When prescribing TMP/SMX to children, the primary care NP should ...

[jman1234]

When prescribing TMP/SMX to children, the primary care NP should recall that:
 
  a. dosing is based on the trimethoprim component of the drug.
  b. TMP/SMX should not be prescribed for children younger than 2 years.
  c. folic acid supplements must be given to children who take this medication.
  d. the medication should be given three or four times per day because of rapid metabolism.

Question 2

A patient is seen in the clinic with a 1-week history of frequent watery stools. The primary care NP learns that a family member had gastroenteritis a week prior. The patient was treated for a UTI with a sulfonamide antibiotic 2 months prior.
 
  The NP should suspect: a. Clostridium difficileassociated disease (CDAD).
  b. viral gastroenteritis.
  c. serum sickness reaction.
  d. recurrence of the UTI.

[lou]

Answer to Question 1

A
When determining the dose of TMP/SMX, the dose is based on the trimethoprim component of the drug. Children older than 2 months of age may take this medication. Folic acid supplements are not indicated. The medication is given twice daily in all age groups.

Answer to Question 2

A
Cases of CDAD have been reported 2 months after a course of antibiotics, and CDAD should be suspected in all patients who present with diarrhea after antibiotic use. Viral gastroenteritis is possible, but the possibility of CDAD must be investigated. Serum sickness reaction is not usually associated with diarrhea and generally occurs within weeks of drug administration.