NR 565 ADVANCED PHARMACOLOGY MIDTERM
CARE OF THE FUNDAMENTALS EXAM QUESTIONS
AND VERIFIED ANSWERS 2024 UPDATE-
CHAMBERLAIN
A 41 year old patient comes into the clinic complaining of increased heart rate after starting nitro patches for stable angina. What would an appropriate response be?
- lets lower the dose and frequency of use
- I will prescribe a BB to help with this
- Next time this happens, lie down and practice deep breathing, this will bring your
heart rate down - ANSWER✔✔2- I will prescribe a BB to help with this What do CYP450 inhibitors and reducers do when not used correctly/what would patient experience? - ANSWER✔✔increased side effects, adverse reactions and toxicity A 55 year old male comes into the clinic with a gouty arthritis. He states that he has one
flareup a year. Your response is:
- I will prescribe you glucocorticoids to help with inflammation
- Lets start you on prophylactic therapy colchicine.
- It will be helpful to take an NSAID to start with to help relive some inflammation. I'll
prescribe naproxen. - ANSWER✔✔3- in patients with infrequent flareups, being less than three per year, treatment of symptoms is all thats needed. NSAIDS are the first line agent for relieving pain of an acute gout attack.A patient comes in stating that he tried NSAIDS to relieve a gouty attack but it hasnt helped. He asks, "what are my options?" He further states that he has attacks every few years but when he does NSAIDS do not help. Your response is: 1 / 4
- I can prescribe a glucocorticoid (prednisone) and that will bring down the
- Have your tried increasing your dosage of NSAIDS and drink plenty of water?
- Lets start by making some changes in your diet, can you tell me what you eat
inflammation and pain.
regularly? - ANSWER✔✔1 3- can also be correct but BEST answer Colchicine is considered for long term treatment if a person has how many gouty attacks per year? - ANSWER✔✔three or more Colchicine should not be taken with what medications? - ANSWER✔✔statins, CYP3A4 inhibitors adverse effects of colchicine - ANSWER✔✔nausea, vomiting, diarrhea, myelosuppression, myopathy, rhabdomyolysis what condition can develop with long term allopurinol - ANSWER✔✔SCAR (severe cutaneous adverse reaction - rash, fever, eosinophilia, liver and kidney function) What should be co-administered with febuxostat? - ANSWER✔✔NSAIDS or colchicine Complications of untreated gout - ANSWER✔✔Erosion and irreversible joint damage, renal damage, tophi (stone deposits in joints and tissues) Alendronate patient education - ANSWER✔✔minimize risk of esophagitis by swallowing the pill whole with a full glass of water, then sit up for at least 30 min but 60 min preferred. intake of food prevents absorption, take this med 30 min prior to other intake Which dietary supplement interferes with Ibandronate absorption? - ANSWER✔✔ calcium, magnesium, iron 2 / 4
1st line treatment of osteoporosis - ANSWER✔✔alendronate Is allopurinol safe to use in a patient with renal dysfunction? - ANSWER✔✔yes - drug of choice for patients with renal dysfunction or who over produce uric acid Baseline diagnostics for DMARDS - ANSWER✔✔CBC with WBC differential s/s of infection (TB and hepatitis) malignancies rule out pregnancy ALT, AST, serum creatinine comprehensive history and physical exam assess risk for immunocompetence and liver and renal status Baseline data for Methotrexate (DMARD) - ANSWER✔✔chest x-ray, emphasis on pulm and GI status which DMARD needs ophthalmologic and cardiac exam? - ANSWER✔✔ hydroxychloroquine black box warning for Raloxifene - ANSWER✔✔risk for venous thromboembolic events (DVT, PE, stroke) Behaviors that should predict controlled substance addiction - ANSWER✔✔reinforcing properties of drugs - pleasurable (euphoria) or reduce unpleasant experience (reduce anxiety and stress physical dependence physiological dependence (well-being depends on drug) social factors (peer pressure) 3 / 4
drug availability (Drugs in hospitals - reason for nurses or pharmacist abuse) vulnerability of individual impulsive low tolerance for frustration rebellious against social norms depressive, anxiety, and anti-social personality disorders abuse other drugs Treatment of chronic pain with pregabalin - ANSWER✔✔adjuvant analgesic for neuropathic pain Effective in diabetic neuropathy, seizures, central neuropathy, postherpetic neuralgia, and fibromyalgia adverse effects of pregabalin - ANSWER✔✔Sedation/drowsy, dizziness, and ataxia, blurred vision, difficulty thinking GI bleeding is linked to - ANSWER✔✔COX-2 inhibitors and NSAID patient education with colchicine - ANSWER✔✔only when needed to relieve an attack: Start taking this medicine at the first sign of the attack for best results. Stop taking this medicine as soon as the pain is relieved or at the first sign of nausea, vomiting, stomach pain, or diarrhea.longer you wait to start with attack, less effective it might be Which drugs are high risk in pregnancy with RA? - ANSWER✔✔methotrexate leflunomide biologics: anti-TNF agents, rituximab and abatacept (end in -mab)
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