NSG 533 Advanced Pharmacology Exams EXAM fully
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Terms in this set (86)
,EP is a 38-year-old female patient that comes in for Exenatide - Exenatide (Bydureon) once weekly has been able to demonstrate
diabetes education and management. She was weight loss and decrease A1C% by 0.7% to 1.2% in clinical trials; however it is
diagnosed 12 years ago and states lately she is not able contraindicated for EP due to the self-reported history of thyroid cancer.
to control her diet although she continues a 1600 Dapagliflozin - Dapagliflozin (Farxiga) is contraindicated in this patient due to
calorie diet with appropriate daily carbohydrate intake hyperkalemia which could be made worse by this drug. The package insert
(per dietitian prescription) and walks 40 minutes every does not indicate a specific potassium concentration cut off to no longer use
day of the week. She states compliance with all this medication; however, there are better choices in this patient.
medications. She denies any history of hypoglycemia Sitagliptin - Sitagliptin (Januvia) is able to obtain an A1C goal of less than 7%
despite being able to identify signs and symptoms and based on clinical trials and currently the patient does not have any cautionary
describe appropriate treatment strategies. objective measures to not use this medication. DPP-IV inhibitors are weight
PMH: T2DM, HTN, obesity, depression, s/p neutral. DPP-IV inhibitors can be used in patients taking sulfonylureas; however,
thyroidectomy due to thyroid cancer it may be recommended to reduce or stop the sulfonylurea dose.
FmHx: Noncontributory Acarbose - Acarbose (Precose) is not recommended for initial management
SHx: (−) Smoking, alcohol use, past marijuana use while and is associated with significant GI side effects. More information would be
in high school needed regarding fasting and post-prandial numbers. In addition, adding
Medications: Metformin 850 mg tid, glipizide 20 mg acarbose would only lower A1c by 0.8% at best and therefore would not
bid, lisinopril 20 mg daily, sertraline 100 mg daily, achieve the desired A1C goal of <7%
multivitamin daily
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
Laboratory test results: Na 134 mEq/L, K 5.4 mEq/L, Cl
106 mEq/L, BUN
JR is a 68-year-old African American man with a new Metformin is the drug of choice recommended for most patients with diabetes
diagnosis of T2DM. He was classified as having in addition to lifestyle modifications assuming no contraindications or
prediabetes (at risk for developing diabetes) 5 years intolerabilities are present upon evaluation. Metformin has also shown to
before the diagnosis and has a strong family history of provide positive weight neutral/loss effects in obese patients. It is crucial to
type 2 diabetes. JR's blood pressure was 150/92 mm Hg. know the renal status of patients commencing metformin therapy to limit the
His laboratory results revealed an A1C of 8.1%, normal risk of lactic acidosis (JR is without contraindication).
cholesterol panel, and normal renal/hepatic function Since his entry A1C is >7.5%, dual therapy is indicated. There are several
were noted with today's laboratory test results. potential choices. The second step can be a dipeptidyl peptidase-4 inhibitor, it
Past medical history: Hypertension (diagnosed 4 y ago) can be a glucagon-like peptide-1 (GLP-1) receptor agonist, it can be a TZD, it
Hyperlipidemia (diagnosed 2 y ago) Pancreatitis can be a sulfonylurea agent, it can be a SGLT2 inhibitor, or it could be basal
(idiopathic) (acute hospitalization 3 y ago) insulin. Anything next can be tried depending on what suits the circumstance
Family history: Type 2 diabetes DPP4 inhibitors are weight neutral bet relatively benign side effect profile.
Medication: HCTZ 25 mg daily, simvastatin 10 mg daily Sitagliptin has been associated with case reports of pancreatitis, so this specific
Allergies: SMZ/TMP agent should be avoided. $$$
Vitals: BP: 150/92 mm Hg P: 78 beats/min RR: 12 rpm GLP-1 analog and has data to support an A1C reduction necessary to gain
Waist Circumference: 46 in Weight: 267 lb Height: 5 ′ 6 ″ glycemic control and may assist with weight loss goals for this patient. New
BMI: 43.1 kg/m 2 information suggests these agents may provide benefits in those with ASCVD.
JR has a past history of pancreatitis and GLP-1 analogs are not recommended
due to this contraindication
Despite improvements in the past six weeks due to TZDs have data to support an A1C reduction necessary to gain glycemic
lifestyle changes and exercise, drug therapy is to be control, but are associated with weight gain, negative effects on lipids and
started for JR's diabet increased risk of fracture. Until recently, TZDs have also been linked to
increased CV events and use has fallen out of favor
Sulfonylureas provide excellent A1C lowering, but are also associated with
weight gain. They also have the potential to cause hypoglycemia, so patient
education is crucial. Because of his allergies to "sulfa", use would be contr
A patient with type 1 diabetes reports taking A patient with Type 1 DM is insulin dependent for glucose control and at high
propranolol for hypertension. What concern does this risk for hypoglycemic episodes. Propanolol causes prolonged hypoglycemic
information present for the provider? episodes. Needs to switch to ACE or ARB.
, A provider teaches a patient who has been diagnosed D. Calcium may reduce levothyroxine absorption. Further education is needed
with hypothyroidism about a new prescription for if the patient feels she can take half of a prescribed medication.
levothyroxine. Which statement by the patient indicates
a need for further teaching?
a. "I should not take heartburn medication without
consulting my provider first."
b. "I should report insomnia, tremors, and an increased
heart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4
hours after the levothyroxine."
d. "If I take calcium supplements, I may need to
decrease my dose of levothyroxine."
MC has undiagnosed multiple gastric ulcers. Shortly I would accept Alka-Selzer. I contains NaHCO3 (as well as ASA). In the
after consuming a large meal and alcohol he presence of HCL it Liberates CO2, that can cause gastric distention, belching
experiences significant GI distress. He takes an OTC and nausea. The reaction is fairly swift allowing little time for dissipation. Tums,
heartburn remedy. Within a minute or two he develops its primary ingredient calcium carbonate which when taken cause a reaction
what he will later describe as "belching, nausea and a with the stomach acid such as production of carbon dioxide gas which can
bad bloated feeling". Several of the ulcers began to cause bloating and the stomach to stretch to tear the ulcers open.
bleed and he becomes profoundly hypotensive from
the blood loss and is taken to the ED. Endoscopy
confirms multiple bleeds; the endoscopist remarks that
it appears as if the lesions had been literally stretched
apart causing additional tissue damage. What did the
patient most likely take (i.e. what was the OTC remedy)?
On your way to this examination, you experience the Loperamide
vulnerable feeling that an attack of acute diarrhea is
imminent! If you stop at a drug store, which anti-
diarrheal drugs could you buy without a prescription
even though it is chemically related to the strong
opioid analgesic meperidine (but acts only on the
peripheral opioid receptor)?
JA has multiple medical problems and is taking several Cimetidine
drugs including theophylline, warfarin and phenytoin.
His conditions were well controlled, but recently he
started to experience some GI distress for which of his
"well intentioned friends" gave him some medication.
He presents to you with toxic effects of all his other
medications and plasma levels of those medications
elevated. What was most likely the medication he took?
What lifestyle modifications should be recommended? -losing weight if overweight
-elevating head of bed while asleep
-eating smaller meals
-avoid foods/meds that exacerbate gerd
-stop smoking
-stop drinking alcohol
What medications / foods can contribute to GERD? -Medications: anticholinergics, barbituates, dopamine, estrogen, opioids,
progesterone, theophylline, nitrates
-Foods: cirus fruits/juices, coffee, tomatoes, spicy food, carbonated drinks
Fried/fatty foods, garlic, onions, chocolate
solved & updated 2026(latest version verified for
accuracy) | 2026 Latest!! Advanced Pharmacology NSG
533
Leave the first rating
Play your way to mastery with fun games
Match Blocks Charms NEW
Students also studied
Flashcard sets Study guides
NSG 533 Advanced Pharm Exam 1 NSG 533 Opioid Quiz NSG 533 Advanced Pharmacology ... Ad
275 terms 24 terms 94 terms 22
amanda_peters68 Preview blazierose Preview ChristopherJ114 Preview
Terms in this set (86)
,EP is a 38-year-old female patient that comes in for Exenatide - Exenatide (Bydureon) once weekly has been able to demonstrate
diabetes education and management. She was weight loss and decrease A1C% by 0.7% to 1.2% in clinical trials; however it is
diagnosed 12 years ago and states lately she is not able contraindicated for EP due to the self-reported history of thyroid cancer.
to control her diet although she continues a 1600 Dapagliflozin - Dapagliflozin (Farxiga) is contraindicated in this patient due to
calorie diet with appropriate daily carbohydrate intake hyperkalemia which could be made worse by this drug. The package insert
(per dietitian prescription) and walks 40 minutes every does not indicate a specific potassium concentration cut off to no longer use
day of the week. She states compliance with all this medication; however, there are better choices in this patient.
medications. She denies any history of hypoglycemia Sitagliptin - Sitagliptin (Januvia) is able to obtain an A1C goal of less than 7%
despite being able to identify signs and symptoms and based on clinical trials and currently the patient does not have any cautionary
describe appropriate treatment strategies. objective measures to not use this medication. DPP-IV inhibitors are weight
PMH: T2DM, HTN, obesity, depression, s/p neutral. DPP-IV inhibitors can be used in patients taking sulfonylureas; however,
thyroidectomy due to thyroid cancer it may be recommended to reduce or stop the sulfonylurea dose.
FmHx: Noncontributory Acarbose - Acarbose (Precose) is not recommended for initial management
SHx: (−) Smoking, alcohol use, past marijuana use while and is associated with significant GI side effects. More information would be
in high school needed regarding fasting and post-prandial numbers. In addition, adding
Medications: Metformin 850 mg tid, glipizide 20 mg acarbose would only lower A1c by 0.8% at best and therefore would not
bid, lisinopril 20 mg daily, sertraline 100 mg daily, achieve the desired A1C goal of <7%
multivitamin daily
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
Laboratory test results: Na 134 mEq/L, K 5.4 mEq/L, Cl
106 mEq/L, BUN
JR is a 68-year-old African American man with a new Metformin is the drug of choice recommended for most patients with diabetes
diagnosis of T2DM. He was classified as having in addition to lifestyle modifications assuming no contraindications or
prediabetes (at risk for developing diabetes) 5 years intolerabilities are present upon evaluation. Metformin has also shown to
before the diagnosis and has a strong family history of provide positive weight neutral/loss effects in obese patients. It is crucial to
type 2 diabetes. JR's blood pressure was 150/92 mm Hg. know the renal status of patients commencing metformin therapy to limit the
His laboratory results revealed an A1C of 8.1%, normal risk of lactic acidosis (JR is without contraindication).
cholesterol panel, and normal renal/hepatic function Since his entry A1C is >7.5%, dual therapy is indicated. There are several
were noted with today's laboratory test results. potential choices. The second step can be a dipeptidyl peptidase-4 inhibitor, it
Past medical history: Hypertension (diagnosed 4 y ago) can be a glucagon-like peptide-1 (GLP-1) receptor agonist, it can be a TZD, it
Hyperlipidemia (diagnosed 2 y ago) Pancreatitis can be a sulfonylurea agent, it can be a SGLT2 inhibitor, or it could be basal
(idiopathic) (acute hospitalization 3 y ago) insulin. Anything next can be tried depending on what suits the circumstance
Family history: Type 2 diabetes DPP4 inhibitors are weight neutral bet relatively benign side effect profile.
Medication: HCTZ 25 mg daily, simvastatin 10 mg daily Sitagliptin has been associated with case reports of pancreatitis, so this specific
Allergies: SMZ/TMP agent should be avoided. $$$
Vitals: BP: 150/92 mm Hg P: 78 beats/min RR: 12 rpm GLP-1 analog and has data to support an A1C reduction necessary to gain
Waist Circumference: 46 in Weight: 267 lb Height: 5 ′ 6 ″ glycemic control and may assist with weight loss goals for this patient. New
BMI: 43.1 kg/m 2 information suggests these agents may provide benefits in those with ASCVD.
JR has a past history of pancreatitis and GLP-1 analogs are not recommended
due to this contraindication
Despite improvements in the past six weeks due to TZDs have data to support an A1C reduction necessary to gain glycemic
lifestyle changes and exercise, drug therapy is to be control, but are associated with weight gain, negative effects on lipids and
started for JR's diabet increased risk of fracture. Until recently, TZDs have also been linked to
increased CV events and use has fallen out of favor
Sulfonylureas provide excellent A1C lowering, but are also associated with
weight gain. They also have the potential to cause hypoglycemia, so patient
education is crucial. Because of his allergies to "sulfa", use would be contr
A patient with type 1 diabetes reports taking A patient with Type 1 DM is insulin dependent for glucose control and at high
propranolol for hypertension. What concern does this risk for hypoglycemic episodes. Propanolol causes prolonged hypoglycemic
information present for the provider? episodes. Needs to switch to ACE or ARB.
, A provider teaches a patient who has been diagnosed D. Calcium may reduce levothyroxine absorption. Further education is needed
with hypothyroidism about a new prescription for if the patient feels she can take half of a prescribed medication.
levothyroxine. Which statement by the patient indicates
a need for further teaching?
a. "I should not take heartburn medication without
consulting my provider first."
b. "I should report insomnia, tremors, and an increased
heart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4
hours after the levothyroxine."
d. "If I take calcium supplements, I may need to
decrease my dose of levothyroxine."
MC has undiagnosed multiple gastric ulcers. Shortly I would accept Alka-Selzer. I contains NaHCO3 (as well as ASA). In the
after consuming a large meal and alcohol he presence of HCL it Liberates CO2, that can cause gastric distention, belching
experiences significant GI distress. He takes an OTC and nausea. The reaction is fairly swift allowing little time for dissipation. Tums,
heartburn remedy. Within a minute or two he develops its primary ingredient calcium carbonate which when taken cause a reaction
what he will later describe as "belching, nausea and a with the stomach acid such as production of carbon dioxide gas which can
bad bloated feeling". Several of the ulcers began to cause bloating and the stomach to stretch to tear the ulcers open.
bleed and he becomes profoundly hypotensive from
the blood loss and is taken to the ED. Endoscopy
confirms multiple bleeds; the endoscopist remarks that
it appears as if the lesions had been literally stretched
apart causing additional tissue damage. What did the
patient most likely take (i.e. what was the OTC remedy)?
On your way to this examination, you experience the Loperamide
vulnerable feeling that an attack of acute diarrhea is
imminent! If you stop at a drug store, which anti-
diarrheal drugs could you buy without a prescription
even though it is chemically related to the strong
opioid analgesic meperidine (but acts only on the
peripheral opioid receptor)?
JA has multiple medical problems and is taking several Cimetidine
drugs including theophylline, warfarin and phenytoin.
His conditions were well controlled, but recently he
started to experience some GI distress for which of his
"well intentioned friends" gave him some medication.
He presents to you with toxic effects of all his other
medications and plasma levels of those medications
elevated. What was most likely the medication he took?
What lifestyle modifications should be recommended? -losing weight if overweight
-elevating head of bed while asleep
-eating smaller meals
-avoid foods/meds that exacerbate gerd
-stop smoking
-stop drinking alcohol
What medications / foods can contribute to GERD? -Medications: anticholinergics, barbituates, dopamine, estrogen, opioids,
progesterone, theophylline, nitrates
-Foods: cirus fruits/juices, coffee, tomatoes, spicy food, carbonated drinks
Fried/fatty foods, garlic, onions, chocolate
