Maryville Pharm 615 Exam 3
Mr. Holloway presents to your clinic with a significantly swollen, painful big toe and you
diagnose him with gout. Of the following options which would be the best treatment for
Mr. Holloway? - ANS-low-dose colchicine 1.2 mg followed by 0.6 mg 1 hour later (lower
side effects than high dose)
Patient education when prescribing colchicine includes? - ANS-a. Colchicine always
causes some degree of diarrhea
You have a patient who is taking allopurinol to prevent gout. What labs will you monitor
for this patient on allopurinol? - ANS-BUN, Creatinine, creatinine clearance
Mr. Thompson has just started taking febuxostat (Uloric) to treat his gout and he needs
to be educated on what to expect - ANS-Gout may worsen before getting better
Ms. Jensen has been on prednisone for 6 months. Patients who have been on
prednisone for some time should be assessed for what? - ANS-Osteoporosis,
decreases bone density
When you place a patient on prednisone and the total dose exceeds 1 gram, what
additional drug should you prescribe? - ANS-a. Omeprazole, a proton-pump inhibitor to
prevent PUD
Janet has fractured her ankle and you give her a prescription for Vicodin
(acetaminophen +hydrocodone). What education should you provide before they leave
your clinic? - ANS-Do not take any other meds that contain acetaminophen
Margaret has been on 60 mg of prednisone for 10 days for her severe asthma
exacerbation. Since she is breathing much better it is time to discontinue the
medication. What should you know when discontinuing this drug? - ANS-develop
tapering schedule to avoid recurring symptoms and cortisol deficiancy
Patients who are currently on or will start chronic corticosteroid therapy should be
monitored for what? - ANS-glucose levels; can raise glucose in non-diabetics
, Patients with rheumatoid arthritis who are on a chronic low-dose prednisone will need
co-treatment with which medications to prevent further adverse effects? - ANS-a.
Vitamin D
b. Calcium supplementation
c. A bisphosphonate
due to decreased bone density
What is the FDA Black Box Warning for ALL nonsteroidal anti-inflammatory drugs
(NSAIDS)? - ANS-a. Potential for causing life-threatening gastrointestinal bleeds
If you are getting ready to prescribe an NSAID, a complete drug history should be
conducted as NSAIDs interact with which drug? - ANS-a. Warfarin (anticoagulant)
Gabriella is a 3-year old diagnosed with otitis media and an upper respiratory infection.
You prescribe her an antibiotic (probably amoxicillin) and ibuprofen. What education
should the parents receive? - ANS-a. Need to keep Gabriella well hydrated while she is
taking ibuprofen; NSAIDS are excreted by the kidney
William is a 78-year old who takes two aspirin every morning while he reads his
newspaper to treat arthritis pain in his back. He states the aspirin helps him to "get
moving" each day. Lately he has had some heartburn from the aspirin. After you rule out
an acute GI bleed, what would be an appropriate course of treatment for William? -
ANS-Add an H2 blocker to his therapy
An early sign of aspirin toxicity is? - ANS-Tinnitus
patient that is on long-tern aspirin therapy and what lab should be conducted annually -
ANS-CBC
Monitoring a patient on a high-dose aspirin level includes - ANS-a. Salicylate level
b. Complete blood count
c. Urine pH
Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs
and symptoms of hypoglycemia include - ANS-a. Dizziness, confusion, diaphoresis, and
tachycardia
s/s hyperglycemia - ANS-polyuria, polydipsia, polyphagia
Mr. Holloway presents to your clinic with a significantly swollen, painful big toe and you
diagnose him with gout. Of the following options which would be the best treatment for
Mr. Holloway? - ANS-low-dose colchicine 1.2 mg followed by 0.6 mg 1 hour later (lower
side effects than high dose)
Patient education when prescribing colchicine includes? - ANS-a. Colchicine always
causes some degree of diarrhea
You have a patient who is taking allopurinol to prevent gout. What labs will you monitor
for this patient on allopurinol? - ANS-BUN, Creatinine, creatinine clearance
Mr. Thompson has just started taking febuxostat (Uloric) to treat his gout and he needs
to be educated on what to expect - ANS-Gout may worsen before getting better
Ms. Jensen has been on prednisone for 6 months. Patients who have been on
prednisone for some time should be assessed for what? - ANS-Osteoporosis,
decreases bone density
When you place a patient on prednisone and the total dose exceeds 1 gram, what
additional drug should you prescribe? - ANS-a. Omeprazole, a proton-pump inhibitor to
prevent PUD
Janet has fractured her ankle and you give her a prescription for Vicodin
(acetaminophen +hydrocodone). What education should you provide before they leave
your clinic? - ANS-Do not take any other meds that contain acetaminophen
Margaret has been on 60 mg of prednisone for 10 days for her severe asthma
exacerbation. Since she is breathing much better it is time to discontinue the
medication. What should you know when discontinuing this drug? - ANS-develop
tapering schedule to avoid recurring symptoms and cortisol deficiancy
Patients who are currently on or will start chronic corticosteroid therapy should be
monitored for what? - ANS-glucose levels; can raise glucose in non-diabetics
, Patients with rheumatoid arthritis who are on a chronic low-dose prednisone will need
co-treatment with which medications to prevent further adverse effects? - ANS-a.
Vitamin D
b. Calcium supplementation
c. A bisphosphonate
due to decreased bone density
What is the FDA Black Box Warning for ALL nonsteroidal anti-inflammatory drugs
(NSAIDS)? - ANS-a. Potential for causing life-threatening gastrointestinal bleeds
If you are getting ready to prescribe an NSAID, a complete drug history should be
conducted as NSAIDs interact with which drug? - ANS-a. Warfarin (anticoagulant)
Gabriella is a 3-year old diagnosed with otitis media and an upper respiratory infection.
You prescribe her an antibiotic (probably amoxicillin) and ibuprofen. What education
should the parents receive? - ANS-a. Need to keep Gabriella well hydrated while she is
taking ibuprofen; NSAIDS are excreted by the kidney
William is a 78-year old who takes two aspirin every morning while he reads his
newspaper to treat arthritis pain in his back. He states the aspirin helps him to "get
moving" each day. Lately he has had some heartburn from the aspirin. After you rule out
an acute GI bleed, what would be an appropriate course of treatment for William? -
ANS-Add an H2 blocker to his therapy
An early sign of aspirin toxicity is? - ANS-Tinnitus
patient that is on long-tern aspirin therapy and what lab should be conducted annually -
ANS-CBC
Monitoring a patient on a high-dose aspirin level includes - ANS-a. Salicylate level
b. Complete blood count
c. Urine pH
Hypoglycemia can result from the action of either insulin or an oral hypoglycemic. Signs
and symptoms of hypoglycemia include - ANS-a. Dizziness, confusion, diaphoresis, and
tachycardia
s/s hyperglycemia - ANS-polyuria, polydipsia, polyphagia
