NR 508 Quiz NR508 midterm review completed with Solutions.
Quiz #1
1) When taking acyclovir, patients should be educated regarding the
Need to drink
... [Show More] lots of water during treatment
2) Precautions that should be taken when prescribing controlled substances include
Using tamper-proof paper for all prescriptions written for controlled drugs
3) Medication agreements or “Pain medication Contracts” are recommended to be used:
Universally for all prescribing for chronic pain
4) Clinical judgment in prescribing include
Factoring the cost to the patient of the medication prescribed
5) Vitamin B12 deficiency may lead to:
Numbness and tingling on the hands
6) Behaviors predictive of addiction to controlled substances include:
Stealing or borrowing another patient’s drugs
7) Isoniazid (INH) may induce a deficiency of which vitamin: C
8) There is often cross-sensitivity and cross-resistance between penicillin and
cephalosporins because: Both drugs contain a beta-lactam ring that is vulnerable to the
beta-lactamase-producing organism
9) An 82 y/o pt who has herpes zoster (shingles)and would benefit from an anti-viral such as
acyclovir. Prior to prescribing valacyclovir, she will need an assessment ofthe Renal
function
10) According to the 2003-2006 National Health and Nutrition Examination Survey study of
dietary intake, the group at risk for inadequate calcium was: Teenage females
Quiz #2
1) Pt with c/o vaginal discharge that when tested meets the criteria for bacteria vaginosis. Tx
of bacterial vaginosis in nonpregnant symptomatic women would be:
Metronidazole 500 mg PO bid x 7 days
2) If a woman presents with recurrent vulvovaginal candidiasis she may be treated with:
Intravaginal tioconazole x 14 days
3) Besides prescribing microbial therapy, pts with bacterial vaginosis require education
regarding the fact that: alcohol should not be consumed during and 1 day after
metronidazole is taken
4) Tx for chancroid in a nonpregnant pt would be: Oral azithromycin; ceftriaxone; oral
ciprofloxacin
5) Dysmenorrhea is one the most common gynecological complaints in young women. The
first line drug for this disorder is: NSAIDS
6) Men who are prescribed an erectile dysfunction drug such as sildenafil (Viagra) should be
warned about the risk for: fatal hypotension if combined with nitrates
7) The drug of choice for tx of primary or secondary syphyllis is: Benzathine penicciliin G
IM
8) A contraindication to the use of combined contraceptives is: A hx of clotting factors9) Patients who are prescribed exogenous androgens need to be warned that decreased
libido:
May occur with androgen therapy
10) Long-term use of androgens requires specific laboratory monitoring of: calcium,
testosterone, PSA, liver function, glucose, and lipids
Quiz #3
1) Pt teaching r/t amlodipine includes: Rise slowly from a supine position to reduce
orthostatic hypotension
2) The NP orders a thyroid panel for a pt on amiodarone. The pt tells the NP that he does not
have thyroid disease and wants to know why the test is ordered:
Amiodarone inhibits an enzyme that is important in making thyroid hormone and can
cause hypothyroidism
3) Which of the foll. AE may occur due to a dihydropyridine-type CCB? Edema of hands
and feet
4) Rodrigo has been prescribed procainamide after a MI. He is monitored for dyspnea,
jugular venous distention, and peripheral edema bcuz they may indicate: Onset of CHF
5) Patrick is 10 y/o pt who presents with uncomfortable constipation. Along with diet
changes, a laxative is ordered to provide more rapid relief of constipation. An appropriate
choice of medication for a 10 y/0 child would be: Bisacodyl (Dulcolax) suppository
6) All pts with HTN benefits from diuretic therapy, but those who benefit the most are:
African Americans
7) Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for diarrhea.
Loperamide: Slows gastric motility and reduces fluid and electrolyte loss from diarrhea
8) Angiotensin-converting enzyme inhibitors are the drug of choice in treating htn in
diabetic pts bcuz they: All of the above
9) Colestipol come in powder form. The pt is taught to: Mix the powder with 4-6 oz of milk
or juice
10) Pts at high risk for developing significant coronary heart disease are those with: Class III
angina
Midterm Outline
Chapter 1: The Role of the Advanced Practce Nurse as Prescriber
Roles and responsibilites of APRN prescribers
Clinical judgement in Prescribing: use tamper proof paper for all prescriptons writen for controlled
substance
Collaboraton with other providers
Autonomy and Prescriptve authority
Chapter 2: Review of Basic Principles of Pharmacology
Metabolism: Metabolism & Half LifeMetabolism is related to drug concentraton so that a fxed fracton of the drug is metabolized per hour.
This is called frst-order metabolism and is characterized by a half-life, the tme period over which the
drug concentraton will decrease by half.
How Drugs are Developed: drugs were developed by accident, this involves designing and synthesizing
compounds based on the known structure of a specifc target molecule
Drug Responses:
Receptors: agonists cause an acton; antagonists: opposes the acton of the agonist
Antagonists occupy a receptor site and prevent other molecules, such as agonists, from occupying the
same site and producing a response. Antagonists produce no direct response
Pharmacokinetcs: The study of what happens to a drug from the tme it is put into the body untl the
parent drug and all metabolites have lef the body. Pharmacokinetcs represent the drug absorpton into,
distributon and metabolism within, and excreton from the body.
Absorpton: is the movement of a drug from its site of administraton into the bloodstream for
distributon to the tssues.
Distributon: refers to the transport of a drug by the bloodstream to its site of acton, frst to those areas
with extensive blood supply. Areas of rapid distributon include the heart, liver, kidneys, and brain; while
areas of slower distributon include muscle, skin, and fat
Protein Binding: Protein binding may lead to an unpredictable drug response called a drug-drug
interacton. A drug-drug interacton occurs when the presence of one drug decreases or increases the
actons of another drug that is administered concurrently (i.e., given at the same tme).
Metabolism: Metabolism of drugs occurs mostly in the smooth endoplasmic retculum of cells in the
liver. A drug that is absorbed from the intestne must frst pass through the liver before it reaches the
systemic circulaton. If a large proporton of a drug is chemically changed into inactve metabolites in the
liver, then a much smaller amount of drug will pass into the circulaton (i.e., will be bioavailable) thus
creatng a frst-past effect that reduces drug bioavailability.
Hepatc metabolism involves the actvity of a very large class of enzymes known as cytochrome P-450
enzymes
First Pass Routes: Hepatc, arterial, Oral, Portal, venous, Rectal
Phase I: It begins with preclinical testng phases, which include in vitro studies (using tssue samples and
cell cultures) and animal studies, healthy people without the disease. Phase I studies is to determine the
optmal dosage range and the pharmacokinetcs of the drug and to ascertain if further testng is needed.
II: Clinical (human) studies follow the preclinical phase. This phase involves small numbers of volunteers
who have the disease that the drug is designed to diagnose or treat and are closely monitored for the
effectveness of treatment
Cytochrome P450 metabolism: the family of enzymes that metabolizes drugs; CYP P450 (mixed-functon
oxidase reacton) catalyzes the metabolism of a large number of diverse drugs and chemicals that are
highly lipid soluble (lipophilic).Excreton: Renal excreton is accomplished through passive glomerular fltraton, actve tubular
reabsorpton, and actve tubular secreton.
Biliary: The excreton of drugs by the intestnes is another route of eliminaton where drugs are taken up
by the liver, released into the bile, and eliminated in the feces.
Other (eg for volatle drugs)
Chapter 3: Ratonal Drug Selecton
Process of ratonal drug prescribing: 6 Steps proposed by WHO Step 1 Defne the patent’s problem.
Step 2 Specify the therapeutc objectve. Step 3 Choose the treatment. Step 4 Start the treatment. Step 5
Educate the patent. Step 6 Monitor effectveness.
Patent educaton:
Monitor effectveness: Passive monitoring occurs when the patent is educated on the expected
outcome of the drug therapy and is instructed to contact the provider if the treatment is not effectve or
if adverse drug effects occur and is common in short term treatment such as antbiotc
Actve monitoring occurs when the provider schedules a follow-up examinaton to determine the
effectveness of the drug therapy; may also include adding are subtractng a medicaton from the
treatment.
Drug, Patent, and Provider factors that influence drug selecton
Drug factors: Drug must be specifc and selectve to the target tssues affected by the disease to have the
greatest therapeutc effect with the least adverse effects; relatonship between a drug’s desired
therapeutc effects and its adverse effects is called its therapeutc index; narrow therapeutc index
requires close monitoring for signs of toxicity, while wide therapeutc index is much safer.
Pt factors: Previous Adverse Drug Reactons, health belief, current drug therapy, patent age, cost,
pregnancy
Provider factors: Ease of Prescribing or Monitoring, fomularies
Influences on Ratonal Prescribing: Pharmaceutcal Promoton: free gifs, free drug samples to providers
to raise awareness of their products and to influence physicians to prescribe a company’s medicines
even when evidence indicates another drug would be more benefcial”
When Prescribing Recommendatons Change: antbiotc resistance and overprescribing of antbiotcs for
URIs: The CDC developed the “Get Smart” campaign, and a similar STAR (Stemming the Tide of Antbiotc
Resis - tance) campaign was conducted in the United Kingdom.
Chapter 4: Legal and Professional Issues in Prescribing
New Drug Approval process including Clinical Phases
Preclinical Investgaton (Stage 1) Range: 1–3 years; Clinical investgaton phase: Range: 2–10 years
Average: 5 years; Phase I – pharmacodynamics, Phase II -controlled studies performed on patents with
the target disease or disorder to determine a compound’s potental usefulness and short-term risks;Phase III - trials are controlled and uncontrolled clinical trials of a drug’s safety and efcacy in hospital
and outpatent setngs.
U.S. FDA Regulatory Jurisdicton: ofcial labelling vs off-label use of drugs
Controlled Substance Laws
Controlled Drug DEA schedules (Table 4-1): Schedule III: Prescripton must be rewriten afer 6 mo or 5
reflls; Telephone or fax prescripton okay
Controlled Substance Misuse: Prescriber Educaton - Behavioral Red Flags, Pressure to Prescribe,
Enabling: refers to the powerful instnct in practtoners to do anything medically possible to enable
patents with a present or potental disability to live at a higher level of functon.
When you suspect a Patent is Misusing Medicatons: Communicaton, Systemic Solutons, Prescribing
Tips, Medicaton Agreements: universal precauton” model of care, meaning that the NP
develops and uses agreements that are expected of all patents requiring ongoing use of medicatons
with potental for misuse., Prescripton Drug Monitoring Programs
State Law:
Writng and Transmitng the Prescripton: Use preprinted prescripton pads/electronic templates that
contain the name, address, and telephone number and NPI number of the prescriber. This will allow the
pharmacist to contact the prescriber if there are any questons about the prescripton.
Ethical Aspects of Prescribing:
Chapter 5: Adverse Drug Reactons: an exaggerated physiological response related to the pharmacology
of the drug eg. Hypotension from a beta-blocker, diarrhea from the fat-blocking drug orlistat, and
insomnia from the stmulant methylphenidate that is either manage by drawing the medicaton or
reducing the dose
Mechanistc Classifcaton of ADRs including Types of Immune-Mediated ADRs: Idiosyncratc reactons
are unpredictable and may be more likely to result in mortality
Type I - IgE-mediated, immediate-type hypersensitvity eg. angioedema and anaphylaxis
Type II Antbody-dependent cytotoxicity Example: heparin-induced thrombocytopenia
Type III Immune complex hypersensitvity Example: Arthus reacton to tetanus vaccine
Type IV- Cell-mediated or delayed hypersensivity Example: Drug Rash, Eosinophilia and Systemic
Syndrome
Types A-F: Type A reactons are equivalent to pharmacological reactons, account for 85% to 90% of
ADRs, are dose-dependent, and are predictable, whereas Type B reactons are idiosyncratc, account for
10% to 15% of ADRs, are not dose-dependent, and are not predictable, Type C reactons result from
chronic medicaton use, Type D reactons are delayed, Type E reactons are from drug–drug interactons,
and Type F reactons result from treatment failures.Common Causes of ADRs: Risk Factors, including common drugs involved and which cause skin reactons
Time-Related Classifcaton of ADRs including drugs associated with withdrawal symptoms: Late reacton
(For example, rapid discontnuaton of oxycodone can cause the patent to experience symptoms of
withdrawal (i.e., anxiety, insomnia, rhinorrhea, diaphoresis, tremor, vomitng, diarrhea, and/or
tachycardia). A patent who takes clonidine or propranolol may experience rebound hypertension
following withdrawal of the medicaton).
Dose-Related ADRs classifcaton: administering an excessive dose or failing to adjust doses properly for
age and organ functon (i.e., renal insufciency or liver failure). For example, a person with diabetes may
become hypoglycemic afer administering an excessive dose of insulin. An individual patent could
experience lithium toxicity upon development of acute renal failure with no adjustment of the lithium
dose.
Severity of ADRs: Any ADR that meets FDA criteria should be reported to the FDA MedWatch program
(death, are life-threatening, result in hospitalizaton (new or prolonged), are disabling or incapacitatng,
produce congenital abnormality or birth defect, or require an interventon to prevent one of these
outcomes).
Risk factors: genetc abnormalites, age, sex, polypharmacy (increasing the risk for drug–drug
interactons), and concomitant medical conditons (increasing the chance for drug–disease interactons)
Chapter 6: Factors that Foster Positve Outcomes
Overview of nonadherence
Keys to effectve patent educaton
Health and Cultural beliefs
Health Literacy
Complexity of Drug Regimen and Polypharmacy
Simplifying the Regimen
Communicaton Difcultes
Chapter 7: Cultural and Ethnic Influences in Pharmacotherapeutcs
Cultural Influences on Care
Ethnopharmacology: —the study of racial differences in drug metabolism and response; a drug that is
eliminated entrely by the kidney through fltraton and reabsorpton and is not highly protein bound is
very unlikely to exhibit racial differences
Chapter 9: Nutriton and Nutraceutcals
Nutrient-Drug Interactons (eg warfarin and vit K): Patents who are taking warfarin should not ingest
foods high in vitamin K (spinach, kale, turnip, swiss chard, parsley, mustard greens) as the combinaton
may lead to therapeutc failure.Influence of Diet on Pharmacokinetcs of Drugs: Drug absorpton, Drug Metabolism, Grapefruit juice and
CYP3A4: Grapefruit juice influences the metabolism of many drugs because it contains components that
inhibit CYP3A4, leading to alteratons in the metabolism of drugs;
foods and CYP1A2: Cruciferous vegetables induce CYP1A2, an enzyme responsible for the metabolism of
drugs including theophylline and may have therapeutc failure if they are being treated with drugs that
are metabolized by CYP1A2
Drug Excreton, Drug -Induced Nutrient Depleton (eg folate and B12): changes in the pH from antacid
therapy or potassium therapy can reduce the absorpton of folic acid, iron, and vitamin B12
Outcomes of Nutrient-Drug Interactons
Nutritonal Management: Recommended vitamins for the following special populatons: infants and:
400 IU of vitamin D daily children; women of child bearing age: 400 mcg/day of folic acid; pregnant
women vegans: d 600 mcg/day of folic acid, a multvitamin/mineral supplement, 27 mg/day of iron (60
mg/d if patent is anemic), and vitamin B 12 if the patent is vegan or lacto-ovo-vegetarian; older adults:
B12 2.4 mcg/day and need to ensure adequate intake of vitamin D and calcium.; those not exposed to
sunlight or with dark skin: should consume vitamin D–fortfed foods and/or supplements; alcoholics: Vit
A; patents taking isoniazid (INH): Vit B6
Nutraceutcals: foods that claim to have a medicinal effect on health. Fiber intake: Male 14-50 y/o – 38
g/d, Female 51 yr or older 21, Male 51 yr or older 30 Table 9-2,
Vitamins and Minerals (including Box 9-1): Vit A is labeled category X; Faty Acids, Defciency of thiamine
can lead to beriberi or Wernicke’s encephalopathy, alcoholics are at risk; inadequate vitamin C intake
may develop scurvy (smokers); Vitamin B 6 defciency may be drug-induced by use of isoniazid (INH);
Vitamin B12 is essental for red blood cell formaton and neurological functon. Older adults and patents
with reduced stomach acid levels, gastric bypass surgery, or intestnal disorders are at risk for defciency.
Plant Sterols: plant sterols compete with cholesterol in the intestne, reducing the amount of cholesterol
that is absorbed.
Pre-, Pro- and Symbiotcs; Vitamin that is teratogenic in excessive amounts, Vitamin that is useful for
migraine prophylaxis: Vit B2
Chapter 12: Pharmacoeconomics
Impact of Generic Drugs on Drug Therapy
Generic Substtuton
Prescribing Generic vs Brand-Name Medicatons: signing “generic substtuton permited vs “dispense as
writen”
Chapter 13: Over-the-counter Medicatons
OTC Medicaton characteristcs and regulaton
OTC Medicaton SalesHazards of OTC Self-Medicaton
Adverse Effects of OTC Self-Medicaton
Drug Interactons: antacids: Most interactons can be avoided by separatng the dosing of antacids by at
least 2 hours apart.
Antcholinergics: primary adverse effects of diphenhydramine and dox - ylamine are antcholinergic, such
as dry mouth, constpaton, blurred vision, and tnnitus.
CNS Depressants: OTC drugs may all cause additve sedaton when taken with CNS-sedatng medicatons.
NSAIDS: and ASA
Abuse of OTC Medicatons: Combat Methamphetamine Epidemic Act: Law requires ID to track the sales,
which is limited to daily or 30 days (ephedrine, pseudophedrine).
Patent Educaton Regarding OTC Medicatons
Chapter 14 Drugs Affectng the Autonomic Nervous System
Pharmacodynamics of Alpha2 Agonists: 2nd/3rd line drug; results in inhibiton of cardioacceleraton and
vasoconstricton centers in the brain that causes a decrease in the peripheral outlow of norepinephrine,
leading to decreases in peripheral resistance, renal vascular resistance, heart rate, and blood pressure.
(Clonidine use to tx withdrawal symptoms from opioids, is used in this class actvate alpha 2 receptors in
the medulla of the brain, reducing sympathetc tone and increasing parasympathetc tone, due to down
regulaton of alpha2 receptors afer chronic use. This results in a decrease in peripheral resistance,
reduced heart rate, reduced blood pressure, and reduced renal vascular resistance. SHOULD NOT STOP
ABRUPTLY bcuz the relatve lack will impair the homeostasis that regulates the SNS.
Pharmacodynamics of Beta Blockers: used in the treatment of cardiac disorders such as heart failure,
asymptomatc lef ventricular dysfuncton, and afer acute myocardial infarcton. When B-1 is bound to
norepinephrine and epinephrine they influence heart rate and myocardial contracton. The blockade of
beta-adrenergic receptors produces clinically signifcant acton on the cardiovascular that acts as the SA
node thus decreasing HR in atria and ventricles, renal by reducing the release of renin, and respiratory
systems and on the eye. For patents with hyperlipidemia, beta2 blockade may worsen the conditon.
metabolized extensively by the liver and eliminated via the bile and feces.
adverse effects: what happens with the abrupt withdrawal of Beta Blockers: withdrawal can result in MI,
ventricular arrhythmias, and death.
Pharmacokinetcs: Beta blockers:
Phamacotherapeutcs: precautons and Contraindicatons of beta blockers
Adverse Drug Reactons: Any unexpected, unintended, undesired, or excessive response to a medicaton
given at therapeutc dosages (as opposed to overdose).
Clinical Uses and Dosing of Beta BlockersMuscarinic Agonists: muscarinic receptors are located in the eye, heart, blood vessels, lung, GI tract,
urinary bladder, and sweat glands. Muscarinic agonists are used clinically to treat glaucoma and to
improve GI and urinary bladder tone.
Stmulaton of these receptors actvates by muscarinic agonists that modify organ functon by releasing
ACh from PNS nerves: (1) to actvate muscarinic receptors on target organs to alter organ functon and
(2) to actvate muscarinic receptors on nerve terminals to inhibit the release of their neurotransmiters
Pharmacodynamics, MOA, treatment uses,
Chapter 15 Drugs Affectng the Central Nervous System
Anorexiiants: Precautons and Contraindicatons
Iminostlbenes: (antepileptcs: Carbamazepine (Tegretol) & Oxcarbazepine (Trileptal, Oxtellar XR))
Metabolism: Carbamazepine is metabolized in the liver and has the unique ability to induce its own
metabolism, and excreton is through urine and feces;
Oxcarbazepine has metabolized into an actve metabolite 10-monohydroxy metabolite, which is
responsible for the pharmacologic effect of the drug, 95% is excreted in the urine, 4% in the feces, and
1% as unmetabolized oxcarbazepine
MOAs: slow the influx of sodium in the cortcal neurons and slowing the spread of abnormal actvity;
indicatons: use to tx epilepsy, bipolar affectve disorder, aggressive and assaultve behavior, and some
neuralgias.
Absolute contraindicatons, precautons, monitoring, adverse drug reactons, drug interactons: ones that
raise the plasma level of the drug including grapefruit (the concurrent administraton of propoxyphene,
hydantoins, cimetdine, some antbiotcs (erythromycin, clarithromycin), isoniazid, and verapamil such as
tetracycline; interactons that cause hepatc damage (anesthetcs, INH); and interactons that decrease
the plasma levels o other drugs (beta blockers, succinimides, valproic acid, warfarin, haloperidol,
doxycycline, and nondepolarizing muscle relaxants).
Black Box warnings: regarding the development of Stevens-Johnson Syndrome (SJS) and toxic epidermal
necrolysis (TEN) in patents of Chinese ethnicity; blood dyscrasia, thrombocytopenia, aplastc anemia…
baseline CBC is required, TSH monitoring
What does Long Term monitoring consist of Iminostlbenes: Carba - seizure actvity, severity, and
duraton, CNS depression, and suicidality or behavioral changes. Range 4-12 mcg/ml
Succinimides: used to tx absent seizures in children and adult. MOA: decreasing nerve impulses and
transmission in the motor cortex.
Monitoring: Plasma, renal, CBC levels should be monitored. The normal therapeutc range of
ethosuximide is 40 to 100 mcg/mL; levels over 150 mcg/mL are considered toxic. The therapeutc range
for methsuximide is 10 to 40 mcg/mL, with levels greater than 40 mcg/mL considered toxic.
Drugs That Affect GABA: benzodiazepines, gabapentn (Neurontn), topiramate (Topamax), and tagabine
(Gabitril). The AEDs that affect the inhibitory neurotransmiter GABA are also used for pain, including
neuropathic pain (gabapentn) and migraine (topiramate).Monitoring: Patents taking topiramate should have serum electrolytes, including sodium bicarbonate,
monitored at baseline and periodically. Weight is monitored in all patents on topiramate as are body
temperature and the ability to sweat, especially in warm weather. Serum ammonia levels should be
drawn in any patent taking topiramate who exhibits any change in the level of consciousness,
unexplained lethargy, or vomitng. ADR’s,
Pharmacotherapeutcs: Precautons and Contraindicatons: contraindicated in patents with multorgan
failure, hypersensitvity to the drug, DIC; Black-Box Warning regarding lifethreatening rashes, Stevens–
Johnson syndrome, toxic epidermal necrolysis, and rash-related death.
Patent Educaton:
Drug interactons: Oral estrogen-containing contraceptves decrease lamotrigine levels by approximately
50% and Rifampin by 40% (Lamotrigine)
Tricyclic Antdepressants (TCA): Precautons and Contradictons: with cardiovascular disorder due to their
direct alpha-adrenergic blocking effect and quinidine-like effect on the myocardium, glaucoma due to
their acetylcholine blocking effect, prostatc hypertrophy, or urinary incontnence. Must not prescribe for
patents on MAOIs.
Monoamine Oxidase Inhibitors(MAOIs - phenelzine (Nardil), isocarboxazid (Marplan), tranylcypromine
(Parnate), and selegiline (Emsam), a transdermal): drug interactons Table15-13- avoid SSRIs, Food and
drug interatons.
SSRIs (Prozac): Adverse Drug Reactons: With MAOIs, there needs to be at least a 14-day washout period
before initatng an SSRI and at least a 21 day washout of fluoxetne before initatng an MAOI,
management in children: , Drug interactons (including herbals & supplement): Concomitant use of St.
John’s wort and/or SAMe (S-adenosylmethionine) may contribute to serotonin syndrome., Patent
Educaton - 3 – 4 weeks before full therapeutc benefts
Chapter 16: Drugs Affectng the Cardiovascular and Renal Systems
ACEIs: increases oxygenaton to heart muscles and decrease inappropriate remodeling of heart muscles
afer MI/HF, ARBs: blocks ATII receptors, does not affect ACEIs; Direct Renin Inhibitors: direct blocking of
renin, decrease ATI & II, suppression of ATII triggers a mechanism that increases renin producton, DO
NOT USE IN DM.
MOAs, indicatons, absolute contraindicatons, precautons, monitoring, adverse drug reactons, drug
interactons
CCBs: MOA, indicatons, precautons, contraindicatons, adverse drug reactons, drug interactons,
differences between dihydropyridines and dihydropyridines, patent educaton, short actng vs long
actng CCB side effects - bradycardia
Cardiac Glycosides: indicatons, MOA, adverse drug reactons, contraindicatons, cautons, toxicity, drug
and potassium, calcium and [Show Less]