NURS 615 2027 Exam 3 Questions and Answers
Question 1.
corticosteroid drugs
Correct Answer: prednisone, methylprednisolone, dexamethasone, topical
such as hydrocortisone, and then joint injections for pain
Question 2.
MOA of corticosteroids drugs
Correct Answer: drugs that suppress inflammation by mimicking
glucocorticoid hormones
Inhibit interleikin one, tumor necrosis factor and other cytokines, impairs
phagocytosis, impairs lymphocytes, and inhibits tissue repair
Question 3.
indications for cortocosteriod use
Correct Answer: Allergy or hypersensitivity, respiratory, shock, rheumatology,
neurology, hepatic, neoplastic... basicly every organ is covered if there is an
issue.
Question 4.
withdrawal from corticorsteriod symptoms
Correct Answer: malaise, myalgia, headache, nausea, fevers, hypotension and
relapse of symptoms (pain, inflammation, ashtma)
Question 5.
what must you do with corticosteriods to prevent withdrawal
Correct Answer: Must taper them down, you can have possible adrenal crisis if
you do not.
Question 6.
corticosteriod considerations
Correct Answer: suppression patients response to infections- no live viral
vaccines, and have increased susceptibility to disease.
If used over 6 months: Increase blood glucose, impair immune function (get
vaccines) , impair wound healing, GI complaints (report black tarry stools) ,
osteoporosis (decreases calcium), anxiety/insomnia, sodium & fluid retention
9monitor weight and fluid retention)
If on 1gram or more also prescribe PPI (omeprazole) to prevent PUD
contraindicated with active infection and hypersensitivity
,Question 7.
What are the adverse effects of corticosteroids if administered for six months or more?
Correct Answer: The main thing you want to worry about is osteoporosis
It can also worsen diabetic control
Patients should report any tarry black stools or abdominal pain.
Question 8.
NSAIDS
Correct Answer: nonsteroidal anti-inflammatory drugs
Ibprofen, aspirin, torsdol, naproxin, Mobic
Question 9.
Arachidonic Acid Cascade
Correct Answer: Cell membrane ► Arachinidonic acid ► Cycloxygenerase
(COX)► prostaglandin's
Or
Cell membrane ► Arachinidonic acid ► Lipoxygenase► Leukotrines
Question 10.
NSAID mechanism of action
Correct Answer: • NSAIDs inhibit the enzymes COX I and II
• Results in reduction in formation of prostaglandin precursors and
thromboxanes from arachidonic acid
COX1- ibuprofen, naproxen, aspirin, when this is inhibited you are also
inhibiting the prostaglandins that protect the stomach
COX2 - celebrex more stomach proctective
Question 11.
Drug interactions with NSAIDS
Correct Answer: Pretty much anything that is highly protien bound. Do not
give together with
ACE inhibitors - counteracts antihypertensive effect
BetaBlockers - counteracts antihypertensive effect
lithium - increases lithium levels
Anticoagulants - increases bleeding
Antidiabetics- increases hypoglycemic effect
Question 12.
Black box warning for NSAIDS
,Correct Answer: May cause an increased risk of serious cardiovascular
thrombotic events:
Question 13.
Patients with cardiovascular disease or with risk factors for cardiovascular disease may
be a greater risk. **
Question 14.
Myocardial-infarction
Question 15.
Stroke which can be fatal.**
•This risk may increase with duration of use.
NSAIDs can also cause an increased risk of serious gastrointestinal adverse effects
including
Question 16.
Bleeding**
Question 17.
Ulceration
Question 18.
Perforation the stomach or intestines which can be fatal.
Question 19.
These events can occur at any time during use and without warning symptoms.
Question 20.
Elderly patients are at greater risk for serious GI events.
Question 21.
Tylenol
Correct Answer: non opioid, non NSAID analgesic
treatment for mild pain and fever, has no anti- inflammatory properties
The main mechanism is performed a proposed is the inhibition of cox.
And recent findings suggest that it's highly selective cox-2.
Because of its selectivity for cox-2 it does not significantly inhibit the
production of pro clotting thromboxanes.
, Question 22.
Tylenol warnings
Correct Answer: Acute overdoses of acetaminophen can cause potentially fatal
liver damage.
**The maximum recommended dose is 3 grams in 24 hours.
Question 23.
DMARDs (disease modifying anti-rheumatic drugs)
Correct Answer: Methotrexate Folic acid antagonist- slows the disease process
by inhibiting DNA synthesis and cell reproduction
causes hepatotoxicity leukopenia, anemia
has tons of drug interations
Question 24.
Drugs for Gout
Correct Answer: allopurinol (Zyloprim), colchicine, and febuxostat (Uloric)
Question 25.
Gout patient teaching
Correct Answer: Decrease alcohol and organ meat, dish and bacon in diet
Question 26.
Allopirinol MOA
Correct Answer: Prevents formation of uric acid by inhibiting xanthine oxidase
Question 27.
Allopirinol considerations
Correct Answer: Monitor renal and liver tests prior to administration,
drowsiness/dizzyness can occur
Question 28.
Febuxostat (Uloric) MOA
Correct Answer: inhibit synthesis of uric acid by inhibiting xanthine oxidase
conversion of hypoxanthine & xanthine to uric acid
Question 29.
Febuxostat (Uloric) considerations
Question 1.
corticosteroid drugs
Correct Answer: prednisone, methylprednisolone, dexamethasone, topical
such as hydrocortisone, and then joint injections for pain
Question 2.
MOA of corticosteroids drugs
Correct Answer: drugs that suppress inflammation by mimicking
glucocorticoid hormones
Inhibit interleikin one, tumor necrosis factor and other cytokines, impairs
phagocytosis, impairs lymphocytes, and inhibits tissue repair
Question 3.
indications for cortocosteriod use
Correct Answer: Allergy or hypersensitivity, respiratory, shock, rheumatology,
neurology, hepatic, neoplastic... basicly every organ is covered if there is an
issue.
Question 4.
withdrawal from corticorsteriod symptoms
Correct Answer: malaise, myalgia, headache, nausea, fevers, hypotension and
relapse of symptoms (pain, inflammation, ashtma)
Question 5.
what must you do with corticosteriods to prevent withdrawal
Correct Answer: Must taper them down, you can have possible adrenal crisis if
you do not.
Question 6.
corticosteriod considerations
Correct Answer: suppression patients response to infections- no live viral
vaccines, and have increased susceptibility to disease.
If used over 6 months: Increase blood glucose, impair immune function (get
vaccines) , impair wound healing, GI complaints (report black tarry stools) ,
osteoporosis (decreases calcium), anxiety/insomnia, sodium & fluid retention
9monitor weight and fluid retention)
If on 1gram or more also prescribe PPI (omeprazole) to prevent PUD
contraindicated with active infection and hypersensitivity
,Question 7.
What are the adverse effects of corticosteroids if administered for six months or more?
Correct Answer: The main thing you want to worry about is osteoporosis
It can also worsen diabetic control
Patients should report any tarry black stools or abdominal pain.
Question 8.
NSAIDS
Correct Answer: nonsteroidal anti-inflammatory drugs
Ibprofen, aspirin, torsdol, naproxin, Mobic
Question 9.
Arachidonic Acid Cascade
Correct Answer: Cell membrane ► Arachinidonic acid ► Cycloxygenerase
(COX)► prostaglandin's
Or
Cell membrane ► Arachinidonic acid ► Lipoxygenase► Leukotrines
Question 10.
NSAID mechanism of action
Correct Answer: • NSAIDs inhibit the enzymes COX I and II
• Results in reduction in formation of prostaglandin precursors and
thromboxanes from arachidonic acid
COX1- ibuprofen, naproxen, aspirin, when this is inhibited you are also
inhibiting the prostaglandins that protect the stomach
COX2 - celebrex more stomach proctective
Question 11.
Drug interactions with NSAIDS
Correct Answer: Pretty much anything that is highly protien bound. Do not
give together with
ACE inhibitors - counteracts antihypertensive effect
BetaBlockers - counteracts antihypertensive effect
lithium - increases lithium levels
Anticoagulants - increases bleeding
Antidiabetics- increases hypoglycemic effect
Question 12.
Black box warning for NSAIDS
,Correct Answer: May cause an increased risk of serious cardiovascular
thrombotic events:
Question 13.
Patients with cardiovascular disease or with risk factors for cardiovascular disease may
be a greater risk. **
Question 14.
Myocardial-infarction
Question 15.
Stroke which can be fatal.**
•This risk may increase with duration of use.
NSAIDs can also cause an increased risk of serious gastrointestinal adverse effects
including
Question 16.
Bleeding**
Question 17.
Ulceration
Question 18.
Perforation the stomach or intestines which can be fatal.
Question 19.
These events can occur at any time during use and without warning symptoms.
Question 20.
Elderly patients are at greater risk for serious GI events.
Question 21.
Tylenol
Correct Answer: non opioid, non NSAID analgesic
treatment for mild pain and fever, has no anti- inflammatory properties
The main mechanism is performed a proposed is the inhibition of cox.
And recent findings suggest that it's highly selective cox-2.
Because of its selectivity for cox-2 it does not significantly inhibit the
production of pro clotting thromboxanes.
, Question 22.
Tylenol warnings
Correct Answer: Acute overdoses of acetaminophen can cause potentially fatal
liver damage.
**The maximum recommended dose is 3 grams in 24 hours.
Question 23.
DMARDs (disease modifying anti-rheumatic drugs)
Correct Answer: Methotrexate Folic acid antagonist- slows the disease process
by inhibiting DNA synthesis and cell reproduction
causes hepatotoxicity leukopenia, anemia
has tons of drug interations
Question 24.
Drugs for Gout
Correct Answer: allopurinol (Zyloprim), colchicine, and febuxostat (Uloric)
Question 25.
Gout patient teaching
Correct Answer: Decrease alcohol and organ meat, dish and bacon in diet
Question 26.
Allopirinol MOA
Correct Answer: Prevents formation of uric acid by inhibiting xanthine oxidase
Question 27.
Allopirinol considerations
Correct Answer: Monitor renal and liver tests prior to administration,
drowsiness/dizzyness can occur
Question 28.
Febuxostat (Uloric) MOA
Correct Answer: inhibit synthesis of uric acid by inhibiting xanthine oxidase
conversion of hypoxanthine & xanthine to uric acid
Question 29.
Febuxostat (Uloric) considerations
