3/29/25, 8:39 NR566 midterm |
AM
NR566 MIDTERM EXAM QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED GRADED A++
Terms in this set (214)
Histamine acts primarily through which two H1 and H2
receptors?
vasodilation, increased capillary permeability, bronchoconstriction, CNS effects,
Effects of H1 stimulation
itching, pain, and increased mucus secretion.
Should antihistamines be used No. H1 stimulation causes bronchiole constriction. This will causes
for treatment of asthma? severe bronchoconstriction in the asthmatic patient.
Effects of H2 receptors Gastric acid secretion.
Two types of antihistamines H1 & H2 antagonists.
When to treat a patient with a H1 antagonist to treat mild allergic reactions.
medication
When to treat a patient with a gastric and duodenal ulcers
H2 antagonist medication
What is the main difference between an First generation are highly sedative where as second generation are not.
first and second generation H1 antagonist
medication?
bind selectively to H1-histaminic receptors which blocks the action of histamine at
H1 antagonist MOA
these sites.
Antihistamine overdose can cause CNS excitation - seizures. children especially at risk.
Effects of antihistamines at a therapeutic CNS depression.
level
Antihistamines in infants caution due to sedation. only use for infants older than six months.
safe in smaller doses. promethazine is contraindicated in children less than two
Antihistamines in children and adolescents
years old.
Antihistamines in pregnancy & avoid unless absolutely necessary in pregnancy (class c risk). small doses okay for
breastfeeding breast feeding. use with caution.
avoid if possible. BEERS criteria. can worsen preexisting glaucoma or BPH. if use is
Antihistamines in older adults.
necessary, start at smaller dose and titrate up.
Antihistamines used to treat motion Promethazine (Phenergan) or Dimenhydrinate (Dramamine).
sickness.
Patient education for first generation H1 avoid other CNS depressants such as alcohol, benzodiazepines, barbiturates, and
antagonist antihistamine use. opioids. do not drive while taking.
Antihistamine anticholinergic effects drying of mucus membranes, urinary hesitancy, constipation, and palpitations.
Antihistamines should be used with BPH, chronic urinary retention, asthma, and hypertension.
caution for patients with which medical
diagnosis?
severe respiratory depression. extreme caution of use in young children.
Promethazine (Phenergan) BBW
contraindicated for children under two years of age.
First generation antihistamine medication Promethazine (Phenergan), Diphenhydramine (Benadryl), Hydroxyzine (Vistaril).
examples
1/
5
, 3/29/25, 8:39 NR566 midterm |
AM
Second generation antihistamine Cetirizine (Zyrtec), Levocetirizine (Xyzal), Fexofenadine (Allegra), Loratadine (Claritin).
medication examples.
Patient education for taking Fexofenadine Avoid fruit juices (apple, grapefruit, orange) four hours before and 1-2 hours after
(Allegra) taking Allegra. Reduces absorption.
metabolism, maintain functional integrity of vascular system, neural excitability (CNS),
Physiologic effects of endogenous
stress response, fluid and electrolyte excretion, contribute it maturing of neonatal
glucocorticoids
lungs during pregnancy.
Synthesis and release of glucocorticoids the negative feedback loop (hypothalamus, anterior pituitary, and adrenal cortex).
are regulated by
How do NSAIDs reduce inflammation by inhibiting prostaglandin production
Short acting systemic glucocorticoid Cortisone, Hydrocortisone
examples
Intermediate acting systemic Prednisolone, Prednisone, Methylprednisolone, Triamcinolone.
glucocorticoid examples
Long acting systemic glucocorticoid Dexamethasone, Betamethasone.
examples
Glucocorticoids are metabolized primarily liver
by the
RA, lupus, IBD (UC, Crohns), allergic conditions, asthma, dermatologic conditions,
Therapeutic uses of glucocorticoids prevention of respiratory distress syndrome (given to pregnant mom), misc.
inflammatory disorders.
Glucocorticoid use in children caution, can inhibit bone growth. risk for life long osteoporosis.
avoid, can cause fetal harm. teratogenic and physiologic harm can occur.
Glucocorticoid use in pregnant women & 1st trimester use associated with cleft palate. 3d trimester use associated
breastfeeding with hypoadrenalism. if must use, use smallest and shortest dose.
Hydrocortisone
preferred for systemic use. large doses contraindicated for breastfeeding moms.
Glucocorticoid use in older adults. long term use can cause osteoporosis, adrenal insufficiency, and GI ulcers.
osteoporosis (compression fractures), infection, impaired wound healing,
hyperglycemia, myopathy, fluid and electrolyte disturbance, growth delays
Glucocorticoid adverse effects
(children), psychologic disturbances, cataracts & glaucoma, PUD, cushings syndrome,
and adrenal suppression.
Glucoorticoids are associated with which Hypokalemia. Increases urinary excretion of potassium.
electrolyte imbalance.
Digoxin, loop or thiazide diuretics - hypokalemia.
Glucocorticoid drug interactions. NSAIDs - increased risk for GIB / ulcers
Vaccines - glucocorticoids can cause immunosuppression. caution with live vaccines.
Glucocorticoid contraindications live vaccines. Patients with systemic fungal infections.
Glucocorticoids - cortisone & hydrocortisone. can cause retention on sodium and
Mineralocorticoid potency
water with depletion of potassium. caution in patients with HTN, HRF, taking digoxin.
Signs of glucocorticoid withdraw hypotension, hypoglycemia, arthralgia, and myalgia.
Why is every other day dosing with benefits - reduced risk of adrenal suppression
glucocorticoids beneficial / not beneficial. side effects - drug may fall to sub-therapeutic levels causing symptom exacerbation.
monitor s/s of fluid retention, hypokalemia, infection, and GIB. take in early morning
Glucocorticoid patient education to mimic natural hormone release. Milk to decrease GI irritation. do not abruptly
stop. regular eye exams for long term therapy.
2/
5
AM
NR566 MIDTERM EXAM QUESTIONS AND ANSWERS WITH COMPLETE
SOLUTIONS VERIFIED GRADED A++
Terms in this set (214)
Histamine acts primarily through which two H1 and H2
receptors?
vasodilation, increased capillary permeability, bronchoconstriction, CNS effects,
Effects of H1 stimulation
itching, pain, and increased mucus secretion.
Should antihistamines be used No. H1 stimulation causes bronchiole constriction. This will causes
for treatment of asthma? severe bronchoconstriction in the asthmatic patient.
Effects of H2 receptors Gastric acid secretion.
Two types of antihistamines H1 & H2 antagonists.
When to treat a patient with a H1 antagonist to treat mild allergic reactions.
medication
When to treat a patient with a gastric and duodenal ulcers
H2 antagonist medication
What is the main difference between an First generation are highly sedative where as second generation are not.
first and second generation H1 antagonist
medication?
bind selectively to H1-histaminic receptors which blocks the action of histamine at
H1 antagonist MOA
these sites.
Antihistamine overdose can cause CNS excitation - seizures. children especially at risk.
Effects of antihistamines at a therapeutic CNS depression.
level
Antihistamines in infants caution due to sedation. only use for infants older than six months.
safe in smaller doses. promethazine is contraindicated in children less than two
Antihistamines in children and adolescents
years old.
Antihistamines in pregnancy & avoid unless absolutely necessary in pregnancy (class c risk). small doses okay for
breastfeeding breast feeding. use with caution.
avoid if possible. BEERS criteria. can worsen preexisting glaucoma or BPH. if use is
Antihistamines in older adults.
necessary, start at smaller dose and titrate up.
Antihistamines used to treat motion Promethazine (Phenergan) or Dimenhydrinate (Dramamine).
sickness.
Patient education for first generation H1 avoid other CNS depressants such as alcohol, benzodiazepines, barbiturates, and
antagonist antihistamine use. opioids. do not drive while taking.
Antihistamine anticholinergic effects drying of mucus membranes, urinary hesitancy, constipation, and palpitations.
Antihistamines should be used with BPH, chronic urinary retention, asthma, and hypertension.
caution for patients with which medical
diagnosis?
severe respiratory depression. extreme caution of use in young children.
Promethazine (Phenergan) BBW
contraindicated for children under two years of age.
First generation antihistamine medication Promethazine (Phenergan), Diphenhydramine (Benadryl), Hydroxyzine (Vistaril).
examples
1/
5
, 3/29/25, 8:39 NR566 midterm |
AM
Second generation antihistamine Cetirizine (Zyrtec), Levocetirizine (Xyzal), Fexofenadine (Allegra), Loratadine (Claritin).
medication examples.
Patient education for taking Fexofenadine Avoid fruit juices (apple, grapefruit, orange) four hours before and 1-2 hours after
(Allegra) taking Allegra. Reduces absorption.
metabolism, maintain functional integrity of vascular system, neural excitability (CNS),
Physiologic effects of endogenous
stress response, fluid and electrolyte excretion, contribute it maturing of neonatal
glucocorticoids
lungs during pregnancy.
Synthesis and release of glucocorticoids the negative feedback loop (hypothalamus, anterior pituitary, and adrenal cortex).
are regulated by
How do NSAIDs reduce inflammation by inhibiting prostaglandin production
Short acting systemic glucocorticoid Cortisone, Hydrocortisone
examples
Intermediate acting systemic Prednisolone, Prednisone, Methylprednisolone, Triamcinolone.
glucocorticoid examples
Long acting systemic glucocorticoid Dexamethasone, Betamethasone.
examples
Glucocorticoids are metabolized primarily liver
by the
RA, lupus, IBD (UC, Crohns), allergic conditions, asthma, dermatologic conditions,
Therapeutic uses of glucocorticoids prevention of respiratory distress syndrome (given to pregnant mom), misc.
inflammatory disorders.
Glucocorticoid use in children caution, can inhibit bone growth. risk for life long osteoporosis.
avoid, can cause fetal harm. teratogenic and physiologic harm can occur.
Glucocorticoid use in pregnant women & 1st trimester use associated with cleft palate. 3d trimester use associated
breastfeeding with hypoadrenalism. if must use, use smallest and shortest dose.
Hydrocortisone
preferred for systemic use. large doses contraindicated for breastfeeding moms.
Glucocorticoid use in older adults. long term use can cause osteoporosis, adrenal insufficiency, and GI ulcers.
osteoporosis (compression fractures), infection, impaired wound healing,
hyperglycemia, myopathy, fluid and electrolyte disturbance, growth delays
Glucocorticoid adverse effects
(children), psychologic disturbances, cataracts & glaucoma, PUD, cushings syndrome,
and adrenal suppression.
Glucoorticoids are associated with which Hypokalemia. Increases urinary excretion of potassium.
electrolyte imbalance.
Digoxin, loop or thiazide diuretics - hypokalemia.
Glucocorticoid drug interactions. NSAIDs - increased risk for GIB / ulcers
Vaccines - glucocorticoids can cause immunosuppression. caution with live vaccines.
Glucocorticoid contraindications live vaccines. Patients with systemic fungal infections.
Glucocorticoids - cortisone & hydrocortisone. can cause retention on sodium and
Mineralocorticoid potency
water with depletion of potassium. caution in patients with HTN, HRF, taking digoxin.
Signs of glucocorticoid withdraw hypotension, hypoglycemia, arthralgia, and myalgia.
Why is every other day dosing with benefits - reduced risk of adrenal suppression
glucocorticoids beneficial / not beneficial. side effects - drug may fall to sub-therapeutic levels causing symptom exacerbation.
monitor s/s of fluid retention, hypokalemia, infection, and GIB. take in early morning
Glucocorticoid patient education to mimic natural hormone release. Milk to decrease GI irritation. do not abruptly
stop. regular eye exams for long term therapy.
2/
5
