Final Exam: NR565 NR 565 Update Advanced Pharmacology

Final Exam: NR565/ NR 565 ( 2023/

2024 Update) Advanced Pharmacology Exam Review Questions and Answers -Chamberlain

• A patient has a TSH of .28, a free T4 of 3, and a free T3 over 650. What medication

should she be started on?

✓ Answer: Methimazole, PTU, radioactive iodine. These labs indicate

hyperthyroidism. Treatment for thyroid storm: K iodide or strong iodine

solution to suppress thyroid release. Methimazole to suppress thyroid synthesis.

• When is it appropriate to increase insulin needs?

✓ Answer: Pregnancy (after first trimester), stress, infection, weight loss,

adolescent growth spurt. DECREASE for exercise and first trimester.

• What is the TDD of a person that weighs 70kg?

IF a person is eating a 50 carb meal, how much insulin will be needed based on the TDD from the above question?

✓ Answer: 42 TDD : 21 basal 21 bolus (Wt in kg x 0.6; 50% long acting and 50% rapid acting)

✓ 500 divided by (the TDD) 42 = 12. (carb to insulin ratio) then (meal carbs) 50 divided 12= 4.1 units with short acting insulin

• "As long as the short-acting insulin is drawn up first I can mix my insulin glargine with

it."

✓ Answer: Of the long-acting medications, ONLY NPH the intermediate

duration is suitable for mixing with the short action insulins.

• A women who is taking Pioglitazone states, "I'm glad that this medication promotes

weight loss."

✓ Answer: First this medication promotes increase in LDL levels, which

increases cardiovascular risk. Also, she's a female so speak about exercise and weight bearing exercise d/t possible increased risk for fractures.

• Glucocorticoid MOA

✓ Answer: Most effective in long-term control of airway inflammation

• Cromolyn MOA

✓ Answer: Used as prophylaxis for mild to moderate asthma

• Monoclonal Antibodies MOA

✓ Answer: Used for allergy-related asthma and Eosinophilic asthma.

Omalizumab for allergy related and Ben ralizumab, mepliz, and resliz are for eosinophilic

• Leukotriene MOA

✓ Answer: Second-line therapy to reduce inflammation and

bronchoconstriction

• B2 adrenergic agonists MOA

✓ Answer: Can be used PRN, for EIB, COPD exacerbations, and

maintenance therapy

• methylxanthines MOA

✓ Answer: Maintenance therapy for chronic stable asthma (theophylline).

• Use ONLY if B2 or anticholinergics are not appropriate.

• anticholinergic MOA

✓ Answer: Approved for bronchospasm related to COPD

• •What are some risk factors of fatal asthma attacks?

✓ Answer: Uncontrolled, hospitalized recently, triggers,

• •Roflumilast (select all that apply)

1.Reduces inflammation 2.Not intended during pregnancy 3.Approved for asthma 4.First-line drug for COPD

✓ Answer: Reduces inflammation, not intended for pregnancy, approved

only for COPD, Second-line drug for COPD

✓ Uses for exacerbations prophylaxis in pts with severe COPD with a primary chronic bronchitis component.

• What pt education can you provide a patient for ICS use?

✓ Answer: Rinse d/t oropharyngeal candidiasis and dysphonia

(hoarseness, difficulty speaking).

• What patient teaching can a provider give when prescribing a PPI?

✓ Answer: Hypomagnesia symptoms: muscle cramps, tremors, cramps, and palpitations. Check Mg levels periodically especially in the elderly.Get enough calcium and VIT D. call if having diarrhea (Cdiff)

• What patient teaching can a provider give when prescribing an H2RA?

✓ Answer: Report lethargy, solmnolance, restlessness, confusion or

hallucinations. (CNS effects). Teach about possible reduced libido, impotence, gynecomastia, pneumonia. P.594 Cimetidine interacts with CYP system so check with pt if they are taking warfarin, phenytoin, theophylline, lidocaine.

• A patient presents with a complaint of reflux and constipation. He states that he drinks

enough water, and admits he has gained 30lbs. He also states that he has been having "reflux" type symptoms. What are your next steps for education?

✓ Answer: Educate that weight gain can promote reflux symptoms, ask

about any otc use such as antacids which may cause constipation.

• zollinger-Ellison syndrome is due to a _______producing tumor. Treatment is long-term

therapy of what medication class?