Buy Metabolism and Drug Interactions

Buy Metabolism and Drug Interactions
Order 5908220
Buy Metabolism and Drug Interactions
1. Which of the following correctly pairs the pharmacodynamics with the antibacterial agents?
A. Oxacillin (time dependent), moxifloxacin (concentration dependent)
B. Vancomycin (concentration dependent), cefazolin (time dependent)
C. Daptomycin (time dependent), amikacin (concentration dependent)
D. Levofloxacin (time dependent), meropenem (time dependent)
2. A 49-year-old male with a past medical history significant for hypertension and end-stage renal
disease on hemodialysis is admitted to the ICU in septic shock from pneumonia. He is intubated
and mechanically ventilated, and requires vasopressor support. Blood cultures grew multidrug–
resistant Acinetobacter baumannii. You begin appropriate treatment. Over the course of
several hours you begin to notice increasing vasopressor requirements and increasing peak
airway pressures. Which of the following antimicrobial choices could adequately explain this
scenario?
A. IV polymyxin B without renal adjustment
B. Meropenem allergy
C. Inhaled colistin hypersensitivity
D. IV tobramycin-induced bronchospasm
3. A 54-year-old man with a past medical history of cirrhosis is in the ICU 4 days after suffering
severe burns to >40% of his body while at work. His respiratory status has been rapidly
declining, and he is currently requiring BiPAP; however his P:F ratio is now <200 and his last
chest radiograph supports your concern for acute respiratory distress syndrome. You make the
decision to intubate and suspect that he will need continuous neuromuscular blockade. Which of
the following neuromuscular blocking drugs will be most appropriate in this patient for
intubation and continuous blockade?
A. Succinylcholine (intubation), vecuronium (continuous)
B. Rocuronium (intubation), rocuronium (continuous)
C. Succinylcholine (intubation), atracurium (continuous)
D. Rocuronium (intubation), cisatracurium (continuous)
4. A 48-year-old, male, liver transplant recipient is readmitted 4 months postsurgery because
altered mental status. On examination, he is confused and agitated; the rest of the examination is
unremarkable. A review of his medications indicates that he in on lisinopril, prednisone, and
tacrolimus. Laboratory tests show Na 136, K 6.1, HCO3 17, Cl 108, blood urea nitrogen 42,
creatinine 4.4. The results of his complete blood count and the rest of the chemistry profile are
normal. CT scan of the brain is normal. What is the most likely cause of this patient’s current
presentation?
A. Normal pressure hydrocephalus
B. Meningitis
C. Acute graft rejection
D. Tacrolimus toxicity
5. A 19-year-old female with a past medical history of sensorineural deafness and mitochondrial
encephalomyopathy lactic acidosis and strokelike episodes (MELAS) presented to the
emergency room with slurred speech, tremor, and unsteady gait. Her physical examination
revealed nystagmus, dysarthria, gait and limb ataxia. While in the ER, she had a generalized
tonic-clonic seizure for which she was intubated. Phenytoin was also administered and an MRI
was obtained that showed bilateral occipitotemporal lesions. She was transferred to the ICU.
Phenytoin is discontinued and sodium valproate started. Laboratory results are unremarkable
except for elevated lactate levels. EEG confirms seizure activity. Which of the following is
most appropriate next step in management?
A. Fluid resuscitation with ringer lactate @ 30 mL/kg
B. Sodium valproate should be discontinued
C. tPA should be administered emergently
D. Empiric broad-spectrum antibiotics should be initiated
6. A 46-year-old male with a past medical history of COPD and uncontrolled diabetes is intubated
and sedated in the ICU requiring inotropic and vasopressor support for septic shock due to
pneumonia. Several days into his admission he develops bradycardia that is refractory to
treatment, necessitating the placement of a transvenous catheter. Urinalysis is positive for
myoglobin and his CK levels approach 50 000 U/L. You obtain a blood gas that reveals a pH of
7.13, PaCO2 39, PaO2 88, HCO3 13 with a base excess of −8. Propofol infusion syndrome
(PRIS) is suspected. Which of the following is NOT a known triggering factor for this
condition?
A. Excessive carbohydrate intake
B. Hydrocortisone therapy
C. Epinephrine infusion
D. Septic shock
7. A 62-year-old Cantonese woman with no significant past medical history is admitted to the ICU
with intense nausea, vomiting, and diarrhea 24 hours after ingestion of an unknown mushroom.
Laboratory studies are negative for Epstein-Barr, all forms of hepatitis, and antinuclear
antibody. ALT and AST are elevated. On day 3 of admission, she goes into acute hepatic
failure. Mushroom poisoning is suspected. Which of the following drugs is amatoxin uptake
inhibitor?
A. Thioctic acid
B. Erythromycin
C. Silibinin
D. Methylprednisolone
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