NSG 6005 FINAL STUDY GUIDEALL EXAM INFO: INCLUDESFinal exam pharmQUESTION & ANSWERS

Guanfacine- used to treat HTN or ADHD, non stimulant. Alpha 2 adrenergic agonist. Antiarrhythmics start on p. 322 Class I: sodium channel blockers Class Ia: lengthens action potential (quinidine, procainamide [requires freq. dosing], disopyramide) Class Ib: shortens action potential (lidocaine, phenytoin) treats ventricular arrhythmias Class Ic: minimal or no effect on action potential; severe ventricular tachycardias- where no other drugs have worked Class II: beta blockers (propranolol, metoprolol, atenolol)- indirectly reduces slope by blocking chronotropic impact of norepinephrine Atenolol has longer half-life than metoprolol Class III: agents that lengthen action potential (potassium channel blockers) – (amiodarone, bretyllium) effective in treating re-entry problems, inhibits v-fib due to myocardial ischemia, improves contractility Class IV: Calcium channel blockers (verapamil, diltiazem, bepridil) & (amlodipine, felodipine) 2 types of CCB: type I- non-hydropyridines-affect conduction through AV node, have neg chronotropic effect (verapamil, diltiazem) type II: hydorphyridines-do not affect conduction through AV node (nifedipine, amlodipine, felodipine) Class IA & IC -what is similar? Lidocaine￾Amiodaraone effective against supraventricular rhythms BPH & HTN med NSG 6005 Doxazosin- used to treat BPH & HTN Mexiletine- only available orally Valerian has no adverse reactions when used at the recommended level; however, overdosage at 2.5 g or more can cause cardiac disturbance, excitability, headache, insomnia, and nausea. It can potentiate alcohol and other CNS depressants if taken in large amounts. (p. 139) Ayurvedic medicine- Although all three doshas exist together, often plants and people are classified by the one that is most dominant in them, referred to as the person’s “Prakruti,” and specific to them as an individual. (p. 132) Glaucoma meds: Longer eyelashes-lanasoprost or bimatoprost – prostaglandin drugs Glaucoma med cause blurriness after instilled into eyes for few minutes Procainamide-short acting; need dose reduction in CHF and renal impairment (p. 325) VLDL- synthesized in the liver (p. 1130) Drugs that inhibit VLDL synthesis in the liver (niacin, fibric acid derivatives) also reduce LDLs via the endogenous pathway (p.1130). Cholesterol meds: -acted on sterols? Inhibitor Hmgcoa- statins Bile from liver-bile sequestrins Cost benefit analysis Cardiotonic Digoxin with renal failure- contradicted in renal impairment; Digoxin can also be problematic when treating older adults and patients with renal insufficiency. Renal function may decrease during heart failure treatment and the drug may not be adequately excreted, allowing it to increase to toxic levels. Digoxin levels should be closely monitored in these patients. (p. 1072) Because digoxin is excreted essentially unchanged by the kidneys, severe renal impairment effectively contraindicates its use. (p. 318) Treatment with hepatitis C- antiviral meds, NS5A inhibitors Tacrine￾NSG 6005 TimololThe nurse concludes that a client newly diagnosed with glaucoma knows the purpose for the prescribed timolol (Timoptic) blocker when the clients makes which statement: Cromolyn-allergic David presents to clinic with symptoms of allergic conjunctivitis. He is prescribed cromolyn sodium (Opticrom) eyedrops. The education regarding using cromolyn eyedrops includes which one of the following tips PNA & hypothyroidism- what med don’t give?? -epi inhaler Which class antiarrhythmic meds treat SVT or VT? HSV med- answer to do with applying to oral lesion at the first sign of outbreak Protozoal infection- which type of med antifungal, antimalarial or antiviral plus one other I can’t remember Erectile dysfunction- sildenafil or something It must be noted that phosphodiesterase-5 inhibitors (sildenafil, Viagra; vardenafil, Levitra; tadalafil, Cialis) used to treat erectile dysfunction, when taken in combination with nitrates used for chest pain, can cause severe vasodilation resulting in hypotension and syncope. (p. 892) Patients with Wolff–Parkinson–White (WPW) syndrome can have ventricular responses that are dangerously rapid. Drugs commonly used to control ventricular response such as diltiazem, verapamil, and digoxin are ineffective in this situation and can facilitate conduction through the accessory pathway, increasing the risk for ventricular fibrillation (p. 315) Final exam pharm 1. Lauren is a 13 year old child who comes to the clinic with a 4 day history of cough, low grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is greenish yellow. The appropriate antibiotic to prescribe would be 2. Pong-tai is a 12month old child who is being treated with amoxicillin for acute otitis media. His parents call the clinic and say he has developed diarrhea. The appropriate action would be to 3. There is often a cross sensitivity and cross resistance between pcn and cephalosporins