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Be familiar with the interactive activities throughout course modules. You could see variations of those same questions on your exams.
Week 5
Thyroid o Diagnosis & Evaluation What labs are used to diagnose? Timeframe for re-check of labs after starting levothyroxine Signs and symptoms of hypo and hyperthyroidism o Treatment Treatment of thyroid storm Result of not treating hypothyroidism during pregnancy Medication to treat symptoms of hyperthyroidism (notice this is treating symptoms and not the hyperthyroidism itself) Drug/Food/Supplement interactions with levothyroxine Diabetes o How to confirm a diagnosis prior to beginning treatment o A1C General goals Older Adult goal When should insulin be considered? At what time interval should it be re-checked? o Action of Insulin o Pioglitazone contraindications o Be familiar with abbreviations of diabetic drug classifications (GLP-1, TZD, DPP4-I, SGLT2i) o Which drug class should be considered for diabetes prior to insulin? Ratio of basal insulin to rapid-acting insulin in total daily dose (TDD) of insulin Know the carbohydrate-to insulin ratio when calculating basal insulin o Simple calculation (No calculators are allowed and will not be needed) Mechanism of Action o GLP- o TZD o DPP-4i o Sulfonylureas o SGLT2i Which diabetic medication(s) come with a concern of hypoglycemia?
Week 6
Methylxanthines Theophylline o Who is at risk for toxicity and why? Those who smoke cigarettes – d/c smoking should have decreased dose Asthma & COPD o Step 1 therapy Complete this sentence: Manage with a SABA as needed. o Symptoms associated with each classification of asthma (mild-persistent, moderate-persistent, etc.). Intermittent: 2 or less days/week, 2 or less nights/month, FEV1 >80% Mild Persistent: 2 or more days/ week, 3-4 nights/month, FEV1 >80% Moderate Persistent: Daily, >1night/week, FEV1 60-80% Severe Persistent: throughout day, 7 nights/ week, FEV1 <60% o Know examples of drug classes (SABA, LABA, ICS, etc.) asked below o SABA Know examples Albuterol, levalbuteral Benefits of use Abort ongoing attacks, prevent exercise-induced bronchospasms, begin working almost immediately Patient instructions Use spacer, wait 1 min b/w inhalations, assess peak flow daily, record assessments, sx freq/ intensity, report chest pain, HR/rhythm changes (ADR: systemic effects – tachycardia, angina, tremor) Why is it important to know the frequency a patient is using their SABA? Knowing freq can change asthma classification or step of tx o LABA Know example Arfemoterol, femorterol, indacaterol, olodaterol, salmeterol Benefits of use Decreased frequency of attacks for long-term control Must be combined w/ ICS, preferably in same inhaler BBW: carry risk of asthma-related death Use in COPD Preferred bronchodilator –1st^ choice in tx of COPD – can be used step A o Inhaled Corticosteroid (ICS) Know examples Betamethasone, budesonide, ciclesonide, flunisolide, fluticasone, mometasone Benefits of use
Decrease use after 12 mo Tuberculosis (TB) o What constitutes drug resistant TB MDR-TB (Multidrug Resistant TB) – TB resistant to isoniazid & rifampin XDR-TB (Extensively Drug-Resistant TB) – TB resistant to isoniazid, rifampin, & all fluoroquinolones (ex Moxifloxacin) & at least 1 of the injectable 2nd^ line anti-TB drugs (amikacin or capreomycin) o Treatment of TB in a pregnant person, what all should be included? Rifabutin is safest, although benefit outweigh risk for isoniazid, rifampin, pyrazinamide Rifapentine not recommended Ethambutol causes teratogenesis o Isoniazid (INH) is a drug that can be used to prevent TB in people that have been o exposed. Cold & Cough o Examples of decongestant Beclomethasone dipropionate, budesonide, fluticasone, riamicinolone, o Which drug class has no significant drug interactions Expectorants (Guaifenesin)
Week 7
H2 receptor antagonists o Examples Cimetidine, famotidine, nizatidine, ranitidine o Which is most likely to interact due to CYP450 enzyme system? Cimetidine Proton Pump Inhibitors o Associated vitamin and/or mineral deficiencies Hypomagnesemia, low vit B-12, low calcium, and low folic acid o Short term use increases risk of what? Community aquired PNA Symptoms this may be occurring GERD o How to treat moderate to severe GERD PPIs, antacids o What medication for GERD to avoid in older adults and why? o Treating GERD during pregnancy Which cytoprotective agents would be used o When to test for h. Pylori How to treat h. Pylori PUD o Lifestyle modifications to support ulcer healing
Anti-diarrheal o Which one contradicted in children during or after chickenpox o Patient teaching for ciprofloxacin for traveler’s diarrhea o Which one associated with gray/black stools and black tongue Constipation o Lifestyle modifications to suggest prior to treatment o Risks of laxatives during pregnancy o Preferred treatment during breastfeeding o Psyllium How it works and what to assess for if it doesn’t produce a bowel movement Irritable Bowel Syndrome (IBS) o A diary can be helpful to aid in diagnosis and treatment Vomiting o How to treat gastroparesis Black box warning associated with treatment Metronidazole o Patient teaching needed
