NURS 615 PHARM EXAM 4 ACTUAL EXAM 2024 LATEST QUESTIONS AND CORRECT ANSWERS (GRADED A+) CO, Exams of Nursing

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NURS 615 PHARM EXAM 4 ACTUAL EXAM 2024

LATEST QUESTIONS AND CORRECT ANSWERS

(GRADED A+) COLORADO CAR SALES MASTERY

TEST 2024

pseudoephedrine - ANSWER ✔children under 4 should not be prescribed this medication. instead encourage rest, fluids, saline sprays, nasal bulb for clearing of secreations coricidin hbp - ANSWER ✔this medication should be prescribed to pts with htn and c/o of nasal congestion antihistamines - ANSWER ✔these medications have ADRs including sedation, dizziness, tinnitus, lassitude, fatigue headache, irritability antihistamine contraindications - ANSWER ✔these populations include narrow-angle glaucoma, lower respiratory tract symptoms (thickened mucus, impaired cough), stenosing peptic ulcer, symptomatic prostatic hypertrophy, bladder neck obsruction, ploroduodenal obstruction, and MAOI usage codeine - ANSWER ✔this medication acts on the cough center in the medulla to suppress cough antitussive - ANSWER ✔benzonatate (tesselon pearles), dextromethorphan, codeine tiotropium - ANSWER ✔an anticholinergic medication used in the maintenance of COPD montelukast (singulair) - ANSWER ✔ADRs of this medication include headache, GI upset, myalgia, fever serious rxn include suicidal thoughts, hallucinations, depression, numbness/tingling, aggression, anxiety montelukast (singulair) - ANSWER ✔take this medication even if symptom free, not used for acute

RATED

asthma episodes instead should use bronchodilator if needed long acting beta agonists - ANSWER ✔african americans should not be prescribed this class of medications due to a black box warning in deaths from salmeterol, formoterol inhaled corticosteroids - ANSWER ✔patients should use spacer for greater percentage of drug delivery. also should rinse with water and spit to decrease risk for developing oral candidiasis albuterol - ANSWER ✔inhaled beta agonists, relaxation of airway smooth muscles by increasing cAMP inhaled corticosteroids - ANSWER ✔unknown but thought to inhibit igE and mast cell migrations into bronchial tissue short acting beta agonists - ANSWER ✔appropriate for use for bronchospasm r/t asthma, bronchitis, copd. rescue inhale

• albuterol, levalbuterol inhaled muscarinic receptor antagonists - ANSWER ✔block muscarinic receptors, decrease formation of cGMP leading to decrease contractility of smooth muscles of the lung
• ipratropium, tiotropium inhaled corticosteroids - ANSWER ✔side effects include oral candidiasis (thrush), hoarseness
• fluticasone, budesonide, beclomethasone dipropionate antacids - ANSWER ✔best taken 1-2 hours after meals and at bedtime, chewed thoroughly an taken with a half glass of water, may have either constipation or diarrhea depending on which type taken loperamide - ANSWER ✔Acts directly on circular and longitudinal intestinal muscles, through the opioid receptor, to inhibit peristalsis and prolong transit time; reduces fecal volume, increases viscosity, and diminishes fluid and electrolyte loss; demonstrates antisecretory activity. increases tone on the anal sphincter bismuth subsalicylate - ANSWER ✔this medication can cause a darkening of stools and tongue bismuth subsalicylate - ANSWER ✔this medication should not be given to pts under 12 years old that have a fever due to increased risk for reyes syndrome and not to be given to those under 2 yrs old bismuth subsalicylate - ANSWER ✔may be taken every 30-60 minutes, if tx travelers diarrhea it should

be taken before each meal and at bedtime. proton pump inhibitors - ANSWER ✔may require testing of h. pylori if sxs presist b12 deficiency may occur and should be checked, calcium, vit d level too protonix and omeprazole - ANSWER ✔PPIs such as this medication reduce acid proucing also putting a risk for iron deficiency anemia, vit b12 and calcium deficiencies. thus a risk for osteoporosis for those with long term use, advanced age, and other risk factors such as hip fx stimulant laxatives - ANSWER ✔most rapid acting laxatives, having a direct action on intestinal mucosa by stimulating the myenteric plexus. they facilitate the release of prostaglandins and increased cMP which increases secretion of electrolytes and stimulates peristalsis metoclopramide - ANSWER ✔in the improvement of GERD this medication produces a dose related increase in LESP. these effects begin at doses as low as 5 mg. (LESP: lower esophageal sphincter pressure) step down approach - ANSWER ✔This approach to the treatment of GERD begins with a standard dose of PPI daily for 8 weeks. If the symptoms have not resolved, then the dose of the PPI is doubled for another 4 - 8 weeks. After 4 weeks a lower dose of PPI is tried; if no relief after 8 weeks of twice daily PPI, then referral to a GI doctor is warranted. The goal is to step down to the lowest PPI dose or transition to a H2RA blocker if symptoms are not relieved step up approach - ANSWER ✔This approach to the treatment of GERD begins with lifestyle modifications and OTC antacids, followed by H2RA blockers and PPI's. If symptoms are refractory after 4- 8 weeks of treatment, or if endoscopy shows evidence of erosive disease, then PPI's become central management. First, once daily and if symptoms continue then twice daily.. This is best with patients with mild disease or occasional symptoms Peptic Ulcer Disease with positive H. Pylori - ANSWER ✔First line treatment for this disease includes triple therapy with a PPI twice a day, Amoxicillin 1 gm twice daily and Clarithromycin 500mg twice daily for 7-14 days. Treatment is suggested for 10 days to 2 weeks. Patients with a PCN allergy can substitute metronidazole for amoxicillin miralax - ANSWER ✔this medication can be given concurrently for children to treat constipation along with potential need for behavior modification as appropriate stimulant laxatives - ANSWER ✔bowel dependency may occur if used long term with these medications phenothiazine antiemetics - ANSWER ✔block dopamine receptors in the chemo trigger zone

• promethazine
• prochlorperazine These medications antagonize dopaminergic D2 receptors in various pathways to the CNS. The D2, or dopamine blockade, results in antipsychotic, antiemetic, and other effects. docusate sodium - ANSWER ✔incorporates water and lipids into stool and reduce surface tension proton pump inhibitors - ANSWER ✔these work irreversibly by combing the H+-K+-ATPase proton pump which. This reduced blood flow to stomach and decreases pepsin secretin and lipase serum (suppresses gastric acid secretion by inhibiting the parietal cell) ondansetron (zofran) - ANSWER ✔elective 5-HT3-receptor antagonist, blocking serotonin, both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone misoprostol (cytotec) - ANSWER ✔contrainidicated in pregnancy or those in child bearing age as they cause a 70% incidence of abortion loop diuretics - ANSWER ✔can lead to the excretion of up to 20 to 25 percent of filtered sodium [1,10]. They act in the medullary and cortical aspects of the thick ascending limb, including the macula densa cells in the early distal tubule. appear to compete for the chloride site on this carrier, thereby diminishing net reabsorption loop diuretics - ANSWER ✔furosemide, bumetadine, torsemide thiazide diuretics - ANSWER ✔primarily inhibit sodium transport in the distal tubule the connecting segment at the end of the distal tubule and possibly the cortical collecting tubule thiazide diuretics - ANSWER ✔hydrochlorthiazide potassium sparing diuretics - ANSWER ✔act in the principal cells in the cortical collecting tubule decrease the number of open sodium channels in the principal cells by two different mechanisms
• Amiloride and triamterene
• spironolactone acetazolamide - ANSWER ✔inhibits the activity of carbonic anhydrase, which plays an important role in

proximal bicarbonate, sodium, and chloride reabsorption. As a result, this agent produces both NaCl and NaHCO3 loss mannitol - ANSWER ✔nonreabsorbable sugar alcohol that acts as an osmotic diuretic, inhibiting sodium and water reabsorption in the proximal tubule and more importantly the loop of Henle hydrochlorothiazide - ANSWER ✔for tx of mild htn started at a low dose of 12.5 mg and increased to 25 g furosemide - ANSWER ✔for tx of moderate to severe with dose from 20mg to 40 mg mast cell stabilizers - ANSWER ✔cramolyn, nedocromil alter function of CL channel inhibits cough, inhibits mast cell and eosiniphil response to antigens tx-asthma prophylaxis mast cell stabilizers - ANSWER ✔adrs including headache cough, bad taste xanthine derivatives - ANSWER ✔theophylline, aminiophylline prroducing an increase in cAMP leads to bronchial smooth muscle and pulmonary vessel relaxationg tx-asthma xanthine derivatives - ANSWER ✔adrs include shaky tachycardia monoclonal antibody - ANSWER ✔$$$ omalizymab limits binding IgE to receptors on the surface of mast cells and basophils tx-mod-severe persistant asthma SQ ADR-inj site rxn, viral infections, pharyngitis intranasal corticosteroids - ANSWER ✔mometasone, fluticasone interrupt inflammation by inhibiting the synthesis of mediators

tx- allergic rhinitis adr- burning of nasal mucosa intranasal corticosteroids - ANSWER ✔pt educate on how to use no blowing nose for 30 minutes 1st generation antihistamine - ANSWER ✔chlorpheniramine, diphenhydramine, hydroxyzine, promethazine 2nd generation antihistamine - ANSWER ✔olopatadine, azelastine, cetirizine, fexofenidine, loratadine 3rd generation antihistamine - ANSWER ✔deslaratidine (clarinex) H1 antagonist - ANSWER ✔tx allergic rhinits, pruritis, urticaria, insomnia, N/V, cold sx block the action of histamine by binding to the histamine receptors CYP ADR-antichol effects (mostly with 1st gen) oral and intranasal decongestant - ANSWER ✔stimulate a-receptors of vascular smooth muscle, constricting dilated arterioles within nasal mucosal tx-nasal congestion, improve eustacian tube func pseudoephedrine - ANSWER ✔not to use in children under 3 adr= rapid hr fuzzy feeling expectorants - ANSWER ✔guaifenesin (mucinex) tx- management of cough r/t bronchiits, colds, sinusitis increase output of resp tract by decreasing adhesiveness and surface tension adr-GI metoclopramide - ANSWER ✔prokinetic drug tx- management of GERD, diabetic gastroparesis postop and chemotherapy induced nv

cytoprotective drug - ANSWER ✔sucralfate tx- PUD, binds electrostatically to positively charged protos within the ulcer to form barriers interaction-chelates with other antacids bulk forming laxatives - ANSWER ✔increase peristalsis and decrease transit time no absorption from GI tract tx-long term manag. of chronic constipation and watery stools psyllium, methylcelluose absorbents - ANSWER ✔decrease h2o lost by absorping bacteria and toxins kaopectate, pepto-bismol