NR 565 Advanced Pharmacology Final Exam (Questions With Complete Solutions) - Chamberlain, Exams of Community Health

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NR 565 Advanced Pharmacology Final Exam (Questions

With Complete Solutions) - Chamberlain

Who should receive Tdap vaccination? Right Answer - Adults in close contact with infants healthcare workers Contraindication for Tdap vaccine Right Answer - Severe allergic reaction to previous dose, or hx of encephalopathy within 7 days of vaccine Varicella vaccine contraindications Right Answer - Hx of anaphylaxis with previous dose, allergy to gelatin or neomycin Hepatitis B vaccine contraindications Right Answer - Previous rxn to vaccine, allergy to yeast and neomycin Examples of attenuated vaccines Right Answer - measles, mumps, rubella, chickenpox, yellow fever, rotavirus examples of live vaccines Right Answer - MMR, varicella, rotavirus, influenza examples of toxoid vaccines Right Answer - Diphtheria, tetanus, pertussis, Examples of inactive viral antigen vaccine Right Answer - Poliovirus (SALK), Hep A, Hep B, influenza What are the types of immunity? Right Answer - active, passive, and herd Define vaccine Right Answer - suspension of organisms or fractions of organisms that induce immunity Post exposure prophylaxis for Rabies Right Answer - human rabies immunoglobulin + human diploid cell vaccine on days 0,3,7,

Patient teaching after vaccination Right Answer - Redness and swelling can occur at site, mild fever or fatigue Who can receive attenuated influenza vaccine (Flumist) Right Answer - individuals >2yo an d less than 50. non pregnant, and those who are not immunocompromised Pantoprazole dosing Right Answer - 40 - 80 mg ORAL or IV Qday Metronidazole (Flagyl) dosing Right Answer - 250 mg 4x day or 500mg BID for 7-14 days Ondansetron (Zofran) dosing Right Answer - -8/24mg po 30 minutes prior to chemo initiation -8/16 mg po Q12h for 1/2 days after chemo administration -TOP 200 Albuterol Sulfate (inhalation) dosage Right Answer - 2 inhalations What labs are used to diagnose thyroid disease Right Answer - TSH T T When should you recheck labs after starting levothyroxine Right Answer

• 6-8 weeks until euthyroid state signs and symptoms of hypothyroidism Right Answer - Thin, dry hair Thick, brittle nails constipation bradycardia Goiter PeriOrbital edema cold intolerance weight gain signs and symptoms hyperthyroidism Right Answer - 1. heat intolerance (high heat production)

2. weight loss, increased appetite
3. hyperactivity
4. diarrhea

How often should A1C be rechecked Right Answer - Every 3-4 months What is the action of insulin Right Answer - Transporting glucose through the cell membrane therefore lowering blood glucose Pioglitazone (Actos) contraindications Right Answer - Type 1 diabetes Diabetic ketoacidosis Hypersensitivity Clinical evidence of active liver disease Active bladder cancer Diabetic drug classifications Right Answer - GLP- TZD DPP-4i Sulfonylureas SGLT2i Which drug class should be considered for diabetes prior to insulin Right Answer - It is recommended that a GLP-1 be considered before starting insulin. Metformin first always unless contraindicated. Ratio of basal insulin to rapid-acting insulin in total daily dose (TDD) of insulin Right Answer - Basal and bolus insulin replacement encompasses approximately 50% of the total daily insulin dose (TDD) Example: TDD = patient's weight in kg (80kg) x 0.6 units = 48 units. That means 24 units of the TDD is the basal insulin dose and the other 24 units is rapid-acting. Carbohydrate to insulin ratio when calculating basal insulin Right Answer - 500 divided by TDD Which diabetic medications come with concern of hypoglycemia Right Answer - Insulin, meglitinides, sulfonylureas, amylin analogues Who is at risk for Methylxanthines toxicity Right Answer - Older Adults taking anticholinergics and beta agonists Smokers

Step 1 therapy for asthma and COPD Right Answer - Manage with a SABA (albuterol) as needed. Asthma Step 1: Intermittent Right Answer - SABA PRN Asthma Step 2: Mild Persistent Right Answer - -General Symptoms > times/week BUT <1 time/day; exacerbations may affect activity -Night Symptoms >2 times/month -Lung Function: FEV1 or PEF ≥80% predicted. PEF variability 20-30% Asthma Step 3: Moderate Persistent Right Answer - -General Symptoms: Daily symptoms. Daily use of inhaled SABA. Exacerbations ≥2 times/week; may last days. -Night symptoms >1 time/week -Lung Function: FEV1 or PEF >60% to <80% predicted. PEF variability >30% Asthma Step 4: Severe Persistent Right Answer - -General Symptoms: Continued symptoms. Limited physical activity. Frequent exacerbations. -Night Symptoms: Frequent -Lung Function: FEV1 or PEF <60% predicted. PEF variability >30% SABAs Right Answer - albuterol, levalbuterol, terbutaline Benefits of SABA Right Answer - Short acting relief of bronchospasm Relieves asthma attacks SABA patient teaching Right Answer - Advise patients to use albuterol first if using other inhalation medications and allow 5 min to elapse before administering other inhalant medications unless otherwise directed. Advise patient to rinse mouth with water after each inhalation dose to minimize dry mouth and clean the mouthpiece with water at least once a week. Instruct patient to notify health care professional if there is no response to the usual dose or if contents of one canister are used in less than 2 wk. Asthma and treatment regimen should be re-evaluated and corticosteroids should be considered. Need for increased use to treat symptoms indicates decrease in asthma control and need to re-evaluate patient's therapy.

Nicotine replacement education Right Answer - inhalers should not be used by clients with asthma, with the gum and loengers no eating or drinking 15 minutes prior to using and during, with the patch take off at night because can cause nightmares or sleep disturbances and teach patient not to use other nicotine products while using patch due to the stimulation of the CNS, the lozenges need to slowly dissolve for effectiveness and no more then 5 in a 6 hrs period Wellbutrin Contraindications Right Answer - caution in patients with a history of seizures, anorexia nervosa, cocaine use, and alcohol withdrawal and bupropion. SR should not be given with MAOI inhibitors Bupropion (Wellbutrin) length of treatment Right Answer - 7-12 weeks Drug resistant TB Right Answer - resistant to at least one first-line anti- TB drug Treatment of TB in pregnancy Right Answer - 2 mos: INH, RIF, EMB 7 mos: INH, RIF Isoniazid (INH) Right Answer - -antiTB

• take daily for 6-12 months and most likely with other meds too -worked if 3 neg. sputum cultures, no temp.
• Liver toxicity (hepato) check liver fxn
• Don't take with alcohol (liver fxn remember?)
• Take on empty stomach Examples of decongestants Right Answer - Phenylephrine Pseudoephedrine Which drug class has no significant drug interactions Right Answer - Expectorants Examples of H2 receptor antagonists Right Answer - Cimetidine Ranitidine Famotidine Nizatidine Which H2RA has the most drug interactions? Right Answer - Cimetidine

PPI associated with what deficiency Right Answer - Calcium Magnesium B Short term use of PPI increases risk of Right Answer - Community Acquired PNA How to treat moderate to severe GERD Right Answer - Long-term maintenance therapy of PPI is recommended for severe. Moderate??? GERD treatment in older adults Right Answer - Avoid long term PPI due to associated bone fracture and vitamin and mineral deficiency Which cytoprotective agents can be given in pregnancy Right Answer - Carafate When to test for H. pylori Right Answer - If on treatment and not getting better. Consider testing before prescribing H2 receptor antagonists/PPIs. how to treat H. pylori Right Answer - 2 antibiotics, PPI, pepto. MOC. AOC Lifestyle modification to support ulcer healing Right Answer - 5-6 small meals a day, stop smoking, avoid NSAIDs Which antidiarrheal agent should not be used in children during or after chickenpox Right Answer - Pepto-Bismol (Bismuth Subsalycitate) Traveler's diarrhea Right Answer - E. coli Traveler's Diarrhea Treatment Right Answer - Cipro Ciproflaxin (Cipro) teaching in Travelers Diarrhea Right Answer - Only start if symptoms are progressive and not getting better with pepto What drug is associated with gray/black stool and black tongue Right Answer - Pepto-Bismol (Bismouth Subsalicylate) constipation lifestyle changes Right Answer - regular exercise