Advanced Clinical Pharmacology - NUR 600 Final Exam Prep Questions and Answers

Signs and symptoms of renal calculi - ANS: • Renal Colic (+ CVA Tenderness), intense flank pain • Severe pain (+/- Nausea and Vomiting) • Hematuria, cloudy urine, painful urination • Urinary retention incontinence - ANS: inability to control bladder and/or bowels Types of incontinence - ANS: 1. Stress Loss of small amounts of urine from increased abdominal pressure without bladder muscle contraction with laughing, sneezing, or lifting. 2. Urge Inability to stop urine flow long enough to reach the bathroom due to an overactive detrusor muscle with increased bladder pressure, 3. Overflow Urinary retention from bladder over-distention and frequent loss of small amounts of urine due to obstruction of the urinary outlet or an impaired detrusor muscle. 4. Reflex Involuntary loss of a moderate amount of urine usually without warning due to hyperrflexia, of the detrusor muscle, usually from spinal cord dysfunction. 5. Functional Loss of urine due to factors that interfere with responding to the need to urinate such as cognitive, mobility, and environmental barriers. 6. Total Unpredictable, involuntary loss of urine that generally does not respond to treatment, Tests to diagnose incontinence - ANS: Urinalysis, Bladder Diary, Post void residual measurement, cystoscopy, Ultrasound Treatment for incontinence - ANS: -bladder training -scheduled toileting -fluid/diet management -pelvic muscle exercises (stress and urge) -pharmacological interventions -surgery Aricept dosing - ANS: The recommended starting dosage of ARICEPT is 5 mg administered once per day in the evening, just prior to retiring. My be increased after 4-6 weeks with the maximum recommended dosage of ARICEPT in patients with mild to moderate Alzheimer's disease is 10 mg per day. Improvement 3-6 weeks after initiation. Side/Adverse Effects - ANS: Nausea, vomiting, diarrhea, loss of appetite/weight loss, dizziness, drowsiness, weakness, trouble sleeping, shakiness (tremor), or muscle cramps Contraindications - ANS: ARICEPT is contraindicated in patients with known hypersensitivity to donepezil hydrochloride or to piperidine derivatives. ARICEPT, as a cholinesterase inhibitor, is likely to exaggerate succinylcholine-type muscle relaxation during anesthesia Probenecid - ANS: Inhibits reabsorption of uric acid in proximal convoluted tubule (also inhibits secretion of penicillin). Can precipitate uric acid calculi. probenecid - mechanism of action? - used for? - ANS: inhibits uric acid reabsorption in proximal tubule - chronic gout Probenecid indications - ANS: Gonorrhea (adjunct) | Chronic gout w/ underexcretion ( 800 mg/day) Probenecid dosing