NUR-635 PHARM FINAL EXAM LATEST UPDATE 2024

While rational drug selection is based on the individual patient the aspect of rational drug selection addressing disease-specific information by a national medical or nursing organization is A. a guideline. B. cost. C. availability. D. patient hepatic and renal function. - ANSWER A. a guideline Drugs that alter synaptic transmission are much more selective than those that alter axonal conduction, why is this? - ANSWER a drug that affects the axonal conduction - non-selective effect. Drugs that alter synaptic transmission - very selective because of the differences in synapses and their specific neurotransmitters What is phenytoin used for? - ANSWER Seizures What should you monitor for with phenytoin? - ANSWER Delayed hypersensitivity - even 1 month later What is carbamazepine used for? - ANSWER Seizures What may cause carbamazepine levels to drop despite no other change? What to do? - ANSWER Autometabolization of drug. Increase dose. What is the black box warning for carbamazepine? - ANSWER Steven-Johnson Syndrome & TENS Monitoring for carbamazepine, and how often? - ANSWER CBC, 3-4 times a year What population is most at risk for Steven-Johnson syndrome & TENS when taking carbamazepine? - ANSWER Asian patients Main class of medication for depression? - ANSWER Selective serotonin reuptake inhibitors (SSRIs) What to watch for with SSRIs? - ANSWER Other medications that can cause serotonin syndrome What is lamictal used for? - ANSWER Seizures Patient on lamictal has fever, rash, swollen lymph nodes. What are we concerned for? - ANSWER Hypersensitivity in lamictal can lead to MODS Patient on lamictal wants birth control. What do we need to change? - ANSWER Increase lamictal dose. When will pt notice improvement after starting an SSRI? - ANSWER 4 weeks later 1st line medication for moderate generalized anxiety - ANSWER Buspar (SNRI) 1st line med for classic migraines - ANSWER Triptans 2nd line treatment for classic migraines - ANSWER Prophylactic - propranolol - ANSWER Why is important that NPs have the authority to prescribe? - ANSWER Increase access to healthcare What must be done if a drug has a narrow therapeutic index? - ANSWER Frequent serum level monitoring Why would 10mg percocet or 10mg oxy work better than the other? - ANSWER Differences in pill filler composition What do medications need in order to be effective: - ANSWER Albumin (binding to) If a patient has a toxic drug level, but normal albumin, what could be happening? - ANSWER Other drugs competing for albumin What does "Sig" mean on a prescription? - ANSWER Directions to pharmacist What items are necessary on a prescription? - ANSWER Drug, dose, route, frequency, quantity, refills Abbreviations to not use - ANSWER QD What drug may cause grey teeth? - ANSWER Tetracyclines Pt reports no improvement in seizures after treatment for a few weeks. What next - ANSWER Assess drug levels for therapeutic index If patient on phenytoin wants birth control? - ANSWER Not oral contraceptives! IUD better Patient on teratogen med wants to get pregnant. When should they stop? - ANSWER Before getting pregnant, beware first trimester Pregnant pt has been taking daily aspirin. Concern for what? - ANSWER Premature close of PFO