NUR 635: ADVANCED PHARMACOLOGY: MIDTERM EXAM STUDY
GUIDE QUESTIONS WITH COMPLETE SOLUTIONS
1) What is milrinone? -- Answer ✔✔ phosphodiesterase inhibitor for acute heart
failure
2) What is nitroglycerin -- Answer ✔✔ a nitrate drug that can be administered IV,
SL, a topical ointment and as a transdermal patch.
3) How to take SL Nitroglycerin -- Answer ✔✔ Proper SL nitroglycerin use
involves placing a table under the tongue if chest pain occurs, and let it dissolve
(do not swallow the tablet) and be absorbed sublingually, repeat every 5 minutes
for a maximum of 3 tablets in 15minutes.
4) Patient education with nitroglycerin -- Answer ✔✔ - Nitroglycerin does not
always cause a burning when administered SL.
- Have the patient sit down when using nitroglycerin sublingually;
dizziness and headache can occur.
5) what is a contraindication for nitrates -- Answer ✔✔ contraindicated with PDE-5
inhibitors like sildenafil and vardenafil
,6) What is isosorbide -- Answer ✔✔ oral long-acting nitrate; dosing should be in
the morning and early afternoon to allow for a long nitrate-free interval and
reduce the occurrence of nitrate tolerance.
7) how should antiarrhythmic medications be dosed -- Answer ✔✔ Antiarrhythmics
such as procainamide need to be scheduled at even intervals throughout the day
to maintain effective blood levels.
8) Side effects of amiodarone -- Answer ✔✔ hypothyroidism (by enzyme blockade)
and also pulmonary toxicity, vision changes, phototoxicity, dizziness and blood
pressure changes.
9) Atrial fibrillation symptoms -- Answer ✔✔ palpitations, fainting, breathless, chest
pain, dementia.
10) Atrial fibrillation treatment -- Answer ✔✔ anticoagulation, rate control,
cardioversion, ablation, surgery.
11) What is the greatest factor when prescribing cholesterol-altering medication --
Answer ✔✔ the patient's risk for coronary artery disease.
12) Bile Acid Sequestrants -- Answer ✔✔ cholestyramine, colesevelam, colestipol
13) Fibrates: -- Answer ✔✔ bezafibrate, fenofibrate, fenofibric acid, gemfibrozil
14) HMG-CoA Reductase Inhibitors (Statins): -- Answer ✔✔ atorvastatin, fluvastatin,
lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin.
,15) Statin combinations -- Answer ✔✔ Caduet (atorvastatin/amlodipine), Liptruzet
(atorvastatin/ezetimibe), Vytorin (simvastatin/ezetimibe)
16) Omega-3 Fatty Acids -- Answer ✔✔ icosapent ethyl (Vascepa), omega-3 ethyl
esters (Lovaza), omega=3carboxylic acids (Epanova)
17) Proprotein Convertase Subtilusin/Kexin Type 9 (PCSK-9) Inhibitors: -- Answer
✔✔ alirocumab (Praluent), evolocumab (Repatha).
18) Cholesterol Absorpton Inhibitor: -- Answer ✔✔ ezetimibe (Zetia)
19) Ezetimibe Combinations: -- Answer ✔✔ Liptruzet (atorvastatin/ezetimibe),
Vytorin (simvastatin/ezetimibe)
20) Oligonucleotide inhibitor of ApoB-100 Synthesis: -- Answer ✔✔ mipomersen
(Kynamro)
21) Nicotinic Acid: -- Answer ✔✔ immediate-release niacin, slow-release niacin (Slo-
Niacin), extended-release niacin (Niaspan).
22) Natural Products with Some Activity vs. Cholesterol -- Answer ✔✔ alpha-
linoleic acid, red yeast rice, garlic (limited), krill (for elevated TGs).
23) No Activity vs. Cholesterol: -- Answer ✔✔ nicotinamide.
24) What is the first step in dyslipidemia/hyperlipidemia therapy -- Answer ✔✔
Lifestyle changes (diet and excercise
, 25) Bile acid sequestrants MOA -- Answer ✔✔ increase LDL catabolism, reduce
cholesterol absorption, but can cause an increase in VLDL production.
26) Niacin MOA -- Answer ✔✔ reduces VLDL and LDL synthesis, and increase HDL
production
27) Fibrates MOA -- Answer ✔✔ increase VLDL clearance, reduce VLDL
production, (reducing TGs), but can increase LDL levels if TGs are high (i.e. over
400mg/dl).
28) Statins MOA -- Answer ✔✔ increase LDL breakdown, decrease LDL production,
moderately reduce TGs, and modestly increase HDL.
29) Ezetimibe MOA -- Answer ✔✔ inhibits cholesterol absorption from the gut,
reducing LDL levels
30) cholesterol and pregnancy -- Answer ✔✔ Statins are contraindicated in
pregnancy (Pregnancy Category X); use a bile acid sequestrant agent (Pregnancy
Category B).
31) when should statins be taken -- Answer ✔✔ dosed specifically at bedtime for
maximal effect on LDL cholesterol synthesis
32) Monitoring during statin therapy -- Answer ✔✔ Evaluate muscle function prior
to initiating statin dosing; muscle cramping, aches, the most severe being
rhabdomyolysis, have been reported with statin use; tell patients to report any
muscle aches or weakness and if the urine is dark to their healthcare provider.
**Avoid using statins if closely-related family members have experienced muscle
aching when placed on a statin product.
GUIDE QUESTIONS WITH COMPLETE SOLUTIONS
1) What is milrinone? -- Answer ✔✔ phosphodiesterase inhibitor for acute heart
failure
2) What is nitroglycerin -- Answer ✔✔ a nitrate drug that can be administered IV,
SL, a topical ointment and as a transdermal patch.
3) How to take SL Nitroglycerin -- Answer ✔✔ Proper SL nitroglycerin use
involves placing a table under the tongue if chest pain occurs, and let it dissolve
(do not swallow the tablet) and be absorbed sublingually, repeat every 5 minutes
for a maximum of 3 tablets in 15minutes.
4) Patient education with nitroglycerin -- Answer ✔✔ - Nitroglycerin does not
always cause a burning when administered SL.
- Have the patient sit down when using nitroglycerin sublingually;
dizziness and headache can occur.
5) what is a contraindication for nitrates -- Answer ✔✔ contraindicated with PDE-5
inhibitors like sildenafil and vardenafil
,6) What is isosorbide -- Answer ✔✔ oral long-acting nitrate; dosing should be in
the morning and early afternoon to allow for a long nitrate-free interval and
reduce the occurrence of nitrate tolerance.
7) how should antiarrhythmic medications be dosed -- Answer ✔✔ Antiarrhythmics
such as procainamide need to be scheduled at even intervals throughout the day
to maintain effective blood levels.
8) Side effects of amiodarone -- Answer ✔✔ hypothyroidism (by enzyme blockade)
and also pulmonary toxicity, vision changes, phototoxicity, dizziness and blood
pressure changes.
9) Atrial fibrillation symptoms -- Answer ✔✔ palpitations, fainting, breathless, chest
pain, dementia.
10) Atrial fibrillation treatment -- Answer ✔✔ anticoagulation, rate control,
cardioversion, ablation, surgery.
11) What is the greatest factor when prescribing cholesterol-altering medication --
Answer ✔✔ the patient's risk for coronary artery disease.
12) Bile Acid Sequestrants -- Answer ✔✔ cholestyramine, colesevelam, colestipol
13) Fibrates: -- Answer ✔✔ bezafibrate, fenofibrate, fenofibric acid, gemfibrozil
14) HMG-CoA Reductase Inhibitors (Statins): -- Answer ✔✔ atorvastatin, fluvastatin,
lovastatin, pitavastatin, pravastatin, rosuvastatin, simvastatin.
,15) Statin combinations -- Answer ✔✔ Caduet (atorvastatin/amlodipine), Liptruzet
(atorvastatin/ezetimibe), Vytorin (simvastatin/ezetimibe)
16) Omega-3 Fatty Acids -- Answer ✔✔ icosapent ethyl (Vascepa), omega-3 ethyl
esters (Lovaza), omega=3carboxylic acids (Epanova)
17) Proprotein Convertase Subtilusin/Kexin Type 9 (PCSK-9) Inhibitors: -- Answer
✔✔ alirocumab (Praluent), evolocumab (Repatha).
18) Cholesterol Absorpton Inhibitor: -- Answer ✔✔ ezetimibe (Zetia)
19) Ezetimibe Combinations: -- Answer ✔✔ Liptruzet (atorvastatin/ezetimibe),
Vytorin (simvastatin/ezetimibe)
20) Oligonucleotide inhibitor of ApoB-100 Synthesis: -- Answer ✔✔ mipomersen
(Kynamro)
21) Nicotinic Acid: -- Answer ✔✔ immediate-release niacin, slow-release niacin (Slo-
Niacin), extended-release niacin (Niaspan).
22) Natural Products with Some Activity vs. Cholesterol -- Answer ✔✔ alpha-
linoleic acid, red yeast rice, garlic (limited), krill (for elevated TGs).
23) No Activity vs. Cholesterol: -- Answer ✔✔ nicotinamide.
24) What is the first step in dyslipidemia/hyperlipidemia therapy -- Answer ✔✔
Lifestyle changes (diet and excercise
, 25) Bile acid sequestrants MOA -- Answer ✔✔ increase LDL catabolism, reduce
cholesterol absorption, but can cause an increase in VLDL production.
26) Niacin MOA -- Answer ✔✔ reduces VLDL and LDL synthesis, and increase HDL
production
27) Fibrates MOA -- Answer ✔✔ increase VLDL clearance, reduce VLDL
production, (reducing TGs), but can increase LDL levels if TGs are high (i.e. over
400mg/dl).
28) Statins MOA -- Answer ✔✔ increase LDL breakdown, decrease LDL production,
moderately reduce TGs, and modestly increase HDL.
29) Ezetimibe MOA -- Answer ✔✔ inhibits cholesterol absorption from the gut,
reducing LDL levels
30) cholesterol and pregnancy -- Answer ✔✔ Statins are contraindicated in
pregnancy (Pregnancy Category X); use a bile acid sequestrant agent (Pregnancy
Category B).
31) when should statins be taken -- Answer ✔✔ dosed specifically at bedtime for
maximal effect on LDL cholesterol synthesis
32) Monitoring during statin therapy -- Answer ✔✔ Evaluate muscle function prior
to initiating statin dosing; muscle cramping, aches, the most severe being
rhabdomyolysis, have been reported with statin use; tell patients to report any
muscle aches or weakness and if the urine is dark to their healthcare provider.
**Avoid using statins if closely-related family members have experienced muscle
aching when placed on a statin product.
