Advanced Pharmacology Final Exam
Review with correct answers
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? - CORRECT ANSWERS-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? - CORRECT ANSWERS-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? - CORRECT
ANSWERS-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? - CORRECT ANSWERS-NSAIDs.
Along with diet, what drug is used to treat hypertriglyceridemia? - CORRECT
ANSWERS-Gemfibrozil (Lopid).
Amenorrhea is the most common side effect of which birth control medication? -
CORRECT ANSWERS-Medroxyprogesterone (Depo-Provera)
Can antacids cause diarrhea? - CORRECT ANSWERS-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? - CORRECT ANSWERS-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? - CORRECT
ANSWERS-Decrease preload.
How do antiprostaglandin drugs cause stomach mucosal injury? - CORRECT
ANSWERS-They alter the thickness of the protective mucosal layer.
, How do Diphenoxylate (Lomotil) and Loperamide (Imodium) help relieve diarrhea? -
CORRECT ANSWERS-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? - CORRECT ANSWERS-With food.
Spironoaldactone (Aldactone) has what mechanism of action (MOA)? - CORRECT
ANSWERS-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? - CORRECT ANSWERS-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? - CORRECT
ANSWERS-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? - CORRECT ANSWERS-Protein binding changes
and decrease in clotting factors.
What anithypertensive agent is safe during pregnancy? - CORRECT ANSWERS-
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. - CORRECT ANSWERS-Levofloxacin (Levaquin).
What are some contrindications for HMG-co A reductase inhibitors (statins)? -
CORRECT ANSWERS-They cause myopathies, especially at higher doses or in
combination with certain drugs. They should never be used in patients taking Warfarin
(Coumadin).
What are two systemic psoriasis medications? - CORRECT ANSWERS-Photo-therapy
and topical corticosteroids
What direction would you give when prescribing Sucralfate (Carafate)? - CORRECT
ANSWERS-The drug must be taken on an empty stomach.
What do gastric parietal cells produce? - CORRECT ANSWERS-Hydrochloric acid.
What does a low level of thyroid-stimulating hormone indicate? - CORRECT
ANSWERS-Hyperthroidism
Review with correct answers
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? - CORRECT ANSWERS-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? - CORRECT ANSWERS-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? - CORRECT
ANSWERS-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? - CORRECT ANSWERS-NSAIDs.
Along with diet, what drug is used to treat hypertriglyceridemia? - CORRECT
ANSWERS-Gemfibrozil (Lopid).
Amenorrhea is the most common side effect of which birth control medication? -
CORRECT ANSWERS-Medroxyprogesterone (Depo-Provera)
Can antacids cause diarrhea? - CORRECT ANSWERS-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? - CORRECT ANSWERS-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? - CORRECT
ANSWERS-Decrease preload.
How do antiprostaglandin drugs cause stomach mucosal injury? - CORRECT
ANSWERS-They alter the thickness of the protective mucosal layer.
, How do Diphenoxylate (Lomotil) and Loperamide (Imodium) help relieve diarrhea? -
CORRECT ANSWERS-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? - CORRECT ANSWERS-With food.
Spironoaldactone (Aldactone) has what mechanism of action (MOA)? - CORRECT
ANSWERS-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? - CORRECT ANSWERS-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? - CORRECT
ANSWERS-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? - CORRECT ANSWERS-Protein binding changes
and decrease in clotting factors.
What anithypertensive agent is safe during pregnancy? - CORRECT ANSWERS-
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. - CORRECT ANSWERS-Levofloxacin (Levaquin).
What are some contrindications for HMG-co A reductase inhibitors (statins)? -
CORRECT ANSWERS-They cause myopathies, especially at higher doses or in
combination with certain drugs. They should never be used in patients taking Warfarin
(Coumadin).
What are two systemic psoriasis medications? - CORRECT ANSWERS-Photo-therapy
and topical corticosteroids
What direction would you give when prescribing Sucralfate (Carafate)? - CORRECT
ANSWERS-The drug must be taken on an empty stomach.
What do gastric parietal cells produce? - CORRECT ANSWERS-Hydrochloric acid.
What does a low level of thyroid-stimulating hormone indicate? - CORRECT
ANSWERS-Hyperthroidism
