Nurs 615 Pharm Exam 3 Latest Questions
and Answers | Updated Professional Prep
with Verified Answers | A+ Verified
• How do antigout medications work? -✓✓by inhibiting the infiltration and phagocytosis
of leukocytes, thus decreasing the breakdown of uric acid to urate crystals.
• Deposition of urate crystals causes -✓✓pain and inflammation
• What is Colchicine -✓✓anti-gout medication
• how does Colchicine work? -✓✓Works by inhibiting inflammation, reducing pain and
swelling
• common side effects of Colchicine -✓✓GI problems (diarrhea) use with caution in
elderly
Also can cause blood dyscrasias & abdominal pain
• patient education with Colchicine -✓✓Can be given with food & milk to decrease GI
issues
Avoid beer, ale, & wine: may cause gout attack
Increase fluid intake: increases excretion of uric acid
Avoid smoked meats & high-protein diets
• Low dose of Colchicine -✓✓Low dose colchicine is 1.2mg followed by 0.6mg one hour
later or 1.8 milligrams total
• High dose of Colchicine -✓✓high dose colchicine is 1.2mg followed by 0.6mg every
four to six hours; or 4.8mg total.
• Difference between high dose and low dose Colchicine -✓✓The difference between
the two is low dose is as effective as high dose with a lower side effect profile.
• Lab values to monitor with Colchicine -✓✓Check renal function test, BUN, Creatine
• Patient education with Colchicine -✓✓Almost always causes some degree of diarrhea,
make sure patients are aware of this side effect
• Patient education with Febuxostat (Uloric) -✓✓Gout may worsen with therapy initially
• Dietary changes to decrease gout attacks and uric acid deposits. -✓✓Avoid beer, ale,
& wine
,Increase fluid intake: increases excretion of uric acid
Avoid smoked meats & high-protein diets
• WHO 3 step ladder for pain medication -✓✓
• What is not a first line for pain medication? -✓✓Narcotics
• Recommendations for pain treatment -✓✓You want to start with NSAIDs first and then
work your way up from there.
• types of Corticosteroid treatment -✓✓Prednisone, Cortisone, Dexamethasone
• how do Corticosteroids work? -✓✓Suppress the inflammatory & immune systems by
inhibiting the synthesis of chemical mediators.
• what are the chemical mediators that Corticosteroids work on? -✓✓Prostaglandins,
leukotrienes, & histamines
• Corticosteroids and inflammation -✓✓Decreases inflammation which decreases
swelling, warmth, redness, & pain.
• Uses for corticosteroid treatment -✓✓Addison's disease, hormone replacement,
cancer therapy
SLE, arthritis, IBD, & to suppress graft rejection
• contraindications for corticosteroid treatment -✓✓Systemic fungal infections & with live
vaccine
• Use corticosteroids cautiously with: -✓✓Pregnancy, kids, HTN, heart failure, renal
impairment, & with infections resistant to treatment
• Patient education with corticosteroids -✓✓Don't discontinue abruptly, doses may need
increased during stress, symptoms of Cushing's and GI bleeding
• Problem with taking Corticosteroids for greater than 6 months -✓✓The main thing you
want to worry about is osteoporosis it can also worsen diabetic control and patients
should report any tarry black stools or abdominal pain.
• Other common side effects with Corticosteroids -✓✓Peptic ulcers, GI bleeding, edema,
hyperglycemia, delayed wound healing, fluid & electrolyte imbalances
• Why is it important to tapper the corticosteroid? -✓✓Tapering must be done carefully
to avoid both recurrent activity of the underlying disease process and possible cortisol
, deficiency resulting from the hypothalamic-pituitary-adrenal axis or HPA suppression
during the period of steroid therapy
• Black box warning -✓✓Increased risk of serious cardiovascular thrombotic events,
myocardial-infarction and stroke which can be fatal.
• What increases risk of black box warning occurring with NSAIDs. -✓✓Risk increases
with duration of use.
Patients with cardiovascular disease or with risk factors for cardiovascular disease may
be a greater risk.
• NSAIDs and GI system -✓✓Increased risk of serious gastrointestinal adverse effects
including: bleeding, ulceration, and perforation the stomach or intestines can be fatal.
Can occur at any time during use and without warning symptoms. Elderly patients are at
greater risk for serious GI events.
• Ibuprofen and mechanism of action -✓✓Exact mechanism of action is unknown.
A non-selective cox-2 inhibitor in that it inhibits two isoforms of psychologic oxygenase
cox-1 and cox-2.
A non-selective inhibitor of cyclooxygenase, believed to be due to inhibition of cox-2
which decreases the synthesis of prostaglandins in mediating the inflammation pain,
fever, and swelling.
• Ibuprofen and antipyretic effects -✓✓Antipyretic effects may be due to action on the
hypothalamus resulting in an increase of peripheral blood flow, basil dilation, and
subsequent heat dissipation.
• Ibuprofen versus NSAIDs -✓✓The analgesic and antipyretic and anti-inflammatory
activity of NSAIDs appear to operate mainly through inhibition of cox-2. Resident
inhibition of cox-1 would be responsible for the unwanted effects on the GI tract.
Inhibition of cox-1 is thought to cause some of the side effects of ibuprofen including GI
ulceration like aspirin and indomethacin.
• Ibuprofen versus NSAIDs -✓✓like aspirin and indomethacin.
Ibuprofen is also a reversible inhibitor of the cox pathway. On the other hand, aspirin is
a non-reversible inhibitor of the cox pathway.
• cox enzyme pathway - Cyclooxygenase is: -✓✓the prostaglandin-endoperoxide
synthase (PTGS)
• Cyclooxygenase is the prostaglandin-endoperoxide synthase (PTGS)- what does it
do? -✓✓Inhibits the formation & release of prostaglandin.
PTGS converts arachidonic to PGH2 which is converted to other prostaglandins that
mediate pain, inflammation, & fever. PGH2 is also converted to thromboxane-A2 which
stimulates platelet aggregation leading to formation of blood clots.
and Answers | Updated Professional Prep
with Verified Answers | A+ Verified
• How do antigout medications work? -✓✓by inhibiting the infiltration and phagocytosis
of leukocytes, thus decreasing the breakdown of uric acid to urate crystals.
• Deposition of urate crystals causes -✓✓pain and inflammation
• What is Colchicine -✓✓anti-gout medication
• how does Colchicine work? -✓✓Works by inhibiting inflammation, reducing pain and
swelling
• common side effects of Colchicine -✓✓GI problems (diarrhea) use with caution in
elderly
Also can cause blood dyscrasias & abdominal pain
• patient education with Colchicine -✓✓Can be given with food & milk to decrease GI
issues
Avoid beer, ale, & wine: may cause gout attack
Increase fluid intake: increases excretion of uric acid
Avoid smoked meats & high-protein diets
• Low dose of Colchicine -✓✓Low dose colchicine is 1.2mg followed by 0.6mg one hour
later or 1.8 milligrams total
• High dose of Colchicine -✓✓high dose colchicine is 1.2mg followed by 0.6mg every
four to six hours; or 4.8mg total.
• Difference between high dose and low dose Colchicine -✓✓The difference between
the two is low dose is as effective as high dose with a lower side effect profile.
• Lab values to monitor with Colchicine -✓✓Check renal function test, BUN, Creatine
• Patient education with Colchicine -✓✓Almost always causes some degree of diarrhea,
make sure patients are aware of this side effect
• Patient education with Febuxostat (Uloric) -✓✓Gout may worsen with therapy initially
• Dietary changes to decrease gout attacks and uric acid deposits. -✓✓Avoid beer, ale,
& wine
,Increase fluid intake: increases excretion of uric acid
Avoid smoked meats & high-protein diets
• WHO 3 step ladder for pain medication -✓✓
• What is not a first line for pain medication? -✓✓Narcotics
• Recommendations for pain treatment -✓✓You want to start with NSAIDs first and then
work your way up from there.
• types of Corticosteroid treatment -✓✓Prednisone, Cortisone, Dexamethasone
• how do Corticosteroids work? -✓✓Suppress the inflammatory & immune systems by
inhibiting the synthesis of chemical mediators.
• what are the chemical mediators that Corticosteroids work on? -✓✓Prostaglandins,
leukotrienes, & histamines
• Corticosteroids and inflammation -✓✓Decreases inflammation which decreases
swelling, warmth, redness, & pain.
• Uses for corticosteroid treatment -✓✓Addison's disease, hormone replacement,
cancer therapy
SLE, arthritis, IBD, & to suppress graft rejection
• contraindications for corticosteroid treatment -✓✓Systemic fungal infections & with live
vaccine
• Use corticosteroids cautiously with: -✓✓Pregnancy, kids, HTN, heart failure, renal
impairment, & with infections resistant to treatment
• Patient education with corticosteroids -✓✓Don't discontinue abruptly, doses may need
increased during stress, symptoms of Cushing's and GI bleeding
• Problem with taking Corticosteroids for greater than 6 months -✓✓The main thing you
want to worry about is osteoporosis it can also worsen diabetic control and patients
should report any tarry black stools or abdominal pain.
• Other common side effects with Corticosteroids -✓✓Peptic ulcers, GI bleeding, edema,
hyperglycemia, delayed wound healing, fluid & electrolyte imbalances
• Why is it important to tapper the corticosteroid? -✓✓Tapering must be done carefully
to avoid both recurrent activity of the underlying disease process and possible cortisol
, deficiency resulting from the hypothalamic-pituitary-adrenal axis or HPA suppression
during the period of steroid therapy
• Black box warning -✓✓Increased risk of serious cardiovascular thrombotic events,
myocardial-infarction and stroke which can be fatal.
• What increases risk of black box warning occurring with NSAIDs. -✓✓Risk increases
with duration of use.
Patients with cardiovascular disease or with risk factors for cardiovascular disease may
be a greater risk.
• NSAIDs and GI system -✓✓Increased risk of serious gastrointestinal adverse effects
including: bleeding, ulceration, and perforation the stomach or intestines can be fatal.
Can occur at any time during use and without warning symptoms. Elderly patients are at
greater risk for serious GI events.
• Ibuprofen and mechanism of action -✓✓Exact mechanism of action is unknown.
A non-selective cox-2 inhibitor in that it inhibits two isoforms of psychologic oxygenase
cox-1 and cox-2.
A non-selective inhibitor of cyclooxygenase, believed to be due to inhibition of cox-2
which decreases the synthesis of prostaglandins in mediating the inflammation pain,
fever, and swelling.
• Ibuprofen and antipyretic effects -✓✓Antipyretic effects may be due to action on the
hypothalamus resulting in an increase of peripheral blood flow, basil dilation, and
subsequent heat dissipation.
• Ibuprofen versus NSAIDs -✓✓The analgesic and antipyretic and anti-inflammatory
activity of NSAIDs appear to operate mainly through inhibition of cox-2. Resident
inhibition of cox-1 would be responsible for the unwanted effects on the GI tract.
Inhibition of cox-1 is thought to cause some of the side effects of ibuprofen including GI
ulceration like aspirin and indomethacin.
• Ibuprofen versus NSAIDs -✓✓like aspirin and indomethacin.
Ibuprofen is also a reversible inhibitor of the cox pathway. On the other hand, aspirin is
a non-reversible inhibitor of the cox pathway.
• cox enzyme pathway - Cyclooxygenase is: -✓✓the prostaglandin-endoperoxide
synthase (PTGS)
• Cyclooxygenase is the prostaglandin-endoperoxide synthase (PTGS)- what does it
do? -✓✓Inhibits the formation & release of prostaglandin.
PTGS converts arachidonic to PGH2 which is converted to other prostaglandins that
mediate pain, inflammation, & fever. PGH2 is also converted to thromboxane-A2 which
stimulates platelet aggregation leading to formation of blood clots.
