Which of the following is true about the use of tobramycin? 1. It is primarily used by patients ...

(Answer to Q. 1)  ANS: C
Patients with cystic fibrosis (CF) have chronic respiratory infection with Pseudomonas aeru-ginosa, as well as other microorganisms. Such chronic infection causes recurrent acute respiratory infections and deterioration of lung function. With the exception of the quinoline derivatives such as ciprofloxacin, antibiotics such as the aminoglycosides (e.g., tobramycin), which are effec-tive against Pseudomonas organisms, have poor lung bioavailability when taken orally. Conse-quently, such antibiotics must be given either intravenously or by inhalation. The aminoglycoside, tobramycin, has been approved for inhaled administration and is intended to manage chronic in-fection with P. aeruginosa in CF. Goals of therapy are to treat or prevent early colonization with P. aeruginosa and maintain present lung function or reduce the rate of deterioration. The emer-gence of bacterial resistance was not seen in clinical trials with inhaled tobramycin.

(Answer to Q. 2)  ANS: B
The use of nitric oxide gas to treat neonates with persistent pulmonary hypertension is approved by the FDA and is discussed in detail in Chapter 41. In addition to this medical gas, inhaled medications are being tested and used to treat pulmonary hypertension. Several such agents are being studied, including epoprostenol (Flolan) and alprostadil (Prostin VR Pediatric); however, only two, iloprost and treprostenil, are approved by the FDA for widespread use.

(Answer to Q. 3)  ANS: D

(Answer to Q. 4)  ANS: D
Inhaled zanamivir is indicated for the treatment of uncomplicated acute illness due to influenza virus in adults and children 5 years of age or older, who have been symptomatic for no longer than 2 days.

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