NR565 Advanced Pharm Midterm
-Therapeutic action of drug classification used - correct answer-
Acetaminophen - correct answer--mild to moderate pain
-children 10 mg/kg every 4-8 hrs
-maximum 4g/day
hepatic injury with OD
renal disease with chronic disease
drug interactions with alcohol
Alan Sayed has neuropathic pain. What nonopioid medications should be considered for his
treatment? Select all that apply. - correct answer-A)Tricyclic antidepressants (TCAs)
B)Topical lidocaine
C)Serotonin and norepinephrine reuptake inhibitors (SNRIs) D)Gabapentin
Answer: ABCD
Amlopidine (Norvasc) - correct answer-
Angina:
-therapeutic action of organic nitrates
-contraindication for ranolazine - correct answer--prevention of MI and death
-antiplatelet drugs, cholesterol-lowering drugs, angiotensin-converting enzyme inhibitors
-Reduction of cardiac ischemia and the associated pain-- nitrates, beta blockers, CCB,
ranolazine
- CCBs and ACEI most expensive
- BB mid-range
-Nitrates cheapest
Assess potential harms of opioid therapy: - correct answer-1. Assess
Evaluate for factors that could increase your patient's risk for harm from opioid therapy such
as: Personal or family history of substance use disorder Anxiety or depression Pregnancy
Age 65 or older COPD or other underlying respiratory conditions Renal or hepatic
insufficiency
2. Check
Consider urine drug testing for other prescription or illicit drugs and check your state's
prescription drug monitoring program (PDMP) for: Possible drug interactions (such as
benzodiazepines) High opioid dosage (≥50 MME/day) Obtaining opioids from multiple
providers
3. Discuss Ask your patient about concerns and determine any harms they may be
experiencing such as: Nausea or constipation Feeling sedated or confused Breathing
interruptions during sleep Taking or craving more opioids than prescribed or difficulty
controlling use
, 4. Observe
Look for early warning signs for overdose risk such as: Confusion Sedation Slurred speech
Abnormal gait
Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score
What is it?
When is it used? - correct answer-
Baseline data needed for drugs in DMARDS class - correct answer-Conventional DMARDS:
-ALT, AST, serum creatine
Methotrexate: CXR, check plum and GI status
Sulfasalazine: CXR, check pulm and neuro status
Hydroxychloroquine: eye exam, cardiac exam with ECG
Leflunomide: CXR, Check pulm status, BP
Be familiar with general development and when absorption would reach adult levels - correct
answer-The drug-metabolizing of infants is limited. The liver does not develop its full
capacity to metabolize drugs until approximately 1 year after birth. During the time before
hepatic maturation, infants are especially sensitive to drugs, and care must be taken to avoid
injury.
Be familiar with pharmacokinetic and pharmacodynamic changes of older adults and how
that would translate to baseline information needed to prescribe - correct
answer-Pharmacokinetic is the study of drug absorption, distribution, metabolism, and
excretion in the body. The ability of older adults to metabolize drugs is commonly decreased.
Drug dosages may need to be reduced to prevent drug toxicity.
Beer's criteria - correct answer-Guidelines for prescribing medications to patients 65 & older.
Drugs on the list should be avoided in patients over 65 expect when the benefits significantly
outweigh the risks. The Beers Criteria includes five lists that describe certain medications
and situations and include: potentially inappropriate medication (PIM) us in older adults, PIM
use in older adults due to medication-disease or medication-syndrome interactions that may
exacerbate the disease or syndrome, medications to be used cautiously in older adults,
clinically significant drug interactions that should be avoided in older adults, medications to
be avoided or dosage decreased in the presence of impaired kidney function in older adults.
Behaviors that predict controlled substance abuse - correct answer-Illegal drug use;
prescription drug use for nonmedical reasons. History of substance use disorder or
overdose.
Mental health conditions (eg, depression, anxiety). Sleep-disordered breathing.
Concurrent benzodiazepine use.
Beta blockers:
-Therapeutic action of drug classification used - correct answer-
Acetaminophen - correct answer--mild to moderate pain
-children 10 mg/kg every 4-8 hrs
-maximum 4g/day
hepatic injury with OD
renal disease with chronic disease
drug interactions with alcohol
Alan Sayed has neuropathic pain. What nonopioid medications should be considered for his
treatment? Select all that apply. - correct answer-A)Tricyclic antidepressants (TCAs)
B)Topical lidocaine
C)Serotonin and norepinephrine reuptake inhibitors (SNRIs) D)Gabapentin
Answer: ABCD
Amlopidine (Norvasc) - correct answer-
Angina:
-therapeutic action of organic nitrates
-contraindication for ranolazine - correct answer--prevention of MI and death
-antiplatelet drugs, cholesterol-lowering drugs, angiotensin-converting enzyme inhibitors
-Reduction of cardiac ischemia and the associated pain-- nitrates, beta blockers, CCB,
ranolazine
- CCBs and ACEI most expensive
- BB mid-range
-Nitrates cheapest
Assess potential harms of opioid therapy: - correct answer-1. Assess
Evaluate for factors that could increase your patient's risk for harm from opioid therapy such
as: Personal or family history of substance use disorder Anxiety or depression Pregnancy
Age 65 or older COPD or other underlying respiratory conditions Renal or hepatic
insufficiency
2. Check
Consider urine drug testing for other prescription or illicit drugs and check your state's
prescription drug monitoring program (PDMP) for: Possible drug interactions (such as
benzodiazepines) High opioid dosage (≥50 MME/day) Obtaining opioids from multiple
providers
3. Discuss Ask your patient about concerns and determine any harms they may be
experiencing such as: Nausea or constipation Feeling sedated or confused Breathing
interruptions during sleep Taking or craving more opioids than prescribed or difficulty
controlling use
, 4. Observe
Look for early warning signs for overdose risk such as: Confusion Sedation Slurred speech
Abnormal gait
Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score
What is it?
When is it used? - correct answer-
Baseline data needed for drugs in DMARDS class - correct answer-Conventional DMARDS:
-ALT, AST, serum creatine
Methotrexate: CXR, check plum and GI status
Sulfasalazine: CXR, check pulm and neuro status
Hydroxychloroquine: eye exam, cardiac exam with ECG
Leflunomide: CXR, Check pulm status, BP
Be familiar with general development and when absorption would reach adult levels - correct
answer-The drug-metabolizing of infants is limited. The liver does not develop its full
capacity to metabolize drugs until approximately 1 year after birth. During the time before
hepatic maturation, infants are especially sensitive to drugs, and care must be taken to avoid
injury.
Be familiar with pharmacokinetic and pharmacodynamic changes of older adults and how
that would translate to baseline information needed to prescribe - correct
answer-Pharmacokinetic is the study of drug absorption, distribution, metabolism, and
excretion in the body. The ability of older adults to metabolize drugs is commonly decreased.
Drug dosages may need to be reduced to prevent drug toxicity.
Beer's criteria - correct answer-Guidelines for prescribing medications to patients 65 & older.
Drugs on the list should be avoided in patients over 65 expect when the benefits significantly
outweigh the risks. The Beers Criteria includes five lists that describe certain medications
and situations and include: potentially inappropriate medication (PIM) us in older adults, PIM
use in older adults due to medication-disease or medication-syndrome interactions that may
exacerbate the disease or syndrome, medications to be used cautiously in older adults,
clinically significant drug interactions that should be avoided in older adults, medications to
be avoided or dosage decreased in the presence of impaired kidney function in older adults.
Behaviors that predict controlled substance abuse - correct answer-Illegal drug use;
prescription drug use for nonmedical reasons. History of substance use disorder or
overdose.
Mental health conditions (eg, depression, anxiety). Sleep-disordered breathing.
Concurrent benzodiazepine use.
Beta blockers:
