NR565 ACTUAL FINAL EXAM (LATEST 2023-2024
UPDATE)ADVANCED PHARMACOLOGY EXAM
REVIEW QNS&ANS-CHAMBERLAIN
• A patient has a TSH of .28, a free T4 of 3, and a free T3 over 650. What medication
should she be started on?
Answer: Methimazole, PTU, radioactive iodine. These labs indicate
hyperthyroidism. Treatment for thyroid storm: K iodide or strong iodine
solution to suppress thyroid release. Methimazole to suppress thyroid
synthesis.
• When is it appropriate to increase insulin needs?
Answer: Pregnancy (after first trimester), stress, infection, weight loss,
adolescent growth spurt. DECREASE for exercise and first trimester.
• What is the TDD of a person that weighs 70kg?
IF a person is eating a 50 carb meal, how much insulin will be needed based on the TDD
from the above question?
Answer: 42 TDD : 21 basal 21 bolus (Wt in kg x 0.6; 50% long acting
and 50% rapid acting)
500 divided by (the TDD) 42 = 12. (carb to insulin ratio) then (meal
carbs) 50 divided 12= 4.1 units with short acting insulin
• "As long as the short-acting insulin is drawn up first I can mix my insulin glargine with
it."
Answer: Of the long-acting medications, ONLY NPH the intermediate
duration is suitable for mixing with the short action insulins.
,• A women who is taking Pioglitazone states, "I'm glad that this medication promotes
weight loss."
Answer: First this medication promotes increase in LDL levels, which
increases cardiovascular risk. Also, she's a female so speak about
exercise and weight bearing exercise d/t possible increased risk for
fractures.
• Glucocorticoid MOA
Answer: Most effective in long-term control of airway inflammation
• Cromolyn MOA
Answer: Used as prophylaxis for mild to moderate asthma
• Monoclonal Antibodies MOA
Answer: Used for allergy-related asthma and Eosinophilic asthma.
Omalizumab for allergy related and Ben ralizumab, mepliz, and resliz
are for eosinophilic
• Leukotriene MOA
Answer: Second-line therapy to reduce inflammation and
bronchoconstriction
• B2 adrenergic agonists MOA
, Answer: Can be used PRN, for EIB, COPD exacerbations, and
maintenance therapy
• methylxanthines MOA
Answer: Maintenance therapy for chronic stable asthma (theophylline).
P. 570. Use ONLY if B2 or anticholinergics are not appropriate.
• anticholinergic MOA
Answer: Approved for bronchospasm related to COPD
• •What are some risk factors of fatal asthma attacks?
Answer: Uncontrolled, hospitalized recently, triggers,
• •Roflumilast (select all that apply)
• Reduces inflammation
• Not intended during pregnancy
• Approved for asthma
• First-line drug for COPD
• Answer: Reduces inflammation, not intended for pregnancy, approved
only for COPD, Second-line drug for COPD
• Uses for exacerbations prophylaxis in pts with severe COPD with a
primary chronic bronchitis component.
• What pt education can you provide a patient for ICS use?
, Answer: Rinse d/t oropharyngeal candidiasis and dysphonia
(hoarseness, difficulty speaking).
• What patient teaching can a provider give when prescribing a PPI?
Answer: Hypomagnesia symptoms: muscle cramps, tremors, cramps,
and palpitations. Check Mg levels periodically especially in the elderly.
Get enough calcium and VIT D. call if having diarrhea (Cdiff)
• What patient teaching can a provider give when prescribing an H2RA?
Answer: Report lethargy, solmnolance, restlessness, confusion or
hallucinations. (CNS effects). Teach about possible reduced libido,
impotence, gynecomastia, pneumonia. P.594 Cimetidine interacts with
CYP system so check with pt if they are taking warfarin, phenytoin,
theophylline, lidocaine.
• A patient presents with a complaint of reflux and constipation. He states that he drinks
enough water, and admits he has gained 30lbs. He also states that he has been having
"reflux" type symptoms. What are your next steps for education?
Answer: Educate that weight gain can promote reflux symptoms, ask
about any otc use such as antacids which may cause constipation.
• zollinger-Ellison syndrome is due to a producing tumor. Treatment is long-term
therapy of what medication class?
Answer: gastrin. ..... PPI's
• •A patient who takes NSAIDS almost daily for arthritic pain and refuses to try another
medication is at risk for an NSAID-induced ulcer. The provider states,
• I will put you on Misoprostol once daily
• If you reduced the NSAID to 4 times a week, that should help prevent an ulcer
UPDATE)ADVANCED PHARMACOLOGY EXAM
REVIEW QNS&ANS-CHAMBERLAIN
• A patient has a TSH of .28, a free T4 of 3, and a free T3 over 650. What medication
should she be started on?
Answer: Methimazole, PTU, radioactive iodine. These labs indicate
hyperthyroidism. Treatment for thyroid storm: K iodide or strong iodine
solution to suppress thyroid release. Methimazole to suppress thyroid
synthesis.
• When is it appropriate to increase insulin needs?
Answer: Pregnancy (after first trimester), stress, infection, weight loss,
adolescent growth spurt. DECREASE for exercise and first trimester.
• What is the TDD of a person that weighs 70kg?
IF a person is eating a 50 carb meal, how much insulin will be needed based on the TDD
from the above question?
Answer: 42 TDD : 21 basal 21 bolus (Wt in kg x 0.6; 50% long acting
and 50% rapid acting)
500 divided by (the TDD) 42 = 12. (carb to insulin ratio) then (meal
carbs) 50 divided 12= 4.1 units with short acting insulin
• "As long as the short-acting insulin is drawn up first I can mix my insulin glargine with
it."
Answer: Of the long-acting medications, ONLY NPH the intermediate
duration is suitable for mixing with the short action insulins.
,• A women who is taking Pioglitazone states, "I'm glad that this medication promotes
weight loss."
Answer: First this medication promotes increase in LDL levels, which
increases cardiovascular risk. Also, she's a female so speak about
exercise and weight bearing exercise d/t possible increased risk for
fractures.
• Glucocorticoid MOA
Answer: Most effective in long-term control of airway inflammation
• Cromolyn MOA
Answer: Used as prophylaxis for mild to moderate asthma
• Monoclonal Antibodies MOA
Answer: Used for allergy-related asthma and Eosinophilic asthma.
Omalizumab for allergy related and Ben ralizumab, mepliz, and resliz
are for eosinophilic
• Leukotriene MOA
Answer: Second-line therapy to reduce inflammation and
bronchoconstriction
• B2 adrenergic agonists MOA
, Answer: Can be used PRN, for EIB, COPD exacerbations, and
maintenance therapy
• methylxanthines MOA
Answer: Maintenance therapy for chronic stable asthma (theophylline).
P. 570. Use ONLY if B2 or anticholinergics are not appropriate.
• anticholinergic MOA
Answer: Approved for bronchospasm related to COPD
• •What are some risk factors of fatal asthma attacks?
Answer: Uncontrolled, hospitalized recently, triggers,
• •Roflumilast (select all that apply)
• Reduces inflammation
• Not intended during pregnancy
• Approved for asthma
• First-line drug for COPD
• Answer: Reduces inflammation, not intended for pregnancy, approved
only for COPD, Second-line drug for COPD
• Uses for exacerbations prophylaxis in pts with severe COPD with a
primary chronic bronchitis component.
• What pt education can you provide a patient for ICS use?
, Answer: Rinse d/t oropharyngeal candidiasis and dysphonia
(hoarseness, difficulty speaking).
• What patient teaching can a provider give when prescribing a PPI?
Answer: Hypomagnesia symptoms: muscle cramps, tremors, cramps,
and palpitations. Check Mg levels periodically especially in the elderly.
Get enough calcium and VIT D. call if having diarrhea (Cdiff)
• What patient teaching can a provider give when prescribing an H2RA?
Answer: Report lethargy, solmnolance, restlessness, confusion or
hallucinations. (CNS effects). Teach about possible reduced libido,
impotence, gynecomastia, pneumonia. P.594 Cimetidine interacts with
CYP system so check with pt if they are taking warfarin, phenytoin,
theophylline, lidocaine.
• A patient presents with a complaint of reflux and constipation. He states that he drinks
enough water, and admits he has gained 30lbs. He also states that he has been having
"reflux" type symptoms. What are your next steps for education?
Answer: Educate that weight gain can promote reflux symptoms, ask
about any otc use such as antacids which may cause constipation.
• zollinger-Ellison syndrome is due to a producing tumor. Treatment is long-term
therapy of what medication class?
Answer: gastrin. ..... PPI's
• •A patient who takes NSAIDS almost daily for arthritic pain and refuses to try another
medication is at risk for an NSAID-induced ulcer. The provider states,
• I will put you on Misoprostol once daily
• If you reduced the NSAID to 4 times a week, that should help prevent an ulcer
