Answer:
Directions to pharmacist
Q: What items are necessary on a prescription?
Answer:
Drug, dose, route, frequency, quantity, refills
Q: Abbreviations to not use
Answer:
QD
Q: What drug may cause grey teeth?
Answer:
Tetracyclines
Q: Pt reports no improvement in seizures after treatment for a few weeks. What next
Answer:
Assess drug levels for therapeutic index
Q: If patient on phenytoin wants birth control?
Powered by https:\/\/learnexams.com\/search\/study?query=<\/a><\/p>\n\n\n\n
While rational drug selection is based on the individual patient the aspect of rational drug selection addressing disease-specific information by a national medical or nursing organization is<\/p>\n\n\n\n
A. a guideline.
B. cost.
C. availability.
D. patient hepatic and renal function.
A. a guideline<\/p>\n\n\n\n
Drugs that alter synaptic transmission are much more selective than those that alter axonal conduction, why is this?
a drug that affects the axonal conduction – non-selective effect.
Drugs that alter synaptic transmission – very selective because of the differences in synapses and their specific neurotransmitters<\/p>\n\n\n\n
What is phenytoin used for?
Seizures<\/p>\n\n\n\n
What should you monitor for with phenytoin?
Delayed hypersensitivity – even 1 month later<\/p>\n\n\n\n
What is carbamazepine used for?
Seizures<\/p>\n\n\n\n
What may cause carbamazepine levels to drop despite no other change? What to do?
Autometabolization of drug. Increase dose.<\/p>\n\n\n\n
What is the black box warning for carbamazepine?
Steven-Johnson Syndrome & TENS<\/p>\n\n\n\n
Monitoring for carbamazepine, and how often?
CBC, 3-4 times a year<\/p>\n\n\n\n
What population is most at risk for Steven-Johnson syndrome & TENS when taking carbamazepine?
Asian patients<\/p>\n\n\n\n
Main class of medication for depression?
Selective serotonin reuptake inhibitors (SSRIs)<\/p>\n\n\n\n
What to watch for with SSRIs?
Other medications that can cause serotonin syndrome<\/p>\n\n\n\n
What is lamictal used for?
Seizures<\/p>\n\n\n\n
Patient on lamictal has fever, rash, swollen lymph nodes. What are we concerned for?
Hypersensitivity in lamictal can lead to MODS<\/p>\n\n\n\n
Patient on lamictal wants birth control. What do we need to change?
Increase lamictal dose.<\/p>\n\n\n\n
When will pt notice improvement after starting an SSRI?
4 weeks later<\/p>\n\n\n\n
1st line medication for moderate generalized anxiety
Buspar (SNRI)<\/p>\n\n\n\n
1st line med for classic migraines
Triptans<\/p>\n\n\n\n
2nd line treatment for classic migraines
Prophylactic – propranolol<\/p>\n\n\n\n
Why is important that NPs have the authority to prescribe?
Increase access to healthcare<\/p>\n\n\n\n
What must be done if a drug has a narrow therapeutic index?
Frequent serum level monitoring<\/p>\n\n\n\n
Why would 10mg percocet or 10mg oxy work better than the other?
Differences in pill filler composition<\/p>\n\n\n\n
What do medications need in order to be effective:
Albumin (binding to)<\/p>\n\n\n\n
If a patient has a toxic drug level, but normal albumin, what could be happening?
Other drugs competing for albumin<\/p>\n\n\n\n
What does “Sig” mean on a prescription?
Directions to pharmacist<\/p>\n\n\n\n
What items are necessary on a prescription?
Drug, dose, route, frequency, quantity, refills<\/p>\n\n\n\n
Abbreviations to not use
QD<\/p>\n\n\n\n
What drug may cause grey teeth?
Tetracyclines<\/p>\n\n\n\n
Pt reports no improvement in seizures after treatment for a few weeks. What next
Assess drug levels for therapeutic index<\/p>\n\n\n\n
If patient on phenytoin wants birth control?
Not oral contraceptives! IUD better<\/p>\n\n\n\n
Patient on teratogen med wants to get pregnant. When should they stop?
Before getting pregnant, beware first trimester<\/p>\n\n\n\n
Pregnant pt has been taking daily aspirin. Concern for what?
Premature close of PFO<\/p>\n\n\n\n
Pain treatment for shingles?
Lidocaine after lesions heal<\/p>\n\n\n\n
How does reglan help with GERD?
Increases esophageal tone<\/p>\n\n\n\n
Who should not take calcium carbonate antacids?
Pt with kidney stones<\/p>\n\n\n\n
Pt on minocycline with HA. Pt has what?
Pseudotumor Cerebri<\/p>\n\n\n\n
Why do we rotate off phentermine?
Pt will develop tolerance<\/p>\n\n\n\n
Education on flagyl?
Avoid alcohol – severe reaction<\/p>\n\n\n\n
What is minocycline?
Tetracycline for acne<\/p>\n\n\n\n
Minocycline can be given safely to?
Adolescents (no pregnancy or liver fx)<\/p>\n\n\n\n
New dx of GERD. First therapy? How often?
H2 blocker – BID<\/p>\n\n\n\n
Paxil side effects to educate?
Sexual dysfunction, can resolve on its own<\/p>\n\n\n\n
What medication for pregnant UTI?
Amoxicillin<\/p>\n\n\n\n
Theophylline, NV\/HA after starting. What do?
See if it resolves in a couple of days<\/p>\n\n\n\n
ICS and beta agonist. Which first?
Beta first, then ICS<\/p>\n\n\n\n
SSRI Paxil, how long til it works?
2-6 weeks<\/p>\n\n\n\n
Pt high risk for osteoporosis. Education?
Vit D\/Calcium + weight bearing exercise<\/p>\n\n\n\n
Pt started on antibiotics. Bloody diarrhea. Pt has?
C. diff<\/p>\n\n\n\n
Asthma patient, education on worsening symptoms?
Call provider, use rescue inhaler more<\/p>\n\n\n\n
Patient with panic disorder?
valium<\/p>\n\n\n\n
Adverse effects of singular?
Aggression, anxiety, suicidal ideation<\/p>\n\n\n\n
Depression with anxiety, what med?
Lexapro<\/p>\n\n\n\n
What to check before starting pt on acyclovir?
Renal function<\/p>\n\n\n\n
How long til improvement on Celexa?
1-2 weeks<\/p>\n\n\n\n
Step down approach for GERD, what do they start on?
PPIs<\/p>\n\n\n\n
Known G63D deficiency, what antibiotic can you not prescribe?
Sulfas<\/p>\n\n\n\n
Chantix – pt education?
Psych side effects, dreams, suicide ideation<\/p>\n\n\n\n
Why should older patients take 2nd gen antihistamines rather than 1st?
CNS effects & urinary retention<\/p>\n\n\n\n
Genital herpes outbreak, what med?
Acyclovir<\/p>\n\n\n\n
UTI, med, how long?
Bactrim, 3 days<\/p>\n\n\n\n
MRSA skin infection. What med?
Bactrim<\/p>\n\n\n\n
Patient has pheochromocytoma. What med to avoid?
Albuterol – hypertensive crisis<\/p>\n\n\n\n
How to taper medication?
Decrease by 50% every 3-4 days<\/p>\n\n\n\n
What is methylnaltrexone?
Treats opioid associated constipation<\/p>\n\n\n\n
SSRI, wants something for weight loss. Why not phentermine?
Serotonin syndrome<\/p>\n\n\n\n
Sprained ankle with soft tissue swelling, what med?
NSAID<\/p>\n\n\n\n
Neuropathic pain, med?
Gabapentin<\/p>\n\n\n\n
Adverse drug reaction of haldol?
Extrapyramidal symptoms.<\/p>\n\n\n\n
When to take dimenhydrinate?
15 min prior to trip<\/p>\n\n\n\n
Antifungal therapy long term puts you at risk for?
liver toxicity<\/p>\n\n\n\n
Giving pt eye drops, education?
don’t wear contacts, wash hands in between handling<\/p>\n\n\n\n
Who should avoid ophthalmic beta blockers?
Pts on beta blockers<\/p>\n\n\n\n
What bronchodilator is safe on beta blocker?
Ipratropium<\/p>\n\n\n\n
How to antacids work?
increases our pH<\/p>\n\n\n\n
Lithium education?
sodium can influence your lithium levels. So intake should be consistent.<\/p>\n\n\n\n
PPIs long term, monitor for?
Osteoporosis, check calcium. Anemia.<\/p>\n\n\n\n
Antibiotic education?
Finish course of therapy. Drink lots of water.<\/p>\n\n\n\n
How quickly should you see improvement in pneumonia with antibiotics?
48-72 hours<\/p>\n\n\n\n
Long term lactulose for constipation, what do you monitor?
Potassium and chloride<\/p>\n\n\n\n
Patient started on ICS. Education?
rinse mouth after every use<\/p>\n\n\n\n
Patient with PUD has Hpylori. 1st treatment?
PPI + amoxicillin + clarithromycin<\/p>\n\n\n\n
What medication can aggravate GERD by affecting esophageal tone?
Estrogen<\/p>\n\n\n\n
Why do long acting beta agonists have blackbox warning?
Can be accidently taken instead of albuterol for acute asthma attack<\/p>\n\n\n\n
Allergy to PCN. What else can they not receive? Why?
Cephalosporins, both vulnerable to beta lactamase producing organisms<\/p>\n\n\n\n
Gonorrhea in a 20yo female with oral contraceptives. Education?
Need back up until next menses<\/p>\n\n\n\n
How to treat eye gonorrhea?
Ceftriaxone, eye drops<\/p>\n\n\n\n
Who is most at risk for a fatal asthma attack?
Previous hx of intubation<\/p>\n\n\n\n
What can help with peripheral neuropathy?
B6<\/p>\n\n\n\n
When can you prescribe tamiflu?
can only give in first 24 hrs of symptoms<\/p>\n\n\n\n
Treating depression, pt feels only partial improvement. What next?
change drug or increase dose<\/p>\n\n\n\n
New onset of mild-mod anxiety, first treatment?
buspar<\/p>\n\n\n\n
Levaquin blackbox warning
tendon rupture<\/p>\n\n\n\n
Decongestant to older patients, what route?
Nasal, no systemic side effects<\/p>\n\n\n\n
Child with acute otitis media, how to treat pain?
Lidocaine eardrops<\/p>\n\n\n\n
Azithromycin – how to dose?
Titrating z pack<\/p>\n\n\n\n
Otitis externa, how to treat?
Cipro and hydrocortisone drop<\/p>\n\n\n\n
Contraindications to antibiotic ear drops?
Ruptured tympanic membrane<\/p>\n\n\n\n
Pt with acute otitis media with conjunctivitis?
High dose amoxicillin<\/p>\n\n\n\n
Why do we worry about st johns wort?
Interacts with many medications, accelerates metabolism of drugs<\/p>\n\n\n\n
Why does topamax help you lose weight?
Gives sensation of fullness<\/p>\n\n\n\n
Severe alcoholic with bad withdrawal?
Thiamine and banana bag.<\/p>\n\n\n\n
Pt malnourished, infected mouth, sores. Suspect?
Scurvy<\/p>\n\n\n\n
Pt has flushing, what could they be taking?
May be taking niacin<\/p>\n\n\n\n
How to treat elevated ammonia?
Lactulose<\/p>\n\n\n\n
Biggest side effect of hydrocodone – constipation, how to treat?
Senna, docusate, miralax<\/p>\n\n\n\n
Step 1 management of asthma?
short acting alpha 2<\/p>\n\n\n\n
Guaifenesin – how does it work?
thins secretions, easier to cough up<\/p>\n\n\n\n
How to treat afrin overuse?
Nasal steroids while weaning<\/p>\n\n\n\n
Alendronate education?
30 min before meal, lots of water<\/p>\n\n\n\n
Increase pain with paget’s disease, what treatment?
Calcitonin salmon<\/p>\n\n\n\n
What is paget’s disease?
Abnormal bone reabsorption<\/p>\n\n\n\n
More than 3 gout flare ups in past year?
Allopurinol<\/p>\n\n\n\n
What is probenecid used for?
Chronic gout<\/p>\n\n\n\n
New diagnosis of rheumatoid arthritis, what med?
Methotrexate<\/p>\n\n\n\n
Which vaccines don’t we need at age 11?
Hep B, PCV23<\/p>\n\n\n\n
Education on flexeril (cyclobenzaprine)?
CNS depression, urinary retention, blurred vision<\/p>\n\n\n\n
Pilocarpine – what does it do?
Drains fluid from the eye to treat glaucoma<\/p>\n\n\n\n
Why do we no longer prescribe demerol?
Many side effects<\/p>\n\n\n\n
Patient on hydrocodone, not as effective. Why?
Developed a tolerance (increase dose)<\/p>\n\n\n\n
How to dose pancreatic enzymes?
Units of lipase<\/p>\n\n\n\n
Who needs pancreatic enzymes?
Cystic fibrosis, gastric bypass<\/p>\n\n\n\n
How to titrate pancreatic enzymes?
Based off poop color (steatorrhea)<\/p>\n\n\n\n
Soft tissue only mrsa?
sulfamethoxazole\/trimethoprim (Bactrim)<\/p>\n\n\n\n
More invasive MRSA, med?
cephalexin (Keflex)<\/p>\n\n\n\n
Why do we not treat onychomycosis?
Liver toxic<\/p>\n\n\n\n
Community acquired with comorbidities – outpatient?
Rocephin + azithromycin<\/p>\n\n\n\n
How to treat PUD peptic ulcer disease?
PPI + clarithromycin + amoxicillin<\/p>\n\n\n\n
Mild intermittent asthma
SABA<\/p>\n\n\n\n
1st step of asthma
albuterol<\/p>\n\n\n\n
2nd step of asthma
give SABAs<\/p>\n\n\n\n
How do you know you need to bump up asthma tier plan?
Rescue inhaler more than 2x week or more than 1x day.<\/p>\n\n\n\n
Why should a pt never run out of paxil?
Short half life. Will withdraw really quick<\/p>\n\n\n\n
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