NURS 615 ADVANCED
PHARMACOTHERAPEUTICS FINAL PAPER
PRACTICE QUESTIONS WITH VERIFIED
ANSWERS PACKAGE
●● MOA of corticosteroids drugs
Answer: drugs that suppress inflammation by mimicking glucocorticoid
hormones
Inhibit interleikin one, tumor necrosis factor and other cytokines,
impairs phagocytosis, impairs lymphocytes, and inhibits tissue repair
●● indications for cortocosteriod use
Answer: Allergy or hypersensitivity, respiratory, shock, rheumatology,
neurology, hepatic, neoplastic... basicly every organ is covered if there is
an issue.
●● withdrawal from corticorsteriod symptoms
Answer: malaise, myalgia, headache, nausea, fevers, hypotension and
relapse of symptoms (pain, inflammation, ashtma)
●● what must you do with corticosteriods to prevent withdrawal
,Answer: Must taper them down, you can have possible adrenal crisis if
you do not.
●● corticosteriod considerations
Answer: suppression patients response to infections- no live viral
vaccines, and have increased susceptibility to disease.
If used over 6 months: Increase blood glucose, impair immune function
(get vaccines) , impair wound healing, GI complaints (report black tarry
stools) , osteoporosis (decreases calcium), anxiety/insomnia, sodium &
fluid retention 9monitor weight and fluid retention)
If on 1gram or more also prescribe PPI (omeprazole) to prevent PUD
contraindicated with active infection and hypersensitivity
●● What are the adverse effects of corticosteroids if administered for six
months or more?
Answer: The main thing you want to worry about is osteoporosis
It can also worsen diabetic control
Patients should report any tarry black stools or abdominal pain.
,●● NSAIDS
Answer: nonsteroidal anti-inflammatory drugs
Ibprofen, aspirin, torsdol, naproxin, Mobic
●● Arachidonic Acid Cascade
Answer: Cell membrane ► Arachinidonic acid ► Cycloxygenerase
(COX)► prostaglandin's
Or
Cell membrane ► Arachinidonic acid ► Lipoxygenase► Leukotrines
●● NSAID mechanism of action
Answer: • NSAIDs inhibit the enzymes COX I and II
• Results in reduction in formation of prostaglandin precursors and
thromboxanes from arachidonic acid
COX1- ibuprofen, naproxen, aspirin, when this is inhibited you are also
inhibiting the prostaglandins that protect the stomach
COX2 - celebrex more stomach proctective
, ●● Drug interactions with NSAIDS
Answer: Pretty much anything that is highly protien bound. Do not give
together with
ACE inhibitors - counteracts antihypertensive effect
BetaBlockers - counteracts antihypertensive effect
lithium - increases lithium levels
Anticoagulants - increases bleeding
Antidiabetics- increases hypoglycemic effect
●● Black box warning for NSAIDS
Answer: May cause an increased risk of serious cardiovascular
thrombotic events:
•Patients with cardiovascular disease or with risk factors for
cardiovascular disease may be a greater risk. **
•Myocardial-infarction
•Stroke which can be fatal.**
•This risk may increase with duration of use.
PHARMACOTHERAPEUTICS FINAL PAPER
PRACTICE QUESTIONS WITH VERIFIED
ANSWERS PACKAGE
●● MOA of corticosteroids drugs
Answer: drugs that suppress inflammation by mimicking glucocorticoid
hormones
Inhibit interleikin one, tumor necrosis factor and other cytokines,
impairs phagocytosis, impairs lymphocytes, and inhibits tissue repair
●● indications for cortocosteriod use
Answer: Allergy or hypersensitivity, respiratory, shock, rheumatology,
neurology, hepatic, neoplastic... basicly every organ is covered if there is
an issue.
●● withdrawal from corticorsteriod symptoms
Answer: malaise, myalgia, headache, nausea, fevers, hypotension and
relapse of symptoms (pain, inflammation, ashtma)
●● what must you do with corticosteriods to prevent withdrawal
,Answer: Must taper them down, you can have possible adrenal crisis if
you do not.
●● corticosteriod considerations
Answer: suppression patients response to infections- no live viral
vaccines, and have increased susceptibility to disease.
If used over 6 months: Increase blood glucose, impair immune function
(get vaccines) , impair wound healing, GI complaints (report black tarry
stools) , osteoporosis (decreases calcium), anxiety/insomnia, sodium &
fluid retention 9monitor weight and fluid retention)
If on 1gram or more also prescribe PPI (omeprazole) to prevent PUD
contraindicated with active infection and hypersensitivity
●● What are the adverse effects of corticosteroids if administered for six
months or more?
Answer: The main thing you want to worry about is osteoporosis
It can also worsen diabetic control
Patients should report any tarry black stools or abdominal pain.
,●● NSAIDS
Answer: nonsteroidal anti-inflammatory drugs
Ibprofen, aspirin, torsdol, naproxin, Mobic
●● Arachidonic Acid Cascade
Answer: Cell membrane ► Arachinidonic acid ► Cycloxygenerase
(COX)► prostaglandin's
Or
Cell membrane ► Arachinidonic acid ► Lipoxygenase► Leukotrines
●● NSAID mechanism of action
Answer: • NSAIDs inhibit the enzymes COX I and II
• Results in reduction in formation of prostaglandin precursors and
thromboxanes from arachidonic acid
COX1- ibuprofen, naproxen, aspirin, when this is inhibited you are also
inhibiting the prostaglandins that protect the stomach
COX2 - celebrex more stomach proctective
, ●● Drug interactions with NSAIDS
Answer: Pretty much anything that is highly protien bound. Do not give
together with
ACE inhibitors - counteracts antihypertensive effect
BetaBlockers - counteracts antihypertensive effect
lithium - increases lithium levels
Anticoagulants - increases bleeding
Antidiabetics- increases hypoglycemic effect
●● Black box warning for NSAIDS
Answer: May cause an increased risk of serious cardiovascular
thrombotic events:
•Patients with cardiovascular disease or with risk factors for
cardiovascular disease may be a greater risk. **
•Myocardial-infarction
•Stroke which can be fatal.**
•This risk may increase with duration of use.
