Midterm Exam: NR565/ NR 565 Advanced Phar d d d d d d
macology Care of the Fundamentals Exam | d d d d d d
Questions and Verified Answers (2023/ 2024 Update)- d d d d d d
Chamberlain d
When is it used - ASCVD Risk Score - ANSWER-
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In children a screening should be done between ages 9 and 11 and then agai
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n at ages 19 and 21. For adults every 5 years after the age of 20. Some peopl
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e are at greater risk like those with diabetes and a risk score greater than 7.5
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% and should be screened more often
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ezetimibe- when can it be used? - ANSWER- d d d d d d d
pregnancy/breastfeeding can be use in monotherapy or as adjunct therapy d d d d d d d d d d
with a statin or a fibrate
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What is ezetimibe? - ANSWER-Cholesterol Absorption Inhibitor-
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dlowers cholesterol levels by decreasing the amount of cholesterol that is ab
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sorbed from the small intestine, so that there is less intestinal cholesterol de
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livered to the liver. Does not affect triglycerides
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lifestyle changes for high cholesterol - ANSWER-
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Lifestyle changes are non drug measures used to lower LDL. Four main iss
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ues are diet, exercise, weight control, and smoking cessation
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If a patient wanted to minimize side effects, which drug classification is a g
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ood choice? - ANSWER-Non-statins-
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fibrates, Ezetimibe, Bile acid sequestrants. Statins are generally well toler
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ated and side effects are uncommon. Some patients develop headache, flat
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ulence, constipation, or GI disturbances, but these effects are usually mild
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and transient d
, Midterm Exam: NR565/ NR 565 Advanced Phar d d d d d d
macology Care of the Fundamentals Exam | d d d d d d
Questions and Verified Answers (2023/ 2024 Update)- d d d d d d
Chamberlain d
Therapeutic action of organic nitrates (nitroglycerin) - ANSWER-
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direct relaxant effect on vascular smooth muscles, and the dilation of coron
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ary vessels improves oxygen supply to the myocardium. The dilation of pe
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ripheral veins, and in higher doses peripheral arteries, reduces preload and
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afterload, and thereby lowers myocardial oxygen consumption.
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promote vasodilation d
Contraindications for ranolazine - ANSWER- d d d d
Agents that inhibit CYP3A4 can increase the levels of ranolazine and there
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by increase the risk of torsades de pointes. These things include: grapefruit
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juice, HIV protease inhibitors, macrolide antibiotics, azole antifungal drug
d d d d d d d d
s, and some CCB. Most CCB but not amlodipine can increase levels of ran
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olazine. Drugs that prolong the QT interval can increase the risk of torsade
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s de pointes. (quinidine, sotalol).
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At what age can statins be prescribed? - ANSWER-
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avoid statin use in children under the age of 10
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CCB role with variant angina - ANSWER-
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promote relaxation of coronary artery spasm, increasing cardiac oxygen su
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pply
what medication can be added for patients with worsening symptoms of HF
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? - ANSWER-aldosterone antagonist-
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promotes myocardial remodeling and fibrosis, help with symptoms
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, Midterm Exam: NR565/ NR 565 Advanced Phar d d d d d d
macology Care of the Fundamentals Exam | d d d d d d
Questions and Verified Answers (2023/ 2024 Update)- d d d d d d
Chamberlain d
CCB stable angina - ANSWER- d d d d
promote relaxation of peripheral arterioles, decreasing afterload and reduc
d d d d d d d d
ing cardiac oxygen demand
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A 41 year old patient comes into the clinic complaining of increased heart r
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ate after starting nitro patches for stable angina. What would an appropriate
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response be?
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1. lets lower the dose and frequency of use
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2. I will prescribe a BB to help with this
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3. Next time this happens, lie down and practice deep breathing, this will br
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ing your heart rate down - ANSWER-2-
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dI will prescribe a BB to help with this
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What do CYP450 inhibitors and reducers do when not used correctly/what
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would patient experience? - ANSWER- d d d d
increased side effects, adverse reactions and toxicity d d d d d d
A 55 year old male comes into the clinic with a gouty arthritis. He states tha
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t he has one flareup a year. Your response is:
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1. I will prescribe you glucocorticoids to help with inflammation
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2. Lets start you on prophylactic therapy colchicine.
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3. It will be helpful to take an NSAID to start with to help relive some inf
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lammation. I'll prescribe naproxen. - ANSWER-3- in patients withd d d d d d d d
, Midterm Exam: NR565/ NR 565 Advanced Phar d d d d d d
macology Care of the Fundamentals Exam | d d d d d d
Questions and Verified Answers (2023/ 2024 Update)- d d d d d d
Chamberlain d
infrequent flareups, being less than three per year, treatment of symptoms i
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s all thats needed. NSAIDS are the first line agent for relieving pain of an ac
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ute gout attack. d d
A patient comes in stating that he tried NSAIDS to relieve a gouty attack bu
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t it hasnt helped. He asks, "what are my options?" He further states that he h
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as attacks every few years but when he does NSAIDS do not help. Your res
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ponse is: d
1. I can prescribe a glucocorticoid (prednisone) and that will bring down th
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e inflammation and pain.
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2. Have your tried increasing your dosage of NSAIDS and drink plenty of
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water?
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3. Lets start by making some changes in your diet, can you tell me what yo
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u eat regularly? - ANSWER-1
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3- can also be correct but BEST answer
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Colchicine is considered for long term treatment if a person has how many
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gouty attacks per year? - ANSWER-three or more
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Colchicine should not be taken with what medications? - ANSWER-
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statins, CYP3A4 inhibitors
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adverse effects of colchicine - ANSWER- d d d d d
nausea, vomiting, diarrhea, myelosuppression, myopathy, rhabdomyolysi
d d d d d
s
macology Care of the Fundamentals Exam | d d d d d d
Questions and Verified Answers (2023/ 2024 Update)- d d d d d d
Chamberlain d
When is it used - ASCVD Risk Score - ANSWER-
d d d d d d d d d
In children a screening should be done between ages 9 and 11 and then agai
d d d d d d d d d d d d d d
n at ages 19 and 21. For adults every 5 years after the age of 20. Some peopl
d d d d d d d d d d d d d d d d d
e are at greater risk like those with diabetes and a risk score greater than 7.5
d d d d d d d d d d d d d d d
% and should be screened more often
d d d d d d
ezetimibe- when can it be used? - ANSWER- d d d d d d d
pregnancy/breastfeeding can be use in monotherapy or as adjunct therapy d d d d d d d d d d
with a statin or a fibrate
d d d d d
What is ezetimibe? - ANSWER-Cholesterol Absorption Inhibitor-
d d d d d d
dlowers cholesterol levels by decreasing the amount of cholesterol that is ab
d d d d d d d d d d d
sorbed from the small intestine, so that there is less intestinal cholesterol de
d d d d d d d d d d d d
livered to the liver. Does not affect triglycerides
d d d d d d d
lifestyle changes for high cholesterol - ANSWER-
d d d d d d
Lifestyle changes are non drug measures used to lower LDL. Four main iss
d d d d d d d d d d d d
ues are diet, exercise, weight control, and smoking cessation
d d d d d d d d
If a patient wanted to minimize side effects, which drug classification is a g
d d d d d d d d d d d d d
ood choice? - ANSWER-Non-statins-
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fibrates, Ezetimibe, Bile acid sequestrants. Statins are generally well toler
d d d d d d d d d d
ated and side effects are uncommon. Some patients develop headache, flat
d d d d d d d d d d
ulence, constipation, or GI disturbances, but these effects are usually mild
d d d d d d d d d d d
and transient d
, Midterm Exam: NR565/ NR 565 Advanced Phar d d d d d d
macology Care of the Fundamentals Exam | d d d d d d
Questions and Verified Answers (2023/ 2024 Update)- d d d d d d
Chamberlain d
Therapeutic action of organic nitrates (nitroglycerin) - ANSWER-
d d d d d d d
direct relaxant effect on vascular smooth muscles, and the dilation of coron
d d d d d d d d d d d
ary vessels improves oxygen supply to the myocardium. The dilation of pe
d d d d d d d d d d d
ripheral veins, and in higher doses peripheral arteries, reduces preload and
d d d d d d d d d d d
afterload, and thereby lowers myocardial oxygen consumption.
d d d d d d
promote vasodilation d
Contraindications for ranolazine - ANSWER- d d d d
Agents that inhibit CYP3A4 can increase the levels of ranolazine and there
d d d d d d d d d d d
by increase the risk of torsades de pointes. These things include: grapefruit
d d d d d d d d d d d d
juice, HIV protease inhibitors, macrolide antibiotics, azole antifungal drug
d d d d d d d d
s, and some CCB. Most CCB but not amlodipine can increase levels of ran
d d d d d d d d d d d d d
olazine. Drugs that prolong the QT interval can increase the risk of torsade
d d d d d d d d d d d d
s de pointes. (quinidine, sotalol).
d d d d
At what age can statins be prescribed? - ANSWER-
d d d d d d d d
avoid statin use in children under the age of 10
d d d d d d d d d
CCB role with variant angina - ANSWER-
d d d d d d
promote relaxation of coronary artery spasm, increasing cardiac oxygen su
d d d d d d d d d
pply
what medication can be added for patients with worsening symptoms of HF
d d d d d d d d d d d
? - ANSWER-aldosterone antagonist-
d d d
promotes myocardial remodeling and fibrosis, help with symptoms
d d d d d d d d
, Midterm Exam: NR565/ NR 565 Advanced Phar d d d d d d
macology Care of the Fundamentals Exam | d d d d d d
Questions and Verified Answers (2023/ 2024 Update)- d d d d d d
Chamberlain d
CCB stable angina - ANSWER- d d d d
promote relaxation of peripheral arterioles, decreasing afterload and reduc
d d d d d d d d
ing cardiac oxygen demand
d d d
A 41 year old patient comes into the clinic complaining of increased heart r
d d d d d d d d d d d d d
ate after starting nitro patches for stable angina. What would an appropriate
d d d d d d d d d d d
response be?
d d
1. lets lower the dose and frequency of use
d d d d d d d
2. I will prescribe a BB to help with this
d d d d d d d d
3. Next time this happens, lie down and practice deep breathing, this will br
d d d d d d d d d d d d
ing your heart rate down - ANSWER-2-
d d d d d d
dI will prescribe a BB to help with this
d d d d d d d d
What do CYP450 inhibitors and reducers do when not used correctly/what
d d d d d d d d d d d
would patient experience? - ANSWER- d d d d
increased side effects, adverse reactions and toxicity d d d d d d
A 55 year old male comes into the clinic with a gouty arthritis. He states tha
d d d d d d d d d d d d d d d
t he has one flareup a year. Your response is:
d d d d d d d d d
1. I will prescribe you glucocorticoids to help with inflammation
d d d d d d d d
2. Lets start you on prophylactic therapy colchicine.
d d d d d d
3. It will be helpful to take an NSAID to start with to help relive some inf
d d d d d d d d d d d d d d d
lammation. I'll prescribe naproxen. - ANSWER-3- in patients withd d d d d d d d
, Midterm Exam: NR565/ NR 565 Advanced Phar d d d d d d
macology Care of the Fundamentals Exam | d d d d d d
Questions and Verified Answers (2023/ 2024 Update)- d d d d d d
Chamberlain d
infrequent flareups, being less than three per year, treatment of symptoms i
d d d d d d d d d d d
s all thats needed. NSAIDS are the first line agent for relieving pain of an ac
d d d d d d d d d d d d d d d
ute gout attack. d d
A patient comes in stating that he tried NSAIDS to relieve a gouty attack bu
d d d d d d d d d d d d d d
t it hasnt helped. He asks, "what are my options?" He further states that he h
d d d d d d d d d d d d d d d
as attacks every few years but when he does NSAIDS do not help. Your res
d d d d d d d d d d d d d d
ponse is: d
1. I can prescribe a glucocorticoid (prednisone) and that will bring down th
d d d d d d d d d d d
e inflammation and pain.
d d d
2. Have your tried increasing your dosage of NSAIDS and drink plenty of
d d d d d d d d d d d
water?
d
3. Lets start by making some changes in your diet, can you tell me what yo
d d d d d d d d d d d d d d
u eat regularly? - ANSWER-1
d d d d
3- can also be correct but BEST answer
d d d d d d d
Colchicine is considered for long term treatment if a person has how many
d d d d d d d d d d d d d
gouty attacks per year? - ANSWER-three or more
d d d d d d d
Colchicine should not be taken with what medications? - ANSWER-
d d d d d d d d d
statins, CYP3A4 inhibitors
d d d
adverse effects of colchicine - ANSWER- d d d d d
nausea, vomiting, diarrhea, myelosuppression, myopathy, rhabdomyolysi
d d d d d
s
