An 18-month-old is diagnosed with acute otitis media for the

An 18-month-old is diagnosed with acute otitis media for the second time in six weeks. The child attends daycare full-time but has no chronic medical conditions. Amoxicillin 80mg/kg/day was prescribed for the first infection, completed as prescribed, with complete resolution of symptoms. There are no known drug allergies. Which antibiotic should be prescribed today? (6 points) __ amoxicillin/clavulanic acid (Augmentin) ­­­__ cefdinir (Omnicef) __ ceftriaxone (Rocephin) ­­__ azithromycin (Zithromax) A toddler is prescribed ferrous sulfate drops PO BID. Which should be included in teaching specific to this treatment? (6 points) ­­__ Offer with milk to enhance the absorption. __ Therapy duration should not exceed seven days. __ Mix with citrus juice and administer with a straw. __ Diarrhea is a common adverse effect. A high school student is diagnosed with group-A strep pharyngitis and reports an “itchy rash” when previously taking amoxicillin (Amoxil). Select the most appropriate antibiotic for this patient. (6 points) ­­__ penicillin VK __ ceftriaxone (Rocephin) __ cephalexin (Keflex) __ doxycycline (Vibramycin) Which of the following medications poses the greatest risk of C. difficile-associated diarrhea? (6 points) __ azithromycin (Zithromax) __ ciprofloxacin (Cipro) __ sulfamethoxazole-Trimethoprim (Bactrim DS) __ clindamycin (Cleocin) Doxycycline (Vibramycin) is most appropriate for which of the following patients? (6 points) __ Preschooler with acute bronchitis __ Sexually abstinent teenager with treatment-resistant acne __ Twenty-four-week pregnant female with Rocky Mountain Spotted Fever __ Adult with urinary tract infection who takes digoxin daily A patient returns for a four-week follow up after initiating methimazole (Tapazole). To assess drug safety and effectiveness orders should include: (6 points) __ ECG and TSH __ TSH and CBC __ Free T4 and eGFR __ Free T4 and T3 An older adult with COPD is suffering from an acute bacterial exacerbation. The patient was recently treated with amoxicillin-clavulanate acid (Augmentin) for acute sinusitis three weeks ago. Considering the most appropriate treatment, select this drug’s associated adverse effect. (6 points) __ Stevens Johnson syndrome __ Disulfiram reaction when combined with alcohol __ Ototoxicity __ Tendon rupture When replacing vitamin B12, oral therapy has the highest rate of absorption. (6 points) __ True __ False Which of the following medications is least appropriate to treat a urinary tract infection? (6 points) __ nitrofurantoin (Macrobid) __ metronidazole (Flagyl) __ sulfamethoxazole-trimethoprim (Bactrim DS) __ fosfomycin (Monurol) Which of the following are associated with vitamin B12 deficiency? (Select all that apply; no partial credit.) (6 points) __ Pregnancy __ Vegetarian diet __ Chronic use of metformin (Fortamet) __ History of bariatric surgery __ Menorrhagia Which of the following is a potential adverse effect of excessive levothyroxine (Synthroid) use? (6 points) __ Renal impairment __ Osteoporosis __ Constipation __ Fatigue Other than matching the drug to the bacteria, list six patient-related factors which influence the antibiotic choice. (2 points each = 12 points) A college age female is prescribed levothyroxine (Synthroid). Which of the following should be included in patient education? (6 points) __ Take this medication with food to prevent adverse gastrointestinal effects. __ If you become pregnant your dosage will likely be decreased. __ A CBC will need to be monitored every four weeks. __ Treatment will be continued throughout your entire lifetime. Select the most common causative organism/bacteria for each condition. (4 points each = 16 points) Use PowerPoint slides and textbook (table 70.4) as reference. Answers may be used more than once. Streptococcus pneumoniae Escherichia coli Streptococcus pyogenes Acute pharyngitis Community-acquired pneumonia Urinary tract infection (uncomplicated) Acute sinusitis

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