidazole DOC), local therapy What is the mechanism of action of azithromycin? P. 729 - correct answer ✅Irreversibly binds to the P site of the 50S ribosome subunit of susceptible organisms and may inhibit RNA-dependent protein synthesis. Which antibiotics block bacterial protein production? - correct answer ✅Bacteriostatic, ethambutol, lincosamides (ex clindamycin), macrolides, nitrofurantoin, oxazolidinones (ex linezolid), sulfonamides, tetracyclines, trimethoprim Gram Positive - correct answer ✅(cocci) Gram Negative - correct answer ✅(rods, bacilli)
Questions And Answers 2025
Penicillins - correct answer ✅Kill Gram positive bacteria through cellular wall destruction. Not effective on gram negative bacteria Types of PCN - correct answer ✅Pen G, Pen V, Amoxicillin, Ampicillin, Amp/Sulbactam, Dicloxicillin, Amox/Clav, Pip/Tazo MRSA coverage: - correct answer ✅1st line IV-Vancomycin-Daptomycin-Linezolid- Tigecycline-Quinupristin and Dalfopristin 1st line oral- Sulfamethoxazole and Trimethoprim-Clindamycin (Systemic)- Doxycycline and Tigecycline-Ceftaroline-Telavancin First generation Cephalosporins - correct answer ✅Effective against Gram + (PO) cephalexin, cefadroxil (IV) cefazolin Second generation Cephalosporins - correct answer ✅Gram +, some Gram - (PO)cefaclor, cefuroxime, cefprozil (IV) cefotetan, cefoxitin, cefuroxime
Questions And Answers 2025
Tetraycyclines (Gram +) - correct answer ✅Doxcycline, Minocycline What vitamin will decrease peripheral neuropathy? - correct answer ✅B-6, folate What lab values should be assessed when administering valacyclovir (Valtrex) for herpes virus? P. 775 - correct answer ✅BUN/SCr initially and periodically during therapy When should treatment oseltamivir phosphate (Tamiflu) be prescribed? P. 776 - correct answer ✅Within 48 hours of the onset of symptoms For what is rifampin prescribed? P. 765 - correct answer ✅prophylaxis for close contacts of people with meningococcal infections caused by N. meningitidis, prophylaxis for close contacts of people with actual or suspected infections with H. influenza type b , leprosy, With other agents in the treatment of serious infections caused by Staphylococcus, including methicillin- resistant and multidrug-resistant strains,, TB, MAC-treatment and prophylaxis
Questions And Answers 2025
What are the adverse effects of isoniazid (INH)? P. 767 - correct answer ✅Used in TB treatment Elevated liver enzymes, numbness When is prophylactic oseltamivir (Tamiflu) recommended? P. 776 - correct answer ✅After exposure to influenza A or B, Give flu shot then give 75mg daily for 4 weeks. When prescribing ketoconazole (antifungal), how should it be administered? P. 779 - correct answer ✅With food What is hypochlorhydria? - correct answer ✅Abnormally low stomach acid. With the increased use of PPIs this is more common, has been associated with pernicious anemia, hyperplasia, increased risk of cholera, gastoparesis, and may interfere with medication absorption. What lab values should be monitored when administering antifungal agents? P. 783 - correct answer ✅Liver function tests
Questions And Answers 2025
What are the side effects of rifampin? P. 764 - correct answer ✅GI: nausea, vomiting, abdominal cramps, diarrhea, Flu-like symptoms:chills, fever,headache, arthralgia, and malaise
