NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDA, Exams of Nursing

Download NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDA and more Exams Nursing in PDF only on Docsity! NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ MODULE 1 1. What are the BON rules and regulations for prescriptive authority for the advance practice nurse? 1. Texas is very restricted 2. Describe the pharmacokinetic processes of absorption, distribution, metabolism and elimination and how differences in these areas affect drug action. 1. Absorption 1. Drug’s movement from the site of administration into the blood. 2. Distribution 1. Drug’s movement from the blood into the interstitial space of tissues and from there into cells. 3. Metabolism 1. Biotransformation is the enzymatically mediated alteration of drug structure. 4. Elimination 1. Combination of metabolism and excretion 3. Compare and contrast pharmacokinetics and pharmacodynamics of special populations—pediatrics, older adults and those that are pregnant. 1. Pediatrics—they have organ immaturity, elderly—they have NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ organ degeneration, loss of nephrons, excretion of drug is decreased and you have to give this population a lower dose of medication. Medication can pass through milk of lactating females. 4. Analyze a drug interaction to determine an appropriate course of action. 1. Basic mechanism of drug-drug interactions through pharmacokinetic interactions are altered absorption, altered distribution, altered metabolism, and altered renal excretion. 5. Identify medications with a narrow therapeutic index requiring drug level monitoring. 1. 6. Discuss the effect of ionization and pH on absorption. 1. Drugs that are weak acids are best absorbed in acidic environments. Acidic drugs accumulate on the alkaline side, basic drugs accumulate on the acidic side known as ion trapping. Ionization of the drugs is pH dependent, when the pH and the fluid on one side of the membrane differs from the pH on the other side, drug molecules tend to accumulate on the side where the pH most favors ionization. 7. Discuss factors affecting drug distribution. 1. Competition for protein binding and alteration of extracellular pH 8. Discuss barriers affecting drug distribution—such as placental NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ activation by endogenous regulatory molecules and drugs. 14.Discuss the impact of food on drug absorption, drug metabolism and on drug toxicity and action—as well as the timing of drug administration. LIFESPAN 1. Hepatic metabolism and GFR increase during pregnancy, dosages of some drugs may need to be increased. 2. Rate of albumin to water decreases 1. Third trimester: Renal blood flow is doubled and renal excretion is accelerated (drugs excreted rapidly) 2. Tone and mobility of bowel decrease 3. Prolongation of drug effects Total (½ life increases) 3. Understand stages of development in pregnancy 1. Conception: through week 2 2. Embryonic period: week 3-week 8 a) Gross malformations can be produced by teratogens 3. Fetal period: week 9-delivery 4. Understand pregnancy labeling 1. 3 categories now a) Pregnancy, lactation, male & female reproductive potential 5. How do you decrease risk in the infant during breastfeeding? 1. Take meds immediately after breastfeeding, avoid NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ drugs that have long half-lives, choose drugs that tend to be excluded from milk, avoid drugs that are known to be hazardous. 6. How do pediatric patients differ in their response to medications? 1. Absorption a) Oral? NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 1. Neonates: drug remain in the stomach longer which increases the levels, low acidity can affect the absorption of acid labile drugs b) Parenteral? 1. Reponses are slow and erratic. 2. Infancy: absorption is more rapid than in neonates & adults 3. Best avoided in infants c) Transdermal? 1. Greater skin permeability which increases topical drug absorption and increases the risk for toxicity 2. Distribution a) Protein binding 1. Neonates: less protein-binding—increased availability of highly protein bound drugs such as phenytoin, diazepam, and phenobarbital. Reduced dosages needed in these highly bound drugs. b) Blood Brain Barrier 1. Not fully developed at birth, drugs have easy access to the CNS, doses should be reduced. NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 10. What are pharmacodynamic and pharmacokinetic differences in geri patients? 1. Absorption? a) GI 1. Produce less acid and fewer parietal cells 2. Bioavailability decreased 3. Rate of absorption decreased 2. Distribution? a) Lean Body Mass 1. Drugs accumulate in adipose tissues because lean muscle mass decreases by 20% b) Body Water 1. Decrease by 10-15%-drugs reach higher serum concentrations c) Albumin 1. Lowered—leads to higher levels of free or unbound drugs 3. Metabolism? a) Hepatic 1. Decreased with age—decreases drug clearance b) T half life 1. Increases—alters drug-drug interactions NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 4. Excretion? a) Renal 1. Decreases—which decreases renal clearance of drugs ANTIMICROBIALS 1. Differentiate Bacteriostatic and Bactericidal. 1. Bacteriostatic: can slow bacteria growth and do NOT cause cell death 2. Baterialcidal: directly lethal to the bacteria 2. What is the difference between broad spectrum and narrow spectrum? 1. Broad spectrum: active against a wide variety of microbes. 2. Narrow spectrum: only active against a few species of bacteria or micro-organisms 3. Which is preferred? 1. Narrow spectrum 4. What are antibiotic classifications? 1. Classifications by susceptible organisms 2. Classified by mechanism of action 5. What is empiric antibiotic use? Therapeutic use? NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ ■ Bacteriostatic: ECSTaTiC ■ E rythromycin ■ C lindamycin ■ Sulfamethoxazole ■ T rimethoprim ■ a ■ T etracycline ■ i ■ C hloramphenicol ■ Bacterialcidal: Very F inely Proficient At Cell Murder ■ V ancomycin ■ F luoroquinolones ■ P enicillin ■ A minoglycosides ■ C ephalosporins ■ M etronidazole NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 1. Initiate treatment before you know what the results of the test-- Treat with broad-spectrum antibiotic for initial treatment and once you get culture and drug sensitivity then you can use narrow spectrum antibiotic. 6. Which antibiotics work by weakening the cell wall? 1. Penicillins NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 3. Adverse reaction i. Rash ii. Diarrhea h) Piperacillin 1. Extended-spectrum penicillin 2. Fights against: pseudomonas, enterbacter, proteus, bacteroides fragilis, klebsiella 3. Administered: parenterally via IV NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 4. Adverse reaction: bleeding secondary to disrupting platelet aggregation. i) Penicillin combination (beta-lactamase inhibitors) 1. Ampicillin/sulbactam 2. Amoxicillin/clavulanate 3. Piperacillin/tazobactam j) Resistance issues with penicillin 1. Primarily against Staphylococcus aureus i. MRSA (sensitive) 2. Developed to resist penicillinase 3. Hepatotoxicity 4. Dose reduction in renal insufficiency k) Nephrotoxicity* 1. Kidney toxicity 2. Monitor renal function 2. Generations of cephalosporins a) Mechanism of action: bind to penicillin-binding proteins and disrupt cell wall synthesis, activate autolysis, damage cell wall. b) Most affective in cells undergoing active growth and division. c) Drug-drug interaction: probenecid NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ d) Cefazolin & Ceftriaxone-do not give with alcohol e) Cefotetan & Ceftriaxone (decreases vitamin K metabolism)-do not give with warfarin f) Ceftriaxone-do not give with calcium g) Adverse effects: allergic reaction, bleeding, thrombophlebitis 1. 1st: 2. 2n d 3. 3rd NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ d) Adverse effects 1. GI: nausea and vomiting 2. Skin rash and pruritus 3. Fever e) Drug-drug interaction: valproate (break through seizures can occur) f) Administered only parenterally 4. Vancomycin g) No beta-lactam ring h) Uses and coverage 1. MRSA and C diff infections (IV)* 2. Oral is only used for c. diff (PO)* 3. Penicillin allergic patients for streptococcal endocarditis (rotten teeth that give a patient heart problems) i) Adverse Effects** 1. Thrombophlebitis 2. Thrombocytopenia 3. Red man syndrome* i. Hypotension ii. Histamine flush iii. Not an allergic reaction* NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ j) Nephrotoxicity and ototoxicity* 1. Monitor renal function 5. Lypoglycoproteins k) Telavanc in 1. Uses NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ i. Gram + bacteria ii. Only given IV iii. ONLY used in vancomycin-resistant infections 2. Adverse Effects i. Taste disturbance ii. Nausea iii. Vomiting iv. Foamy urine v. Red man syndrome vi. Prolong QT interval vii. BLACK BOX WARNING: mortality increases in pts. With hospital-acquired or ventilator-associated pneumonia and creatinine clearance <50. 3. Drug-drug interactions: NSAIDS or ACE Inhibitors (damage kidneys), Clarithromycin, ketoconazole (cause prolonged QT interval) 6. Monobactrams l) Aztreonam 1. Binds to PBP3 NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ f) Symptoms improve within 2-3 days after taking BACTERIOSTATIC INHIBITORS (suppress growth, do not kill) 1. Tetracyclines (tetracycline, demeclocycline, doxycycline, minocycline) a) Broad spectrum b) Work against gram + and – c) Mostly used outpatient d) Extensive use = increased in bacterial resistance e) Uses 1. Chylamydial infections and other STDs 2. Helicobacter pylori (causes ulcers in the duodenal and gastric) 3. Acne 4. Skin infections 5. Anthrax (doxycycline) 6. Infectious disease 7. PUD 8. Periodontal disease 9. RA 10.RMSF 11.Pneumonia NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 12.Lyme disease f) Why can’t we give to children under 8 and pregnant women?* 1. Can irreversibly stain teeth (4 months-8 years old)* 2. Impact skeletal development in babies* g) Photosensitivity* 3. Wear sunscreen h) Adverse effects 1. Nausea, cramps, epigastric burning 2. Create superinfections—c. diff 3. Hepatotoxicity—IV form i) tetracycline with iron, vitamins, or calcium – bioavailability* 1. Impaired absorption of antibiotic 2. If you want to take iron, vitamins, or calcium leave 2 hours in between tetracyclines 2. Macrolides a) Broad spectrum b) Erythromycin 1. High dose IV is cidal 2. Low dose PO is static NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 3. Food increases absorption 4. Metabolized by CYP3A4 system 5. Drug-drug interactions: theophylline, carbamazepine, warfarin, verapamil, diltiazem, HIV protease inhibitors, simvastatin cipro NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 5. Myelosuppression f) Drug-drug interactions 1. MAOIs and Tedizolid 4. Ketolides NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ a) Telithromycin 1. Uses i. Strep pneumonia 2. Adverse effects i. Severe liver damage ii. GI effects iii. Visual disturbances iv. Prolonged QT interval v. BLACK BOX WARNING: muscle weakness and shouldn’t be used in myasthenia gravis due to respiratory failure. 5. Streptogramins a) Dalfopristin 1. Uses i. Vancomycin-resistant enterococcus 2. Adverse effects i. Hepatic toxicity 3. Drug-drug interactions: CYP3A4 system b) Chloramphenicol 1. Uses i. Life threatening infections NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 2. Adverse effects i. Reversible bone marrow depression ii. Fatal aplastic anemia (BLACK BOX WARNING) iii. Gray syndrome iv. GI effects v. Peripheral neuropathy 6. Tigecycline a) Broad spectrum bacteria b) Causes increased mortality (not used unless other infection isn’t responding to other agents) 7. Retapamulin and mupirocin a) Topical used for impetigo 8. Mupirocin a) Used in nostrils for MRSA for people who are carriers 9. Aminoglycosides (gentamycin, tobramycin, amikacin) a) Uses and coverage 1. Gram negative only i. Serious or life-threatening infections* 1. Alone or with other antibiotics NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 2. Hypersensitivity reactions 3. Blood dyscrasias e) Drug-drug interactions 1. Neuromuscular blocking agents 2. General anesthetics 3. Cephalosporins, polymyxins, vancomycin, cyclosporine, aspirin (toxic to kidneys when used in combination) f) Beneficial drug-drug interactions 1. Penicillin 2. Cephalosporins 3. Vancomycin g) Do not give to pt. with myasthenia gravis 1. Reversal treatment of choice is calcium salt h) Gentamycin 1. Uses vi. Gram – bacilli 2. Pseudomonas, e. coli, klebsiella, Serratia, proteus mirabilis 3. Used where resistance is high in hospitals 2. Adverse effects NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ vii. Nephrotoxicity, ototoxicity 10. Sulfonamides a) Broad spectrum b) Mechanism of action** 1. Suppress bacterial growth by inhibiting tetrahydrofolic acid (derivative of folic acid or folate) c) Uses NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 1. UTIs (main use) 2. Gram negative 3. Others i. Nocardiosis ii. Malaria iii. Ulcerative colitis iv. Toxoplasmosis v. Chlamydia d) Adverse effects 1. Skin, skin, skin i. Skin rashes & itching ii. Stevens-Johnson syndrome iii. Photosensitivity 2. Hematologic effects i. Hemolytic anemia ii. Kernicterus 3. Renal damage e) Drug-drug interactions** 1. Phenytoin, glipizide, glyburide (inhibit hepatic metabolism) 2. Thiazide (Celebrex) diuretics and sulfides (cross- hypersensitivity) NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ d) Adverse effects 1. GI—nausea and vomiting 2. Rash 3. Hyperkalemia 4. Steven-Johnson syndrome 5. Blood dyscrasias 6. Kernicterus 7. Renal damage or crystal urea 8. Birth defects in 1st trimester DRUGS TO TREAT UTIs** 1. Uncomplicated UTIs a) Single dose therapy 1. For uncomplicated, non pregnant females b) Conventional therapy 1. For pregnant females c) Nitrofurantoin and Bactrim DS** d) If there’s resistance: fluoroquinolones are used** e) Fosomycin= single dose therapy f) Nitrofurantoin rapidly metabolized and concentrates in the bladder** 1. Used for acute cystitis, NOT pyleo NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 2. Acute and uncomplicate Pyleo a) Mild and moderate infection treat at home 1. First line: TMP, SMZ, Cipro and levofloxacin for 10-14 days 2. Second line: augmentin (amoxicillin clavulanate AKA cephalexin) b) Severe infection requires hospitalization and IV antibiotics then once controlled you start oral antibiotics 3. Cipro, ceftrizxone, ceftazidime, ampicillin plus gentamicin, ampicillin/culbactam 3. Complicated UTIs a) Need to do a C&S and treat with broad spectrum until it comes back** 4. UTI relapse a) Long-term therapy: prophylactically low dose of TMP/SMZ 3x weekly for 6 months or TMP at bedtime for 6 months or nitrofurantoin for 6 months** 5. Postcoital cystitis a) Take nitrofurantoin and void after intercourse 6. Prostatitis** NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ a) Signs & Symptoms 1. High fever, chills, malaise, myalgia, localized pain, dysuria, nocturia, urinary urgency, urinary frequency b) Causes NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ iv. GI infections v. Bones, joints, soft tissue infecitons 2. Adverse Effects** i. Cartilage damage** NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 1. FDA black box warning: increase risk of tendonitis and tendon rupture—not dose dependent* ii. Photosensitivity 1. Wear sunscreen iii. Confusion in elderly iv. N/V/D v. Dizziness vi. Headaches vii. Restlessness viii. Occasionally seizures ix. Candida infections of pharynx & vagina x. C. diff xi. Increased risk for aortic dissection or ruptured abdominal aortic aneurysm. 3. Drug-drug interactions** i. Glucocorticoids ii. Antacids, magnesium, arm salts, zinc salts, sucralfate, milk, dairy products (absorption is reduced) NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ Quinolones interfere with warfarin so you must watch the PT/INR because it would be high NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ iii. Theophylline, warfarin, tinidazole (causes elevations of these meds) 4. Contraindications i. Don’t give to pregnant or lactating women and children <18* ii. Myasthenia gravis (causes muscle weakness) e) Ofloxacin, Moxifloxacin, Levofloxacin 1. Uses i. Respiratory tract ii. UTI iii. GI tract iv. Skin and soft tissues f) Gemifloxacin 1. Uses i. CAP and bacterial bronchitis g) Delafloxacin 1. Uses i. Skin and skin structure infections h) Flagyl (metronidazole) 1. Uses** NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ i. Ears, eyes, and skin DRUGS TO TREAT STDS 1. Chylamida** l) Uncomplicated infections 1. Azithromycin (1 gram) i. Preferred in a pregnancy ii. Children >45 grams and under 8 years old 2. Doxycycline (100mg PO twice daily for 7 days) i. Used in children over 8 years old 3. Erythromycin i. Preferred in infants for pneumoniae & conjunctivitis ii. Pre-adolescents (child sexual abuse) 2. <45 grams 2. Lymphogranuloma venereum a) Strain of C. trachomatous b) Small erosion/papule and migrates to lymph nosed c) Doxycycline used as treatment, erythromycin as a substitute 3. Gonococcal infections** a) Cephalosporins (preferred treatment) NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 1. Ceftriaxone 250mg once + azithromycin 1g PO once for urethritis, cervicitis, proctitis, pharyngitis, conjunctivitis 2. Disseminated-ceftriaxone 1g IM or IV every 24 hrs + azithromycin 1g once b) Neonatal infection NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 1. Ophthalmia can cause blindness iii. Single dose of ceftriaxone IM or IV 2. Prevention iv. 0.5% erythromycin ophthalmic ointment @ birth required by law c) Preadolescent 1. Weight >45kg: treatment same as adults 2. Weight <45kg: single dose of ceftiaxon for vaginitis, cervicitis, urethritis, pharyngitis, proctitis 3. Systemic is IM or IV ceftriaxone daily for 7 days 4. Nongonococcal urethritis a) Diagnosis: presence of polymorphonuclear leukocytes and negative culture for gonorrhea b) Azithromycin or doxycycline 1. Alternatives: erythromycin, levofloxacin or ofloxacin, metronidazole, tinidazole for trichomonas. c) Pelvic inflammatory disease 1. Cause: gonorrhea or chlamydia 2. Causes infertility 3. Broad coverage and combo therapy is required NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 3. Azithromycin, ceftriaxone, cipro, erythromycin base j) Herpes simplex virus** 1. Acyclovir, famciclovir, valacyclovir i. Can be taken every day for suppressive therapy or can preserve it and take them when there’s an active outbreak ii. Vancyclovir 500mg taken daily can decrease transmission by 50% iii. Infants exposed at birth should be treated with acyclovir ANTIFUNGA LS 5. Amphotericin B (broad spectrum, given IV) a) Uses 1. Some protozoa 2. Systemic mycoses b) Mechanism of action 1. Binds to ergosterol in the fungal cell membrane and increases permeability and the cell leaks intracellular cations reduces viability. Bacteria not affected. NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 2. Fungicidal or fungistatic c) Adverse effects 1. Infusion reactions i. Phle bitis 2. Renal damag e causes hypoka lemia (may need potassi um and monito r creatin ine) 3. Fever, chills, rigors, nausea, headache. 4. Hematologic effects: bone marrow suppression and normochromic normocytic anemia (monitor h&h) d) Drug-drug reactions 1. Hydrocortisone-high incidence of phlebitis 2. Aminogylcosides-nephrotoxic 3. Cyclosporins-nephrotoxic 4. NSAIDS-nephrotoxic e) BLACK BOX WARNING 1. Highly toxic, only used in the setting of life threatening infections. 6. Azoles (Itraconazole, fluconazole, voriconazole, ketoconazole, Posaconazole, isavuconazonium) a) Uses (orally) 1. Systemic mycoses b) Mechanism of Action 1. Inhibits the synthesis of the ergosterol and disrupts the fungal cell membrane . Inhibits fungal cytochrome p450 c) Adverse effects NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 1. Liver damage (monitor liver enzymes) NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ a) Tinea pedis 1. Terbinafine (topical) 2. Butenafine (topical) 3. Ciclopirox (topical) NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ b) Tinea corporis 1. Terbinafine (topical) 2. Butenafine (topical) 3. Ciclopirox (topical) c) Tinea cruris 1. Terbinafine (topical) 2. Butenafine (topical) 3. Ciclopirox (topical) d) Tinea capitis 1. Fluconazole 2. Terbinafine 3. Itraconazole 4. Butenafine e) Vulvovaginal candidiasis 1. Topical antifungals 2. 1 dose of fluconazole 150mg f) Onychomycosis 1. Terbinafine (topical) and itraconazole TUBERCULOSIS DRUGS 1. Two species of bacteria NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ a) Tubercular bacilli b) 2. When is treatment considered effective? a) 3. How are drugs chosen for treatment? a) Initial drug selection is empiric based on patterns of drug resistance in the community and immunocompetence of the patient. Once culture sputum results come back, regimen should be adjusted accordingly. 4. What are first line drugs? Second line? a) 1st line: Isoniazid, Rifampin, Pyrazinamide, Ethambutol, Rifapentine, and Rifabutin b) 2nd line: Cycloserine, Ethionamide, Capreomycin, Para- aminosalicylic acid, aminoglycosides, quinolones. 5. What is the induction phase of treatment? Continuation Phase? a) Induction phase: eliminate actively dividing extracellular tubercle bacilli b) Continuation phase: eliminate persistent intracellular NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 1. Hepatotoxic 2. Non-gouty polyarthralgia 3. Hyperuricemia 4. GI disturbances 5. Photosensitivity 10. Ethambutol a) Adverse effects 1. Optic neuritis 2. Hyperuricemia 3. Dermatitis 4. GI upset 5. Peripheral neuropathy 6. Renal damage 7. Thrombocytopenia 11. Levofloxacin and Moxifloxacin (quinolones) a) Adverse effects 1. Look at “fluoroquinolones” b) Drug-drug interactions 1. Look at “fluoroquinolones” 12. Capreomycin (injectable) a) Adverse effects 1. Renal damage NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 2. Eighth cranial nerve damage 3. Hearing loss 4. Tinnitus NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 5. Disturbed balance 13. Amikacin (injectable) a) Adverse effects 1. Nephrotoxic 2. Eighth cranial nerve damage (BLACK BOX WARNING) 14. Para-aminosalicylic acid a) Adverse effects 1. GI disturbances: N/V/D 2. Salt loading 3. Allergic reactions 4. Hepatotoxicity 5. Goiter 15. Ethionamide a) Adverse effects 1. GI disturbances: N/V/D 2. Hepatotoxicity 3. Peripheral neuropathy 4. CNS effects: convulsions, mental disturbance 5. Allergic reactions 6. Hypoglycemia 16. Cycloserine NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ b) Multi drug resistant? 1. Isoniazid resistant i. Treated for 6 months with 3 drugs 1. Rifampin, ethambutol, pyrazinamide 2. Rifampin resistant i. Treated for 18-24 months with 3 drugs 1. Isoniazid, ethambutol, pyrazinamide c) Extensively drug resistant? 1. Treatment is prolonged to at least 24 months 2. Use 2nd and 3rd line drug—less effective 3. Initial therapy can consist of 5,6,7 drugs i. Isoniazid, rifampin, pyrazinamide, ethambutol, amikacin or capreomycin, levofloxacin, cycloserine, ethionamide or PAS. 4. Last resort i. Infected tissue removed by surgery d) Patients with TB and HIV? 1. Rifabutin can be used but it can accelerate the metabolism of protease inhibitors and NNRTIs but not as much as rifampin. NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ e) Latent TB? 1. Treated with one or two drugs 2. TB must be ruled out 3. Isoniazid alone daily or twice weekly for nine months or isoniazid daily or twice weekly for 6 months 4. Rifampin alone daily for 4 months, isoniazid plus rifapentines taken weekly for three months f) How do you promote treatment adherence? 1. Directly observed therapy i. Administration of each dose is done in front of representative of the health department 2. Intermittent dosing (2-3 times a week) g) How do you evaluate? 1. Three primary modes i. Bacteriologic evaluation of sputum 1. Evaluated monthly until 2 consecutives are negative ii. Chest radiographs 1. Done in pt with negative NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ pretreatment sputum test 2. Repeat every 2 months after initial tx iii. Clinical evaluation 1. Fever, malaise, anorexia, cough must be evaluated at every clinic visit 2. Should be markedly decreased within 2 weeks NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 1. Live varicella & zoster vaccine 4. Ganciclovir a) Uses NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 1. Herpes simplex viruses, CMV virus (prevention and tx in immunocompromised pt—transplant pt, HIV, and those receiving immunosuppressing drugs) b) Adverse effects 1. Granulocytopenia 2. Thrombocytopenia 3. Reproductive toxicity 4. Teratogenic and carcinogenic effects 5. Nausea, fever, rash, anemia, liver dysfunction, confusion, other CNS symptoms 5. Valganciclovir a) Uses 1. CMV, retinitis, prevention of CMV disease in high-risk organ transplant recipients b) Adverse effects 1. Blood dyscrasias i. Bone marrow suppression ii. Granulocytopenia iii. Anemia iv. Thrombocytopenia 2. N/V/D NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ 3. Potential mutagenesis and carcinogenesis 6. Cidofovir a) Uses 1. CMV retinitis in patients with AIDS b) Adverse effects 1. Nephrotoxicity 2. Neutropenia 3. Ocular disorders VIRAL HEPATITIS DRUGS & FLU a. What are the medications used in the treatment of hepatitis? i. Hep C 1. Pegylated interferon alfa combined with ribavirin a. Interferon alfa: only given subQ i. Conventional vs. long acting ii. Adverse effects: flu-like, neuropsychiatric effects, depression, fatigue, thyroid dysfunction, heart damage, bone marrow suppression, neutropenia, thrombocytopenia NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ HIV? What is MOA for each? i. Reverse transcriptase inhibitors 1. Inhibits the HIV replication by suppressing synthesis of the viral DNA. ii. Non nucleoside reverse transfer inhibitors 1. Bind to the active center of reverse transcriptase and cause direct inhibition iii. Protease inhibitors 1. Reduce viral load to an undetectable level iv. Integrase strand transfer inhibitors 1. Treat those infected with HIV-1 v. Fusion inhibitors 1. Blocks entry of the HIV into the CD4 T cells vi. CCR5 antagonists 1. Used for those infected with CCR5-tropic HIV-1 strain b. Know major side effects and drug interactions with each i. Reverse transcriptase inhibitors (zidovudine) 1. Adverse effects a. Hematologic toxicity, lactic acidosis, myopathy ii. Non nucleoside reverse transfer inhibitors NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ (efavirenz, nevirapine, delavirdine, etravirine, rilpirvirine) iii. Protease inhibitors (lopinavir, ritonavir, indinavir, squinavir, nelfinavir, fosamprenavir, atazanavir, tipranavir, darunavir) 1. Adverse effects NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ a. Hyperglycemia, fat redistribution, hyperlipidemia, increased bleeding in pt with hemophilia, reduce bone density, elevation of serum transaminase 2. Drug-drug interactions iv. Integrase strand transfer inhibitors (raltegravir) 1. Adverse effects a. Insomnia, headache, rare hypersensitivity v. Fusion inhibitors (enfuvirtide AKA fuzeon) 1. Adverse effects a. Injection site reactions, ammonia, hypersensitivity reactions vi. CCR5 antagonists (maraviroc) 1. Adverse effects a. Hepatic toxicity, myocardial ischemia, orthostatic hypotension, immune reconstitution syndrome, increased risk for infection, potential risk for malignancy, upper respiratory infections, cough. c. What are laboratory tests used to guide treatment of HIV? i. Plasma HIV RNA or viral load assays NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ DRUGS FOR HEADACHES 1. What is pathophysiology of migraine? a. Neurovascular disorder that involves the dilation and inflammation of intracranial blood vessels. Vasodilation causes the pain. 2. What foods can trigger migraines? a. Aged cheeses, wine, cured meats, hot dogs, lunch meat, chocolate, Chinese food, canned soups, diet sodas, artificial sweeteners, yellow food coloring. 3. What drug classes are abortive medications? a. NSAIDs/aspirin b. Opioid analgesics: butorphanol and meperidine c. Serotonin 1B/1D receptor agonists: triptan d. Ergot alkaloids 4. What drug classes are preventive? What can happen with all preventive medications have if taken too frequently? a. Beta blockers, antiepileptic drug, tricyclic antidepressants, calcium channel blockers, botulism toxin, ACE inhibitors, Angiotensin 2 receptor blockers. b. Chronic headache 5. What are some herbal meds effective with migraines? What are their NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ side effects? a. riboflavin B2 and coenzyme Q-10 b. Side effects: GI, liver damage and cancer 6. What is treatment for menstrual migraine? a. Tricyclic antidepressants, estrogen gel and patches HEADACHES 1. NSAIDs: First line 2. Seratonin 1B1D Receptor Agonists/Triptans a. What is MOA? NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ i. Binds to receptors on the intracranial blood vessels and causes vasoconstriction, diminishes perivascular inflammation b. Side effects? i. Chest symptoms: heavy arms or chest pressure ii. Teratogenic iii. Vertigo, malaise, fatigue, tingling sensation, bad taste with intranasal form c. Drug/drug interactions? i. Ergot alkaloids, sumatriptan and all other triptans d. What is Treximet? i. Combination of Sumatriptan & Naproxen 3. Ergot Alkaloids a. What is MOA? i. Works by agonist activity at subtypes of serotonin receptors and specifically the 5HT1B and 5HT1D receptors. Suppresses the release of CGRP, to block inflammation associated with the trigeminal vascular system. b. Side effects? i. N/V ii. Overdose: causes ischemia secondary to constriction of NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ existing cognitive impairment. iii. What is tolerance? Cross tolerance? Dependence? 1. Tolerance: increased doses are needed to obtain the same response. 2. Cross tolerance: tolerance to another opioid agonists will develop, but there’s no tolerance to the miosis or constipation. 3. Dependence: abstinence syndrome with abrupt discontinuation, occurs about 10 hours after the last dose. a. Initial: yawning, rhinorrhea, sweating b. Progess: violent sneezing, weakness, n/v/d, bone & muscle pain, muscle spasms and kicking movement. iv. What are the medications available to treat opioid induced constipation (OIC)? 1. Naloxegol, methylnaltrexone, lubiprostone v. What is the reversal drug? Naloxene vi. Drug designed to discourage abuse? Naltrexone b. Others: fentanyl 5. Mod-strong opioid agonist a. Codeine: Class II alone, III with acetaminophen, V as cough NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ suppressant b. Oxycodone c. Hydrocodone d. Tapentadol 6. Opioid agonist antagonist a. Pentazocine b. Nalbuphine c. Butorphanol d. Buprenorphine Prolongs QT 7. Dosing guidelines NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ a. Define physical dependence, abuse, addiction. i. Physical dependence: abstinence syndrome will occur if the dependent producing drug is abruptly withdrawn and its not equated with addiction. ii. Abuse: drug use that is inconsistent with medical or social norms iii. Addiction: continued use of psychoactive substance despite physical, psychological, or social harm b. Identify patients at risk with screening tools i. NIDA tool ii. State prescription drug monitoring program iii. Obtain urine drug test c. What is prescription drug monitoring program (PDMP)? i. Database that contains information regarding all scheduled medications prescribed to a patient, who prescribed them, and the amount prescribed. d. What is REMS? i. Risk evaluation and mitigation strategy. Designed to reduce opioid related injuries and death. OPIOID ANTAGONISTS 1. Naloxene NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ a. NSAIDs first line b. Glucocorticoids: Second or if intolerant to NSAIDs 3. Flare up > 3 times per year a. Uricosurics 4. Colchicine a. No longer first line b. Treats acute gouty attack c. Reduces incidences of attack d. Aborts an impending attack e. Adverse effects? i. GI ii. Myelosuppression iii. Leukopenia iv. Granulocytopenia v. Thrombocytopenia vi. Pancytopenia vii. rhabdomyolysis f. Drug/drug? i. Statins ii. P-glycoprotein inhibitors iii. Inhibitors of the CYP3A4 5. Inhibits uric acid formation NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ a. Allopurinol-drug of choice b. Febuxostat c. Probenecid 6. Converts uric acid to allantoin, a compound readily excreted by the kidney Pegloticase- IV for those that have not responded to ANTIINFLAMMATORIES 1. Cyclooxygenase Inhibitors a. NSAIDs b. Acetaminophen 2. Differentiate Cox 1 and Cox 2 drugs a. Cox 1: located in all the tissues and do important things such as, protects gastric mucosa, supports renal function, promotes platelet aggregation. i. Protect against MI and stroke NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+ b. Cox 2: mediates inflammation and sensitizes receptors to painful stimuli, mediates fever, contributes to perception of pain, promotes vasodilation, contributes to colon cancer. i. Risk for MI and stroke 3. ASA a. Drug interactions? i. Anticoagulants (warfarin and heparin) ii. Glucocorticoids iii. Alcohol iv. Ibuprofen v. ACE inhibitors and ARBs b. Side effects? i. Ulceration and bleeding of GI ii. Reversible impairment of kidneys iii. Edema iv. Toxic levels—tinnitus, sweating, headache, dizziness v. Children <18 years old—Reye syndrome 4. Non ASA first generation NSAIDs –indications RA, OA a. Ibuprofen, Naproxen b. SAFETY ALERT: All first-generation NSAIDs are associated with an increased risk of GI bleeding that can lead to NURS 5344PHARM STUDY GUIDE QUIZ 1 Q & As BEST EXAM SOLUTION GUARANTEED SUCCESS LATEST UPDATE 2023 GRADED A+