Exam 3: NURS 615/ NURS615 (Latest 2024/ 2025
Update) Advanced Pharmacotherapeutics Review |Qs
& As| 100% Correct| Grade A (Verified Answers)-
Maryville
fluoroquinolones interfere with DNA synthesis and are bactericidal - ANSWERtrue
When should HIV + pts START therapy - ANSWERTherapy should begin as soon as
possible, including the day of diagnosis.
Drugs Used for HIV Infection:
Fusion Inhibitors - ANSWEREnfuvirtide (Fuzeon, also known as T-20)-Prototype
-prevent viruses from successfully fusing with the host cell
Mechanism of action: work by attaching to proteins on the surface of T-cells or
proteins on the surface of HIV. This prevents HIV from binding to the proteins on T-
cells.
Contraindications: hypersensitivity
Use: HIV that has become resistant to other medications
ADR's: Increased risk of bacterial pneumonia- especially smokers and those with lung
disease, history of IV drug use
Administration: requires 2 subcutaneous injections per day.
Cost: extremely expensive
Macrolides - ANSWERAzithromycin
Clarithromycin
Erythromycin
Spectrum: broad
Bacteriostatic (bactericidal in high doses and susceptible bacteria)
ADR's:
-will increase drug levels of theophylline, warfarin and others.
-GI distress VERY common. (Food helps with somewhat with GI issues)
-Can cause prolongation of the QT interval which can result in "torsades de pointe".
Uses
a substitute for penicillin in penicillin-allergic patients;
,first-line drug for many infections (diphtheria, , mycoplasma pneumonia);
Atypical pneumonias Legionella)
STD-chlamydia
respiratory tract infections and skin infections
gram-positive cocci (streptococcal infections
Sulfonamides - ANSWER-Sulfamethoxazole (SMX)
-sulfisoxazole,
-sulfadiazine
-trimethoprim-sulfamethoxazole (Bactrim, Septra)
-Dapsone, used to leprosy
Spectrum: broad
Bacteriostatic: when used alone
Bactericidal: when combined with trimethoprim
ADR's:
Rash Blood abnormalities Photosensitivity-must counsel patients Stevens-Johnson
Syndrome (mortality 25%)
Precautions:
G6PD deficiency (causes hemolytic anemia), renal impairment,
infants < 2 mos.,
*Pregnancy Category C (causes hyperbilirubinemia in newborns if used near term)
***Take with plenty of water to avoid crystals.***
Important drug interactions: salicylates, warfarin, phenytoin
Uses:
-Gram-positives, gram-negatives, Nocardia, Chlamydia. Triple sulfas or
UTI's, upper respiratory infections, ear infections, traveler's diarrhea
SMX for simple UTI.
Important drug interactions: salicylates, warfarin, phenytoin
-Toxicity: Hypersensitivity reactions, hemolysis if G6PD deficient, nephrotoxicity
(tubulointerstitial nephritis),
photosensitivity,
kernicterus in infants,
displace other drugs from albumin (e.g., warfarin).
Can increase drug levels of : warfarin, theophylline, digoxin. Monitor drug levels of
these drugs ans signs/symptoms of toxicity.
Allergy considerations:
, -allergic reactions are common due to sulfa.
***Those with sulfonamide allergy often can tolerate other agents such as loop and
thiazide diuretics, sulfonylureas (used for Type II diabetes)***
although textbook and standardized tests recommend to avoid use.
Elements of a prescription - ANSWER*The prescription should have the name,
address, phone number, and professional degree/license status of the prescriber.
*The date is very important and should be completed. The pharmacist may call a
prescriber to inquire about the prescription if too much time has elapsed since the
time the prescription was written.
*The name and address of the patient should be clearly written on the prescription.
*When writing the drug name, either the brand name or the generic name may be
used (include whether brand preferred, or generic substitution allowed).
*The strength of the medication should be written in metric units.
*The quantity prescribed reflects the anticipated duration of therapy, the cost, how
soon the prescriber wishes to be in contact with the patient, the potential for abuse,
and the potential for toxicity or accidental overdose. Consideration should also be
given to standard sizes/amounts that the drug is available. For chronic diseases, one
might consider ordering a small quantity for the first prescription of a new
medication, in case of adverse drug reactions. This would reduce cost to the patient
if the drug must be discontinued. Once it is established that the patient tolerates the
drug well, larger quantities can be prescribed.
*The directions for use should be as simple as possible. The fewer the number of
doses a day, the better. Directions can be written out in plain English, but the Latin
abbreviations are still used and should be known by the prescriber. (Examples: tid,
PO, ac, qhs etc...) It is best to avoid "take as directed". This saves the prescriber time,
but it may lead to confusion for the patient if they forget what the prescriber said to
them during their visit.
*The instructions of how and when to take the medication should be clearly
explained by the prescriber and the pharmacist. Neither s
Causes of Prescription Errors - ANSWER-Errors of omission of information
-Poor hand-writing
-Inappropriate drug prescriptions
The advantages of electronic prescribing (EP) include - ANSWER-eliminates paper
and faxes,
-avoids error due to poor handwriting
-avoids fraud and stolen prescriptions
-prescriber information to enter prescription is encrypted.
Pharmacokinetics - ANSWERdrug movement throughout the body and how the body
acts on the drug
What are the 4 Processes of Pharmacokinetics - ANSWER-Absorption
-Distribution
Update) Advanced Pharmacotherapeutics Review |Qs
& As| 100% Correct| Grade A (Verified Answers)-
Maryville
fluoroquinolones interfere with DNA synthesis and are bactericidal - ANSWERtrue
When should HIV + pts START therapy - ANSWERTherapy should begin as soon as
possible, including the day of diagnosis.
Drugs Used for HIV Infection:
Fusion Inhibitors - ANSWEREnfuvirtide (Fuzeon, also known as T-20)-Prototype
-prevent viruses from successfully fusing with the host cell
Mechanism of action: work by attaching to proteins on the surface of T-cells or
proteins on the surface of HIV. This prevents HIV from binding to the proteins on T-
cells.
Contraindications: hypersensitivity
Use: HIV that has become resistant to other medications
ADR's: Increased risk of bacterial pneumonia- especially smokers and those with lung
disease, history of IV drug use
Administration: requires 2 subcutaneous injections per day.
Cost: extremely expensive
Macrolides - ANSWERAzithromycin
Clarithromycin
Erythromycin
Spectrum: broad
Bacteriostatic (bactericidal in high doses and susceptible bacteria)
ADR's:
-will increase drug levels of theophylline, warfarin and others.
-GI distress VERY common. (Food helps with somewhat with GI issues)
-Can cause prolongation of the QT interval which can result in "torsades de pointe".
Uses
a substitute for penicillin in penicillin-allergic patients;
,first-line drug for many infections (diphtheria, , mycoplasma pneumonia);
Atypical pneumonias Legionella)
STD-chlamydia
respiratory tract infections and skin infections
gram-positive cocci (streptococcal infections
Sulfonamides - ANSWER-Sulfamethoxazole (SMX)
-sulfisoxazole,
-sulfadiazine
-trimethoprim-sulfamethoxazole (Bactrim, Septra)
-Dapsone, used to leprosy
Spectrum: broad
Bacteriostatic: when used alone
Bactericidal: when combined with trimethoprim
ADR's:
Rash Blood abnormalities Photosensitivity-must counsel patients Stevens-Johnson
Syndrome (mortality 25%)
Precautions:
G6PD deficiency (causes hemolytic anemia), renal impairment,
infants < 2 mos.,
*Pregnancy Category C (causes hyperbilirubinemia in newborns if used near term)
***Take with plenty of water to avoid crystals.***
Important drug interactions: salicylates, warfarin, phenytoin
Uses:
-Gram-positives, gram-negatives, Nocardia, Chlamydia. Triple sulfas or
UTI's, upper respiratory infections, ear infections, traveler's diarrhea
SMX for simple UTI.
Important drug interactions: salicylates, warfarin, phenytoin
-Toxicity: Hypersensitivity reactions, hemolysis if G6PD deficient, nephrotoxicity
(tubulointerstitial nephritis),
photosensitivity,
kernicterus in infants,
displace other drugs from albumin (e.g., warfarin).
Can increase drug levels of : warfarin, theophylline, digoxin. Monitor drug levels of
these drugs ans signs/symptoms of toxicity.
Allergy considerations:
, -allergic reactions are common due to sulfa.
***Those with sulfonamide allergy often can tolerate other agents such as loop and
thiazide diuretics, sulfonylureas (used for Type II diabetes)***
although textbook and standardized tests recommend to avoid use.
Elements of a prescription - ANSWER*The prescription should have the name,
address, phone number, and professional degree/license status of the prescriber.
*The date is very important and should be completed. The pharmacist may call a
prescriber to inquire about the prescription if too much time has elapsed since the
time the prescription was written.
*The name and address of the patient should be clearly written on the prescription.
*When writing the drug name, either the brand name or the generic name may be
used (include whether brand preferred, or generic substitution allowed).
*The strength of the medication should be written in metric units.
*The quantity prescribed reflects the anticipated duration of therapy, the cost, how
soon the prescriber wishes to be in contact with the patient, the potential for abuse,
and the potential for toxicity or accidental overdose. Consideration should also be
given to standard sizes/amounts that the drug is available. For chronic diseases, one
might consider ordering a small quantity for the first prescription of a new
medication, in case of adverse drug reactions. This would reduce cost to the patient
if the drug must be discontinued. Once it is established that the patient tolerates the
drug well, larger quantities can be prescribed.
*The directions for use should be as simple as possible. The fewer the number of
doses a day, the better. Directions can be written out in plain English, but the Latin
abbreviations are still used and should be known by the prescriber. (Examples: tid,
PO, ac, qhs etc...) It is best to avoid "take as directed". This saves the prescriber time,
but it may lead to confusion for the patient if they forget what the prescriber said to
them during their visit.
*The instructions of how and when to take the medication should be clearly
explained by the prescriber and the pharmacist. Neither s
Causes of Prescription Errors - ANSWER-Errors of omission of information
-Poor hand-writing
-Inappropriate drug prescriptions
The advantages of electronic prescribing (EP) include - ANSWER-eliminates paper
and faxes,
-avoids error due to poor handwriting
-avoids fraud and stolen prescriptions
-prescriber information to enter prescription is encrypted.
Pharmacokinetics - ANSWERdrug movement throughout the body and how the body
acts on the drug
What are the 4 Processes of Pharmacokinetics - ANSWER-Absorption
-Distribution
