NR 565 Advanced Pharmacology
Exam Questions with Detailed
Answers
1. Signs and symptoms of hypothyroidism - ANSWER Face is pale, puffy, and
expressionless.
Skin is cold and dry.
hair is brittle, and hair loss occurs.
Heart rate and temperature are lowered. The patient lethargy, fatigue, and
intolerance to cold.
Mentation may be impaired.
2. Signs and symptoms of hyperthyroidism - ANSWER Heart Rate is Rapid;
Possible arrhythmia/angina
Nervousness, insomnia, rapid thought flow, and rapid speech
Skeletal muscles may weaken and atrophy
Metabolic rate is raised, resulting in increased heat production, increased body
temperature, intolerance to heat, and skin that is warm and moist
Weight loss occurs if caloric intake fails to match the increase in metabolic rate
3. Severe hypothyroidism - ANSWER Myxedema
4. Basal insulin replacement - ANSWER 50% of the total daily insulin dose
which replaces insulin from fasting (overnight) and between meals.
,5. Bolus insulin replacement - ANSWER 50% of the total daily insulin dose
and provides carbohydrate coverage and high blood sugar correction.
6. Biguanides Drug Class - ANSWER Metformin
7. Metformin - ANSWER Decreases glucose production by the liver
(glucogenesis), increases tissue response to insulin;
Decrease glucose absorption; Increase glucose uptake
drug of choice for initial therapy in most patients with type 2 diabetes
8. Metformin contraindications - ANSWER renal disease, acidosis from
hepatic disease, alcoholics, or in patients with hypoxia.
9. Metformin Major AE - ANSWER Gastrointestinal (GI) symptoms:
decreased appetite, nausea, diarrhea
Lactic acidosis (rarely)
10.Sulfonylureas Prototype/MOA - ANSWER Glyburide (Prototype Drug)
-Promote insulin secretion by the pancreas; may also increase tissue response to
insulin;
-stimulate beta cells of the pancreas to secrete more insulin
11.Sulfonylureas AE - ANSWER high risk of severe hypoglycemia;
photosensitivity; therefore, patient education is needed regarding sunscreen.
,blood dyscrasias
weight gain.
12.Sulfonylureas Contraindication - ANSWER should be avoided in patients
with impaired hepatic or renal function.
13.Meglitinides (Glinides) Prototype/MOA - ANSWER -Repaglinide
(Prototype Drug)
-stimulation of pancreatic insulin release though shorter acting then
sulfonylureas and are taken with each meal
-Facilitates calcium influx in pancreatic β cells, which leads to increased insulin
release
14.Meglitinides Main AE - ANSWER Hypoglycemia
15.Meglitinides Contraindications - ANSWER Use with caution in patients
with liver impairment and those taking gemfibrozil.
16.Thiazolidinediones (Glitazones) Prototype/MOA - ANSWER -Pioglitazone
(Prototype Drug)
-enhance insulin sensitivity/decrease insulin resistance in muscle tissue and
reduce glucagon production in the liver
-Mainly an add on to Metformin
17.Thiazolidinediones (TZDs) Main AE - ANSWER Hypoglycemia but only in
the presence of excessive insulin
, Heart failure
Bladder cancer
Fractures (in women)
Ovulation and thus possible unintended pregnancy
18.Pioglitazone Black Box Warning - ANSWER associated with heart failure
(HF) secondary to renal retention of fluid. If HF is diagnosed, should be
discontinued or used in reduced dosage.
19.Thiazolidinediones (TZDs) Contraindicatgions - ANSWER patients with
heart failure, bladder cancer or history of bladder cancer.
20.Dipeptidyl Peptidase-4 Inhibitors (Gliptins) Prototype/MOA - ANSWER
Sitagliptin/Januvia (Prototype Drug)
-Enhances actions of incretin hormones to stimulate glucose dependent insulin
and suppresses glucagon release
21.Dipeptidyl Peptidase-4 Inhibitors (Gliptins) Main AE - ANSWER -joint
pain
-hypersensitivity/ angioedema
-acute pancreatitis.
22.Dipeptidyl Peptidase-4 Inhibitors (Gliptins) Contraindications - ANSWER
Use cautiously with patients with hx of pancreatitis
23.Sodium-Glucose Cotransporter 2 Inhibitors Prototype/MOA - ANSWER -
Canagliflozin (Prototype Drug)
-Reduces the reabsorption of glucose, increasing urinary excretion of glucose
Exam Questions with Detailed
Answers
1. Signs and symptoms of hypothyroidism - ANSWER Face is pale, puffy, and
expressionless.
Skin is cold and dry.
hair is brittle, and hair loss occurs.
Heart rate and temperature are lowered. The patient lethargy, fatigue, and
intolerance to cold.
Mentation may be impaired.
2. Signs and symptoms of hyperthyroidism - ANSWER Heart Rate is Rapid;
Possible arrhythmia/angina
Nervousness, insomnia, rapid thought flow, and rapid speech
Skeletal muscles may weaken and atrophy
Metabolic rate is raised, resulting in increased heat production, increased body
temperature, intolerance to heat, and skin that is warm and moist
Weight loss occurs if caloric intake fails to match the increase in metabolic rate
3. Severe hypothyroidism - ANSWER Myxedema
4. Basal insulin replacement - ANSWER 50% of the total daily insulin dose
which replaces insulin from fasting (overnight) and between meals.
,5. Bolus insulin replacement - ANSWER 50% of the total daily insulin dose
and provides carbohydrate coverage and high blood sugar correction.
6. Biguanides Drug Class - ANSWER Metformin
7. Metformin - ANSWER Decreases glucose production by the liver
(glucogenesis), increases tissue response to insulin;
Decrease glucose absorption; Increase glucose uptake
drug of choice for initial therapy in most patients with type 2 diabetes
8. Metformin contraindications - ANSWER renal disease, acidosis from
hepatic disease, alcoholics, or in patients with hypoxia.
9. Metformin Major AE - ANSWER Gastrointestinal (GI) symptoms:
decreased appetite, nausea, diarrhea
Lactic acidosis (rarely)
10.Sulfonylureas Prototype/MOA - ANSWER Glyburide (Prototype Drug)
-Promote insulin secretion by the pancreas; may also increase tissue response to
insulin;
-stimulate beta cells of the pancreas to secrete more insulin
11.Sulfonylureas AE - ANSWER high risk of severe hypoglycemia;
photosensitivity; therefore, patient education is needed regarding sunscreen.
,blood dyscrasias
weight gain.
12.Sulfonylureas Contraindication - ANSWER should be avoided in patients
with impaired hepatic or renal function.
13.Meglitinides (Glinides) Prototype/MOA - ANSWER -Repaglinide
(Prototype Drug)
-stimulation of pancreatic insulin release though shorter acting then
sulfonylureas and are taken with each meal
-Facilitates calcium influx in pancreatic β cells, which leads to increased insulin
release
14.Meglitinides Main AE - ANSWER Hypoglycemia
15.Meglitinides Contraindications - ANSWER Use with caution in patients
with liver impairment and those taking gemfibrozil.
16.Thiazolidinediones (Glitazones) Prototype/MOA - ANSWER -Pioglitazone
(Prototype Drug)
-enhance insulin sensitivity/decrease insulin resistance in muscle tissue and
reduce glucagon production in the liver
-Mainly an add on to Metformin
17.Thiazolidinediones (TZDs) Main AE - ANSWER Hypoglycemia but only in
the presence of excessive insulin
, Heart failure
Bladder cancer
Fractures (in women)
Ovulation and thus possible unintended pregnancy
18.Pioglitazone Black Box Warning - ANSWER associated with heart failure
(HF) secondary to renal retention of fluid. If HF is diagnosed, should be
discontinued or used in reduced dosage.
19.Thiazolidinediones (TZDs) Contraindicatgions - ANSWER patients with
heart failure, bladder cancer or history of bladder cancer.
20.Dipeptidyl Peptidase-4 Inhibitors (Gliptins) Prototype/MOA - ANSWER
Sitagliptin/Januvia (Prototype Drug)
-Enhances actions of incretin hormones to stimulate glucose dependent insulin
and suppresses glucagon release
21.Dipeptidyl Peptidase-4 Inhibitors (Gliptins) Main AE - ANSWER -joint
pain
-hypersensitivity/ angioedema
-acute pancreatitis.
22.Dipeptidyl Peptidase-4 Inhibitors (Gliptins) Contraindications - ANSWER
Use cautiously with patients with hx of pancreatitis
23.Sodium-Glucose Cotransporter 2 Inhibitors Prototype/MOA - ANSWER -
Canagliflozin (Prototype Drug)
-Reduces the reabsorption of glucose, increasing urinary excretion of glucose
