NR 565 Advanced Pharmacology Midterm Newest Exam
Preparation Newest With Complete Questions And
Correct Detailed Answers| Brand New Version
CYP3A4 inhibitors and grapefruit juice (levels can be increased) - answer;-Amiodarone should NOT be
taken with what?
No - answer;-Are statins safe in pregnancy?
ezetimibe and fibrates - answer;-What can be used in pregnancy if needed? (related to statins and
pregnancy)
evening- cholesterol synthesis increases at night - answer;-At what time of day should statins be given
and why?
rhabdomyolysis, hepatoxicity, new-onset diabetes - answer;-adverse effects of statins
inhibitors of CYP3A4 (ex/ erythromycin, amiodarone, grapefruit) - answer;-What medications should be
used cautiously with statins bc they can raise plasma levels?
decrease LDL - answer;-What are bile salts such as colesevlam used for?
decreases total glyiceride and raises HDL - answer;-What is gemfibrozil used to treat
,warfarin (increases anti-coagulant effects) - answer;-What is a major drug interaction with gemfibrozil
(fibrate)
liver and gallbladder disease - answer;-fibrates are contraindicated in what patients
headache, hypotension, and tachycardia (secondary to vasodilation) - answer;-adverse effects of nitro
inhibitors of PDE-5 - answer;-what medication is contraindicated when a patient is prescribed nitro?
use lowest effective dosage and long term acting formulations (patches, sustained release) used on
intermittent schedule allowing at least 8 drug free hours every day (usually at night) - answer;-How can
we prevent nitro tolerance?
suppresses coagulation by decreasing production of four clotting factors, inhibits enzyme vit K from
converting to active form - answer;-Warfarin MOA
2.5 to 3.5 - answer;-INR target range for warfarin
bleeding - soft toothbrush, electric razor, avoid green leafy vegetables - answer;-patient education on
warfarin
Beta Blockers suppress nitroglycerin induced tachycardia. They do so by preventing sympathetic
activation of beta 1 adrenergic receptors on the heart.
Nitroglycerin lowers BP by reducing venous return and dilating arterioles. the lowered BP activates the
baroreceptor reflex causing reflex tachycardia. Which will increase cardiac demand and negate the
therapeutic effects of nitroglycerin. Txt with beta blocker can suppress the heart and slow the rate.
no digoxin - increase contractility of heart - answer;-Beta-blockers use with nitroglycerin
end in -lol/-olol
Atenolol, bisoprolol, metoprolol, metoprolol succinate,
Carvedilol, labetalol, nadolol, propranolol, and Sotalol (Betapace®) - answer;-examples of beta blockers
,Stopping abruptly can increase the incidence and intensity of anginal attacks and may even precipitate
MI - answer;-Risk of stopping beta blockers abruptly
Beta blockers can increase airway reactivity and may interfere with the activity of beta-agonists and can
cause bronchospasms - answer;-What happens when beta blockers are given to someone with asthma?
Sulfa Allergy
Pts w severe renal impairment and/or/cardiovascular issues
History of gout
diabetes
hyperlipidemia - answer;-contraindications to thiazide diuretics
weight
vitals
blood glucose
BUN & creatinine/kidney function
electrolytes - sodium, potassium, calcium, magnesium - answer;-Monitoring needs for diuretics
increase the output force of the heart and increase its rate of contractions by acting on the cellular
sodium-potassium ATPase pump
Positive Inotropic action can increase myocardial contractile force.
Increase cardiac output.
Positive impact on neurohormonal systems. - answer;-cardiac glycosides (Digoxin)
Quinidine can cause plasma levels of digoxin to rise by 1) displacing digoxin from tissue binding sites and
2) reducing renal excretion of digoxin. By elevating free levels of digoxin, quinidine can promote digoxin
toxicity. The combo should be avoided - answer;-Quinidine and digoxin - what happens when they are
combined
, ASCVD risk assessment is directed at determining the patient's absolute risk of developing clinical
coronary disease over the next 10 years. Defines high risk as 7.5% or greater.
a calculation of your 10-year risk of having a cardiovascular problem, such as a heart attack or stroke. -
answer;-Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score
What is it?
In children a screening should be done between ages 9 and 11 and then again at ages 19 and 21. For
adults every 5 years after the age of 20. Some people are at greater risk like those with diabetes and a
risk score greater than 7.5% and should be screened more often - answer;-When is it used - ASCVD Risk
Score
pregnancy/breastfeeding
can be use in monotherapy or as adjunct therapy with a statin or a fibrate - answer;-ezetimibe- when
can it be used?
Cholesterol Absorption Inhibitor- lowers cholesterol levels by decreasing the amount of cholesterol that
is absorbed from the small intestine, so that there is less intestinal cholesterol delivered to the liver.
Does not affect triglycerides - answer;-What is ezetimibe?
Lifestyle changes are non drug measures used to lower LDL. Four main issues are diet, exercise, weight
control, and smoking cessation - answer;-lifestyle changes for high cholesterol
Non-statins- fibrates, Ezetimibe, Bile acid sequestrants. Statins are generally well tolerated and side
effects are uncommon. Some patients develop headache, flatulence, constipation, or GI disturbances,
but these effects are usually mild and transient - answer;-If a patient wanted to minimize side effects,
which drug classification is a good choice?
direct relaxant effect on vascular smooth muscles, and the dilation of coronary vessels improves oxygen
supply to the myocardium. The dilation of peripheral veins, and in higher doses peripheral arteries,
reduces preload and afterload, and thereby lowers myocardial oxygen consumption.
promote vasodilation - answer;-Therapeutic action of organic nitrates (nitroglycerin)
Agents that inhibit CYP3A4 can increase the levels of ranolazine and thereby increase the risk of
torsades de pointes. These things include: grapefruit juice, HIV protease inhibitors, macrolide antibiotics,
Preparation Newest With Complete Questions And
Correct Detailed Answers| Brand New Version
CYP3A4 inhibitors and grapefruit juice (levels can be increased) - answer;-Amiodarone should NOT be
taken with what?
No - answer;-Are statins safe in pregnancy?
ezetimibe and fibrates - answer;-What can be used in pregnancy if needed? (related to statins and
pregnancy)
evening- cholesterol synthesis increases at night - answer;-At what time of day should statins be given
and why?
rhabdomyolysis, hepatoxicity, new-onset diabetes - answer;-adverse effects of statins
inhibitors of CYP3A4 (ex/ erythromycin, amiodarone, grapefruit) - answer;-What medications should be
used cautiously with statins bc they can raise plasma levels?
decrease LDL - answer;-What are bile salts such as colesevlam used for?
decreases total glyiceride and raises HDL - answer;-What is gemfibrozil used to treat
,warfarin (increases anti-coagulant effects) - answer;-What is a major drug interaction with gemfibrozil
(fibrate)
liver and gallbladder disease - answer;-fibrates are contraindicated in what patients
headache, hypotension, and tachycardia (secondary to vasodilation) - answer;-adverse effects of nitro
inhibitors of PDE-5 - answer;-what medication is contraindicated when a patient is prescribed nitro?
use lowest effective dosage and long term acting formulations (patches, sustained release) used on
intermittent schedule allowing at least 8 drug free hours every day (usually at night) - answer;-How can
we prevent nitro tolerance?
suppresses coagulation by decreasing production of four clotting factors, inhibits enzyme vit K from
converting to active form - answer;-Warfarin MOA
2.5 to 3.5 - answer;-INR target range for warfarin
bleeding - soft toothbrush, electric razor, avoid green leafy vegetables - answer;-patient education on
warfarin
Beta Blockers suppress nitroglycerin induced tachycardia. They do so by preventing sympathetic
activation of beta 1 adrenergic receptors on the heart.
Nitroglycerin lowers BP by reducing venous return and dilating arterioles. the lowered BP activates the
baroreceptor reflex causing reflex tachycardia. Which will increase cardiac demand and negate the
therapeutic effects of nitroglycerin. Txt with beta blocker can suppress the heart and slow the rate.
no digoxin - increase contractility of heart - answer;-Beta-blockers use with nitroglycerin
end in -lol/-olol
Atenolol, bisoprolol, metoprolol, metoprolol succinate,
Carvedilol, labetalol, nadolol, propranolol, and Sotalol (Betapace®) - answer;-examples of beta blockers
,Stopping abruptly can increase the incidence and intensity of anginal attacks and may even precipitate
MI - answer;-Risk of stopping beta blockers abruptly
Beta blockers can increase airway reactivity and may interfere with the activity of beta-agonists and can
cause bronchospasms - answer;-What happens when beta blockers are given to someone with asthma?
Sulfa Allergy
Pts w severe renal impairment and/or/cardiovascular issues
History of gout
diabetes
hyperlipidemia - answer;-contraindications to thiazide diuretics
weight
vitals
blood glucose
BUN & creatinine/kidney function
electrolytes - sodium, potassium, calcium, magnesium - answer;-Monitoring needs for diuretics
increase the output force of the heart and increase its rate of contractions by acting on the cellular
sodium-potassium ATPase pump
Positive Inotropic action can increase myocardial contractile force.
Increase cardiac output.
Positive impact on neurohormonal systems. - answer;-cardiac glycosides (Digoxin)
Quinidine can cause plasma levels of digoxin to rise by 1) displacing digoxin from tissue binding sites and
2) reducing renal excretion of digoxin. By elevating free levels of digoxin, quinidine can promote digoxin
toxicity. The combo should be avoided - answer;-Quinidine and digoxin - what happens when they are
combined
, ASCVD risk assessment is directed at determining the patient's absolute risk of developing clinical
coronary disease over the next 10 years. Defines high risk as 7.5% or greater.
a calculation of your 10-year risk of having a cardiovascular problem, such as a heart attack or stroke. -
answer;-Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score
What is it?
In children a screening should be done between ages 9 and 11 and then again at ages 19 and 21. For
adults every 5 years after the age of 20. Some people are at greater risk like those with diabetes and a
risk score greater than 7.5% and should be screened more often - answer;-When is it used - ASCVD Risk
Score
pregnancy/breastfeeding
can be use in monotherapy or as adjunct therapy with a statin or a fibrate - answer;-ezetimibe- when
can it be used?
Cholesterol Absorption Inhibitor- lowers cholesterol levels by decreasing the amount of cholesterol that
is absorbed from the small intestine, so that there is less intestinal cholesterol delivered to the liver.
Does not affect triglycerides - answer;-What is ezetimibe?
Lifestyle changes are non drug measures used to lower LDL. Four main issues are diet, exercise, weight
control, and smoking cessation - answer;-lifestyle changes for high cholesterol
Non-statins- fibrates, Ezetimibe, Bile acid sequestrants. Statins are generally well tolerated and side
effects are uncommon. Some patients develop headache, flatulence, constipation, or GI disturbances,
but these effects are usually mild and transient - answer;-If a patient wanted to minimize side effects,
which drug classification is a good choice?
direct relaxant effect on vascular smooth muscles, and the dilation of coronary vessels improves oxygen
supply to the myocardium. The dilation of peripheral veins, and in higher doses peripheral arteries,
reduces preload and afterload, and thereby lowers myocardial oxygen consumption.
promote vasodilation - answer;-Therapeutic action of organic nitrates (nitroglycerin)
Agents that inhibit CYP3A4 can increase the levels of ranolazine and thereby increase the risk of
torsades de pointes. These things include: grapefruit juice, HIV protease inhibitors, macrolide antibiotics,
