NR566 Final Exam Review (Latest 2022/2023): Advanced Pharmacology for
Care of the Family - Chamberlain
Doxazosin side effects (due to alpha 1
... [Show More] receptor being blocked) - dizziness/syncope,
headache, first-dose orthostatic hypotension, drowsiness, nasal congestion
Dutasteride (finasteride) patient teaching - benefits take months to develop, must
continue taking med even if improvement not rapidly seen
may lower ejaculatory volume & libido
How to know Terazosin is working? - improved symptoms of dysuria, urgency, urinary
tract infections, hesitancy etc.
When is it safe and not safe to prescribe Progesterone (Progestin)? - if woman has had
a hysterectomy/pregnant
side effects of progestin-only oral contraceptives? - more likely to cause
irregular/inconsistent bleeding, must be taken at same time every day to be effective
Benefits of prescribing medroxyprogesterone acetate - doesn't cause thromboembolic
disorders, headaches, nausea, or most of the other adverse effects associated with
combo OCs.
does not decrease milk supply during lactation
Testosterone replacement therapy routes: - treatment that involves administering
testosterone supplements through pills, injections, or skin patches
testosterone patch patient teaching: - ○ good hand washing is required after application
○ cover application site with clothing after medication has dried
○ wash the application site before skin-to-skin contact with another person
■ females and children may experience negative effects from exposure to testosterone
■ if cross contamination occurs, wash the affected area with soap and water to prevent
absorption
When is androgen therapy appropriate vs. not needed related to puberty? - Short term:
The psychological pressures of delayed sexual maturation are causing a boy significant
distress.
Long term: if delayed puberty related to true hypogonadism
testosterone replacement therapy side effects? - Hot flashes, bone fractures, decreased
libido, insulin resistance, erectile dysfunction, gynecomastia, acne, HTN, sterility,
hepatotoxicity, mood swings/ aggression.
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Alprostadil: benefits of various routes? (for ED) - injection: can be done by patient or in
ER setting; rapidly leads to erection, painless
intraurethral pellet insertion: can be done by patient, erection occurs within 5-10 mins,
minimal side effects
How does carbamazepine impact oral contraceptives and what symptoms may be
associated with that? - accelerates OC metabolism, reducing OC effect
can lead to abnormal bleeding, return of menstrual symptoms, and of course
pregnancy!
what can the provider do is carbamazepine effecting patient's OC? - 1. Increase the
estrogen dosage of the OC.
2. Combine the OC with a second form of birth control.
3. Switch to an alternative form of birth control.
Benefits of Etonogestrel subdermal implant (Nexplanon)? - it is one of the most effective
forms of contraception, long-term option (contraception up to 5 years), reversible by
removing rod
Papaverine plus phentolamine patient education: - do not inject more than once in a 24
hr period, notify provider of erection duration and efficacy, do not take other ED meds
with this medication, needle/injection teaching, do not change the dose yourself, seek
medical attention if erection is >3 hrs
Chlamydia first line drug/dose/route/frequency - Azithromycin 1000 mg PO once
OR
Doxycycline 100 mg PO BID × 7 days
Uncomplicated gonococcal urethritis first line drug/dose/route/frequency - Ceftriaxone
250-500mg IM once
Bacterial Vaginosis first line drug/dose/route/frequency - 500 mg Metronidazole PO BID
x 7 days
Herpes Simplex Virus first line drug/dose/route/frequency - Acyclovir 400 mg PO TID x
7-10 days
Trichomoniasis first line drug/dose/route/frequency - women: 500 mg Metronidazole PO
BID x 7 days
men: 2 g Metronidazole PO once
Syphilis first line drug/dose/route/frequency - Penicillin G IV (dose depends on the
patient)
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Adverse effects associated with Pramipexole - nausea, dizziness, daytime somnolence,
insomnia, constipation, weakness, and hallucinations.
Impulse control disorder can occur (excessive gambling, spending etc.)
Sleep attacks (overwhelming and irresistible sleepiness that comes on without warning)
When is Pramipexole best used in treating Parkinson's? - early stages of Parkinsons
when are COMT inhibitors indicated? (I.e. Entacapone) - If patient experiences "off"
phases with their medication therapy (return of symptoms for random periods of time)
extends the half-life of Levadopa
What are sleep attacks associated with Parkinsons treatment? -
overwhelming/irresistible sleepiness that comes on without warning
How to manage side effects of Bromocriptine (dopamine agonist): - Take with food to
decrease GI upset
start with lowest effective dose and gradually increase
screen for hx of compulsion/sleep disturbance
what seizure meds reduce OC efficacy? - carbamazepine, eslicarbazepine, lamotrigine,
oxcarbazepine, phenytoin, phenobarbital, rufinamide, topiramate
Phenytoin side effects - drowsiness, ataxia
nystagmus
blurred vision
lethargy
GI upset
suicidal behavior/cognitive decline
patient teaching with Phenytoin - strict adherence to medication is important due to its
narrow therapeutic range
patient teaching regarding anti-seizure meds and OC/pregnancy: - effectiveness of OC
may be decreased by many anti-seizure meds, if pregnancy is unwanted the pt should
consider adding or increasing contraception.
lowest dose/lowest number of meds used during pregnancy tends to be most safe. Risk
vs benefit!
Folic acid is essential [Show Less]