Chapter 17 Drug Therapy With Aminoglycosides and Fluoroquinolones


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Chapter 17  Drug Therapy With Aminoglycosides and Fluoroquinolones



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Sample Questions



1. A patient is diagnosed with an infection attributable to the gram-negative microorganism Pseudomonas. Which of the following anti-infective agents is most reliable in treating this microorganism?

  1. A)  Aminoglycoside
  2. B)  Antifungal
  3. C)  Aminopenicillin
  4. D)  GABA analog

Ans: A
Aminoglycosides are used to treat infections caused by gram-negative microorganisms, such as Pseudomonas. Antifungal and aminopenicillin agents are not used to treat Pseudomonas. A GABA analog is used to treat pain related to neuropathy.

2. A patient is diagnosed with a gram-negative infection and is prescribed an aminoglycoside. What is the action of an aminoglycoside?

  1. A)  It blocks protein synthesis of the cell wall.
  2. B)  It blocks DNA replication.
  3. C)  It destroys the integrity of the cell wall structure.
  4. D)  It increases white blood cell viability.

Ans: A Feedback:

Aminoglycosides penetrate the cell walls of susceptible bacteria and bind irreversibly to 30S and 50S ribosomes, intracellular structures that synthesize proteins. Aminoglycosides do not block DNA replication, destroy cell wall structure, or increase white blood cells.

3. The nurse is preparing to administer gentamicin (Garamycin) to a patient when he mentions that he has recently been experiencing diminished hearing. What action should the nurse take based on this statement?

  1. A)  Administer the dosage and notify the physician of the alteration in hearing.
  2. B)  Hold the dosage and notify the physician of the alteration in hearing.
  3. C)  Administer the dosage and report the alteration in hearing to the audiologist.
  4. D)  Hold the dosage and document the finding in the nurses’ notes.

Ans: B
Aminoglycosides accumulate in high concentrations in the inner ear, damaging sensory cells in the cochlea and vestibular apparatus. The medication should be held and alteration in hearing reported to the physician. The administration of the medication will only cause more damage to the cochlea and vestibular apparatus. Holding the medication and documenting the information in the nurses’ notes will not allow for a new anti-infective to be administered and for the hearing to be assessed.

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4. A patient is diagnosed with multidrug-resistant tuberculosis. Which of the following aminoglycoside medications is used in a 4- to 6-drug regimen?

  1. A)  Tetracycline hydrochloride (Achromycin)
  2. B)  Amoxicillin (Amoxil)
  3. C)  Sulfadiazine (Sulfisoxazole)
  4. D)  Streptomycin (Sulfate)

Ans: D Feedback:

Streptomycin may be used as part of a 4- to 6-drug regimen for treatment of multidrug-resistant tuberculosis. Tetracycline, amoxicillin, and sulfadiazine are not aminoglycosides or drugs of choice for multidrug-resistant tuberculosis.

  1. A patient is scheduled for a bowel resection. He is to receive neomycin sulfate (Neo-Fradin) by mouth. The patient asks the nurse the purpose of this medication. What is the most appropriate response the nurse can provide to the patient?
    1. A)  “The administration by mouth will prevent renal damage.”
    2. B)  “The administration by mouth will prevent ototoxicity.”
    3. C)  “The administration will decrease the risk of contamination.”
    4. D)  “The administration decreases the risk of airborne contamination.”

    Ans: C
    Neomycin can be given before bowel surgery to suppress intestinal bacterial growth. The administration of neomycin will not prevent renal damage or ototoxicity. It will also not affect the risk of airborne contamination.

  2. A patient has been administered an aminoglycoside. It is time for his next dose, and the nurse learns his creatinine level is elevated at 3.9 mg/dL. What action should the nurse take regarding this assessment?
    1. A)  Administer the medication and report the creatinine level.
    2. B)  Hold the dose until another creatinine level is assessed.
    3. C)  Administer the medication with 100 mL of fluids.
    4. D)  Hold the medication and assess the urine output.

Ans: D


Aminoglycosides are nephrotoxic and should not be administered in the presence of renal impairment. It is important to hold the medication, assess the urine output, and notify the physician. The medication should not be administered. The medication should be held, but the creatinine level cannot be reassessed without a doctor’s order. The administration with fluids will not protect the patient from renal impairment.

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