NURS 8024 Pharm Exam 1 Latest Update -

NURS 8024 Pharm Exam 1 Latest Update - m 500 Questions and 100% Verified Correct Answers Guaranteed A+

*Antifungal treatment must be - CORRECT ANSWER: *long enough for complete

turnover of skin* -If treatment is not sufficient duration infection recurs* Oral agents often needed for fungal nail infection

2 kinds of drug contraindications - CORRECT ANSWER: Absolute

Relative

2 Major drug administration routes - CORRECT ANSWER: Enteral

Parenteral

25% of the elderly - CORRECT ANSWER: are taking inappropriate medications

• steps to treatment of peptic ulcer disease - CORRECT ANSWER: 1) eradicating the
• pylori infection

2) reduction of gastric acid secretion (H2blockers and PPIs) 3) agents that protect gastric mucosa from damage (misoprostol and sucralfate)

4 Fundamental pathways for a drug - CORRECT ANSWER: Absorption

Distribution Metabolism Elimination

(ADME)

• Major variables determining pharmacologic response to drugs applied to the skin

include - CORRECT ANSWER: 1. Regional variation in drug penetration

• Concentration Gradient
• Dosing Schedule
• Vehicles and Occlusion

• factors affecting placental drug transfer and fetal effects include - CORRECT

ANSWER: 1.Physicochemical properties of the drug

• Rate at which the drug crosses the placenta and the amount of drug reaching the

fetus

• Duration of exposure to the drug
• Distribution characteristics in different fetal tissues
• Stage of placental and fetal development at the time of exposure to the drug
• Effects of drugs used in combination
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A decline in hepatic blood flow, enzyme production, biotransformation, and phase I oxidation reactions in the liver of the elderly causes - CORRECT ANSWER: reduction in metabolism of some drugs, ↑ half-life & risk of ADRs/Toxicities

A decrease in total body water in the elderly will cause - CORRECT ANSWER:

increasing concentrations of water-soluble drugs

A large volume of distribution will effect - CORRECT ANSWER: half-life of the drug

A more variable drug effect on CNS in the elderly is due to - CORRECT ANSWER: • r/t ↓ blood supply, changes in the blood-brain barrier (allowing fatsoluble drugs to permeate the brain), •↓ in acetylcholine, dopamine, and serotonin → potentiating ADRs

Absolute Contraindications - CORRECT ANSWER: situations in which a medication

should never be given if the contraindication is present

Absorption - CORRECT ANSWER: Entry of pharmacological agent into plasma

Absorption/Action of PPIs - CORRECT ANSWER: *Coating is removed* in the alkaline duodenum, and the prodrug, a weak base, is absorbed and transported to the parietal cell canaliculus → Converted to the active form

All PPIs inhibit both basal and stimulated gastric acid secretion by > 90% • Onset of gastric acid suppression w/i 1 to 2 hrs post first dose of lansoprazole and slightly earlier with omeprazole

Acid secretion, blood flow, and GI tract motility

↓ and pH level ↑ possibly causes - CORRECT ANSWER: reduced drug absorption

Acitretin (Soriatane) - CORRECT ANSWER: Retinoid derivative, similar ADE as

isotretinoin

• *BBW - for blood donation and pregnancy prohibited during Tx and 3 yrs after!*
• No ETOH- forms teratogen w/ longer half-life

Acne Pathogenesis and drug mechanisms - CORRECT ANSWER:

Acne Treatment Considerations - CORRECT ANSWER: • Severity

• Lesions- non-inflammatory or inflammatory • Treatment preferences • Cost implications Patient Age • Skin type • Adherence 2 / 4

• Response to previous therapy • Presence of scarring • Psychologic effects • Family history of persistent acne

Acute ulcerative blepharitis - CORRECT ANSWER: inflammation/infectious processes of the lids

Acyclovir, Valacyclovir, penciclovir and famciclovir inhibitory against - CORRECT

ANSWER: herpes viruses

Additional Adverse Drug Effect categories - CORRECT ANSWER: • Augmented effects- hypotension w/ propanolol • Bizarre effects - Angioedema w/ACEI • Chronic effects -tremors from cyclosporin • Delayed effects-cardiomyopathy from adriomycin, "moon facies" w/ steroid use • End of Treatment effects- hypertensive crisis from stopping clonidine, adrenocortical insufficiency secondary to abrupt withdraw of steroids

Additive effect - CORRECT ANSWER: When 2 drugs w/ similar action taken together

and combined effect is summative (1+1=2)

Adolescent age criteria - CORRECT ANSWER: >12 years

Adsorbents - - CORRECT ANSWER: Kaopectate; *Kaolin (naturally occurring hydrated magnesium aluminum silicate), combined with *pectin (indigestible carbohydrate derived from apples) • absorbs bacterial toxins and fluid in infectious diarrhea • → decreased stool liquidity • Reduce motility and adsorbs fluid

Adverse Drug Reaction or Event (ADR, AE) - CORRECT ANSWER: Any response that

is unfavorable or unintended and occurs with normal dose

Adverse effects of antacids - CORRECT ANSWER: • Aluminum hydroxide tends to be constipating • Magnesium hydroxide tends to cause diarrhea • Binding of phosphate by aluminum-containing antacids → hypophosphatemia • Sodium bicarbonate → belching and flatulence, potential for systemic alkalosis • Sodium content of antacids → can be important in pts w/ HTN or CHF • Excessive intake of calcium carbonate along w/ calcium foods → hypercalcemia

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Adverse effects of Minoxidil (Rogaine) - CORRECT ANSWER: • Allergic and irritant contact dermatitis • Hair growth in undesirable locations - reversible on stopping the drug • Patients instructed to wash hands after applying • Percutaneous absorption of minoxidil minimal in normal scalp - possible systemic effects on blood pressure

Adverse Events that are both serious and unexpected should be reported to the FDA

within - CORRECT ANSWER: 15 days

Adverse local effects of topical corticosteroids - CORRECT ANSWER: Atrophy-shiny, depressed, wrinkled appearing skin with prominent telangiectasia

-Purpura and ecchymosis

• Telangiectatic vessels, pustules, and papules

-Perioral dermatitis

• Steroid acne
• hypopigmentation
• Hypertrichosis
• Increased intraocular pressure
• worsening of cutaneous infections

Adverse local reactions caused by acyclovir or penciclovir - CORRECT ANSWER:

Pruritus and mild pain with transient stinging and burning

Adverse systemic effects of topical corticosteroids - CORRECT ANSWER: • All

absorbable topical corticosteroids have potential to suppress Hypothalamic Pituitary adrenal (HPA) axis • Iatrogenic Cushing's syndrome can occur as a result of long term use of topical corticosteroids in large quantities • Steroid induced glaucoma/cataracts

• Adverse systemic effects in children-may take lesser amt/duration for ADE- growth

retardation possible • Pregnancy -caution advised-esp. 1st trimester • Geriatric patients more susceptible to secondary infection

Advise for prescribers based on malpractice litigation - CORRECT ANSWER: • Write clearly or have electronic system • If suicidal ideation- no more than 7 days of any medication that can be lethal OD • Warn about side effects • Discontinue if SE occurs • Informed consent if drug has potential for permanent, serious SE • Document rationale for "off label" prescribing

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