NR 567 ADVANCED PHARM MIDTERM EXAM GUIDE ACTUAL EXAM COMPLETE 200
QUESTIONS WITH DETAILED VERIFIED ANSWERS (100% CORRECT ANSWERS)
/ALREADY GRADED A+
What is the mechanism of action of thrombolytics like alteplase?
They bind with plasminogen to form an active complex that converts plasminogen to plasmin,
which digests the fibrin meshwork of clots.
What is a major side effect of thrombolytics?
Bleeding, including the risk of intracranial hemorrhage.
What are some contraindications for using thrombolytics?
Prior intracranial hemorrhage, recent ischemic strokes, severe uncontrolled hypertension, recent
major surgery, and active internal bleeding.
What laboratory parameters should be monitored when administering thrombolytics?
CBC, PT/INR, and PTT.
What is the recommended dosing for alteplase in acute myocardial infarction (MI)?
100 mg total: 15 mg IV bolus, 50 mg over 30 minutes, and 35 mg over 60 minutes.
What is the bioavailability of alteplase when administered IV?
100% due to IV administration.
How is alteplase metabolized?
Rapid hepatic clearance, mainly by the liver through internalization and catabolism by hepatic
cells.
What is the initial elimination half-life of alteplase?
About 5 minutes (rapid plasma clearance).
What is the terminal elimination half-life of alteplase?
About 35-50 minutes (slower elimination).
What is the mechanism of action of statins like lovastatin?
Statins inhibit HMG-CoA reductase in the liver, reducing cholesterol synthesis and lowering
LDL cholesterol levels.
What are the medications used in acute pulmonary embolism?
Heparin and alteplase (Activase).
What is the recommended dosage of alteplase for pulmonary embolism?
, 2
100 mg infused IV over 2 hours.
What are the side effects and adverse effects of thrombolytics?
Bleeding, including major bleeding risks and intracranial hemorrhage.
What precautions should be taken when administering thrombolytics?
Monitor for contraindications such as prior intracranial hemorrhage and active internal bleeding.
What is the route of administration for alteplase?
IV only.
What is the significance of monitoring coagulation parameters in patients receiving
thrombolytics?
To assess bleeding risk and ensure safe administration.
What is the pharmacokinetic property of alteplase regarding its distribution?
It is mostly distributed in plasma.
What are the key concepts to remember regarding drug classes in this course?
Know the drug class and individual generic drug names, mechanisms of action,
pharmacokinetics, side effects, and contraindications.
What is the time frame for monitoring after administering thrombolytics?
Continuous monitoring for signs of bleeding and changes in coagulation parameters.
What is the importance of understanding pharmacodynamics in drug administration?
It helps predict how the drug affects the body and informs safe and effective dosing.
What is the primary use of statins after myocardial infarction (MI)?
To reduce the risk of death, recurrent myocardial infarction, and thromboembolic events such as
stroke or systemic embolization.
What are the potential side effects of statins?
Hepatotoxicity, myopathy, and rhabdomyolysis.
What does hepatotoxicity indicate in patients taking statins?
Increased liver enzymes indicating potential liver damage.
What should be monitored to assess muscle breakdown in patients on statins?
, 3
CK lab values.
What precautions should be taken before starting statin treatment?
Perform liver function tests prior to initiating treatment and when clinically indicated.
Why should statins be used cautiously in elderly clients?
Due to an increased risk of muscle-related side effects.
What specific consideration should be made for clients of Asian descent regarding statin
use?
Certain statins, particularly rosuvastatin, may cause toxicity due to altered metabolism.
What drug interactions should be considered when prescribing statins?
Combining statins with other lipid-lowering medications increases the risk of myopathy and
hepatotoxicity.
Which enzyme metabolizes statins, and what can inhibit it?
CYP3A4; drugs and foods like grapefruit juice, macrolide antibiotics, azole antifungals, and
amiodarone can inhibit it.
When is evening administration of statins commonly recommended?
Due to the body's natural rhythm of cholesterol production.
What should be monitored in patients taking statins?
LFTs, CK, lipid profiles, and BMP for kidney function.
What are the two types of beta-blockers mentioned?
Non-selective (e.g., propranolol) and selective (e.g., metoprolol) beta-blockers.
What is the mechanism of action (MOA) of nitrates?
Nitrates relax vascular smooth muscle through conversion to nitric oxide, causing venous and
arterial dilation.
What is the primary use of nitrates in clinical practice?
For relief of angina symptoms and prophylaxis of angina pectoris in clients with stable angina.
What are common side effects of nitrates?
Headache, reflex tachycardia, and orthostatic hypotension.
What precautions should be taken when using nitrates?
QUESTIONS WITH DETAILED VERIFIED ANSWERS (100% CORRECT ANSWERS)
/ALREADY GRADED A+
What is the mechanism of action of thrombolytics like alteplase?
They bind with plasminogen to form an active complex that converts plasminogen to plasmin,
which digests the fibrin meshwork of clots.
What is a major side effect of thrombolytics?
Bleeding, including the risk of intracranial hemorrhage.
What are some contraindications for using thrombolytics?
Prior intracranial hemorrhage, recent ischemic strokes, severe uncontrolled hypertension, recent
major surgery, and active internal bleeding.
What laboratory parameters should be monitored when administering thrombolytics?
CBC, PT/INR, and PTT.
What is the recommended dosing for alteplase in acute myocardial infarction (MI)?
100 mg total: 15 mg IV bolus, 50 mg over 30 minutes, and 35 mg over 60 minutes.
What is the bioavailability of alteplase when administered IV?
100% due to IV administration.
How is alteplase metabolized?
Rapid hepatic clearance, mainly by the liver through internalization and catabolism by hepatic
cells.
What is the initial elimination half-life of alteplase?
About 5 minutes (rapid plasma clearance).
What is the terminal elimination half-life of alteplase?
About 35-50 minutes (slower elimination).
What is the mechanism of action of statins like lovastatin?
Statins inhibit HMG-CoA reductase in the liver, reducing cholesterol synthesis and lowering
LDL cholesterol levels.
What are the medications used in acute pulmonary embolism?
Heparin and alteplase (Activase).
What is the recommended dosage of alteplase for pulmonary embolism?
, 2
100 mg infused IV over 2 hours.
What are the side effects and adverse effects of thrombolytics?
Bleeding, including major bleeding risks and intracranial hemorrhage.
What precautions should be taken when administering thrombolytics?
Monitor for contraindications such as prior intracranial hemorrhage and active internal bleeding.
What is the route of administration for alteplase?
IV only.
What is the significance of monitoring coagulation parameters in patients receiving
thrombolytics?
To assess bleeding risk and ensure safe administration.
What is the pharmacokinetic property of alteplase regarding its distribution?
It is mostly distributed in plasma.
What are the key concepts to remember regarding drug classes in this course?
Know the drug class and individual generic drug names, mechanisms of action,
pharmacokinetics, side effects, and contraindications.
What is the time frame for monitoring after administering thrombolytics?
Continuous monitoring for signs of bleeding and changes in coagulation parameters.
What is the importance of understanding pharmacodynamics in drug administration?
It helps predict how the drug affects the body and informs safe and effective dosing.
What is the primary use of statins after myocardial infarction (MI)?
To reduce the risk of death, recurrent myocardial infarction, and thromboembolic events such as
stroke or systemic embolization.
What are the potential side effects of statins?
Hepatotoxicity, myopathy, and rhabdomyolysis.
What does hepatotoxicity indicate in patients taking statins?
Increased liver enzymes indicating potential liver damage.
What should be monitored to assess muscle breakdown in patients on statins?
, 3
CK lab values.
What precautions should be taken before starting statin treatment?
Perform liver function tests prior to initiating treatment and when clinically indicated.
Why should statins be used cautiously in elderly clients?
Due to an increased risk of muscle-related side effects.
What specific consideration should be made for clients of Asian descent regarding statin
use?
Certain statins, particularly rosuvastatin, may cause toxicity due to altered metabolism.
What drug interactions should be considered when prescribing statins?
Combining statins with other lipid-lowering medications increases the risk of myopathy and
hepatotoxicity.
Which enzyme metabolizes statins, and what can inhibit it?
CYP3A4; drugs and foods like grapefruit juice, macrolide antibiotics, azole antifungals, and
amiodarone can inhibit it.
When is evening administration of statins commonly recommended?
Due to the body's natural rhythm of cholesterol production.
What should be monitored in patients taking statins?
LFTs, CK, lipid profiles, and BMP for kidney function.
What are the two types of beta-blockers mentioned?
Non-selective (e.g., propranolol) and selective (e.g., metoprolol) beta-blockers.
What is the mechanism of action (MOA) of nitrates?
Nitrates relax vascular smooth muscle through conversion to nitric oxide, causing venous and
arterial dilation.
What is the primary use of nitrates in clinical practice?
For relief of angina symptoms and prophylaxis of angina pectoris in clients with stable angina.
What are common side effects of nitrates?
Headache, reflex tachycardia, and orthostatic hypotension.
What precautions should be taken when using nitrates?
