NR 565 Pharm Midterm Exam with
Complete Solutions
ACE inhibitors MOA - ANS-Inhibit ACE--> decrease angiotensin II--> decrease GFR
(prevent constriction of efferent arteriole)
Increasing levels of renin (loss of feedback)
ACE inhibition--> prevents inactivation of bradykinin (vasodilator)
USE FOR KIDNEY PROTECTION IN DM
Avoid in pregnancy
Aldosterone Antagonists (spironolactone) - ANS-- Blocks actions of aldosterone in distal
nephron so K+ retained while Na excreted; binds to protein that permits K+ secretion at
distal tubule
- Usually used along with other diuretics.
- Response time: up to 48hrs
- Uses: HTN & hyperaldosteronism. Concurrently prescribed with thiazide or loop
diuretics to treat edema.
- SE: Hyperkalemia
Alendronate - ANS-Fosamax
Patients need to sit upright for 3060 minutes after taking this medication and also
should watch for dietary supplement that may interfere with the absorption Tom's
calcium iron and magnesium
ARBs MOA - ANS-block angiotensin receptor to reduce vasoconstriction and
aldosterone secretion
ASCVD - ANS-Used to determine patient's risk for disease and is used when
medication dosing for cholesterol is present. Can be used for patients that have
comorbidities.
Ezetimibe (Zetia) - ANS-cholesterol absorption inhibitor Ask on the cells of the brush
border of the small intestine to inhibit dietary and cholesterol absorbed in. So it's
blocking the absorption of cholesterol in the small intestine and inhibits reabsorption of
cholesterol secreted in the bile can be used with statins to lower LDL's
Febuxostat MOA - ANS-inhibits xanthine oxidase
Should be taken with nsaids or colchicine
Gout - ANS-Swollen, red, acutely painful great toe joint
, If untreated patient could develop joint erosion tophi and renal damage
Guideline principles for prescribers for opioids - ANS-Opioids are not first line of
therapy, establish goals for pain and function, discuss risk and benefits, use immediate
release opioids when starting, use the lowest effective dose, prescribed short duration's
for acute pain, evaluate benefits and harms frequently, use strategies to mitigate risk,
review the PDMP, urine drug testing, avoid opioid and benzo, offer treatment for opioid
disorder.
How does limited prescriptive authority impact patients within the healthcare system? -
ANS-Decreased access to care, longer wait times for APRN/MD signatures, decreased
treatment time of the patient
Impacts - outcomes of polypharmacy - ANS-Simplifying drug regimen, providing clear
and concise verbal and written instructions, using an appropriate dosage form, clearly
labeling and dispensing easy to open containers, developing daily reminders,
monitoring frequently, affordability of drugs, support system.
JNC HTN ALGORITHM - ANS-See website on Laptop
Key responsibility of prescribing? - ANS-Documentation of discussion between
prescriber and patient, did not prescribe to friends and family, obtain thorough H&P,
document discussions regarding medication's, side effects, respecters, monitoring and
titrating
Labetalol - ANS-Use for pregnant women
Long term use of allopurionl - ANS-Cataracs
metabolic syndrome - ANS-High triglyceride levels 150 mg or higher low HDL
cholesterol below 40 for men below 50 for women
hyperglycemia which is fasting blood glucose over 100
high blood pressure systolic 130 or higher over diastolic 85 or higher
and an increase waist circumference of 40 inches or more for men or 35 inches or more
for women
Methadone black box warning/benefits of using opioid use disorder - ANS-Similar to
morphine, long half life, relieves pain and addiction.
Can be dangerous due to the prolong QT interval
Methotrexate - ANS-Is a folate antagonist because folate is necessary for DNA
synthesis and cellular replication it inhibits this process
Neonate an infant drug absorption - ANS-Adult rate for absorption at two years old for
oral distribution adult rate is 10 to 12 months protein binding, hepatic metabolism and
renal excretion by one year old
Complete Solutions
ACE inhibitors MOA - ANS-Inhibit ACE--> decrease angiotensin II--> decrease GFR
(prevent constriction of efferent arteriole)
Increasing levels of renin (loss of feedback)
ACE inhibition--> prevents inactivation of bradykinin (vasodilator)
USE FOR KIDNEY PROTECTION IN DM
Avoid in pregnancy
Aldosterone Antagonists (spironolactone) - ANS-- Blocks actions of aldosterone in distal
nephron so K+ retained while Na excreted; binds to protein that permits K+ secretion at
distal tubule
- Usually used along with other diuretics.
- Response time: up to 48hrs
- Uses: HTN & hyperaldosteronism. Concurrently prescribed with thiazide or loop
diuretics to treat edema.
- SE: Hyperkalemia
Alendronate - ANS-Fosamax
Patients need to sit upright for 3060 minutes after taking this medication and also
should watch for dietary supplement that may interfere with the absorption Tom's
calcium iron and magnesium
ARBs MOA - ANS-block angiotensin receptor to reduce vasoconstriction and
aldosterone secretion
ASCVD - ANS-Used to determine patient's risk for disease and is used when
medication dosing for cholesterol is present. Can be used for patients that have
comorbidities.
Ezetimibe (Zetia) - ANS-cholesterol absorption inhibitor Ask on the cells of the brush
border of the small intestine to inhibit dietary and cholesterol absorbed in. So it's
blocking the absorption of cholesterol in the small intestine and inhibits reabsorption of
cholesterol secreted in the bile can be used with statins to lower LDL's
Febuxostat MOA - ANS-inhibits xanthine oxidase
Should be taken with nsaids or colchicine
Gout - ANS-Swollen, red, acutely painful great toe joint
, If untreated patient could develop joint erosion tophi and renal damage
Guideline principles for prescribers for opioids - ANS-Opioids are not first line of
therapy, establish goals for pain and function, discuss risk and benefits, use immediate
release opioids when starting, use the lowest effective dose, prescribed short duration's
for acute pain, evaluate benefits and harms frequently, use strategies to mitigate risk,
review the PDMP, urine drug testing, avoid opioid and benzo, offer treatment for opioid
disorder.
How does limited prescriptive authority impact patients within the healthcare system? -
ANS-Decreased access to care, longer wait times for APRN/MD signatures, decreased
treatment time of the patient
Impacts - outcomes of polypharmacy - ANS-Simplifying drug regimen, providing clear
and concise verbal and written instructions, using an appropriate dosage form, clearly
labeling and dispensing easy to open containers, developing daily reminders,
monitoring frequently, affordability of drugs, support system.
JNC HTN ALGORITHM - ANS-See website on Laptop
Key responsibility of prescribing? - ANS-Documentation of discussion between
prescriber and patient, did not prescribe to friends and family, obtain thorough H&P,
document discussions regarding medication's, side effects, respecters, monitoring and
titrating
Labetalol - ANS-Use for pregnant women
Long term use of allopurionl - ANS-Cataracs
metabolic syndrome - ANS-High triglyceride levels 150 mg or higher low HDL
cholesterol below 40 for men below 50 for women
hyperglycemia which is fasting blood glucose over 100
high blood pressure systolic 130 or higher over diastolic 85 or higher
and an increase waist circumference of 40 inches or more for men or 35 inches or more
for women
Methadone black box warning/benefits of using opioid use disorder - ANS-Similar to
morphine, long half life, relieves pain and addiction.
Can be dangerous due to the prolong QT interval
Methotrexate - ANS-Is a folate antagonist because folate is necessary for DNA
synthesis and cellular replication it inhibits this process
Neonate an infant drug absorption - ANS-Adult rate for absorption at two years old for
oral distribution adult rate is 10 to 12 months protein binding, hepatic metabolism and
renal excretion by one year old
