Regis NU641 Clinical Adv Pharmacology Final Exam 2023

Clonodine - Answer- Has several off-label uses including: alcohol and nicotine withdrawal and post therpautic neuralgia Guanfacine - Answer- hypertension drug that has also been approved to use for ADHD Ramelteon (Rozerem) - Answer- Insomnia med that does not have inverse risk for patients engaging in activities while somnolent with no memory of having taking pill Common mistakes practitioners make in treating anxiety disorders - Answer- General diagnosis and following up to see if treatment goals are being met Xanax - Answer- The benzodiazepine with the greatest likelihood of causing dependency s/t it has a short half-life Although a patient sees a neurologist for the management of her partial seizures, why is it important to know her medication regimen? - Answer- There are many drug-drug interactions with anticonvulsants Routine education for patient being treated with levetiracetam (Keppra) for seizures - Answer- To not abruptly discontinue Keppra due to risk for withdrawal seizures What advice you would give a woman who has been on Depakote for seizure and wants to get pregnant - Answer- Valproate is a known teratogen but may be taken after the first trimester if necessary Prior to starting antidepressants, the patient should have lab testing to rule out - Answer- hypothyroidism Cholinergic blockers are used to: - Answer- Counteract the ERS effects of phenothiazines Control tremors and relax smooth muscles in Parkinson's Disease Inhibit the muscarinic action of Ach on bladder muscle Memantine - Answer- A drug used to treat Alzheimer's disease but is not an anticholinergic Verapamil - Answer- Preventative therapy for cluster headache Minocycline (PO) - Answer- When prescribing for migraines, patient education includes: - Answer- Stress reduction and regular sleep are integral to migraine treatment Acetaminophen - Answer- Migraines in pregnancy may be safely treated with this When are migraines considered cured? - Answer- There is no known cure Nonpharmacologic Therapy for tension headache includes: - Answer- biofeedback, stress management, massage therapy Fluoxetine - Answer- First-line antidepressant for children with major depression between 8 to 17 years old SSRIs - Answer- Contains a black-box warning of suicidal ideation in pediatric and adolescent groups Stimulants (methylphenidate or amphetamine salts) - Answer- Are the most effective therapy and are generally first line of treatment of ADHD in children unless contraindications exist Hypercalcemia - Answer- Pt treated with more than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for An adolescent female calls the clinic with concerns that her acne is worse 2 weeks after starting topical tretinoin. What would be the appropriate care for her? - Answer- Reassure her that the worsening of acne is normal and it should improve with continued use Treatment for Tinea capitis - Answer- Oral griseofulvin or Biweekly shampoo with selenium sulfide or ketoconazole for 6 to 8 weeks Treatment for Tinea corporis and tinea pedis - Answer- Topical antifungals like miconazole applied twice daily for 4 weeks Treatment of Onychomycosis - Answer- Oral griseofulvin, ketoconazole, itraconazole, or terbinafine for several months; topical product is ciclopirox 8% (Penlac) Common treatments and counseling points for scabies - Answer- Common therapies: permethrin, ivermectin, crotamiton For permethrin, apply from the neck down, and leave the medication on for at least eight to 10 hours. Often, all household members and other close contacts should be treated. Bedding, clothing, and towels used by infested persons or their household, sexual, and close contacts (as defined above) anytime during the three days before treatment should be decontaminated by washing in hot water and drying in a hot dryer, by dry-cleaning, or by sealing in a plastic bag for at least 72 hours. Reduces Oral contraceptive efficacy - Answer- Concomitant use of hepatic enzyme inducers such as rifampin; barrier methods of contraception should be used as backup Long-term use of androgens requires specific laboratory monitoring of: - Answer- Calcium, testosterone, PSA, liver function, glucose, & lipids existing pregnancy - Answer- A contraindication to using the morning after (Plan B) contraceptive for emergency contraception (EC) To avoid breakthrough bleeding - Answer- When a hormonal contraceptive and a hormone replacement therapy drug are taken together, they should be taken at the same time each day A progestin-only type of contraceptive - Answer- Can cause irregular menstrual bleeding during the first month of use Effects of estrogen include - Answer- regulation of the menstrual cycle and maintaining normal skin structure and blood vessel integrity. Medroxyprogesterone injection - Answer- may cause an adverse effect of depression Older male patients using testosterone replacement therapy (TRT) - Answer- should have a digital prostate screening examination at 3 and 6 months after starting therapy Diarrhea - Answer- Is not a side effect of anticholinergic therapy for urinary incontinence antimicrobial efficacy - Answer- For an uncomplicated UTI in a child, reduced symptoms within 48 hours is a good indicator of Amoxicillin - Answer- A woman who is in her first trimester of pregnancy with a diagnosed urinary tract infection (UTI) is treated with Nitrofurantoin - Answer- Can be used to treat UTI in pregnant women if there is an amoxicillin resistance benzoyl alcohol - Answer- The only antifungal agent effective for head lice that is not neurotoxic Serotonin 5-HT3 receptor antagonists should be avoided in which of the patient populations? - Answer- Pregnant patients Treatment for preeclampsia - Answer- Bedrest (not strict bedrest), control of BP, seizure prophylaxis, and timely delivery Treatment algorithm for symptomatic bacterial vaginosis - Answer- First line - Flagyl (PO)