NR 566/NR566 Midterm Exam | Advanced Pharmacology for Care of the Family | Latest 2025/ 2026 Update | Questions and Answers (100% Verified Solutions) GRADED A.

NR 566/NR566 Midterm Exam | Advanced Pharmacology for Care of the Family | Latest 2025/ 2026 Update | Questions and Answers (100% Verified Solutions) GRADED A. Questions: What pathogen is highly associated with CAP in general population? streptococcus pneumoniae Questions: Other common pathogens with CAP atypical bacteria (mycoplasma pneumonia) viruses (influenza, respiratory syncytial virus) Questions: First line treatment CAP in previous healthy adults Amoxicillin, doxycycline, macrolides (DAM) Questions: Treatment of CAP in pregnancy amoxicillin, cephalosporins, erythromycin (ACE) Questions: Treatment for mycoplasma pneumonia in the pediatric patient Macrolides (erythromycin, clarithromycin, azithromycin) Questions: Treatment of chlamydial pneumonia in infant Erythromycin base/ethylsuccinate Questions: Broad-spectrum antibiotics - when to use? empiric therapy When you don't know which bacteria it is more likely to facilitate emergence of drug-resistant organisms and superinfections prescribe these before culture results back suspects patient has UTI Questions: Narrow spectrum antibiotics - when to use? When the pathogen is known Preferred Questions: What are empiric antibiotics? Broad Spectrum antibiotics that are given BEFORE the results are in for certain circumstances. Also can be prescribed when the NP believes it is a certain disease. A)Prescription for an antibiotic for severe infection based on knowledge B)Prescription of an antibiotic for severe infection based on clinical evaluation C)Prescription of antibiotic for severe infection based on most likely causative agent Questions: When to prescribe empiric antibiotics? E for Emergency E for enticpation Embulatory patients Pt has severe infxn, initiate treatment before test results available Questions: How to treat C Diff Stop taking the abx that caused it flagyl and vancomycin Questions: Drug class known for all drugs in class to promote development of C diff cephalosporins (especially second or third generations) Questions: Penicillin's have cross-sensitivity with which drug class? cephalosporins Questions: Can you take penicillin's if pregnant? Yes Questions: Can you prescribe cephalosporins if pregnant? yes Questions: Patient education needed for cephalosporins Can promote C diff, instruct patients to report increase in stool frequency Questions: Can you prescribe tetracyclines in pregnant patients No - can cause tooth staining Questions: Patient education for tetracyclines Photosensitivity. Advise patients to avoid prolonged exposure to sunlight, to wear protective clothing, and to apply sunscreen to exposed skin/avoid tanning beds. Instruct patients not to take this medication together with calcium supplements, milk products, iron supplements, magnesium-containing laxatives, and most antacids. Advise patients to notify the provider if diarrhea occurs, as this is an indication of potentially life-threatening superinfection of the bowel. Questions: Macrolides patient education increased risk of Torsades due to prolonged QT Questions: Which macrolide is ok for pregnancy? erythromycin Questions: Aminoglycosides patient education (ex. gentamicin, tobramycin, amikacin) use is associated with ototoxicity and nephrotoxicity Questions: Prescribing sulfonamides during pregnancy not safe (especially in first trimester)- causes birth defects if taken near term, infant can develop kernicterus (brain damage caused by too much bilirubin) Questions: Which cephalosporins may induce a disulfiram-like reaction if alcohol is ingested? Cefazolin and cefotetan Questions: Sulfonamides patient education complete full course even if symptoms resolved take with 8-10 glasses of water or noncaffeinated beverages per day to decrease risk of crystalluria protect skin from sun no tanning beds monitor for hypersensitivity symptoms Questions: Gentamicin (aminoglycoside) monitor Cr cl in elderly renal adjustments If renal dx dose reduces or dosing interval increased Questions: What do we need to be aware of in our female patients of childbearing age with clindamycin decrease oral contraceptive activity Questions: Aminoglycosides are safe for what age group children (infant 8 days old) Questions: Clindamycin can be used as an alternative to what penicillin Questions: Specific drug to treat aspergillosis Voriconazole Questions: Which ones carry risk for hypotension with patients on antihypertensives? Ivermectin and Moxidectin Questions: Which ones can cause bone marrow suppression and liver impairment? Albendazole and Mebendazole Questions: Which is generally safe to give without obtaining baseline data? Pyrantel Pamoate Questions: How to treat tinea capitis aka ringworm Drug Class - Oral antifungal (not topical) Oral griseofulvin taken for 6-8 weeks, is considered standard therapy Questions: Budesonide risks of use in children risk for delayed growth Questions: Ketoconazole and omeprazole concurrently- what does the patient need to know decrease absorption of ketoconazole and reduce effectiveness Questions: Which weight loss drug(s) are associated with a suicide risk in children, adolescents, and young adults? Naltrexone and bupropion (contrave) Questions: Which weight loss drugs are DEA scheduled drugs? Diethylpropion Locaserin Phentermine/topiramate (Phentermine is scheduled, not topiramate) Phendimetrazine Questions: At what BMI level should bariatric surgery be considered? BMI 35 or more Questions: Topiramate -Therapeutic effect induces sense of satiety (Sense of satisfaction- don't feel hungry) Questions: How to discontinue phentermine and/or topiramate if the person has not lost 5% of weight loss by 6 months then d/c medication tolerance can develop n 6-12 weeks Questions: Which of the following would be contraindicated to prescribing phentermine/topiramate? glaucoma, hyperthyroidism, hypertension Questions: Orlistat patient education (orlistat acts in the GI tract to reduce absorption of fat) may cause hypothyroidism in patients taking levothyroxine (two drugs should be administered 4 hours apart) take vitamins A, D, E, and K stools often fatty or oily and fecal incontinence can occur (bulk forming laxative) taken with food vitamin k deficency can occur and compound effects of warfarin, so coagulation must be monitored taking more of the meds in a day won't help weight loss not for patients with malabsorption issues or cholestasis Questions: Liraglutide- Baseline data needed Ha1C, lipids, renal function Questions: Ongoing monitoring/assessment needs - Liraglutide assess for s/s of cholecystitis, pancreatitis, depression, and suicidal thoughts do not give to someone with thyroid cancer or history of thyroid cancer Questions: Loarcaserin- Baseline data needed baseline assessment to rule out valvular disorders and pulmonary hypertension Questions: Ongoing monitoring/assessment needs - Loarcaserin CBC w/ differential for s/s of blood dyscrasias Questions: Naltrexone/bupropion (contrave)- Baseline data needed blood glucose, liver function, renal functions, and mental status Questions: Ongoing monitoring/assessment needs - Contrave (Naltrexone/bupropion) periodic assessments for blood glucose, liver and renal function, s/s of depression, anxiety, panic attacks, or suicidal ideation, and mania think naltrexone (opioid antagonist) so pain medicine will not work for them Questions: Phentermine baseline data needed cardiac assessment Questions: On-going monitoring/assessment needs Ongoing assessment of cardiac status Questions: Organic sunscreen needs what ingredient to be effective? Avobenzone Questions: 1st line treatment for mild to moderate acne Benzoyl peroxide (both an antibiotic and kerolytic) Questions: 1st line treatment for severe acne Doxycycline and isotretinoin and retinoids Questions: How to treat glaucoma in someone with COPD or asthma Betaxolol Questions: Latanoprost- Side effects harmless heightened brown pigmentation of the iris and eyelid blurred vision, burning, stinging, conjunctival hyperemia or edema, and punctate keratopathy Questions: Allergic Rhinitis- Monoclonal antibody drug treatment option Omalizumab (treats asthma and seasonal allergic rhinitis) Questions: How to treat otomycosis Thorough cleaning and application of 2% acetic acid solution or antifungal 3-4 times a day for 7 days Questions: Causes of excessive cerumen in ear usually caused by pushing excess cerumen deeper into the ear while cleaning Questions: Treatment of excessive cerumen in ear irrigation of ear canal with warm water or saline Debrox drops may assist with cerumen disimpaction by softening the wax and making it easier to remove, but it does not prevent acute otitis externa Questions: This pathogen is highly associated with CAP in smokers and those with COPD Haemophilus influenzae Questions: What antibiotics can be prescribed SAFELY throughout pregnancy? penicillin's, cephalosporins, erythromycin Questions: Second line treatment for CAP (if amoxicillin doesn't work) Respiratory fluoroquinolone Questions: The patient was treated with an antibiotic in the last 90 days of contracting CAP what type of antibiotics should be prescribed? quinolone (ex. fluoroquinolone) Questions: Tendonitis/tendon rupture is highly associated with which antibiotic class? fluoroquinolone (why they should be avoided in pregnancy) Questions: Anthelmintic safe for pregnancy Praziquantel Questions: Anthelmintic’s safe for breastfeeding Mebendazole pyrantel pamoate Questions: Anthelmintic’s caution with breastfeeding/pregnancy albendazole ivermectin diethylcarbamazine Questions: Risks with didanosine lactic acidosis, severe hepatomegaly with steatosis, severe pancreatitis Questions: Voriconazole (-azoles) should NOT be combined with what drugs that are P450 inducers (Phenobarbital), reduce levels of Voriconazole Questions: What is Enterobius vermicularis? Pinworm infestation (Nematode) Most common in US pinworms in ileus and large intestine symptoms - perianal itching and sleep disturbance Once itching/on hands can spread through touching Questions: Who would you expect to have Enterobius vermicularis? Primarily in children (spread through daycares/schools) Questions: How to treat Enterobius vermicularis? Medication: albendazole, mebendazole, pyrantel pamoate Hand washing, all family members should be treated at same time Questions: Monitoring needs for long term antifungal use Liver function - AST, ALT, alkaline phosphate, and bilirubin Questions: How to treat systemic fungal infections Treating systemic mycoses can be difficult: these infections often resist treatment and hence may require prolonged therapy with drugs that frequently prove toxic. Aspergillosis - voriconazole candidiasis- amphotericin B or fluconazole plus or minus flucytosine Histoplasmosis- amphotericin B or itraconazole Questions: Adverse effects of abacavir Lactic acidosis, a severe hepatomegaly with steatosis Questions: Risks with saquinavir Use caution in patients with structural heart dx, cardiac conduction disturbances, and ischemic heart disease and taking other drugs that prolong PR interval Questions: How to measure success with antiretroviral therapy for HIV reduction in plasma HIV RNA Questions: What does an increase in CD4 indicate? increase in CD4, reduction in viral load indicating restoration of immune function Questions: When do use foscarnet in HIV+ patients? Used to treat cytomegalovirus (CMV) and CMV-related ophthalmic retinitis in individuals with AIDs and who have been unable to tolerate gancyclovir. Also approved for use in immunocompromised patients with HSV with resistance to acyclovir. "It has no use in treating HIV because it does it does not have antiretroviral properties" (NIH) Questions: PR interval impacts use of which HIV drugs atazanavir, saquinavir, lopinavir, ritonavir Questions: Metronidazole patient teaching do not take with alcohol to prevent a disulfiram-like reaction Questions: Mechanism of action with antihistamines H1 blockers bind selectively to H1-histaminic receptors, thereby blocking the actions of histamine at these sites. These drugs can relieve sneezing, rhinorrhea, and nasal itching; however, they do not reduce nasal congestion. Questions: cromolyn mechanism of action Suppresses release of histamine and inflammatory mediators from mast cells Questions: Therapeutic action of guaifenesin expectorant - thins secretions and loosens mucous Questions: Patient education needed for isotretinoin (Accutane) protect skin from sunlight, avoid sunlamps and tanning beds pregnancy should be avoided, and two reliable birth control methods used risk for depression and suicide Questions: What is the first line treatment of acute otitis media high dose amoxicillin Questions: What is likely the etiology for an elderly patient with conductive hearing loss cerumen impaction Questions: Best predictor of otitis media middle ear effusion Questions: Avoid supplements that contain vitamin A when taking Isotretinoin Questions: Treatment of acute otitis media in pediatric patient amoxicillin 40-45mg/kg BID Questions: Sympathomimetics mechanism of action nasal congestion by activating a1- adrenergic receptors on nasal blood vessels. This causes, vasoconstriction, which, in turn, causes shrinkage of swollen membranes followed by nasal drainage do not decrease sneezing, itching, or rhinorrhea. Questions: What is the most effective drug for prevention and treatment of seasonal perennial rhinitis? Intranasal glucocorticoids Questions: Glucocorticoids- Therapeutic action in allergic reactions prevents inflammatory response to allergens and reduce symptoms s/e slowed growth in kids, nasal irritation Questions: Salicylic acid patient education Cleansers and mask should be rinsed off after use. Decrease number of applications for excessive skin dryness, peeling, or irritation. Questions: Benzoyl peroxide (topical) side effects skin redness, stinging, dryness, peeling, photosensitivity. Hypersensitivity reactions in asthma patients Questions: Benzoyl peroxide patient teaching If signs of severe local irritation occur (e.g., burning, blistering, scaling, swelling), the frequency of application should be reduced. Do not use Benzoyl peroxide with Dapsone to avoid skin discoloration. If excessive stinging occurs, wash off medication with mild soap and water then resume use the next day. Questions: Patient education for loarcaserin increase in hypoglycemic episodes (if diabetic) since it can cause hypoglycemia, patients should not increase insulin dose not for women who are pregnant Questions: Contrive (naltrexone/bupropion) patient education stop for a few days if going to dentist Questions: Why might a patient being treated with contrave for obesity not have therapeutic effects from hydrocodone after dental procedure contrave contains naltrexone Questions: Antifungals to use in immunocompromised patients fluconazole and ketoconazole for oral candidiasis Questions: What antifungal can you not give to immunocompromised patients amphotericin B Questions: first line agent for someone with glaucoma lantanoprost