1
NR 565 - advanced pharmacology
midterm - Chamberlain
12 CDC guidelines for prescribing opioids - ANSWER Opioids are not first line
m
therapy
.co
establish goals for pain and function
ail
Discuss risks and benefits
gm
Use immediate release opioids when starting
Use the lowest effective dose
r@
Prescribe short durations for acute pain
he
Evaluate benefits and harms frequently
hig
Use strategies to migrate risk
Review PDMP data
ing
Use urine drug testing
fly
Avoid concurrent opioid and benzo prescribing
Offer treatment for opioid use disorder
1st line treatment of osteoporosis - ANSWER alendronate
, 2
A 41 year old patient comes into the clinic complaining of increased heart rate after
starting nitro patches for stable angina. What would an appropriate response be?
1. lets lower the dose and frequency of use
2. I will prescribe a BB to help with this
m
3. Next time this happens, lie down and practice deep breathing, this will bring your
.co
heart rate down - ANSWER 2- I will prescribe a BB to help with this
ail
gm
A 55 year old male comes into the clinic with a gouty arthritis. He states that he has one
flareup a year. Your response is:
r@
1. I will prescribe you glucocorticoids to help with inflammation
he
2. Lets start you on prophylactic therapy colchicine.
hig
3. It will be helpful to take an NSAID to start with to help relive some inflammation. I'll
prescribe naproxen. - ANSWER 3- in patients with infrequent flareups, being less than
ing
three per year, treatment of symptoms is all thats needed. NSAIDS are the first line agent
fly
for relieving pain of an acute gout attack.
, 3
A patient comes in stating that he tried NSAIDS to relieve a gouty attack but it hasnt
helped. He asks, "what are my options?" He further states that he has attacks every few
years but when he does NSAIDS do not help. Your response is:
1. I can prescribe a glucocorticoid (prednisone) and that will bring down the
inflammation and pain.
m
2. Have your tried increasing your dosage of NSAIDS and drink plenty of water?
.co
3. Lets start by making some changes in your diet, can you tell me what you eat
ail
regularly? - ANSWER 1
gm
3- can also be correct but BEST answer
r@
A patient with HF develops fibrotic changes, what should the provider do next? -
he
ANSWER ensure that a patient is on an ARB (valsartan) as this inhibits fibrosis
hig
(aldosterone antagonist)
ing
A person who is depend on a pure opioid agonist should NEVER receive an opioid
fly
agonist antagonist - ANSWER true
, 4
ACE inhibitors MOA - ANSWER Angiotensin Converting Enzyme Inhibitors (ACE-I)
prevent the conversion of angiotensin I to angiotensin II, which disrupts the
renin-angiotensin-aldosterone system (RAAS).
1. reduce levels of angiotensin II (through inhibition of ACE)
2. increasing levels of bradykinin (through inhibition of kinase 11)
m
.co
End in -pril
ail
gm
adverse effects for bisphosphonates - ANSWER osteonecrosis of the jaw and hip
fracture, Esophagitis
r@
he
adverse effects of CCBs in elderly patients - ANSWER gingival hyperplasia (overgrowth
hig
of gum tissue) and chronic eczematous rash
ing
adverse effects of colchicine - ANSWER nausea, vomiting, diarrhea, myelosuppression,
fly
myopathy, rhabdomyolysis
adverse effects of digoxin - ANSWER GI- anorexia, nausea, vomiting
CNS- fatigue
NR 565 - advanced pharmacology
midterm - Chamberlain
12 CDC guidelines for prescribing opioids - ANSWER Opioids are not first line
m
therapy
.co
establish goals for pain and function
ail
Discuss risks and benefits
gm
Use immediate release opioids when starting
Use the lowest effective dose
r@
Prescribe short durations for acute pain
he
Evaluate benefits and harms frequently
hig
Use strategies to migrate risk
Review PDMP data
ing
Use urine drug testing
fly
Avoid concurrent opioid and benzo prescribing
Offer treatment for opioid use disorder
1st line treatment of osteoporosis - ANSWER alendronate
, 2
A 41 year old patient comes into the clinic complaining of increased heart rate after
starting nitro patches for stable angina. What would an appropriate response be?
1. lets lower the dose and frequency of use
2. I will prescribe a BB to help with this
m
3. Next time this happens, lie down and practice deep breathing, this will bring your
.co
heart rate down - ANSWER 2- I will prescribe a BB to help with this
ail
gm
A 55 year old male comes into the clinic with a gouty arthritis. He states that he has one
flareup a year. Your response is:
r@
1. I will prescribe you glucocorticoids to help with inflammation
he
2. Lets start you on prophylactic therapy colchicine.
hig
3. It will be helpful to take an NSAID to start with to help relive some inflammation. I'll
prescribe naproxen. - ANSWER 3- in patients with infrequent flareups, being less than
ing
three per year, treatment of symptoms is all thats needed. NSAIDS are the first line agent
fly
for relieving pain of an acute gout attack.
, 3
A patient comes in stating that he tried NSAIDS to relieve a gouty attack but it hasnt
helped. He asks, "what are my options?" He further states that he has attacks every few
years but when he does NSAIDS do not help. Your response is:
1. I can prescribe a glucocorticoid (prednisone) and that will bring down the
inflammation and pain.
m
2. Have your tried increasing your dosage of NSAIDS and drink plenty of water?
.co
3. Lets start by making some changes in your diet, can you tell me what you eat
ail
regularly? - ANSWER 1
gm
3- can also be correct but BEST answer
r@
A patient with HF develops fibrotic changes, what should the provider do next? -
he
ANSWER ensure that a patient is on an ARB (valsartan) as this inhibits fibrosis
hig
(aldosterone antagonist)
ing
A person who is depend on a pure opioid agonist should NEVER receive an opioid
fly
agonist antagonist - ANSWER true
, 4
ACE inhibitors MOA - ANSWER Angiotensin Converting Enzyme Inhibitors (ACE-I)
prevent the conversion of angiotensin I to angiotensin II, which disrupts the
renin-angiotensin-aldosterone system (RAAS).
1. reduce levels of angiotensin II (through inhibition of ACE)
2. increasing levels of bradykinin (through inhibition of kinase 11)
m
.co
End in -pril
ail
gm
adverse effects for bisphosphonates - ANSWER osteonecrosis of the jaw and hip
fracture, Esophagitis
r@
he
adverse effects of CCBs in elderly patients - ANSWER gingival hyperplasia (overgrowth
hig
of gum tissue) and chronic eczematous rash
ing
adverse effects of colchicine - ANSWER nausea, vomiting, diarrhea, myelosuppression,
fly
myopathy, rhabdomyolysis
adverse effects of digoxin - ANSWER GI- anorexia, nausea, vomiting
CNS- fatigue
