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Download Applied Pharmacology for the Dental Hygienist 7th Edition Haveles Solutions Manual all chapters
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Haveles: Evolve Resources for Applied Pharmacology for the Dental
Hygienist, 7th Edition
Chapter 07: Antiinfective Agents
Case Studies
Julie W. is a junior dental hygiene student who had the misfortune to puncture her glove with a
contaminated instrument. Although her patient tested negative for both hepatitis C and human
immunodeficiency virus, the wound became badly infected. Her physician prescribed 500 mg of
amoxicillin three times a day for 7 days, but at the end of 3 days, the infection is worse and is
spreading. Julie feels too ill to attend classes, and she returns to the college’s health center to see
the physician again. Her temperature is 103.4° F, her pulse rate is 110 bpm, and her cervical
lymph nodes are swollen. The physician is concerned about the infection and admits Julie to the
hospital. Her current medications include oral contraceptive pills and multivitamins.
ANS: A
These gram-positive bacteria are common inhabitants of the oral cavity and were introduced into
the wound by the contaminated instrument. E. coli, Salmonella sp., Shigella sp., and C. difficile
are usually found in the intestinal tract.
ANS: C
More than 95% of staphylococci in the hospital setting are resistant to the penicillins, and an
increasing number of oral strains of S. viridans are also resistant. Administering amoxicillin
orally is preferable due to an increased chance of allergic reaction when given parenterally.
Amoxicillin is the drug of choice for gram-positive strep and staph species that are sensitive to
the drug. The dose is appropriate for this patient.
3. Laboratory tests show the presence of penicillinase in Julie’s blood. Which antibiotic would be
indicated next?
a. Penicillin G
b. Ampicillin
c. Cloxacillin
d. Penicillin VK
ANS: C
4. Within hours after the first dose of cloxacillin, Julie becomes extremely nauseated and starts
vomiting. Which type of reaction is she having to the medication?
a. Allergic reaction
b. Toxic reaction
c. Idiosyncratic reaction
d. Therapeutic reaction
ANS: B
5. In spite of the change in antibiotics, Julie’s condition continues to worsen, and the infection
becomes life threatening. Her physician tells her family that they are going to administer an
intravenous antibiotic that has not developed cross-resistance with other antibiotics because it
has a different structure than other antibiotics. The physician also tells her family that this
antibiotic is also used as a last resort against methicillin-resistant S. aureus. To which antibiotic
is the physician referring?
a. Aminoglycosides
b. Vancomycin
c. Sulfonamides
d. Quinolones (fluoroquinolones)
ANS: B
absorption and is often given when other antibiotics have proven ineffective as a result of
resistance. Aminoglycoside antibiotics are rarely used because of their major adverse effects
including ototoxicity, or damage to the eighth cranial nerve. This results in auditory and
vestibular disturbances. The sulfonamides or “sulfa drugs” were the first antibiotics developed
and are bacteriostatic against many gram-positive and some gram-negative bacteria. They are
frequently used to treat acute otitis media in children, chronic bronchitis in adults, and urinary
tract infections. Their most common adverse reaction is an allergic skin reaction.
The quinolones (fluoroquinolones) are an orally effective antibacterial agent that are bactericidal
against most gram-negative and many gram-positive organisms. The most well-known drug in
this group is ciprofloxacin.
6. The infection responds to the large doses of vancomycin, Julie starts to improve, and her fever
subsides. Within a few days, she is able to go home from the hospital, but the physician wants
her to continue on antibiotics for another 7 days to clear the residual infection. Which group of
bacteriocidal antibiotics effective against gram-positive microorganisms could be used orally that
has not shown cross-resistance to other antimicrobial agents?
a. Macrolides
b. Sulfonamides
c. Quinolones
d. Cephalosporins
ANS: C
Quinolones (fluoroquinolones) are a group of orally effective antibacterial agents that are
bacteriocidal against most gram-negative and many gram-positive organisms, and these agents
do not have cross-resistance with other antimicrobial agents. The macrolides (erythromycin,
azithromycin, and clarithromycin) are bacteriostatic, not bactericidal. The sulfonamides or “sulfa
drugs” were the first antibiotics developed and are bacteriostatic against many gram-positive and
some gram-negative bacteria. They are frequently used to treat acute otitis media in children,
chronic bronchitis in adults, and urinary tract infections. Their most common adverse reaction is
an allergic skin reaction. The cephalosporins are bactericidal, but are closely related to the
penicillins, which have shown resistance to this organism.
7. What special instructions should her health care provider give Julie about her daily routine
once she has returned to school?
ANS: E
Taking all of the antibiotics as directed is important to prevent the development of resistance.
Antibiotics may interfere with the action of oral contraceptives, thus an alternate form of
contraception should be used for the remainder of her menstrual cycle. With the exception of the
tetracyclines, taking antibiotics on a full or empty stomach does not affect their efficacy.
Language: Italian
ROMA ANTICA
III.
ULTIMI SPLENDORI
DECADENZA E ROVINA
FIRENZE
FELICE LE MONNIER
1922
Proprietà letteraria italiana
Copyright by G. Ferrero and C. Barbagallo
Le copie che non portano la firma di uno degli Autori
s’intendono contraffatte.
INDICE
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LA QUARTA GUERRA CIVILE