NURS 676 ADVANCED PHARMACOLOGY FINAL EXAM REVIEW / QUESTIONS AND CORRECT ANSWERS 2023/2024 GRADED A+.

A 75-year old patient is taking Timolol Maleate (Timpotic) for chronic open angle glaucoma and is well controlled. What side effect might you watch for if Propanolol (Inderal) is added? - Bradycardia. A patient complains of "puffy feet" shortly after beginning a new medication three months ago. There is no underlying physiological cause for this condition. What medication is most likely causing the problem? - Amlodipine (Norvasc). A patient is taking the ACEI Enalapril (Vasotec) for the last four months for the treatment of congestive heart failure, and is complaining of a nonproductive cough. What should the NP advise the patient regarding this side effect? - The cough should subside 1-4 days after discontinuing the drug. A patient presents with a history of GERD and many other medical conditions. What medication would you encourage her to avoid? - NSAIDs. Along with diet, what drug is used to treat hypertriglyceridemia? - Gemfibrozil (Lopid). Amenorrhea is the most common side effect of which birth control medication? - Medroxyprogesterone (Depo-Provera) Can antacids cause diarrhea? - Yes, antacids containing magnesium, which decrease bowel transit time, may cause diarrhea. Most often seen in renal insufficiency. Heparin exerts its therapeutic action by what? - Upregulating the activity of one of the body's natural anticoagulant molecules, antithrombin III How are IV morphine and nitroglycerin beneficial in acute heart failure? - Decrease preload. How do antiprostaglandin drugs cause stomach mucosal injury? - They alter the thickness of the protective mucosal layer. How do Diphenoxylate (Lomotil) and Loperamide (Imodium) help relieve diarrhea? - They decrease the motility of the ileum and colon, slowing the transit time and promoting more water absorption. How should an oral glucocorticoid be taken? - With food. Spironoaldactone (Aldactone) has what mechanism of action (MOA)? - Aldosterone antagonist The normal starting dose of levothyroxine is 50-100mcg per day for primary hypothroidism. What is the most appropriate starting dose in a 71-year old female patient? - 25mcg per day. What action is most effective in decreasing the risk of hyperkalemia associated with the start of angiotensin-converting enzyme inhibitor (ACEI) therapy? - Making sure that the patient is well hydrated. What age-related changes place the elderly at risk for an exaggerated response to Warfarin (Coumadin) and Heparin? - Protein binding changes and decrease in clotting factors. What anithypertensive agent is safe during pregnancy? - Methyldopa (Aldomet). What antimicrobial agent would be appropriate to prescribe in a 65-year old patient who presents with a past medical history of coronary artery disease, a 101F temperature, and tachypnea of 24 breaths per minute. Chest X-ray confirms a left lower lobe pneumonia. - Levofloxacin (Levaquin