1
(Maryville University) Pharm test NURS 615
Questions and Answers Latest
100%
How do antigout medications work?
{{Ans- by inhibiting the infiltration and phagocytosis of leukocytes, thus decreasing the
breakdown of uric acid to urate crystals.
Deposition of urate crystals causes
{{Ans- pain and inflammation
What is Colchicine {{Ans- anti-gout medication
how does Colchicine work? {{Ans- Works by inhibiting inflammation, reducing pain and swelling
common side effects of Colchicine
{{Ans- GI problems (diarrhea) use with caution in
elderly Also can cause blood dyscrasias & abdominal
pain
patient education with Colchicine
{{Ans- Can be given with food & milk to decrease GI
issues Avoid beer, ale, & wine: may cause gout
attack Increase fluid intake: increases excretion of
uric acid Avoid smoked meats & high-protein diets
Low dose of Colchicine
{{Ans- Low dose colchicine is 1.2mg followed by 0.6mg one hour later or 1.8 milligrams total
High dose of Colchicine
{{Ans- high dose colchicine is 1.2mg followed by 0.6mg every four to six hours; or 4.8mg total.
Difference between high dose and low dose Colchicine
{{Ans- The difference between the two is low dose is as effective as high dose with a lower side
effect profile.
Lab values to monitor with Colchicine
{{Ans- Check renal function test, BUN, Creatine
Patient education with Colchicine
{{Ans- Almost always causes some degree of diarrhea, make sure patients are aware of this side effect
Patient education with Febuxostat (Uloric) {{Ans- Gout may worsen with therapy initially
, 2
Dietary changes to decrease gout attacks and uric acid deposits.
{{Ans- Avoid beer, ale, & wine
Increase fluid intake: increases excretion of uric
acid Avoid smoked meats & high-protein diets
What is not a first line for pain medication? {{Ans- Narcotics
Recommendations for pain treatment
{{Ans- You want to start with NSAIDs first and then work your way up from there.
types of Corticosteroid treatment {{Ans- Prednisone, Cortisone, Dexamethasone
how do Corticosteroids work?
{{Ans- Suppress the inflammatory & immune systems by inhibiting the synthesis of chemical
mediators.
what are the chemical mediators that Corticosteroids work on?
{{Ans- Prostaglandins, leukotrienes, & histamines
Corticosteroids and inflammation
{{Ans- Decreases inflammation which decreases swelling, warmth, redness, & pain.
Uses for corticosteroid treatment
{{Ans- Addison's disease, hormone replacement, cancer therapy
SLE, arthritis, IBD, & to suppress graft rejection
contraindications for corticosteroid treatment
{{Ans- Systemic fungal infections & with live vaccine
Use corticosteroids cautiously with:
{{Ans- Pregnancy, kids, HTN, heart failure, renal impairment, & with infections resistant to treatment
Patient education with corticosteroids
{{Ans- Don't discontinue abruptly, doses may need increased during stress, symptoms of
Cushing's and GI bleeding
Problem with taking Corticosteroids for greater than 6 months
{{Ans- The main thing you want to worry about is osteoporosis it can also worsen diabetic control
and patients should report any tarry black stools or abdominal pain.
, 3
Other common side effects with Corticosteroids
{{Ans- Peptic ulcers, GI bleeding, edema, hyperglycemia, delayed wound healing, fluid &
electrolyte imbalances
Why is it important to tapper the corticosteroid?
{{Ans- Tapering must be done carefully to avoid both recurrent activity of the underlying disease
process and possible cortisol deficiency resulting from the hypothalamic-pituitary-adrenal axis
or HPA suppression during the period of steroid therapy
Black box warning
{{Ans- Increased risk of serious cardiovascular thrombotic events, myocardial-infarction and
stroke which can be fatal.
What increases risk of black box warning occurring with NSAIDs.
{{Ans- Risk increases with duration of use.
Patients with cardiovascular disease or with risk factors for cardiovascular disease may be a greater
risk.
NSAIDs and GI system
{{Ans- Increased risk of serious gastrointestinal adverse effects including: bleeding, ulceration,
and perforation the stomach or intestines can be fatal.
Can occur at any time during use and without warning symptoms. Elderly patients are at greater
risk for serious GI events.
Ibuprofen and mechanism of action
{{Ans- Exact mechanism of action is unknown.
A non-selective cox-2 inhibitor in that it inhibits two isoforms of psychologic oxygenase cox-1 and
cox-2. A non-selective inhibitor of cyclooxygenase, believed to be due to inhibition of cox-2 which
decreases the synthesis of prostaglandins in mediating the inflammation pain, fever, and swelling.
Ibuprofen and antipyretic effects
{{Ans- Antipyretic effects may be due to action on the hypothalamus resulting in an increase of
peripheral blood flow, basil dilation, and subsequent heat dissipation.
Ibuprofen versus NSAIDs
{{Ans- The analgesic and antipyretic and anti-inflammatory activity of NSAIDs appear to operate
mainly through inhibition of cox-2. Resident inhibition of cox-1 would be responsible for the
unwanted effects on the GI tract.
Inhibition of cox-1 is thought to cause some of the side effects of ibuprofen including GI ulceration
like aspirin and indomethacin.
Ibuprofen versus NSAIDs
{{Ans- like aspirin and indomethacin.
(Maryville University) Pharm test NURS 615
Questions and Answers Latest
100%
How do antigout medications work?
{{Ans- by inhibiting the infiltration and phagocytosis of leukocytes, thus decreasing the
breakdown of uric acid to urate crystals.
Deposition of urate crystals causes
{{Ans- pain and inflammation
What is Colchicine {{Ans- anti-gout medication
how does Colchicine work? {{Ans- Works by inhibiting inflammation, reducing pain and swelling
common side effects of Colchicine
{{Ans- GI problems (diarrhea) use with caution in
elderly Also can cause blood dyscrasias & abdominal
pain
patient education with Colchicine
{{Ans- Can be given with food & milk to decrease GI
issues Avoid beer, ale, & wine: may cause gout
attack Increase fluid intake: increases excretion of
uric acid Avoid smoked meats & high-protein diets
Low dose of Colchicine
{{Ans- Low dose colchicine is 1.2mg followed by 0.6mg one hour later or 1.8 milligrams total
High dose of Colchicine
{{Ans- high dose colchicine is 1.2mg followed by 0.6mg every four to six hours; or 4.8mg total.
Difference between high dose and low dose Colchicine
{{Ans- The difference between the two is low dose is as effective as high dose with a lower side
effect profile.
Lab values to monitor with Colchicine
{{Ans- Check renal function test, BUN, Creatine
Patient education with Colchicine
{{Ans- Almost always causes some degree of diarrhea, make sure patients are aware of this side effect
Patient education with Febuxostat (Uloric) {{Ans- Gout may worsen with therapy initially
, 2
Dietary changes to decrease gout attacks and uric acid deposits.
{{Ans- Avoid beer, ale, & wine
Increase fluid intake: increases excretion of uric
acid Avoid smoked meats & high-protein diets
What is not a first line for pain medication? {{Ans- Narcotics
Recommendations for pain treatment
{{Ans- You want to start with NSAIDs first and then work your way up from there.
types of Corticosteroid treatment {{Ans- Prednisone, Cortisone, Dexamethasone
how do Corticosteroids work?
{{Ans- Suppress the inflammatory & immune systems by inhibiting the synthesis of chemical
mediators.
what are the chemical mediators that Corticosteroids work on?
{{Ans- Prostaglandins, leukotrienes, & histamines
Corticosteroids and inflammation
{{Ans- Decreases inflammation which decreases swelling, warmth, redness, & pain.
Uses for corticosteroid treatment
{{Ans- Addison's disease, hormone replacement, cancer therapy
SLE, arthritis, IBD, & to suppress graft rejection
contraindications for corticosteroid treatment
{{Ans- Systemic fungal infections & with live vaccine
Use corticosteroids cautiously with:
{{Ans- Pregnancy, kids, HTN, heart failure, renal impairment, & with infections resistant to treatment
Patient education with corticosteroids
{{Ans- Don't discontinue abruptly, doses may need increased during stress, symptoms of
Cushing's and GI bleeding
Problem with taking Corticosteroids for greater than 6 months
{{Ans- The main thing you want to worry about is osteoporosis it can also worsen diabetic control
and patients should report any tarry black stools or abdominal pain.
, 3
Other common side effects with Corticosteroids
{{Ans- Peptic ulcers, GI bleeding, edema, hyperglycemia, delayed wound healing, fluid &
electrolyte imbalances
Why is it important to tapper the corticosteroid?
{{Ans- Tapering must be done carefully to avoid both recurrent activity of the underlying disease
process and possible cortisol deficiency resulting from the hypothalamic-pituitary-adrenal axis
or HPA suppression during the period of steroid therapy
Black box warning
{{Ans- Increased risk of serious cardiovascular thrombotic events, myocardial-infarction and
stroke which can be fatal.
What increases risk of black box warning occurring with NSAIDs.
{{Ans- Risk increases with duration of use.
Patients with cardiovascular disease or with risk factors for cardiovascular disease may be a greater
risk.
NSAIDs and GI system
{{Ans- Increased risk of serious gastrointestinal adverse effects including: bleeding, ulceration,
and perforation the stomach or intestines can be fatal.
Can occur at any time during use and without warning symptoms. Elderly patients are at greater
risk for serious GI events.
Ibuprofen and mechanism of action
{{Ans- Exact mechanism of action is unknown.
A non-selective cox-2 inhibitor in that it inhibits two isoforms of psychologic oxygenase cox-1 and
cox-2. A non-selective inhibitor of cyclooxygenase, believed to be due to inhibition of cox-2 which
decreases the synthesis of prostaglandins in mediating the inflammation pain, fever, and swelling.
Ibuprofen and antipyretic effects
{{Ans- Antipyretic effects may be due to action on the hypothalamus resulting in an increase of
peripheral blood flow, basil dilation, and subsequent heat dissipation.
Ibuprofen versus NSAIDs
{{Ans- The analgesic and antipyretic and anti-inflammatory activity of NSAIDs appear to operate
mainly through inhibition of cox-2. Resident inhibition of cox-1 would be responsible for the
unwanted effects on the GI tract.
Inhibition of cox-1 is thought to cause some of the side effects of ibuprofen including GI ulceration
like aspirin and indomethacin.
Ibuprofen versus NSAIDs
{{Ans- like aspirin and indomethacin.
