Exam 1.Exam 2,Exam 3 & Final Exams: NURS5334/
NURS 5334 (Latest 2024/ 2025 Updates STUDY BUNDLE
PACKAGE WITH SOLUTIONS) Advanced Pharmacology
for Nurse Practitioners| Qs & As| 100% Correct| Grade
A
Albuterol - ANSWERClass: Short acting B2 agonist with minor B1
Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and
COPD
ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS
excitation effects (tremors, dizziness), HA, tachycardia, palpitations
Comments: Safe for children and pregnancy; may combine with ipratropium; least
expensive
Terbutaline - ANSWERClass: Short acting B2 agonist with minor B1
Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and
COPD
ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS
excitation effects (tremors, dizziness), HA, tachycardia, palpitations
X: Pregnancy category B or C
Salmeterol - ANSWERClass: Long acting B2 agonist, more selective
Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and
COPD
ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS
excitation effects (tremors, dizziness), HA, tachycardia, palpitations
Comments: Do not use alone for persistent asthma, combine with an inhaled
corticosteroid; don't wash it, powder can get clogged
What are some things you can educate your patients on regarding beta agonist
inhalers? - ANSWER1. Demonstrate and have patient do return demonstration
2. Check correct inhaler use if patient says it's not working
3. Encourage use of spacer
Fluticasone - ANSWERClass: Inhaled corticosteroid
Used for: 1st line treatment for persistent asthma
MOA: Anti-inflammatory, minimal systemic exposure
Budesonide - ANSWERClass: Inhaled corticosteroid
Used for: 1st line treatment for persistent asthma
MOA: Anti-inflammatory, minimal systemic exposure
Zafirlukast - ANSWERClass: Leukotriene modifier/antagonist
Used for: 2nd line to decrease bronchoconstriction, edema
MOA: Works similar to prostaglandins in r/t to inflammation, blocks lipoxygenase
,Theophylline - ANSWERClass: Xanthine; stimulant
Used for: Asthma
MOA: Bronchial smooth muscle relaxation
ADR: cardiovascular effects, increased gastric acid production, CNS effects
(irritability, restlessness, seizures, insomnia), GI effects (reflux, worsens heartburn),
cardiac effects (palpitations, tachycardia, hypotension, life-threatening arrhythmias)
X: GERD, HTN, ischemic heart dx, coronary insufficiency, CHF, history of stroke,
cardiac arrhythmias; smoking increases clearance
Comments: Stay away from charcoal-broiled foods (accelerates the hepatic
metabolism), avoid large amounts of caffeine containing beverages; elimination is
influenced by diet
What are the signs of Theophylline toxicity? - ANSWERVomiting, insomnia,
jitteriness, HA, severe GI pain, irregular heartbeat
Ipratropium Bromide - ANSWERClass: Inhaled anticholinergic
Used for: NOT 1st line, supplemental use in acute bronchospasm
MOA: Blocks the muscarinic cholinergic receptors, causes bronchial smooth muscle
relaxation; uses alternate pathway, effects additive with beta receptors
What is asthma? - ANSWERChronic inflammatory disorder of the airways, recurrent
episodes of wheezing, breathlessness and chest tightness, airflow obstruction is
reversible - recommendations by Expert Panel III is to take an aggressive approach to
gain quick control
What would you treat mild intermittent asthma with? - ANSWERStep 1 therapy:
1. Use short acting B2 agonists PRN for symptoms - patients may have symptoms
when exposed to triggers (URI, allergens, chemical inhalents, exercise)
2. Educate on annual flu shot
What would you treat mild persistent asthma with? - ANSWERStep 2 therapy:
1. Long-term/low dose inhaled corticosteroids such as Fluticasone or Budesonide
2. Use short acting B2 agonist PRN, if using more than 2 days/week, then step up
therapy
What would you treat moderate persistent asthma with? - ANSWERStep 3 therapy:
1. Treat with medium dose inhaled corticosteroids (Fluticasone or Budesonide) OR
1. Low dose inhaled steroid (Fluticasone or Budesonide) plus long acting B2 agonist
(Advair or Salmeterol) OR
1. Medium dose inhaled steroid (Fluticasone or Budesonide) plus leukotriene
receptor antagonist (Zafirlukast)
2. May use short acting B2 agonists (Albuterol or Terbutaline)
What would you treat severe persistent asthma with? - ANSWERStep 4 therapy:
1. Medium dose inhaled corticosteroid (Fluticasone or Budesonide) AND long-acting
B2 agonist (Salmeterol) OR
, 1. Medium dose inhaled corticosteroid (Fluticasone or Budesonide) AND a
leukotriene modifier (Zafirlukast) OR Theophylline
Step 5 therapy:
1. High dose inhaled corticosteroid AND long acting B2 agonist
Step 6 therapy:
1. High dose inhaled corticosteroid AND long acting B2 agonist AND oral
corticosteroid
**Severe persistent asthma requires consultation with asthma specialist
What drugs would you consider for pregnant patients who have asthma? -
ANSWERInhaled beta agonists are acute drug of choice; inhaled corticosteroids are
the long term drug of choice
When would you refer a child with asthma to a specialist? - ANSWERAt step 3
therapy
When would you consider using a long acting B2 agonists as monotherapy? -
ANSWERIf your patient has COPD
Systematic antibiotics are required for ____? - ANSWERModerate to severe
impetigo, boils, abscesses, perianal strep, cellulitis, MRSA suspected skin infections
Mupirocin - ANSWERClass: Topical ATB
Used for: Mild impetigo, nasal MRSA carriers
Comments: Generic Mupirocin is less expensive
Bacitracin - ANSWERClass: Topical ATB
Used for: Mild impetigo
Comments: Can be combined to make double or triple ATB
Retapamulin - ANSWERClass: Topical ATB
Used for: Mild impetigo or nasal MRSA carriers
Comments: Cannot be given intranasal or will destroy sense of smell
Polymixin B - ANSWERClass: Topical ATB
Used for: Mild impetigo
Comments: A double and triple ATB
Neomycin - ANSWERClass: Topical ATB
Used for: Mild impetigo
Comments: May cause sensitivity in triple ATB
Cephalexin - ANSWERClass: Oral ATB
NURS 5334 (Latest 2024/ 2025 Updates STUDY BUNDLE
PACKAGE WITH SOLUTIONS) Advanced Pharmacology
for Nurse Practitioners| Qs & As| 100% Correct| Grade
A
Albuterol - ANSWERClass: Short acting B2 agonist with minor B1
Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and
COPD
ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS
excitation effects (tremors, dizziness), HA, tachycardia, palpitations
Comments: Safe for children and pregnancy; may combine with ipratropium; least
expensive
Terbutaline - ANSWERClass: Short acting B2 agonist with minor B1
Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and
COPD
ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS
excitation effects (tremors, dizziness), HA, tachycardia, palpitations
X: Pregnancy category B or C
Salmeterol - ANSWERClass: Long acting B2 agonist, more selective
Used for: Bronchospasms associated with asthma, bronchitis (acute or chronic), and
COPD
ADR: Potential drug-induced hyperglycemia, cardiac arrhythmias, some CNS
excitation effects (tremors, dizziness), HA, tachycardia, palpitations
Comments: Do not use alone for persistent asthma, combine with an inhaled
corticosteroid; don't wash it, powder can get clogged
What are some things you can educate your patients on regarding beta agonist
inhalers? - ANSWER1. Demonstrate and have patient do return demonstration
2. Check correct inhaler use if patient says it's not working
3. Encourage use of spacer
Fluticasone - ANSWERClass: Inhaled corticosteroid
Used for: 1st line treatment for persistent asthma
MOA: Anti-inflammatory, minimal systemic exposure
Budesonide - ANSWERClass: Inhaled corticosteroid
Used for: 1st line treatment for persistent asthma
MOA: Anti-inflammatory, minimal systemic exposure
Zafirlukast - ANSWERClass: Leukotriene modifier/antagonist
Used for: 2nd line to decrease bronchoconstriction, edema
MOA: Works similar to prostaglandins in r/t to inflammation, blocks lipoxygenase
,Theophylline - ANSWERClass: Xanthine; stimulant
Used for: Asthma
MOA: Bronchial smooth muscle relaxation
ADR: cardiovascular effects, increased gastric acid production, CNS effects
(irritability, restlessness, seizures, insomnia), GI effects (reflux, worsens heartburn),
cardiac effects (palpitations, tachycardia, hypotension, life-threatening arrhythmias)
X: GERD, HTN, ischemic heart dx, coronary insufficiency, CHF, history of stroke,
cardiac arrhythmias; smoking increases clearance
Comments: Stay away from charcoal-broiled foods (accelerates the hepatic
metabolism), avoid large amounts of caffeine containing beverages; elimination is
influenced by diet
What are the signs of Theophylline toxicity? - ANSWERVomiting, insomnia,
jitteriness, HA, severe GI pain, irregular heartbeat
Ipratropium Bromide - ANSWERClass: Inhaled anticholinergic
Used for: NOT 1st line, supplemental use in acute bronchospasm
MOA: Blocks the muscarinic cholinergic receptors, causes bronchial smooth muscle
relaxation; uses alternate pathway, effects additive with beta receptors
What is asthma? - ANSWERChronic inflammatory disorder of the airways, recurrent
episodes of wheezing, breathlessness and chest tightness, airflow obstruction is
reversible - recommendations by Expert Panel III is to take an aggressive approach to
gain quick control
What would you treat mild intermittent asthma with? - ANSWERStep 1 therapy:
1. Use short acting B2 agonists PRN for symptoms - patients may have symptoms
when exposed to triggers (URI, allergens, chemical inhalents, exercise)
2. Educate on annual flu shot
What would you treat mild persistent asthma with? - ANSWERStep 2 therapy:
1. Long-term/low dose inhaled corticosteroids such as Fluticasone or Budesonide
2. Use short acting B2 agonist PRN, if using more than 2 days/week, then step up
therapy
What would you treat moderate persistent asthma with? - ANSWERStep 3 therapy:
1. Treat with medium dose inhaled corticosteroids (Fluticasone or Budesonide) OR
1. Low dose inhaled steroid (Fluticasone or Budesonide) plus long acting B2 agonist
(Advair or Salmeterol) OR
1. Medium dose inhaled steroid (Fluticasone or Budesonide) plus leukotriene
receptor antagonist (Zafirlukast)
2. May use short acting B2 agonists (Albuterol or Terbutaline)
What would you treat severe persistent asthma with? - ANSWERStep 4 therapy:
1. Medium dose inhaled corticosteroid (Fluticasone or Budesonide) AND long-acting
B2 agonist (Salmeterol) OR
, 1. Medium dose inhaled corticosteroid (Fluticasone or Budesonide) AND a
leukotriene modifier (Zafirlukast) OR Theophylline
Step 5 therapy:
1. High dose inhaled corticosteroid AND long acting B2 agonist
Step 6 therapy:
1. High dose inhaled corticosteroid AND long acting B2 agonist AND oral
corticosteroid
**Severe persistent asthma requires consultation with asthma specialist
What drugs would you consider for pregnant patients who have asthma? -
ANSWERInhaled beta agonists are acute drug of choice; inhaled corticosteroids are
the long term drug of choice
When would you refer a child with asthma to a specialist? - ANSWERAt step 3
therapy
When would you consider using a long acting B2 agonists as monotherapy? -
ANSWERIf your patient has COPD
Systematic antibiotics are required for ____? - ANSWERModerate to severe
impetigo, boils, abscesses, perianal strep, cellulitis, MRSA suspected skin infections
Mupirocin - ANSWERClass: Topical ATB
Used for: Mild impetigo, nasal MRSA carriers
Comments: Generic Mupirocin is less expensive
Bacitracin - ANSWERClass: Topical ATB
Used for: Mild impetigo
Comments: Can be combined to make double or triple ATB
Retapamulin - ANSWERClass: Topical ATB
Used for: Mild impetigo or nasal MRSA carriers
Comments: Cannot be given intranasal or will destroy sense of smell
Polymixin B - ANSWERClass: Topical ATB
Used for: Mild impetigo
Comments: A double and triple ATB
Neomycin - ANSWERClass: Topical ATB
Used for: Mild impetigo
Comments: May cause sensitivity in triple ATB
Cephalexin - ANSWERClass: Oral ATB
