Advanced Pharmacology Final Exam Review
A 75-year old patient is taking Timolol Maleate (Timpotic) for chronic open angle glaucoma and
is well controlled. What side effect might you watch for if Propanolol (Inderal) is added? -
ANS-Bradycardia.
A patient complains of "puffy feet" shortly after beginning a new medication three months ago.
There is no underlying physiological cause for this condition. What medication is most likely
causing the problem? - ANS-Amlodipine (Norvasc).
A patient is taking the ACEI Enalapril (Vasotec) for the last four months for the treatment of
congestive heart failure, and is complaining of a nonproductive cough. What should the NP
advise the patient regarding this side effect? - ANS-The cough should subside 1-4 days after
discontinuing the drug.
A patient presents with a history of GERD and many other medical conditions. What medication
would you encourage her to avoid? - ANS-NSAIDs.
Along with diet, what drug is used to treat hypertriglyceridemia? - ANS-Gemfibrozil (Lopid).
Amenorrhea is the most common side effect of which birth control medication? -
ANS-Medroxyprogesterone (Depo-Provera)
Can antacids cause diarrhea? - ANS-Yes, antacids containing magnesium, which decrease
bowel transit time, may cause diarrhea. Most often seen in renal insufficiency.
Heparin exerts its therapeutic action by what? - ANS-Upregulating the activity of one of the
body's natural anticoagulant molecules, antithrombin III
How are IV morphine and nitroglycerin beneficial in acute heart failure? - ANS-Decrease
preload.
How do antiprostaglandin drugs cause stomach mucosal injury? - ANS-They alter the thickness
of the protective mucosal layer.
How do Diphenoxylate (Lomotil) and Loperamide (Imodium) help relieve diarrhea? - ANS-They
decrease the motility of the ileum and colon, slowing the transit time and promoting more water
absorption.
How should an oral glucocorticoid be taken? - ANS-With food.
, Spironoaldactone (Aldactone) has what mechanism of action (MOA)? - ANS-Aldosterone
antagonist
The normal starting dose of levothyroxine is 50-100mcg per day for primary hypothroidism.
What is the most appropriate starting dose in a 71-year old female patient? - ANS-25mcg per
day.
What action is most effective in decreasing the risk of hyperkalemia associated with the start of
angiotensin-converting enzyme inhibitor (ACEI) therapy? - ANS-Making sure that the patient is
well hydrated.
What age-related changes place the elderly at risk for an exaggerated response to Warfarin
(Coumadin) and Heparin? - ANS-Protein binding changes and decrease in clotting factors.
What anithypertensive agent is safe during pregnancy? - ANS-Methyldopa (Aldomet).
What antimicrobial agent would be appropriate to prescribe in a 65-year old patient who
presents with a past medical history of coronary artery disease, a 101F temperature, and
tachypnea of 24 breaths per minute. Chest X-ray confirms a left lower lobe pneumonia. -
ANS-Levofloxacin (Levaquin).
What are some contrindications for HMG-co A reductase inhibitors (statins)? - ANS-They cause
myopathies, especially at higher doses or in combination with certain drugs. They should never
be used in patients taking Warfarin (Coumadin).
What are two systemic psoriasis medications? - ANS-Photo-therapy and topical corticosteroids
What direction would you give when prescribing Sucralfate (Carafate)? - ANS-The drug must be
taken on an empty stomach.
What do gastric parietal cells produce? - ANS-Hydrochloric acid.
What does a low level of thyroid-stimulating hormone indicate? - ANS-Hyperthroidism
What does the half-life of a medication determine? - ANS-How often the drug is to be
administered.
What drug can exacerbate the symptoms of GERD? - ANS-Verapamil (Calan).
What drug class exacerbates hyperglycemia? - ANS-Corticosteroids like Prednisone
(Deltasone).
What drug class should be avoided in patients with a diagnosis of osteopenia or osteoporosis? -
ANS-Clucocorticoids like Prednisone.
A 75-year old patient is taking Timolol Maleate (Timpotic) for chronic open angle glaucoma and
is well controlled. What side effect might you watch for if Propanolol (Inderal) is added? -
ANS-Bradycardia.
A patient complains of "puffy feet" shortly after beginning a new medication three months ago.
There is no underlying physiological cause for this condition. What medication is most likely
causing the problem? - ANS-Amlodipine (Norvasc).
A patient is taking the ACEI Enalapril (Vasotec) for the last four months for the treatment of
congestive heart failure, and is complaining of a nonproductive cough. What should the NP
advise the patient regarding this side effect? - ANS-The cough should subside 1-4 days after
discontinuing the drug.
A patient presents with a history of GERD and many other medical conditions. What medication
would you encourage her to avoid? - ANS-NSAIDs.
Along with diet, what drug is used to treat hypertriglyceridemia? - ANS-Gemfibrozil (Lopid).
Amenorrhea is the most common side effect of which birth control medication? -
ANS-Medroxyprogesterone (Depo-Provera)
Can antacids cause diarrhea? - ANS-Yes, antacids containing magnesium, which decrease
bowel transit time, may cause diarrhea. Most often seen in renal insufficiency.
Heparin exerts its therapeutic action by what? - ANS-Upregulating the activity of one of the
body's natural anticoagulant molecules, antithrombin III
How are IV morphine and nitroglycerin beneficial in acute heart failure? - ANS-Decrease
preload.
How do antiprostaglandin drugs cause stomach mucosal injury? - ANS-They alter the thickness
of the protective mucosal layer.
How do Diphenoxylate (Lomotil) and Loperamide (Imodium) help relieve diarrhea? - ANS-They
decrease the motility of the ileum and colon, slowing the transit time and promoting more water
absorption.
How should an oral glucocorticoid be taken? - ANS-With food.
, Spironoaldactone (Aldactone) has what mechanism of action (MOA)? - ANS-Aldosterone
antagonist
The normal starting dose of levothyroxine is 50-100mcg per day for primary hypothroidism.
What is the most appropriate starting dose in a 71-year old female patient? - ANS-25mcg per
day.
What action is most effective in decreasing the risk of hyperkalemia associated with the start of
angiotensin-converting enzyme inhibitor (ACEI) therapy? - ANS-Making sure that the patient is
well hydrated.
What age-related changes place the elderly at risk for an exaggerated response to Warfarin
(Coumadin) and Heparin? - ANS-Protein binding changes and decrease in clotting factors.
What anithypertensive agent is safe during pregnancy? - ANS-Methyldopa (Aldomet).
What antimicrobial agent would be appropriate to prescribe in a 65-year old patient who
presents with a past medical history of coronary artery disease, a 101F temperature, and
tachypnea of 24 breaths per minute. Chest X-ray confirms a left lower lobe pneumonia. -
ANS-Levofloxacin (Levaquin).
What are some contrindications for HMG-co A reductase inhibitors (statins)? - ANS-They cause
myopathies, especially at higher doses or in combination with certain drugs. They should never
be used in patients taking Warfarin (Coumadin).
What are two systemic psoriasis medications? - ANS-Photo-therapy and topical corticosteroids
What direction would you give when prescribing Sucralfate (Carafate)? - ANS-The drug must be
taken on an empty stomach.
What do gastric parietal cells produce? - ANS-Hydrochloric acid.
What does a low level of thyroid-stimulating hormone indicate? - ANS-Hyperthroidism
What does the half-life of a medication determine? - ANS-How often the drug is to be
administered.
What drug can exacerbate the symptoms of GERD? - ANS-Verapamil (Calan).
What drug class exacerbates hyperglycemia? - ANS-Corticosteroids like Prednisone
(Deltasone).
What drug class should be avoided in patients with a diagnosis of osteopenia or osteoporosis? -
ANS-Clucocorticoids like Prednisone.
