REGIS NU641 ADV CLINICAL PHARMACOLOGY/ NU641/ Exam Bundle

Regis NU641 Adv Clinical Pharmacology Midterm Exam Questions and Answers

Angina, Coronary Artery Disease, & Migraines - Answer- Patients that are at highest risk for abruptly stopping a beta blocker are those with Angiotensin... [Show More] -converting enzyme (ACE) inhibitors - Answer- The medication that helps the imbalance between myocardial oxygen supply and myocardial oxygen demand in the myocardium by increasing the myocardial oxygen supply improves insulin sensitivity improves renal hemodynamics reduce production of angiotensin II - Answer- Roles of Angiotensin-converting enzyme (ACE) inhibitors in DM patients Activation of the sympathetic nervous system that increases heart rate and preload - Answer- The pathological change that takes place in HF that is not addressed by ACE inhibitors blunted coronary artery dilation due to calcified plaque - Answer- Reason why nitro glycerin tablets "do not work well" in patient with hyperlipidemia and angina age factoring in the cost to the patient of the medication prescribed - Answer- Clinical judgement in prescribing includes decreased renal function - Answer- Prior to prescribing an ACE inhibitor the NP should access for statins - Answer- First-line pharmacologic therapy for hyperlipidemia Any end-organ damage, direct effects on lifestyle, or inability to perform the tasks of daily living - Answer- When is consultation with or referral to a cardiologist appropriate? Diuretics - Answer- If not chosen as the first drug in hypertension treatment, which drug class should be added as a second step because it will enhance the effects of most other agents? Determine their other risk factors - Answer- A 65-year-old patient who has been on a lipid-lowering diet and is using plant sterol margarine daily for the past three months. Her LDL is 135mg/dL. What would an appropriate treatment for them be? promote smooth muscle dilation by stopping intracellular entry of calcium into the cell, which increases contractility, which increase the activity of the NA+/K+/ATPase pump indirectly - Answer- Calcium Channel Blocker's helps control blood pressure because it discussion of expected adverse drug reactions - Answer- Patient education regarding prescribed medications includes Do not take any herbal products without first discussing this with the provider - Answer- Patient education when prescribing clopidogrel includes which of the following statements? If they stop the medication, their lipid levels will return to pretreatment levels; medication is a supplement to diet therapy and exercise; and if they have muscle aches or pain, they should contract their provider - Answer- When starting a patient on a statin, what would education include? Lung - Answer- When treating a patient for hypertension with a non-selective beta blocker, what other organ may be unintentionally affected? The brand name of warfarin and "do not substitute" - Answer- When writing a prescription for warfarin it is common to write this on the prescription Sublingual tablets - Answer- Which formulation of nitrate may be most cost effective for the patient who rarely has the need for dosing? Asthma - Answer- What disease processes could be made worse by taking a nonselective beta blocker? Oral Methyldopa - Answer- What drug is considered as treatment for hypertension in women during pregnancy? bismuth subsalicylate before each meal and at bedtime - Answer- Treatment for possible traveler's diarrhea electrolytes, including potassium and chloride - Answer- Elderly prescribed lactulose for chronic constipation; Monitoring with long-tern treatment would include PPI bid plus clarithromycin plus amoxicillin for 14 days - Answer- An acceptable first-line treatment for peptic ulcer disease with positive Helicobacter pylori (H. pylori) test is: a PPI for 8 to 12 weeks until healing is complete - Answer- After H. pylori treatment is completed, the next step in peptic ulcer disease therapy is: Histamine 2 Receptor Antagonists - Answer- A patient with mild GERD is started on the medication first refer the patient for endoscopy - Answer- The next step in treatment when a patient has been on PPIs twice daily for 12 weeks and not improving is to: Add an H2 blocker such as ranitidine to his therapy or decrease his aspirin does to one tablet daily - Answer- 82-year-old man takes two aspirin every morning to treat the arthritis pain in his back. Heartburn lately from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for him? AA women as a group are at risk of developing osteoporosis due to their lower calcium intake when young and 75% of them are lactose-intolerant, so they avoid milk and other dairy products that are excellent sources of calcium. - Answer- Education for AA Women about Osteoporosis Alendronate (Fosamax) - Answer- The drug recommended as the primary treatment for osteoporosis in women over age 70 is: Preterm and newborn infants do not yet have functional pain pathways - Answer- Age-related statement about pain that is NOT true Multiple time when prescriptions are lost with request to refill - Answer- Statement that raises a "red flag" about potential chemical dependency Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs. - Answer- True statement about pain Nonopiates, increase dose of nonopiates, opiates - Answer- If interventions to resolve the cause of pain (e.g., rest, ice, compression, and elevation) are insufficient, pain medications are given based on severity of pain. Drugs are given in which order of use? Cimetidine (Tagamet) - Answer- The histamine type-2 receptor antagonist (H2HA) that is recommended to avoid because of increased potential side effects and risk of drug interactions Psyllium (Metamucil) orally - Answer- Pregnant patient in 2nd trimester with constipation needs laxative treatment. What would be the safest and most appropriate for the duration of her pregnancy? NSAID (Such as Ibuprofen) - Answer- What medication can be used to treat an acute gout attack? Colchicine (Colcrys) - Answer- What medication should not be used to prevent the progression of gout in a patient? Regular monitoring of weight, glucose level, and vitamin D levels; do not stop abruptly; take with food to minimize GI distress - Answer- Education for patient taking prednisone Patient who have chronic liver dysfunction/alcoholics - Answer- Acetaminophen is NOT the drug of choice for mild to moderate pain for which patient? [Show Less]

Regis NU641 ADV Clinical Pharmacology: Mental Health Exam Questions with correct Answers

the frontal cortex, diencephalons, brainstem and cerebellum, and the limbic system - Answer- Which structures are involved with anxiety and mood sx? neu... [Show More] rotransmitters - Answer- Psychiatric drugs change what in the brain Alertness, concentration, energy - Answer- Norepinephrine regulates memory, compulsions, and obsessions - Answer- Serotonin affects what in the brain motivation and pleasure - Answer- Dopamine affects this in the brain amitriptyline(elevil) phelenzine(Nardil) nortryptyline - Answer- tricyclic antidepressants phelenzine (nardil) isocarboxazid - Answer- MAOI examples fluoxetine( prozac) sertraline (zoloft) citalopram (celexa) - Answer- SSRIs uloxetine(cymbalta) venlafaxine (effexor) desvenlafaaxine (pristig) - Answer- SNRIs drowsiness orthostatic hypotension weight gain - Answer- Adverse reactions from TCAs

MAOI use

glaucoma BPH - Answer- Contraindications for TCA use panic disorder neuropathic pain depression OCD - Answer- TCAs are used for MAOIS(MONOAMINE OXIDASE INHIBITORS) - Answer- Not used often s/t significant food & drug interactions Newer agents - Answer- typically have a low toxicity index With SSRI use - Answer- more serotonin is available to bind to postsynaptic receptors sexual dysfunction GI upset increased SI - Answer- Some side effects associated with SSRIs QT prolongation - Answer- Citalopram has this potential risk in higher doses 5-7 - Answer- Wait time for increasing SSRIs dose may require an increased dose taper slowly - Answer- Patient is taking paroxetine(paxil) for OCD precautions excessive dose of med titrating and changing too quickly using combo serotonin agents - Answer- Serotonin syndrome may be caused by rash - Answer- S/S of serotonin syndrome Quinolones - Answer- potential drug interaction with SNRIs Give 50mg QOD - Answer- Patient is on Pristiq an SNR [Show Less]

Regis NU641 Adv Clinical Pharmacology: Neurology Exam Questions and Answers

Urecholine - Answer- is an example of a cholinergic drug Neostigmine - Answer- used to treat myasthenia gravis Cholinergic agents - Answer- are organ... [Show More] specific Cholinesterase inhibitors - Answer- are used to treat Alzheimers's disease & myesthenia gravis Donepezil (Aricept) - Answer- used to treat mild to moderate dementia caused by Alzheimer's disease. improves the function of nerve cells in the brain. It works by preventing the breakdown of a chemical called acetylcholine. If my patient was on a dopaminergic agent, important labs to monitor would be - Answer- LFTs & renal function What is another name for a cholinergic agent? - Answer- parasympathomimetric myasthenia gravis (MG) - Answer- autoimmune neuromuscular disorder characterized by weakness of voluntary muscles that is not curable Donezepil may be chosen over other agents due to - Answer- longer duration of action and better side effect profile acetylcholine - Answer- Dopaminergic agents attempt to restore the balance of dopamine and this neurotransmitter dopamine - Answer- A major goal of Parkinson's is to restore this in the brain amantadine - Answer- A common agent for the treatment of Parkinson's N/V, Hallucinations, & confusion - Answer- Common side effects with dopaminergic are NSAIDs - Answer- Patient has an early onset migraine this agent should be tried first Anticonvulsants - Answer- are not used just to treat seizure disorders Antiseizure drugs - Answer- work by stimulating an influx of CL ions, delaying NA and CA ions gingival hyperplasia - Answer- Maybe an UNUSUAL side effect, s/t Phenytoin (Dilantin) being a hydantoin agent blood dyscrasias - Answer- black box warning for tegretol butalbital preparation - Answer- A midrange migraine treatment for a patient that is not responding to NSAIDs might be vasoconstriction and constipation - Answer- Ergot preparations such as cafergot work by causing this Zolpidem (Ambien) - Answer- Sedatives or hypnotics are often used for sleep. a common agent would be ADD/ADHD - Answer- Treatment consists of stimulants being used heavily Atomoxetine(Strattera) - Answer- non-amphetamine stimulant Tension - Answer- Neck stiffness is often associated with which type of headache classic migraine - Answer- A migraine with aura abort headache - Answer- Goals of migraine therapy Serotinin 5-HT antagonist or triptans - Answer- are a common migraine treatment CAD, Uncontrolled HTN - Answer- contraindication for a triptan such as sumatriptan antiemetic - Answer- It is common to give this with abortive migraine treatment beta blocker, tricyclic antidepressant, & antiepileptic - Answer- Tx for a patient that is having 3 migraines per month Metoprolol - Answer- beta blocker for my asthmatic patient with migraine serotonin - Answer- Amitriptyline work on these receptors tension headache - Answer- patient reports band like pressure of the head that may last for days Nonpharmacologic measures - Answer- should be used with muscle tension headaches indomethacin - Answer- patient with hemicrania continua will likely respond to beta blocker, tca, DHE + antiemetic, or fluoxetine - Answer- chronic daily headaches might respond to cluster headache - Answer- Unilateral, severe periorbital headache with tearing and conjunctival erythema, that does not last for days, and oxygen can be used for treatment sumatriptan, intranasal lidocaine, ergotamine derivatives - Answer- Potential drug therapy for cluster headaches midrin + cyproheptadine, naproxen - Answer- Analgesic detoxification for medication overuse headache may require [Show Less]

NU641 Adv Clinical Pharmacology Quiz 2 GI/Pain/ID Questions and Answers 2023

Vitamin D - Answer- Calcium antacids requires this for absorption Magnesium based antacids - Answer- Antacids for patients with renal failure Constip... [Show More] ation - Answer- A common side effect of Aluminum & Calcium based antacids False - Answer- Should antacids be taken with other meds? (T/F) True - Answer- Lomotil (Diphenoxylate / Atropine) can be used for diarrhea (T/F) Bismuth subsalicylate (Pepto-Bismol) - Answer- Which medication has the potential to cause Reye's Syndrome in children? False - Answer- Antidiarrheal's are gold standard for children with diarrhea (T/F) NSAID Use - Answer- A 20yo college student who presents with peptic ulcer disease so you would ask about? Sulcrafate (Carafate) - Answer- A medication that has the ability to coat a peptic ulcer and used for a pregnant patient with a stomach ulcer Zofran (ondansetron) - Answer- Pt with Parkinson's has extreme nausea what med would you prescribe? H2 antagonist in IVFs - Answer- Your is NPO, she will likely get False - Answer- Cimetidine is a good choice for men with GERD (T/F)? depression, tardive dyskinesia, dizziness - Answer- Side effects of prokinetic medications include no food or drink 2 hours before bed smoking cessation increase HOB - Answer- Lifestyle modifications for GERD Osteoporosis c-difficile nutrient deficiencies - Answer- PPI's may increase the risk of False - Answer- A typical PPI duration is 3 months (T/F) True - Answer- It is safe to use H2 antagonist/PPI for infant reflux (T/F)? False - Answer- 72 yr old patient has N/V with no BM for 5 days a laxative should be prescribed immediately(T/F)? stomach and duodenum - Answer- Primary site for peptic ulcers True - Answer- Treatment of peptic ulcer includes multiple agents (T/F)? broaden the spectrum of coverage - Answer- The addition of a beta lactamase inhibitor will do what? False - Answer- Penicillin is a category D (T/F)? Amoxicillin - Answer- What is the 1st line for sinusitis and acute otitis media? Non draining skin infections - Answer- Cephalexin is commonly used to treat gram negative activity - Answer- Fluoroquinolone have strong True - Answer- Lincosamides such as clindamycin has no gram negative activity (T/F)? Hold the statin while on the ABX - Answer- You are prescribing azithromycin. Patient is on atorvastatin. You should tell the patient to Community Acquired Pneumonia (CAP) - Answer- Azithromycin is typically the drug of choice for good gram positive and gram negative inhibition - Answer- Sulfonamides such as sulfamethoxazole trimethoprim has children less than 8 pregnant women lactating women - Answer- Tetracyclines should not be prescribed to red man syndrome ototoxicity nephrotoxicity - Answer- ADR's for vancomycin include altered purine metabolism - Answer- Gout is the result of Colchicine - Answer- Which medication works very quickly to relieve inflammation with gout surgery? febuxostat, allopurinol - Answer- Which of the following prevent/reduce uric acid secretion? Increasing the rate of uric secretion - Answer- Uricosuric medications work by allopurinol, colchicine - Answer- The patient has liver disease and having a gout attack. You should avoid Allopurinol - Answer- What is the drug of choice for patients with chronic high serum urate? Probenecid (Benemid) - Answer- What is the uricosuric drug of choice in gout? immunosuppressant anti-inflammatory promotes water retention potential for increase bleeding - Answer- Corticosteroids have which of the following properties adrenal crisis - Answer- Abrupt cessation of corticosteriods may result in reduced GI sx - Answer- A benefit of COX-2 inhibitors is False - Answer- Acetaminophen is an anti-inflammatory (T/F)? anti-platelet activity anti-inflammatory activity anti-pyretic activity analgesic activity - Answer- Aspirin has the following properties connective tissue, bone, muscle, skin - Answer- Somatic pain arises from [Show Less]

Regis NU641 Adv Pharmacology Quiz 1 Questions with correct Answers

hyperlipidemia - Answer- high cholesterol levels in the blood, which can lead to heart dz, stroke and other problems caused by block arteries Atheroscle... [Show More] rosis - Answer- Changes in the walls of large arteries consisting of lipid deposits on the artery walls, which incidences can be reduced with proper treatment of hyperlipidemia Treatment goal of hyperlipidemia - Answer- lowering of the cholesterol to appropriate levels to decrease the risk of heart attack and stroke Non-pharmacology treatment - Answer- Therapeutic Lifestyle Changes (TLC) important part of treatment and are not futile Pharmacology - Answer- Medications Statins - Answer- lower cholesterol in the blood and reduce its production in the liver by blocking the enzyme that produces it; has adverse effects that can occur more frequently at higher doses. LDL cholesterol - Answer- goal of < 70 in high risk patients goal of < 100 in mod high-risk patients DM pts w/ acute coronary artery syndrome & multiple or uncontrolled risk factors; Tx = - Answer- TLC, changes in diet restrict refined carbs (sugar & liquid calories), wgt loss (pt will not be able to participate in aerobic activity if had previous MI), decreased insulin resistance, decreased BP, improved cardiovascular conditioning, limit/ restrict ETOH consumption. Which patients are easier to manage? - Answer- Patients at low risk for developing heart dz. What med is recommended if the LDL cannot be decreased by a high dose of potent statin? - Answer- Nicotinic acid Med combination to lower triglycerides and increase the HDL - Answer- a fibrate/nicotinic acid with statin Patient Education for Statin - Answer- Pt to report report extreme fatigue, darked-color urine, ck elevated, rhabdomylitis (muscle aches); if reported stop immediately and check LFT(Liver Fxn Test) lescol (Statin) - Answer- This med can affect liver function and increase liver enzymes as well cause the pt to feel weak, fatigue and have muscle aches checking the LFT is recommended Acute drug induced hepatitis - Answer- the Liver enzymes are elevated w/ the use of statin If pt has acute and chronic hepatitis, liver disease cirrhosis and alcoholism; or pregnant/breastfeeding mothers - Answer- DO NOT PRESCRIBE STATINS First-line therapy for hyperlipidemia - Answer- Therapeutic Life Changes (TLC) Such as: balanced diet, weight loss, minimize risk factors before medications Which drug class is most effective for the management of hyperlipidemia with concurrent elevated triglycerides (TGs)? - Answer- Fibrates How do you identify the potential serious adverse drug reactions with hyperlipidemia agents? - Answer- Monitor BP within 1 to 3 hours of administration to check for hypotensive affect What type of counseling would you give to a pt who just started on hyperlipidemia agents, such as an HMG Co-A reductase inhibitor (statin), etc? - Answer- myopathy and hepatatoxicity What is the second line treatment options if a patient fails a statin? - Answer- Bile acid-binding resins Patient factors which preclude use of an HMG Co-A reductase inhibitor - Answer- *patients with active hepatic disease or unexplained persistent elevations in aminotransferase levels * in pregnancy and during breastfeeding as cholesterol is an essential component for fetal and infant synthesis of steroids and cell membrane development *caution is necessary for patients with already increased blood glucose *levels or increased Hba1c levels. can increase the risk of statin-induced myopathy Which hyperlipidemia agents are appropriate for use in pregnancy with respect to risk to fetus as well as mother? - Answer- Fibrates Which drug (statin) decrease LDL at a greatest percentage? - Answer- Rosuvastatin Post MI dose of ASA - Answer- BMI > 29 = 325mg ASA BMI < 29 = 81mg ASA (low dose) heart failure (HF) - Answer- A condition in which the heart fails to discharge its contents adequately; affects the cardiovascular, musculoskeletal, renal and neuroendocrine systems systolic failure - Answer- occurs when the EF is < 40% diastolic failure - Answer- HF with preserved systolic function occurs when patients are symptomatic with EFs near normal Characteristics of HF - Answer- decreased ventricular compliance and altered relaxation caused by HTN and AF Underlying Causes of Heart Failure - Answer- •Hypertension (HTN) •Diabetes •Myocardial infarction (MI) •Valvular disease •Coronary artery disease (CAD) •Congenital heart disease •Rheumatic fever •Dysrhythmias •Aging of the myocardium •Thyroid disease •Illicit drug use •Excessive alcohol use •Exposure to cardiotoxic agents •Collagen vascular disease Pathophysiology of Heart Failure •Pump failure •Cardiac remodeling •Physiologic adaptations to reduced cardiac output •Cardiac dilation •Increased sympathetic tone - •Water retention and increased blood volume •The vicious cycle of "compensatory" physiologic responses Cardiac Remodeling •Remodeling driven by neurohormonal systems •SNS sympathetic nervous system •RAAS •Ventricular dilation •Ventricular hypertrophy •Increased wall stress [Show Less]

Regis NU641 Adv Pharmacology Week 7 & Week 8 Exam 2023

Inhaled Short-Acting Beta-Agonist (SABA) (Albuterol or Levalbuterol) - Answer- Treatment for Intermittent Asthma Rescue SABA and an Inhaled low dose c... [Show More] orticosteroids (Budesonide or Beclomethasone) - Answer- Treatment for Persistent Mild Asthma luekotriene receptor antagonist (Montelukast or Zafirlukast) - Answer- Alternative to Low dose corticosteroid Cromolyn - Answer- mast cell stabilizer that is used for patients with exercise induced asthma or patients with predictable asthma exposure Add an inhaled long-acting beta-agonist to the low dose inhaled corticosteroids and short-acting beta-agonist (Budesonide-Formoterol = Symbicort or Fluticasone-Salmeterol = Advair) - Answer- Treatment for Persistent Moderate Asthma Med-High dose of inhaled corticosteroids in combination with a LABA and all other previous medications (SABA, mast cell stabilizer, leukotriene inhibitors) - Answer- Treatment for Persistent Severe Asthma Omalizumab (Xolair) - Answer- Treatment for allergic asthma or for patients that has asthma that is driven by an IgE response Systemic Corticosteroids - Answer- Treatment if symptoms persist in severe asthmatic patients Rifampin, Isoniazid, Pyrazinamide, and Ethambutol - Answer- Drugs to treat TB Bodily fluids turn red - orange - Answer- Side Effects of Rifampin peripheral neuropathy - Answer- Side effects of Isoniazid Vitamin B6 (pyridoxine) - Answer- Treatment for Peripheral Neuropathy Hyperuricemia (gout) - Answer- Side Effect of Pyrazimide red-green color blindness - Answer- Side effects of Ethambutol Blue-green color blindness - Answer- Side effects of Sildenafil Hepatoxicity - Answer- Major side effect of TB Medications [Show Less]

NU641 Week 11 Quiz 2023-solved

Generalized seizure types (6) - Answer- -Tonic clonic (grand mal) -Absence (petit mal) -Clonic -Myoclonic -Tonic -Atonic Status epilepticus (2) - A... [Show More] nswer- -Two or more seizures without full consciousness between seizure episodes -Requires immediate treatment Absence seizures - Answer- -Impaired consciousness for short period of time -Typically seen in children 4 to 12 -EEG typically shows generalized 3 Hz waves Focal seizure types (2) - Answer- -Simple partial -Complex partial Antiepileptic drugs mechanism of action (4) - Answer- -Reducing sodium and/or calcium influx into brain cells -Causes increase in inhibitory gamma-amino butyric acid (GABA) activity -Enhances influx of chloride -Interferes with excitatory glutamate transmission Antiepileptic agents that reduce efficacy of oral contraceptives (3) - Answer- -Phenytoin -Phenobarbital -Carbamazepine Seizure medications and pregnancy - Answer- -None are safe -Use only if benefit outweighs risk and patient realizes potential of birth defects Phenytoin (Dilantin) (2) - Answer- -Highly plasma protein bound -Serum levels 10 to 20 mcg/ml should be interpreted according to patient's serum albumin level Fosphenytoin (2) - Answer- -Prodrug that is converted to phenytoin -Can be given IM Hypersensitivity syndrome and phenytoin - Answer- -Can occur about 3 to 8 weeks after starting therapy Gabapentin (4) - Answer- -GABA analog -Does not increase GABA brain levels -Does not act at GABAnergic receptors -Few drug interactions Primidone metabolism - Answer- Metabolized to phenobarbital Phenobarbital - Answer- -Usually used in status epilepticus Levetiracetam (Keppra) (3) - Answer- -Chemically different than other AEDs -Should not be stopped abruptly because of increased risk of withdrawal seizures -Can cause dizziness somnolence Benzodiazepines MOA (3) - Answer- -Bind to GABA receptors -Allows influx of chloride through central ion channels -Reduces neurotransmission Hypnotic agents that bind to benzodiazepine receptors (subtype BZ) (3) - Answer- -Zlpidem -Zaleplon (Sonata) -Eszopiclone (Lunesta) Benzodiazepines use (4 - Answer- -Anxiety -Sedative/hypnotics -Anterograde amnesia in procedures -Muscle relaxants Benzodiazepine antagonist - Answer- Flumazenil, a GABA receptor antagonist Most common types of headaches (3) - Answer- -Tension -Migraine -Cluster Migraine characteristics (5) - Answer- -Family hx -Females 3x more than males -Pulsating or throbbing type of pain -Duration of 2 to 72 hours -Associated with visual auras, light and sound sensitivity, pale facial complexion, N/V Migraine therapy goals (4) - Answer- -Relieving headaches -Avoiding overuse of medications -Diminishing impact of migraines on patient's quality of life -Reduction of 50% occurrence realistic goal [Show Less]

NU641 Week 2 Quiz Study Guide: Antihypertensive Agents

Alpha-1 adrenergic receptor stimulation causes: - Answer- vasoconstriction and an increased blood pressure Alpha-1 adrenergic receptor blockade results ... [Show More] in: - Answer- vasodilation and reduced blood pressure The only alpha-1 adrenergic receptor blocking drugs used to treat hypertension include: - Answer- prazosin and alfuzin What can occur with the first dose of an alpha-1 receptor blocking agent? - Answer- Orthostatic hypotension Beta adrenergic blocking agents: - Answer- propranolol, metoprolol, esmolol (short-acting), atenolol, nadolol Beta-1 adrenergic stimulation results in: - Answer- increased heart rate, increased blood pressure and increased cardiac output Beta-1 adrenergic blockade results in: - Answer- reduced heart rate, reduced blood pressure and reduced cardiac output Beta blocking agents include: - Answer- nonselective agents (e.g., propranolol) that block beta-2 receptors in the lungs Selective beta blockers block: - Answer- beta-1 receptors in the heart and vasculature What is not used in hypertensive emergencies and why? - Answer- Carvedilol- because it is an alpha and beta receptor blocker First-line therapy for hypertension include: - Answer- ACE inhibitors, angiotensin receptor blockers (ARBs), and calcium channel blockers Beta-blockers are not considered first-line therapy in hypertension because of: - Answer- increased morbidity and mortality Dihydropyridine (DHP) calcium channel blockers: - Answer- amlodipine, nicardipine, isradipine, felodipine, nifedipine Non-DHP calcium channel blockers: - Answer- diltiazem, verapamil Calcium channel blockers reduce the amount of intracellular calcium, which reduces: - Answer- vascular rigidity and lowers blood pressure The 2014 Hypertension Guideline Management algorithm recommends a calcium channel blocker for: - Answer- black individuals who have normal renal function Calcium channel blocking agents are useful in hypertensive patients with: - Answer- underlying angina or diabetes Adverse effects of calcium channel blocking agents include: - Answer- first-degree AV block, dizziness, headache, constipation, and peripheral edema Dihydropyridine (DHP)-type calcium channel blockers can cause: - Answer- gingival hyperplasia and peripheral edema The DHP-type calcium channel blocker amlodipine causes: - Answer- the most peripheral edema, especially pedal edema; edema of the hands is also possible Angiotensin converting enzyme inhibitors (ACEIs): - Answer- lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril Important side effects of ACE inhibitors include: - [Show Less]

NUR 641E Midterm Study Guide with complete solutions

Prodrug - Answer- An inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body. -Cyt... [Show More] ochrome P450 -Ex. Aspirin, psilocybin, heroin Bioavailability - Answer- the rate at and the extent to which a nutrient is absorbed and used -Affected by route of administration and drug dosage -Drug clearance (rate drug leaves circulation) -Steady state concentration -Affected by chemical stability, solubility, and first pass Steady state (of a drug) - Answer- stable level of drug in the body, occurs in 5 half lives of the drug -rate of drug being added to system is equal to amount being eliminated from system Pharmacokinetics - Answer- The process by which drugs are absorbed, distributed within the body, metabolized, and excreted. -what the body does to the drug First pass - Answer- the fact that a medication in the GI tract passes through the liver before entering other organs does not - Answer- bioequivalence does/does not affect bioavailability Bioequivalence - Answer- relative therapeutic effectiveness of chemically equivalent drugs. Bioavailability (is affected by) - Answer- -chemical instability -solubility -first pass metabolism Cytochrome P450 - Answer- -enzymes that function to metabolize potentially toxic compounds, including drugs and products of endogenous metabolism such as bilirubin, principally in the liver. -genetics influence presence of enzymes -affects metabolism of warfarin, antidepressants, antiepileptics, and statins. -the levels of these drugs are higher when taken with certain drugs that are inhibitors (ex. warfarin with omeprazole) because there is competition for enzyme metabolism. -inducers lead to decreased plasma concentration of drug. cytochrome p450 inducer - Answer- An inducer increases the metabolism of a substrate resulting in a decreased level or effect of the substrate cytochrome p450 inhibitor - Answer- An inhibitor decreases the metabolism of a substrate resulting in an increased level or effect of the substrate. Clopidogrel - Answer- prodrug that must be activated by hepatic CYP2C19 metabolism; individuals who are poor metabolizers may not form the active metabolite and have reduced antiplatelet response half-life (determines) - Answer- how often a drug is administered 4-5 - Answer- steady state is reached in _-_ times the half-life Warfarin (MOA) - Answer- -Vitamin K antagonist -Factors II, VII, IX, X -takes several days to take effect -monitor INR Vitamin K - Answer- warfarin antidote Heparin (MOA) - Answer- -rapid anticoagulation by binding with antithrombin III and inhibits factors IXa, Xa, XIIa, and XIII -aPTT monitoring (low dose SQ does not require monitoring) Apixaban (MOA) - Answer- direct factor Xa inhibitor parenteral administration - Answer- -directly into systemic circulation -poor absorption or unstable in GI tract (ex. heparin, insulin), rapid absorption, unable to take meds PO -IV, IM, SQ, ID IV - Answer- -into the vein -can be given through bolus (rapid peak) or infusion (lower peak, longer duration) -ex. rocuronium (neuromuscular blocker) IM - Answer- -aqua solutions absorbed rapidly -depot absorbed slowly in a nonaqueous solution such as polyethene glycol (simple diffusion) SQ - Answer- -absorption via simple diffusion -constant, slow, and sustained effects -not for drugs that cause tissue irritation d/t pain and necrosis ID - Answer- -diagnostic determination and allergy sensitivity inhalation - Answer- -drug effects as rapid as IV bolus -minimizes systemic side effects of respiratory drugs oral - Answer- -antidotes may be provided -most common, convenient, and economical method of drug administration -most complicated drug pathway -low gastric pH inactivates some drugs -20-60 minutes for effects -enteric, extended-release enteric-coated - Answer- -protects the drug from stomach acid -delivers to less acidic intestine -useful for drugs that are acid labile or irritating to stomach (ex. omeprazole, aspirin) extended-release - Answer- -control drug release -maintain therapeutic range over longer period -good for drugs with short half-life (i.e. morphine with half-life of 2-4 hours) aPTT - Answer- activated partial thromboplastin time 30-40 seconds - Answer- Normal activated partial thromboplastin time (APTT) 1.5-2.5 - Answer- therapeutic aPTT is x more than normal [Show Less]

NU641 Weeks 7 & 8 Study Guide latest updated (Graded A)

Nasal corticosteroids for allergic rhinitis (7) - Answer- -Beclomethasone -Budesonide -Ciclesonide -Flusonide -Fluticasone -Mometasone -Triamcinolone... [Show More] Inhaled corticosteroids (6) - Answer- -Beclomethasone HFA -Budesonide DPI -Budesonide for nebulizer -Flunisolide (HFA & MDI) -Fluticasone (HFA, MDI, DPI) -Mometasone DPI Allergic rhinitis with nasal congestion and runny nose best treatment - Answer- Inhaled nasal steroid (glucocorticoid) for long-term use After each use of any inhaled corticosteroid... - Answer- rinse mouth Rebound nasal congestion (2) - Answer- -Major drawback to inhaled nasal sprays with more than 3 day use -Common with oxymetazoline (Afrin) Advantages to second generation antihistamines (2) - Answer- -Less sedating -Few anticholinergic effects Children with acute viral URIs should not be given - Answer- -Systemic decongestants -Nasal corticosteroids -Systemic antimicrobial agents Productive cough responds well to... - Answer- cough preparations containing codeine Do not use cough preparations containing codeine if... - Answer- congestion cannot be mobilized Treatment if patient has congestion, productive cough, and tenacious mucous (2) - Answer- -Cough preparation containing an expectorant the thins out mucus -Plus cough suppresent Cough expectorant - Answer- Guaifenesin Cough suppressants (2) - Answer- -Codeine -Dextromethorphan Treatment if bacterial sinusitis does not respond to first line empiric abx therapy after three days and no culture results available - Answer- Broader spectrum abx Respiratory fluoroquinolones (2) - Answer- -Levofloxacin -Moxifloxacin When is a respiratory fluoroquinolone or doxycycline effective in bacterial sinusitis? - Answer- If a patient is anticholinergicic to penicillin and penicillin-like agents Primary cause of community acquired pneumonia - Answer- Strep. pneumoniae When to use combination antimicrobial therapy for CAP - Answer- Patient has been on antimicrobial therapy in recent past Combination antimicrobial therapy for CAP example - Answer- Beta-active plus macrolide or azalide Treatment for CAP for individuals not recently on antibiotics - Answer- Macrolide antibiotics such as azithromycin Fluoroquinolone in patients with cardiac conditions (2) - Answer- -Use caution when prescribing -Can prolong QT interval Mild intermittent asthma - Answer- -S/S no more 2x week Exercise induced asthma (2) - Answer- -Often mild intermittent type -Effectively treated with inhaled short-acting beta-2 type agonist Mild persistent asthma - Answer- Symptoms occur >2x/wk, but not daily Mild persistent asthma treatment - Answer- Inhaled low dose corticosteroid Moderate persistant asthma - Answer- Daily asthma symptoms Moderate persistent asthma treatment - Answer- -Short acting beta-2 agonist for acute symptoms -Inhaled medium dose corticosteroid for long term control Severe persistent asthma - Answer- Symptoms occur continually, along w/ frequent exacerbations that limit physical activity & QOL Severe persistent asthma treatment - Answer- -Long acting beta-2 agonist -High potency inhaled corticosteroid -Oral corticosteroid drug Inhaled short acting beta 2 agonists are indicated only for... - Answer- PRN use SABA can be used... - Answer- alone or more commonly with other inhaled agents SABA uses - Answer- Acute asthma attacks SABA side effects (4) - Answer- -Increased HR -Tremors -Nervousness -Reduce potassium levels Anticholinergic agents for asthma - Answer- -Ipratropium -Tiotropium Ipratropium use - Answer- Acute asthma attack Tiotropium uses (2) - Answer- -Once a day in asthma and COPD -Not for acute asthmatic attacks Best bronchodilator for patient with acute breathing issue and uses oral nonspecific beta blocker - Answer- Ipratropium Leukotriene inhibitors are n [Show Less]