ANCC AGPCNP Study Set Questions and
Answers 100% Solved
Safety issue with Vitamin K antaognist:
Warfarin (Coumadin) - Interacts with "G" herbs (garlic, ginger, gingko, ginseng) and other
herbs (feverfew, green tea, and fish oil
- Numerous drug interactions
- Discontinue 7 days before surgery
Safety Issues with TZDs :
Pioglitazone (Actos) BB Warning: Cause or exacerbate congestive heart failure
- Contraindications: Hx of MI, stroke, bladder cancer, type 1 DM, eye or liver problems
- Stop if causes dyspnea, weight gain, cough (heart failure)
Safety Issues with Atypical antipsychotics:
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel) - High risk of weight gain, metabolic syndrome, type 2 DM -
MONITOR WEIGHT q3 months
,- BB Warning: higher mortality in elderly patients
- Monitor TSH, lipids, blood glucose/A1C, weight/body mass index
Safety Issues with Bisphosphonates:
-Alendronate (Fosamax)
- Risedronate (Actonel) - Erosive esophagitis (S/sx: chest pain w/ eating, odonophagia,
dysphagia, heartburn) STOP immediately if symptoms occur or jaw pain
-- Take alone upon awakening with 8 oz glass of water (NO JUICE) before breakfast and do not
lie down for 30 min to avoid erosive esophagitis
- Contraindications: Active GI disease (GERD, PUD), CKD, esophageal stricture/varices
Safety Issues with Statins:
- Atorvastatin (Lipitor)
- Lovastatin (Mevacor)
- Rosuvastatin (Crestor)
-Simvastatin (Zocor)
- Fluvastatin (Lescol)
- Pravastatin (Pravachol)
- Pitavastatin (Livalo) - Do not mix with grapefruit juice
, - Increase risk of drug inducsed hepatitis or rhabdomyolysis if mixed with azole antifungals
- High dose Zocor (80 mg) = highest risk of rhabdomyolysis (muscle pain/tenderness, muscle
weakness, brown or dark red urine)
- Chinese descent = higher risk of myopathy or rhabdomyolysis when taking simvastatin 40
mg/d (or higher) with niacin
- Creatinine kinase level goes up
Safety Issues with Lincosamides:
- Clindamycin (Cleocin) - Increased risk of CDAD (C diff)
Safety Issues with systemic glucocorticoids - Cataracts, osteoporosis, skin changes
(telangiectasia, easy bruising), emotional lability, weight gain, high BP
Safety Issues with Phenytoin (Dilantin) - Earliest signs of toxicity (horizontal nystagmus,
unsteady gait) -- severe: slured speech, lethargy, confusion, coma
- Monitor blood levels
- Can cause gingival hyperplasia
BEERS Criteria Medications to avoid in 65+
Answers 100% Solved
Safety issue with Vitamin K antaognist:
Warfarin (Coumadin) - Interacts with "G" herbs (garlic, ginger, gingko, ginseng) and other
herbs (feverfew, green tea, and fish oil
- Numerous drug interactions
- Discontinue 7 days before surgery
Safety Issues with TZDs :
Pioglitazone (Actos) BB Warning: Cause or exacerbate congestive heart failure
- Contraindications: Hx of MI, stroke, bladder cancer, type 1 DM, eye or liver problems
- Stop if causes dyspnea, weight gain, cough (heart failure)
Safety Issues with Atypical antipsychotics:
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel) - High risk of weight gain, metabolic syndrome, type 2 DM -
MONITOR WEIGHT q3 months
,- BB Warning: higher mortality in elderly patients
- Monitor TSH, lipids, blood glucose/A1C, weight/body mass index
Safety Issues with Bisphosphonates:
-Alendronate (Fosamax)
- Risedronate (Actonel) - Erosive esophagitis (S/sx: chest pain w/ eating, odonophagia,
dysphagia, heartburn) STOP immediately if symptoms occur or jaw pain
-- Take alone upon awakening with 8 oz glass of water (NO JUICE) before breakfast and do not
lie down for 30 min to avoid erosive esophagitis
- Contraindications: Active GI disease (GERD, PUD), CKD, esophageal stricture/varices
Safety Issues with Statins:
- Atorvastatin (Lipitor)
- Lovastatin (Mevacor)
- Rosuvastatin (Crestor)
-Simvastatin (Zocor)
- Fluvastatin (Lescol)
- Pravastatin (Pravachol)
- Pitavastatin (Livalo) - Do not mix with grapefruit juice
, - Increase risk of drug inducsed hepatitis or rhabdomyolysis if mixed with azole antifungals
- High dose Zocor (80 mg) = highest risk of rhabdomyolysis (muscle pain/tenderness, muscle
weakness, brown or dark red urine)
- Chinese descent = higher risk of myopathy or rhabdomyolysis when taking simvastatin 40
mg/d (or higher) with niacin
- Creatinine kinase level goes up
Safety Issues with Lincosamides:
- Clindamycin (Cleocin) - Increased risk of CDAD (C diff)
Safety Issues with systemic glucocorticoids - Cataracts, osteoporosis, skin changes
(telangiectasia, easy bruising), emotional lability, weight gain, high BP
Safety Issues with Phenytoin (Dilantin) - Earliest signs of toxicity (horizontal nystagmus,
unsteady gait) -- severe: slured speech, lethargy, confusion, coma
- Monitor blood levels
- Can cause gingival hyperplasia
BEERS Criteria Medications to avoid in 65+
