Regis NU641 Adv Clinical Pharmacology Midterm Exam 2023/2024

Angina, Coronary Artery Disease, & Migraines Patients that are at highest risk for abruptly stopping a beta blocker are those with Angiotensin-converting enzyme (ACE) inhibitors The medication that helps the imbalance between myocardial oxygen supply and myocardial oxygen demand in the myocardium by increasing the myocardial oxygen supply improves insulin sensitivity improves renal hemodynamics reduce production of angiotensin II Roles of Angiotensin-converting enzyme (ACE) inhibitors in DM patients Activation of the sympathetic nervous system that increases heart rate and preload The pathological change that takes place in HF that is not addressed by ACE inhibitors blunted coronary artery dilation due to calcified plaque Reason why nitro glycerin tablets "do not work well" in patient with hyperlipidemia and angina age factoring in the cost to the patient of the medication prescribed Clinical judgement in prescribing includes decreased renal function Prior to prescribing an ACE inhibitor the NP should access for statins First-line pharmacologic therapy for hyperlipidemia Any end-organ damage, direct effects on lifestyle, or inability to perform the tasks of daily living When is consultation with or referral to a cardiologist appropriate? Diuretics If not chosen as the first drug in hypertension treatment, which drug class should be added as a second step because it will enhance the effects of most other agents? Determine their other risk factors A 65-year-old patient who has been on a lipid-lowering diet and is using plant sterol margarine daily for the past three months. Her LDL is 135mg/dL. What would an appropriate treatment for them be? promote smooth muscle dilation by stopping intracellular entry of calcium into the cell, which increases contractility, which increase the activity of the NA+/K+/ATPase pump indirectly Calcium Channel Blocker's helps control blood pressure because it discussion of expected adverse drug reactions Patient education regarding prescribed medications includes Do not take any herbal products without first discussing this with the provider Patient education when prescribing clopidogrel includes which of the following statements? If they stop the medication, their lipid levels will return to pretreatment levels; medication is a supplement to diet therapy and exercise; and if they have muscle aches or pain, they should contract their provider When starting a patient on a statin, what would education include? Lung When treating a patient for hypertension with a non-selective beta blocker, what other organ may be unintentionally affected? The brand name of warfarin and "do not substitute" When writing a prescription for warfarin it is common to write this on the prescription Sublingual tablets Which formulation of nitrate may be most cost effective for the patient who rarely has the need for dosing? Asthma What disease processes could be made worse by taking a nonselective beta blocker? Oral Methyldopa What drug is considered as treatment for hypertension in women during pregnancy? bismuth subsalicylate before each meal and at bedtime Treatment for possible traveler's diarrhea electrolytes, including potassium and chloride Elderly prescribed lactulose for chronic constipation; Monitoring with long-tern treatment would include PPI bid plus clarithromycin plus amoxicillin for 14 days An acceptable first-line treatment for peptic ulcer disease with positive Helicobacter pylori (H. pylori) test is: a PPI for 8 to 12 weeks until healing is complete After H. pylori treatment is completed, the next step in peptic ulcer disease therapy is: Histamine 2 Receptor Antagonists A patient with mild GERD is started on the medication first refer the patient for endoscopy The next step in treatment when a patient has been on PPIs twice daily for 12 weeks and not improving is to: Add an H2 blocker such as ranitidine to his therapy or decrease his aspirin does to one tablet daily 82-year-old man takes two aspirin every morning to treat the arthritis pain in his back. Heartburn lately from the aspirin. After ruling out an acute GI bleed, what would be an appropriate course of treatment for him? AA women as a group are at risk of developing osteoporosis due to their lower calcium intake when young and 75% of them are lactose-intolerant, so they avoid milk and other dairy products that are excellent sources of calcium. Education for AA Women about Osteoporosis Alendronate (Fosamax) The drug recommended as the primary treatment for osteoporosis in women over age 70 is: Preterm and newborn infants do not yet have functional pain pathways Age-related statement about pain that is NOT true Multiple time when prescriptions are lost with request to refill Statement that raises a "red flag" about potential chemical dependency Acetaminophen is especially useful in both children and adults because it has no effect on platelets and has fewer adverse effects than NSAIDs. True statement about pain Nonopiates, increase dose of nonopiates, opiates If interventions to resolve the cause of pain (e.g., rest, ice, compression, and elevation) are insufficient, pain medications are given based on severity of pain. Drugs are given in which order of use? Cimetidine (Tagamet) The histamine type-2 receptor antagonist (H2HA) that is recommended to avoid because of increased potential side effects and risk of drug interactions Psyllium (Metamucil) orally Pregnant patient in 2nd trimester with constipation needs laxative treatment. What would be the safest and most appropriate for the duration of her pregnancy? NSAID (Such as Ibuprofen) What medication can be used to treat an acute gout attack? Colchicine (Colcrys) What medication should not be used to prevent the progression of gout in a patient? Regular monitoring of weight, glucose level, and vitamin D levels; do not stop abruptly; take with food to minimize GI distress Education for patient taking prednisone Patient who have chronic liver dysfunction/alcoholics Acetaminophen is NOT the drug of choice for mild to moderate pain for which patient? bulk forming What type of laxatives would you recommend for short- or long-term treatment of mild constipation?