NUR 635 Advanced Pharmacology Exam Questions and Answers Solved 2024

Pt on heparin in hospital setting. Why start coumadin 2 days before dc? - ANSWER Because coumadin needs a couple days before it starts working. Angina: bc pts dev tolerance to long-acting nitroglycerine w/i 1 day. How to prevent? - ANSWER Pts must have 8hrs with no nitroglycerine every days. Hint: At night, remove nitro patch bc no risk of exertional angina Underlying cause of angina - ANSWER coronary disease, athlerosclerosis Why do we give aspirin in pts w/atherosclerosis? - ANSWER Aspirin is an antiplatelet.. Prevents the existing plaques from getting bigger. Prevents plaque rupture. Cardio protective, prevents stroke, MI, CVA What is prescribed for angina pts w/DM? - ANSWER ACE inhibitors to protect the kidneys and nerves SE of high doses of aspirin? - ANSWER Tinnitus: ringing ears Pt education regarding Plavix(clopidogrel bisulfate)? - ANSWER Anti-platelet med. S/sx bleeding: blood in stool or vomit, excessive bruising, abd pain uterine bld, back pain, petichae. Interactions with EVERYTHING: OTC, herbals, supplements Pts on coumadin? What are we watching for? - ANSWER INR to check therapeutic levels. Half life is long. Check 12hrs after taking. What can be caused if pt started on heparin? - ANSWER day4, ordering blood work to check platelet count to observe for THROMBOCYTOPENIA coumadin and childbearing aged females - ANSWER Interactions with oral contraceptives- must have a back up method during time you're taking coumadin Pregnancy considerations and coumadin - ANSWER Need to monitor anti-Xa levels biggest food group interaction with coumadin - ANSWER Grapefruit, green leafy veggies. Why? high in vitamin K which counteracts warfarin Short duration: rapid acting insulin indication, MOA, usage - ANSWER Given w/meals Provide bs control between meals at night Can use in conjunction w/intermediate or long-acting agent lispro, aspart, gluulocene Short duration: short acting insulin indication, MOA, usage - ANSWER Before meals to control postprandial hyperglycemia Infused SQ via pump humulin/regular intermediate(humalin/novalin) duration insulin indication, MOA, usage - ANSWER BS control between meals and during the night Only one suitable for mixing w/short actings basal coverage Long duration: Insulin glargine U100 - ANSWER up to 24hrs, once daily subq dosing, basal coverage for DM1 or Dm2 Neostigmine is a medication uesd to tx what disease/disorder? - ANSWER Myastenia Gravis: AI disorder, antibodies destroy communication btw nerves and muscles. S/S weak skeletal muscles, voluntary muscles, dysphagia, ptosis Myasthenia gravis is an AI disorder that may cause what s/s? - ANSWER difficulty swallowing Medication must cross _____________ to affect CNS - ANSWER BBB Goal in Parkinson's tx is to restore ________________ in brain - ANSWER dopamine MCSE of dopaminergics - ANSWER sleep attacks, hallucinations, confusion Med appropriate to treat acute psychosis? - ANSWER Haloperidol ASE of first-generation antipsychotic(FGA) medications such as haloperidol, chlorpromazine: diff speaking, chewing - ANSWER tardive dyskinesia Med to help manage panic attacks? - ANSWER SSRI Cholinesterase inhibitors are used in tx of what conditon? - ANSWER Alzheimer's disease. MOA block normal breakdown of acetylocholine which increases their levels and duration of action in the CNS and PNS (neuromuscular junction). Also used in tx of myasthenia gravis Ex: neostigmine, donepezil, galantamine, rivastigmine What are some diseases/disorders/conditions are anticonvulsants used to treat other than seizure disorders? - ANSWER migraine HA prevention, bipolar DO, epilepsy Examples: carbamazepine(Tegretol), gabapentin(Neurontin), phenobarbital, topiramate(Topamax) Anti-seizure med used for prophylactic tx of migraines - ANSWER topiramate Anti-seizure med that is also an anti-arrhythmic - ANSWER phenytoin(Dilantin) Anti-seizure med w/black box warning for blood dyscrasias and serious derm rxns - ANSWER carbamazepine(Tegretol) First-line agent for early onset migraine - ANSWER NSAIDs Hallucinations may occur if __________ is stopped abruptly - ANSWER baclofen atomoxetine(Straterra), clonidine, and guanfacine are used in tx of which DO? - ANSWER ADHD initial intervention for infrequent migraine HA - ANSWER HA diary Meds that may cause QT prolongation - ANSWER methadone, tricyclic antidepressants, amiodarone