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Pharmacology Exam Notes - 2023-2024, Exams of Health sciences

Detailed notes for final pharmacology exam covering drug side effects, patient teaching, benefits, routes of administration, and management of various conditions such as chlamydia, migraines, anxiety disorders, and sleep disturbance. Includes information on specific medications, interactions, adverse effects, and patient education.

Typology: Exams

2023/2024

Available from 05/17/2024

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Download Pharmacology Exam Notes - 2023-2024 and more Exams Health sciences in PDF only on Docsity! NR 566 Final Exam-with 100% verified solutions-2023-2024 Doxazosin side effects (due to alpha 1 receptor being blocked) - dizziness/syncope, headache, first-dose orthostatic hypotension, drowsiness, nasal congestion Dutasteride (finasteride) patient teaching - benefits take months to develop, must continue taking med even if improvement not rapidly seen may lower ejaculatory volume & libido How to know Terazosin is working? - improved symptoms of dysuria, urgency, urinary tract infections, hesitancy etc. When is it safe and not safe to prescribe Progesterone (Progestin)? - if woman has had a hysterectomy/pregnant side effects of progestin-only oral contraceptives? - more likely to cause irregular/inconsistent bleeding, must be taken at same time every day to be effective Benefits of prescribing medroxyprogesterone acetate - doesn't cause thromboembolic disorders, headaches, nausea, or most of the other adverse effects associated with combo OCs. does not decrease milk supply during lactation Testosterone replacement therapy routes: - treatment that involves administering testosterone supplements through pills, injections, or skin patches testosterone patch patient teaching: - ○ good hand washing is required after application ○ cover application site with clothing after medication has dried ○ wash the application site before skin-to-skin contact with another person ■ females and children may experience negative effects from exposure to testosterone ■ if cross contamination occurs, wash the affected area with soap and water to prevent absorption When is androgen therapy appropriate vs. not needed related to puberty? - Short term: The psychological pressures of delayed sexual maturation are causing a boy significant distress. Long term: if delayed puberty related to true hypogonadism testosterone replacement therapy side effects? - Hot flashes, bone fractures, decreased libido, insulin resistance, erectile dysfunction, gynecomastia, acne, HTN, sterility, hepatotoxicity, mood swings/ aggression. Alprostadil: benefits of various routes? (for ED) - injection: can be done by patient or in ER setting; rapidly leads to erection, painless intraurethral pellet insertion: can be done by patient, erection occurs within 5-10 mins, minimal side effects How does carbamazepine impact oral contraceptives and what symptoms may be associated with that? - accelerates OC metabolism, reducing OC effect can lead to abnormal bleeding, return of menstrual symptoms, and of course pregnancy! what can the provider do is carbamazepine effecting patient's OC? - 1. Increase the estrogen dosage of the OC. 2. Combine the OC with a second form of birth control. 3. Switch to an alternative form of birth control. Benefits of Etonogestrel subdermal implant (Nexplanon)? - it is one of the most effective forms of contraception, long-term option (contraception up to 5 years), reversible by removing rod Papaverine plus phentolamine patient education: - do not inject more than once in a 24 hr period, notify provider of erection duration and efficacy, do not take other ED meds with this medication, needle/injection teaching, do not change the dose yourself, seek medical attention if erection is >3 hrs Chlamydia first line drug/dose/route/frequency - Azithromycin 1000 mg PO once OR Doxycycline 100 mg PO BID × 7 days Uncomplicated gonococcal urethritis first line drug/dose/route/frequency - Ceftriaxone 250-500mg IM once Bacterial Vaginosis first line drug/dose/route/frequency - 500 mg Metronidazole PO BID x 7 days Herpes Simplex Virus first line drug/dose/route/frequency - Acyclovir 400 mg PO TID x 7-10 days Trichomoniasis first line drug/dose/route/frequency - women: 500 mg Metronidazole PO BID x 7 days men: 2 g Metronidazole PO once Syphilis first line drug/dose/route/frequency - Penicillin G IV (dose depends on the patient) SNRIs- Buspirone (Buspar) Approach when first anti-depression drug doesn't seem to be working? - wait at least 4 weeks minimum before increasing/changing dose. 1st increase dose, then change drug within same class, then switch to new class, then start second med How long should it take antidepressants to work? - 4-8 weeks Suicide risk associated with antidepressants: - increased risk of suicide in those taking antidepressants, especially in children and young adults never to be stopped abruptly (increases risk) First-line treatment options for sleep disturbance? - Benzodiazepines: Triazolam Benzodiazepine-Like Drugs: Zolpidem (Ambien), Zaleplon (sonata), eszopiclone (Lunesta) Melatonin Receptor Agonist: Melatonin, Ramelteon (Rozerem) Orexin Receptor Agonist: Suvorexant (Belsomra) Therapeutic drug level of lithium: - 0.6-0.8 mEq/L Lithium drug-drug interactions - •Thiazides-Diuretics- lithium toxicity •NSAIDS- higher plasma lithium levels •Haloperidol-encephalopathic syndrome (weakness, tremors, confusion, lethargy) -Carbamazepine •anti-acids-decreases effectiveness of lithium *** Common adverse reactions of 1st generation antipsychotics - extrapyramidal symptoms: Parkinsonism, akathisia, dystonia (all manageable w/ anticholinergics), Tardive Dyskinesia (no treatment) dry mouth, constipation (anticholinergic effects) pt teaching regarding first gen. antipsychotics: - inform provider immediately about any signs/symptoms of tardive dyskinesia/adverse effects sunscreen use s/s of toxicity Drug-Drug Interactions of SSRIs - +MAOIs- can cause serotonin syndrome Fluoxetine- not to be taken w/ warfarin or lithium Baseline data needed to prescribe SSRIs/SNRIs: - Na levels in pt on diuretics Common adverse effects of SSRIs: - sexual dysfunction, n/v, agitation, insomnia, weight gain Ways to manage SSRI adverse effects? - sexual dysfunction: add Bupropion, drug holidays weight gain: diet, lifestyle changes n/v: take with food Baseline data needed to prescribe Tricyclic Antidepressants (TCAs)? - EKG especially in those w/ dysrhythmias or 40+ years old Patient education needed for TCAs - Educate patients regarding orthostatic hypotension and anticholinergic effects, including dry mouth, blurred vision, constipation, and urinary hesitancy. Baseline data needed to prescribe MAOIs: - baseline BP Patient education for MAOIs: - Educate patients on foods containing tyramine (DO NOT EAT THESE) and to report signs of hypertensive crisis (nausea, vomiting, profuse sweating, severe headache) immediately. What foods contain tyramine? - Avocados, aged meats, bean curd, bananas, cold cuts/sausages, cured fish, cheese, yeast, beers, protein supplements, soups, shrimp, soy sauce, chocolate, caffeine Symptoms of serotonin withdrawal: - dizziness, headache, nausea, sensory disturbances, tremor, anxiety, and dysphoria