1
NR 565 Week 1 Quiz, NR 565 Quiz #2,
NR 565 Quiz #3, NR565 midterm, week 4,
NR565 week 5, NR 565- Week 6, NR 565
Pharmacology Week 7, NR 565 WEEK 8
m
.co
ail
- Be able to calculate the total daily dose of insulin based on weight. Calculate with the
gm
lowest possible dose unless otherwise specified. - ANSWER For example, the total daily
dose (TDD) of insulin can be calculated by taking the total weight of the patient's weight
r@
in kilograms (kg), which is 80 kg (184 pounds) multiplied by 0.6 units equals 48 units.
he
This means 24 units of the TDD is the basal insulin dose of glargine (Lantus) (50%) and
hig
the other 24 units of rapid-acting bolus/mealtime insulin (50%).
ing
80x0.6= 48 (tdd)
fly
- Be familiar with benefits of various nicotine replacement options - ANSWER Nicotine
Chewing Gum (Nicotine Polacrilex):
Nonprescription; user controls dose
, 2
Nicotine Lozenges (Nicotine Polacrilex):
Nonprescription; user controls dose; easier to use than nicotine gum
Nicotine Transdermal Systems (Patches):
m
Nonprescription; provides a steady level of nicotine; easy to use; unobtrusive
.co
ail
Nicotine inhaler:
gm
User controls dose; mimics hand-to-mouth motion of smoking
r@
Nicotine nasal spray:
he
User controls dose; fastest nicotine delivery and highest nicotine levels of all
hig
nicotine-based products
ing
- Be familiar with frequency of Hgb A1C monitoring timeline. - ANSWER Perform the
fly
A1C test at least two times a year in patients who are meeting treatment goals (and who
have stable glycemic control). E
, 3
Perform the A1C test quarterly in patients whose therapy has changed or who are not
meeting glycemic goals. E
Point-of-care testing for A1C provides the opportunity for more timely treatment
changes. E
m
.co
pg. 398
ail
teaching. -
gm
- Be familiar with metoclopramide's use, MOA, side effects, monitoring and patient
ANSWER Metoclopramide (Reglan) has two beneficial actions: (1) it
r@
suppresses emesis (by blocking receptors for dopamine and serotonin in the CTZ), and
he
(2) it increases upper GI motility (by enhancing the actions of acetylcholine).
hig
Indications depend on the route (oral or intravenous). Oral metoclopramide has two
ing
approved uses: diabetic gastroparesis and suppression of gastroesophageal reflux.
fly
Intravenous metoclopramide has four approved uses: suppression of postoperative
nausea and vomiting, suppression of CINV, facilitation of small bowel intubation, and
facilitation of radiologic examination of the GI tract. Off-label uses include the
treatment of hiccups and nausea and vomiting of early pregnancy.
, 4
Adverse Effects
With high-dose therapy, sedation and diarrhea are common. Long-term high-dose
therapy can cause irreversible tardive dyskinesia, characterized by repetitive, involuntary
movements of the arms, legs, and facial muscles. Older adults are especially vulnerable
m
and can develop involuntary movement disorders after a single dose. To reduce the risk
.co
for tardive dyskinesia, treatment should be as brief as possible using the lowest effective
ail
dose. Owing to its ability to increase gastric and intestinal motility, metoclopramide is
gm
contraindicated in patients with GI obstruction, perforation, or hemorrhage. Of note,
exposure to metoclopramide during the first trimester of pregnancy is not associated
r@
with an excess risk for congenital malformations.
he
hig
- Be familiar with roflumilast - Know when to use LABA, SABA, Combo drugs in COPD
- ANSWER One phosphodiesterase 4 (PDE4) inhibitor, Roflumilast (Daliresp. Daxas)
ing
is approved for management of COPD. In patients with severe, chronic COPD with a
fly
primary chronic bronchitis component, the risk for exacerbations may be reduced with
this drug.
Mechanism of action.
NR 565 Week 1 Quiz, NR 565 Quiz #2,
NR 565 Quiz #3, NR565 midterm, week 4,
NR565 week 5, NR 565- Week 6, NR 565
Pharmacology Week 7, NR 565 WEEK 8
m
.co
ail
- Be able to calculate the total daily dose of insulin based on weight. Calculate with the
gm
lowest possible dose unless otherwise specified. - ANSWER For example, the total daily
dose (TDD) of insulin can be calculated by taking the total weight of the patient's weight
r@
in kilograms (kg), which is 80 kg (184 pounds) multiplied by 0.6 units equals 48 units.
he
This means 24 units of the TDD is the basal insulin dose of glargine (Lantus) (50%) and
hig
the other 24 units of rapid-acting bolus/mealtime insulin (50%).
ing
80x0.6= 48 (tdd)
fly
- Be familiar with benefits of various nicotine replacement options - ANSWER Nicotine
Chewing Gum (Nicotine Polacrilex):
Nonprescription; user controls dose
, 2
Nicotine Lozenges (Nicotine Polacrilex):
Nonprescription; user controls dose; easier to use than nicotine gum
Nicotine Transdermal Systems (Patches):
m
Nonprescription; provides a steady level of nicotine; easy to use; unobtrusive
.co
ail
Nicotine inhaler:
gm
User controls dose; mimics hand-to-mouth motion of smoking
r@
Nicotine nasal spray:
he
User controls dose; fastest nicotine delivery and highest nicotine levels of all
hig
nicotine-based products
ing
- Be familiar with frequency of Hgb A1C monitoring timeline. - ANSWER Perform the
fly
A1C test at least two times a year in patients who are meeting treatment goals (and who
have stable glycemic control). E
, 3
Perform the A1C test quarterly in patients whose therapy has changed or who are not
meeting glycemic goals. E
Point-of-care testing for A1C provides the opportunity for more timely treatment
changes. E
m
.co
pg. 398
ail
teaching. -
gm
- Be familiar with metoclopramide's use, MOA, side effects, monitoring and patient
ANSWER Metoclopramide (Reglan) has two beneficial actions: (1) it
r@
suppresses emesis (by blocking receptors for dopamine and serotonin in the CTZ), and
he
(2) it increases upper GI motility (by enhancing the actions of acetylcholine).
hig
Indications depend on the route (oral or intravenous). Oral metoclopramide has two
ing
approved uses: diabetic gastroparesis and suppression of gastroesophageal reflux.
fly
Intravenous metoclopramide has four approved uses: suppression of postoperative
nausea and vomiting, suppression of CINV, facilitation of small bowel intubation, and
facilitation of radiologic examination of the GI tract. Off-label uses include the
treatment of hiccups and nausea and vomiting of early pregnancy.
, 4
Adverse Effects
With high-dose therapy, sedation and diarrhea are common. Long-term high-dose
therapy can cause irreversible tardive dyskinesia, characterized by repetitive, involuntary
movements of the arms, legs, and facial muscles. Older adults are especially vulnerable
m
and can develop involuntary movement disorders after a single dose. To reduce the risk
.co
for tardive dyskinesia, treatment should be as brief as possible using the lowest effective
ail
dose. Owing to its ability to increase gastric and intestinal motility, metoclopramide is
gm
contraindicated in patients with GI obstruction, perforation, or hemorrhage. Of note,
exposure to metoclopramide during the first trimester of pregnancy is not associated
r@
with an excess risk for congenital malformations.
he
hig
- Be familiar with roflumilast - Know when to use LABA, SABA, Combo drugs in COPD
- ANSWER One phosphodiesterase 4 (PDE4) inhibitor, Roflumilast (Daliresp. Daxas)
ing
is approved for management of COPD. In patients with severe, chronic COPD with a
fly
primary chronic bronchitis component, the risk for exacerbations may be reduced with
this drug.
Mechanism of action.
