Advanced Pharmacology Final Exam Review, Exams of Pharmacology

Download Advanced Pharmacology Final Exam Review and more Exams Pharmacology in PDF only on Docsity! Advanced Pharmacology Final Exam Review with complete solutions why are nitrate-free periods every 24 hours necessary for the patient on nitroglycerin therapy? - ANSWER-To inhibit the development of tolerance What does a low level of thyroid-stimulating hormone indicate? - ANSWER- Hyperthroidism What would be the best option to treat a newly diagnosed patient with a low TSH level with? - ANSWER-Propanolol (Inderal) Spironoaldactone (Aldactone) has what mechanism of action (MOA)? - ANSWER- Aldosterone antagonist Heparin exerts its therapeutic action by what? - ANSWER-Upregulating the activity of one of the body's natural anticoagulant molecules, antithrombin III What physiologic action happens when the offending drug is administered during an anaphylactic reaction. - ANSWER-Mast cells liberate large doses of histamine. What are two systemic psoriasis medications? - ANSWER-Photo-therapy and topical corticosteroids What is the first choice of drug therapy for the majority of patients with uncomplicated stage I hypertension? - ANSWER-Thiazide diuretics What is the effect of cardiac glycosides? - ANSWER-Digitalis glycosides have a negative chronotropic effect on the cardiac muscle cells. Amenorrhea is the most common side effect of which birth control medication? - ANSWER-Medroxyprogesterone (Depo-Provera) What is an anti-hypertensive agent which competes with epinephrine for available beta-receptor sites? - ANSWER-Atenolol (Tenormin) What type of action does nitrates have on the body? - ANSWER-Reduction in systemic venous tone. What is the recommended level of low-density lipoprotein cholesterol (LDL) for patients with known coronary artery disease? - ANSWER-100mg/dl or less. What is the MOA of group IV anti-dysrhythmia drugs? - ANSWER-Depressing phase 4 depolarization and lengthening phases 1 and 2 repolarization. Which drug therapy should be used to lower the serum concentration of thyroid hormones and re-establish eumetabolic state in a patient with Graves' disease? - ANSWER-Anti-thyroid drugs. Which type of diuretic would be used for a stage I hypertension in a patient with renal insufficiency? - ANSWER-Loop diuretic. What drug should be considered as first-line therapy for a client with hypertension and heart failure? - ANSWER-Enalapril (Vasotec) Which drug is considered safe for hypertension treatment during pregnancy? - ANSWER-Methyldopa (Aldomet) What drug will reduce afterload because it is an alpha-adrenergic blocker? - ANSWER-Prazosin (Minipress) What is an expected effect of the use of a beta-adrenergic blocker to control angina? - ANSWER-Reduced force of cardiac contraction. What side effect should be monitored closely in the elderly when taking Metformin (Glucophage) for type 2 diabetes? - ANSWER-Lactic acidosis. What is the primary role of cytochrome p-450 in the liver? - ANSWER-Deactivate and detoxify medications and other substances. The normal starting dose of levothyroxine is 50-100mcg per day for primary hypothroidism. What is the most appropriate starting dose in a 71-year old female patient? - ANSWER-25mcg per day. What drug class should be avoided in patients with a diagnosis of osteopenia or osteoporosis? - ANSWER-Clucocorticoids like Prednisone. What thyroid drug blocks thyroid hormone production and release? - ANSWER-L- thyroxine (Levothyroid). What drug class exacerbates hyperglycemia? - ANSWER-Corticosteroids like Prednisone (Deltasone). What drug would you add for a patient who has been taking a sulfonylurea medication like Glipizide (Glucotrol) for type 2 diabetes when there is poor glucose control? - ANSWER-Add Metformin (Glucophage) to the sulfonylurea. Which drug class may predispose an insulin dependent patient to hypoglycemia? - ANSWER-A selective beta-adrenergic blocker like Nadolol (Corgard). What side effects may an elderly patient who has just been placed on a calcium channel blocker for treatment of hypertension and angina except to watch for? - ANSWER-Constipation, peripheral edema, and decreased heart rate. What might be a probable cause of a decreased digoxin level of 0.5mg/ml in a 70- year old with previously stable levels be a result of? - ANSWER-Antacid use. What drug used in the treatment of congestive heart failure is NOT associated with decreased mortality? - ANSWER-Digoxin (Lanoxin). A patient complains of "puffy feet" shortly after beginning a new medication three months ago. There is no underlying physiological cause for this condition. What medication is most likely causing the problem? - ANSWER-Amlodipine (Norvasc). What drugs affect the action of Warfarin (Coumadin)? - ANSWER-Alcohol, NSAIDs, and oral antifungals. What drug has a beneficial effect on benign prostate hypertrophy that may be used to treat simultaneous hypertension? - ANSWER-Doxazosin (Cardura). What anithypertensive agent is safe during pregnancy? - ANSWER-Methyldopa (Aldomet). A patient is taking the ACEI Enalapril (Vasotec) for the last four months for the treatment of congestive heart failure, and is complaining of a nonproductive cough. What should the NP advise the patient regarding this side effect? - ANSWER-The cough should subside 1-4 days after discontinuing the drug. Which medication classification has been found to be most helpful in managing the problems associated with congestive heart failure? - ANSWER-ACE inhibitors like Trandolapril (Mavik). What potentially serious side effect should a NP monitor or suspect in a patient who has begun taking Lovastatin (Mevacor) approximately three weeks ago, and who now presents complaining of generalized muscle aches. - ANSWER- Rhabdomyolysis. What drug is a dihydropyridine calcium channel blocker? - ANSWER-Amlodipine (Norvasc). A 75-year old patient is taking Timolol Maleate (Timpotic) for chronic open angle glaucoma and is well controlled. What side effect might you watch for if Propanolol (Inderal) is added? - ANSWER-Bradycardia. What is the preferred lab test to evaluate coagulation status in a 76-year old female who is taking Warfarin (Coumadin) for chronic atrial fibrillation, and who is being managed outpatient? - ANSWER-International normalization ratio (INR). Which drug class is the only one proven to decrease cardiovascular mortality in hypertensive patients? - ANSWER-Beta-adrenergic blockers like Metoprolol (Toprol). What is the most common adverse side effect of drugs taken to lower low-density lipoprotein (LDL) cholesterol, such as a bile acid sequestrant like Questran and Ezetimibe (Zetia)? - ANSWER-Gastrointestional symptoms. What medications are most appropriate for efectively managing a patient with moderate persistent asthma? - ANSWER-An inhaled steroid (Fluticasone) and a long-acting bronchodilator (Advair). What medication class should be avoided in patients with bronchitis due to the fact it might worsen the symptoms of congestion. - ANSWER-Antihistamines like Benadryl. Which antibiotic is most effective in treating community acquired pneumonia (CAP) in a young adult without co-morbid conditions? - ANSWER-Azthromycin (Zithromax). What drug combination would be most effective to keeping a 20-year old patient with mild persistent asthma symptom free? - ANSWER-A short-acting bronchodilator prn like Albuterol (Proventil) and an inhaled corticosteroid). What drug should be avoided in a patient who is taking Theophylline twice daily for bronchospastic disease, and who presents today with thick, discolored, tenacioius sputum, and mild shortness of breath, and fever? - ANSWER- Prednisone (Deltasone). What is the optimal time to start antiviral therapy, such as Oseltamivir Phosphate (Tamiflu), in select patients with influenza? - ANSWER-Within 48 hours of developing symptoms. What is the most important teaching point for a patient taking Salmeterol (Serevent) for asthma? - ANSWER-It is not effective during an acute asthma attack. Which medication is most effective for patients with chronic emphysema? - ANSWER-Apratropium (Atrovent).