NUR 635 Final Tyler review
Prescribing concerns with SSRI - answer serotonin syndrome caused by drug-drug
interactions
what causes carbamazepine levels to drop despite no other change – answer auto
metabolizes- med digests itself, need to increase dose
Long-term carbamazepine use requires monitoring of – answer CBC minimum 4 times a
year due to risk of hematological effects
Prescribing SSRI: Educate - When should pts notice a difference - answer Check back
in four weeks. May take some time.
Carbamazepine black box warning - answer Asians are at higher risk for SJS and TEN
Moderate generalized anxiety disorder: good first medication - answerBuspar
Buspar class - answerSNRI
classic migraine, first choice tx - answertriptans
classic migraine, tx after triptans are not working, first choice prophylactic -
answerpropranolol (beta blocker)
10mg Percocet and 10mg oxycodone, Pt asks why does the Percocet work faster? -
answerMedication formulations (fillers and other additives) can effect
pharmacodynamics
"Sig" on a prescription - answerhow you take the medication, Latin for directions.
Directions to pharmacist
Abbreviation not used in rx - answerQD
pts taking teratogen rx and thinking about getting pregnant, when to dc - answerNow.
Before getting pregnant. Most defects occur in first trimester
Pneumonia tx goal: Fever gone in 2-4 days. If fever persists: - answercurrent AB not
targeting the right pathogen
Adults w/no risk factors with CAP tx: - answermacrolide such as azithromycin,
clarithromycin, erythromycin or doxycycline when allergic to pcn
most common pathogen: s.pneumoniae
, Adults with pneumonia and comorbidities i.e. heart/lung/liver disease; dm; etoh; ca;
asplenia; immunosuppressed; or use of ab w/in 3 mos; or other risk for DRSP inf. Tx: -
answerrespiratory fluoroquinolone: levofloxacin(Levaquin) or beta-lactam PLUS
macrolide such as amoxicillin or amoxicillin-clavulanate (Augmentin)
adults older than 60, comorbid w/CAP. Outpt tx: - answerceftriaxone (Rocephin) IM/IV
IM
or
levofloxacin IV daily
switch to oral once pt can tolerate
CAP in preg women tx: - answerw/o comorbidities: erythromycin, azithromycin,
clarithromycin
comorbid: azithromycin PLUS pcn
when tx pneumonia how long before leukocytosis should be resolved - answer4 days
Pt taking digoxin. What medication should we be concerned about r/t drug-drug
interaction? - answerAlbuterol. Albuterol can decrease plamsma levels of digoxin
moderate persistent asthma, in a 42 yo African American. What med am i going to be
really cautious with or avoid? - answerLABA monotherapy is to be avoided. LABA must
always be combined with a glucocorticoid in the tx of asthma
Spiriva Handihaler (tiotropium bromide) indication for use: - answerbronchospasm in
COPD (bronchodilator)
Beclamethasone (Qvar), tx of exercise induced asthma and pt education -
answerinhaled corticosteroid for asthma, not for exercise induced or acute exacerbation
of asthma, it is for prevention of asthma attacks. Maintenance med
Older male w/seasonal allergies, what should he take - answeravoid systemic allergy
meds like OTC Benadryl(diphenhydramine), adverse rxns include urinary retention and
CNS effects (sedation)
2nd gen allergy meds preferred like Zyrtec(cetirizine)
Betexalol opthalmic drops. What should be monitored? - answer-topical betaxolol-
monitor their intraocular pressure.
-betaxolol can cause decreases in blood pressure and heart rate.
-monitor the patient for the potential systemic adverse effects seen with betaxolol and
other beta-blockers for patients on both topical and oral forms.
Pt with new onset of depression. What do we check? - answerThyroid testing.
Hypothyroid symptoms similar to depression syptoms. T3, T4, TSH
Prescribing concerns with SSRI - answer serotonin syndrome caused by drug-drug
interactions
what causes carbamazepine levels to drop despite no other change – answer auto
metabolizes- med digests itself, need to increase dose
Long-term carbamazepine use requires monitoring of – answer CBC minimum 4 times a
year due to risk of hematological effects
Prescribing SSRI: Educate - When should pts notice a difference - answer Check back
in four weeks. May take some time.
Carbamazepine black box warning - answer Asians are at higher risk for SJS and TEN
Moderate generalized anxiety disorder: good first medication - answerBuspar
Buspar class - answerSNRI
classic migraine, first choice tx - answertriptans
classic migraine, tx after triptans are not working, first choice prophylactic -
answerpropranolol (beta blocker)
10mg Percocet and 10mg oxycodone, Pt asks why does the Percocet work faster? -
answerMedication formulations (fillers and other additives) can effect
pharmacodynamics
"Sig" on a prescription - answerhow you take the medication, Latin for directions.
Directions to pharmacist
Abbreviation not used in rx - answerQD
pts taking teratogen rx and thinking about getting pregnant, when to dc - answerNow.
Before getting pregnant. Most defects occur in first trimester
Pneumonia tx goal: Fever gone in 2-4 days. If fever persists: - answercurrent AB not
targeting the right pathogen
Adults w/no risk factors with CAP tx: - answermacrolide such as azithromycin,
clarithromycin, erythromycin or doxycycline when allergic to pcn
most common pathogen: s.pneumoniae
, Adults with pneumonia and comorbidities i.e. heart/lung/liver disease; dm; etoh; ca;
asplenia; immunosuppressed; or use of ab w/in 3 mos; or other risk for DRSP inf. Tx: -
answerrespiratory fluoroquinolone: levofloxacin(Levaquin) or beta-lactam PLUS
macrolide such as amoxicillin or amoxicillin-clavulanate (Augmentin)
adults older than 60, comorbid w/CAP. Outpt tx: - answerceftriaxone (Rocephin) IM/IV
IM
or
levofloxacin IV daily
switch to oral once pt can tolerate
CAP in preg women tx: - answerw/o comorbidities: erythromycin, azithromycin,
clarithromycin
comorbid: azithromycin PLUS pcn
when tx pneumonia how long before leukocytosis should be resolved - answer4 days
Pt taking digoxin. What medication should we be concerned about r/t drug-drug
interaction? - answerAlbuterol. Albuterol can decrease plamsma levels of digoxin
moderate persistent asthma, in a 42 yo African American. What med am i going to be
really cautious with or avoid? - answerLABA monotherapy is to be avoided. LABA must
always be combined with a glucocorticoid in the tx of asthma
Spiriva Handihaler (tiotropium bromide) indication for use: - answerbronchospasm in
COPD (bronchodilator)
Beclamethasone (Qvar), tx of exercise induced asthma and pt education -
answerinhaled corticosteroid for asthma, not for exercise induced or acute exacerbation
of asthma, it is for prevention of asthma attacks. Maintenance med
Older male w/seasonal allergies, what should he take - answeravoid systemic allergy
meds like OTC Benadryl(diphenhydramine), adverse rxns include urinary retention and
CNS effects (sedation)
2nd gen allergy meds preferred like Zyrtec(cetirizine)
Betexalol opthalmic drops. What should be monitored? - answer-topical betaxolol-
monitor their intraocular pressure.
-betaxolol can cause decreases in blood pressure and heart rate.
-monitor the patient for the potential systemic adverse effects seen with betaxolol and
other beta-blockers for patients on both topical and oral forms.
Pt with new onset of depression. What do we check? - answerThyroid testing.
Hypothyroid symptoms similar to depression syptoms. T3, T4, TSH
