NSG6005 Advanced Pharmacology Quiz 1|2023 LATEST UPDATE|GUARANTEED SUCCESS

Ways to help patients obtain accurate information from Web Listservs News groups Computerized drug systems Expedite filling of rx direct links to pharmacy provides alerts, drug interactions, ADRs, tests, etc Use of internet Facilitates access to patient data, management choices, patient education, referral mechanisms, documentation of patient-provider interactions etc. Search engines Give patient info on reputable sites Cost effectiveness Two or more treatments/programs that are not necessarily therapeutically equivalent ex: treatment of HTN-triple therapy reduces SBP by 35 pts vs 2 agents that reduce SBP by 20 pts Insulin therapy vs oral therapy and achieved A1c level Measures effectiveness in therapeutic outcomes vs dollars saved Cost benefit analysis The costs of a specific treatment or intervention are calculated and then compared with the $$ value of the benefit received. Compare and determine the greatest benefit for the dollar spent Cost-benefit ratio Difference in 2 therapies Ex: Anticoagulation clinic vs hypertension clinic Donut hole (Medicare Part D) Changes to Part D Medicare due to reform of 2010 enrollees in the donut hole will get a $250 rebate. Enacted to assist seniors with med cost Covers 75% cost after deductible of $250 until costs exceed $2250 Between $2250 and $5100 no coverage Afer $5100, covered at 100% Gap between 2250 and 5100 is the donut hole Two-tiered medication coverage Generic vs brand name Pharmacoeconomics influence every rx Ask about patient's coverage and their cost of med Consult with pharmacist Know generic equivalents OTC antihistamines First line drug for treating allergies First and second generation available OTC Combined with decongestants in cold and flu meds May cause sedation or hang-over effects Can get a DUI with them Decongestants Sympathomimetics, vasoconstrictors that reduce nasal congestion Oral or nasal route is best Topical are minimally absorbed Rebound congestion common if used 5days Decongestants Constrict vascular beds Increase BP cause insomina increase HR Caution with HTN, BPH, and glaucoma Precursor of methamphetamine Not for use for children 4 yrs-cause death NSAIDs Cox 1 and Cox 2 inhibitor Analgesic, antipyretic, antiplatelet, and anti-inflammatory GI ADRs Decreases renal blood flow-can cause renal failure Can cause confusion in elderly Acetaminophen (APAP) Max dose 4g/day 3g/day for chronic use Can cause liver failure Mucomyst antidote Condoms Effective in preventing pregnancy and infections Male and female Spermicides (Nonoxynol-9) Cream, jelly, foam, suppository, lubricant in condom Plan B (One Step and Next Choice) Prevent pregnancy after unprotected intercourse or contraceptive failure (condom broke) Must take within 72 hrs Nausea most common ADR Patients under 17 need rx (April ruling negates this) Diphenydramine /Antihistamine AKA benadryl (Sominex, Nytol) +tylenol (Tylenol PM) + ibuprofen (Advil PM) Caution in older pts. May develop delirium from small doses of Diphenydramine Doxylamine/Antihistimine (Unisom) Anticholinergic ADRs Loperamide (Immodium) Reduces diarrhea and relieves cramping Do not use 48 hrs Bismuth subsalicylate (Pepto-Bismol) Used to prevent traveler's diarrhea Binds to toxins produced by Ecoli believed to have bactericidal action Toxic if taken with aspirin Do not give to children-Rise Syndrome Causes black tongue Bisacodyl (Dulcolax) Anthraquinone (Senna) Bulk-forming laxatives Produce build in the form of gel Takes 12-24 hrs to work Safest long-term laxative Stimulant Used to empty the colon before bowel exams and surgical procedures Overuse can cause dehydration, loss of protein and K+ balance, dysfunctional colon Colace (Docusate) Surfactant laxative Anionic surfactants that increase the wetting efficiency of intestinal fluid and soften fecal mass Stool softeners Prevent constipation Effective after 1-2 days PEG 3350 (Miralax) Osmotic laxatives Increases fecal water content by osmosis not habit-forming Magnesium hydroxide Osmotic saline laxative Well tolerated except by elderly