NU 578 Unit 2 Exam | ACTUAL EXAM | Advanced Pharmacology | University of South Alabama | Cardiovascular, Respiratory, Renal, Endocrine | 75 Questions & Expert Rationales | Pass Guaranteed - A+ Graded

Pass the NU 578 Unit 2 Advanced Pharmacology Exam on your first attempt with the most current actual exam resource available. This A+ Graded comprehensive study resource contains 75 Questions with Expert Rationales fully aligned with the University of South Alabama NU 578 Advanced Pharmacology curriculum, covering Cardiovascular, Respiratory, Renal, and Endocrine pharmacology domains essential for graduate-level nursing success. Designed to mirror the official NU 578 Unit 2 Examination format, this resource provides the most thorough preparation for advanced practice nursing students seeking to demonstrate mastery of pharmacotherapeutics for complex cardiovascular, respiratory, renal, and endocrine conditions. Comprehensive content coverage includes: CARDIOVASCULAR PHARMACOLOGY Antihypertensive Agents: ACE inhibitors (lisinopril, enalapril, ramipril: mechanism—inhibits angiotensin-converting enzyme, reduces vasoconstriction and aldosterone; adverse effects—angioedema, cough, hyperkalemia, renal impairment; monitoring—creatinine, potassium, blood pressure), ARBs (losartan, valsartan, candesartan: mechanism—blocks angiotensin II receptors; adverse effects—less cough than ACE inhibitors, angioedema, hyperkalemia), calcium channel blockers (dihydropyridines: amlodipine, nifedipine—peripheral edema, headache; non-dihydropyridines: diltiazem, verapamil—negative inotropy, chronotropy, constipation, AV block), beta-blockers (cardioselective: metoprolol, atenolol; non-selective: propranolol, carvedilol; mechanism—blocks beta-adrenergic receptors, decreases heart rate and contractility; adverse effects—bradycardia, hypotension, bronchospasm, masking of hypoglycemia, fatigue), thiazide diuretics (hydrochlorothiazide, chlorthalidone: first-line for hypertension, hypokalemia, hypercalcemia, hyperglycemia, hyponatremia), loop diuretics (furosemide, bumetanide, torsemide: hypertension with renal impairment, ototoxicity, electrolyte depletion), alpha-blockers (doxazosin, prazosin: benign prostatic hyperplasia, first-dose syncope, orthostatic hypotension), centrally acting agents (clonidine: rebound hypertension, sedation), direct vasodilators (hydralazine: reflex tachycardia, drug-induced lupus; minoxidil: hypertrichosis, fluid retention) Heart Failure Pharmacotherapy: ACE inhibitors and ARBs (first-line for HFrEF, reduce mortality and hospitalizations), beta-blockers (carvedilol, metoprolol succinate, bisoprolol: reduce mortality, titrate slowly), ARNI (sacubitril/valsartan: neprilysin inhibitor + ARB, superior to ACE inhibitors for HFrEF, monitoring for hypotension, hyperkalemia, angioedema), aldosterone antagonists (spironolactone, eplerenone: reduce mortality in HFrEF, monitor potassium and renal function, gynecomastia with spironolactone), SGLT2 inhibitors (empagliflozin, dapagliflozin: reduce HF hospitalizations regardless of diabetes status, euglycemic DKA risk, UTIs), loop diuretics (furosemide, bumetanide, torsemide: symptom management, monitor weight, electrolytes, renal function), digoxin (positive inotrope, narrow therapeutic index, monitor levels, toxicity: nausea, visual changes, arrhythmias; hypokalemia increases toxicity), hydralazine/isosorbide dinitrate (HFrEF in African Americans, adjunct therapy), ivabradine (reduces heart rate in HFrEF with elevated heart rate) Ischemic Heart Disease & Acute Coronary Syndrome: Nitrates (nitroglycerin: sublingual, transdermal, IV; mechanism—venodilation, reduced preload, coronary vasodilation; tolerance with continuous use; contraindications: phosphodiesterase inhibitors (sildenafil, tadalafil) within 24-48 hours, hypotension), beta-blockers (first-line post-MI, reduce myocardial oxygen demand, mortality benefit), calcium channel blockers (non-dihydropyridines for vasospastic angina, verapamil/diltiazem for rate control), antiplatelet agents (aspirin: 81-325 mg, irreversible COX inhibition; P2Y12 inhibitors: clopidogrel, ticagrelor, prasugrel—dual antiplatelet therapy post-stent, CYP2C19 metabolism for clopidogrel), anticoagulants in ACS (unfractionated heparin, enoxaparin, bivalirudin), statins (high-intensity statin post-ACS, atorvastatin 80 mg, rosuvastatin 40 mg) Dyslipidemia Management: Statins (HMG-CoA reductase inhibitors: atorvastatin, rosuvastatin, simvastatin, pravastatin; mechanism—reduce LDL cholesterol, anti-inflammatory effects; adverse effects—myalgia, myopathy, rhabdomyolysis, elevated transaminases, new-onset diabetes; monitoring—LFTs, CK; drug interactions: CYP3A4 inhibitors, gemfibrozil, niacin; cardiovascular event reduction), ezetimibe (cholesterol absorption inhibitor, additive LDL reduction), PCSK9 inhibitors (alirocumab, evolocumab: monoclonal antibodies, profound LDL reduction, injectable), fibrates (fenofibrate, gemfibrozil: triglyceride reduction, gemfibrozil-statin interaction), niacin (triglyceride reduction, flushing, hyperglycemia), omega-3 fatty acids (triglyceride reduction) Antidysrhythmic Agents: Vaughan-Williams classification: Class I (sodium channel blockers: quinidine, procainamide, lidocaine, flecainide—proarrhythmia risk), Class II (beta-blockers: metoprolol, propranolol), Class III (potassium channel blockers: amiodarone, sotalol, dofetilide—QT prolongation, amiodarone: pulmonary toxicity, thyroid dysfunction, corneal deposits, hepatotoxicity, blue-gray skin discoloration; monitoring: chest X-ray, LFTs, TSH), Class IV (calcium channel blockers: verapamil, diltiazem), digoxin, adenosine (AV nodal blocker, first-line for SVT, very short half-life, transient asystole, flushing) Anticoagulants & Antiplatelets: Warfarin (vitamin K antagonist, INR monitoring, drug-drug/food interactions, reversal: vitamin K, fresh frozen plasma, prothrombin complex concentrate), direct oral anticoagulants (apixaban, rivaroxaban, edoxaban: factor Xa inhibitors; dabigatran: direct thrombin inhibitor; advantages: no routine monitoring, fewer drug interactions; reversal agents: andexanet alfa for factor Xa inhibitors, idarucizumab for dabigatran; renal dosing considerations), heparin and LMWH (unfractionated heparin: aPTT monitoring, HIT risk; enoxaparin: anti-Xa monitoring in renal impairment), antiplatelet agents (aspirin, clopidogrel, ticagrelor, prasugrel, dipyridamole, cilostazol) Peripheral Vascular Disease: Antiplatelet therapy, statins, cilostazol (intermittent claudication, contraindicated in heart failure), pentoxifylline RESPIRATORY PHARMACOLOGY Asthma & COPD Management: GINA guidelines for asthma (stepwise approach, SABA for symptom relief, low-dose ICS for persistent asthma, add-on LABA, LTRA, tiotropium, or biologic therapy for severe asthma), GOLD guidelines for COPD (SABA or SAMA for mild symptoms, LABA or LAMA for moderate symptoms, LABA/LAMA combination, add ICS for exacerbations, triple therapy for severe disease), SABA (albuterol, levalbuterol: acute bronchospasm, tachycardia, tremor, hypokalemia), LABA (salmeterol, formoterol: maintenance therapy, not for acute use, black box warning for asthma-related death), SAMA (ipratropium bromide: COPD, acute asthma exacerbation), LAMA (tiotropium, umeclidinium, aclidinium: once-daily, COPD maintenance), ICS (fluticasone, budesonide, beclomethasone: oral candidiasis, hoarseness, pneumonia risk in COPD, adrenal suppression with high doses), combination inhalers (ICS/LABA: fluticasone/salmeterol, budesonide/formoterol; LABA/LAMA; triple therapy: ICS/LABA/LAMA), leukotriene modifiers (montelukast, zafirlukast, zileuton: asthma, allergic rhinitis, neuropsychiatric events black box warning), monoclonal antibodies for severe asthma (omalizumab: anti-IgE; mepolizumab, reslizumab, benralizumab: anti-IL-5; dupilumab: anti-IL-4/IL-13), methylxanthines (theophylline: narrow therapeutic index, drug interactions, monitoring), systemic corticosteroids (prednisone, methylprednisolone: acute exacerbations, short courses, adverse effects with chronic use), mucolytics (acetylcysteine, hypertonic saline: COPD, cystic fibrosis), phosphodiesterase-4 inhibitors (roflumilast: COPD with chronic bronchitis and exacerbations) Pulmonary Arterial Hypertension: Endothelin receptor antagonists (bosentan, ambrisentan: hepatotoxicity, teratogenicity, REMS program), phosphodiesterase-5 inhibitors (sildenafil, tadalafil: vasodilation), prostacyclin analogs (epoprostenol, treprostinil: continuous infusion, inhaled, oral), soluble guanylate cyclase stimulators (riociguat) Antitussives & Expectorants: Dextromethorphan (non-opioid antitussive, serotonin syndrome risk with serotonergic drugs), benzonatate (peripheral antitussive), codeine (opioid antitussive, CYP2D6 metabolism, respiratory depression risk), guaifenesin (expectorant), acetylcysteine (mucolytic, acetaminophen overdose) RENAL PHARMACOLOGY Diuretics: Loop diuretics (furosemide, bumetanide, torsemide: mechanism—inhibits Na-K-Cl cotransporter in loop of Henle; potency—most potent; indications: heart failure, renal impairment, edema; adverse effects: ototoxicity, electrolyte depletion, dehydration; monitoring: electrolytes, creatinine, weight, urine output), thiazide diuretics (hydrochlorothiazide, chlorthalidone, metolazone: mechanism—inhibits Na-Cl cotransporter in distal convoluted tubule; indications: hypertension, mild-moderate edema; adverse effects: hypokalemia, hypercalcemia, hyperglycemia, hyponatremia, hyperuricemia; metolazone synergistic with loop diuretics), potassium-sparing diuretics (spironolactone, eplerenone: aldosterone antagonists; amiloride, triamterene: epithelial sodium channel blockers; indications: heart failure, hypertension; adverse effects: hyperkalemia, gynecomastia with spironolactone; monitoring: potassium, renal function), carbonic anhydrase inhibitors (acetazolamide: metabolic alkalosis, glaucoma, altitude sickness; metabolic acidosis, hypokalemia), osmotic diuretics (mannitol: increased intracranial pressure, increased intraocular pressure; heart failure risk, renal impairment), vasopressin receptor antagonists (tolvaptan: hyponatremia, SIADH; hepatotoxicity risk, fluid restriction) Chronic Kidney Disease Pharmacotherapy: ACE inhibitors and ARBs (first-line for proteinuric CKD, slow progression, monitor potassium and creatinine), SGLT2 inhibitors (empagliflozin, dapagliflozin, canagliflozin: reduce CKD progression, eGFR decline; indicated in diabetic and non-diabetic CKD), erythropoiesis-stimulating agents (epoetin alfa, darbepoetin: anemia of CKD, target hemoglobin 10-11 g/dL, black box warning for increased cardiovascular risk, thrombosis, death), iron supplementation (oral ferrous sulfate; IV iron sucrose, ferric carboxymaltose: for iron deficiency, infusion reactions), phosphate binders (calcium acetate, sevelamer, lanthanum: hyperphosphatemia in CKD, dosing with meals), vitamin D analogs (calcitriol, paricalcitol: secondary hyperparathyroidism, hypercalcemia risk, calcium and phosphorus monitoring), potassium binders (patiromer, sodium zirconium cyclosilicate: hyperkalemia in CKD) End-Stage Renal Disease & Dialysis: Medication dosing adjustments based on GFR, drugs dialyzable vs. non-dialyzable, timing of medication administration relative to dialysis, dialyzable medications (vancomycin, aminoglycosides, many beta-lactams), non-dialyzable medications (DOACs, many oral agents) ENDOCRINE PHARMACOLOGY Diabetes Mellitus Pharmacotherapy: ADA Standards of Care , glycemic targets, comprehensive approach Insulins: Rapid-acting (lispro, aspart, glulisine: onset 10-30 min, peak 30-90 min, duration 3-5 hours; administer with meals, immediate pre-prandial or post-prandial correction), short-acting (regular insulin: onset 30-60 min, peak 2-4 hours, duration 5-8 hours; IV administration for DKA/HHS), intermediate-acting (NPH: onset 1-2 hours, peak 4-8 hours, duration 12-18 hours; cloudy appearance, must resuspend), long-acting (glargine, detemir, degludec: onset 1-2 hours, no pronounced peak, duration 24-42 hours; do not mix with other insulins, degludec flexible dosing), insulin administration (subcutaneous injection sites, rotation, storage, insulin pumps), insulin regimens (basal-bolus, sliding scale, continuous subcutaneous insulin infusion) Oral and Injectable Antidiabetics: Metformin (first-line: decreases hepatic gluconeogenesis, increases peripheral glucose uptake; contraindications: eGFR 30, metabolic acidosis, lactic acidosis risk, hold before contrast procedures, B12 deficiency with long-term use), sulfonylureas (glipizide, glyburide, glimepiride: increase insulin secretion; adverse effects: hypoglycemia, weight gain; glyburide caution in elderly due to prolonged hypoglycemia), meglitinides (repaglinide, nateglinide: rapid-onset insulin secretagogues, take with meals, hypoglycemia risk), thiazolidinediones (pioglitazone, rosiglitazone: increase insulin sensitivity; adverse effects: fluid retention, heart failure risk, weight gain, bladder cancer risk with pioglitazone, fractures; monitoring: heart failure symptoms, LFTs), DPP-4 inhibitors (sitagliptin, linagliptin, saxagliptin: increase incretin levels; neutral weight, minimal hypoglycemia; adverse effects: pancreatitis, arthralgias; saxagliptin heart failure hospitalization risk), GLP-1 receptor agonists (semaglutide, liraglutide, dulaglutide, exenatide: increase insulin secretion, delay gastric emptying, promote weight loss; cardiovascular benefit; adverse effects: nausea, vomiting, diarrhea, constipation, gallbladder disease, pancreatitis, thyroid C-cell tumor risk; administration: subcutaneous injection; liraglutide 0.6-1.8 mg, semaglutide weekly), SGLT2 inhibitors (empagliflozin, dapagliflozin, canagliflozin: increase urinary glucose excretion; cardiovascular and kidney benefit; adverse effects: UTIs, genital mycotic infections, volume depletion, euglycemic DKA, lower limb amputation risk with canagliflozin, Fournier's gangrene; monitoring: eGFR, volume status), alpha-glucosidase inhibitors (acarbose, miglitol: delay carbohydrate absorption; adverse effects: flatulence, diarrhea; take with first bite of meals), combination agents Diabetic Ketoacidosis & Hyperglycemic Emergencies: IV insulin (regular insulin infusion), fluid resuscitation (0.9% NS, then 0.45% NS), potassium replacement, bicarbonate (controversial), monitoring (glucose hourly, electrolytes, venous pH) Hypoglycemia Management: Rule of 15 (15 grams fast-acting carbohydrate, recheck in 15 minutes, repeat if 70 mg/dL), glucagon (IM, subcutaneous, intranasal for unconscious patients or unable to swallow), prevention strategies Thyroid Disorders: Hypothyroidism (levothyroxine: synthetic T4, dosing based on weight, age, comorbidities; administration: fasting, morning, 30-60 minutes before food, consistent timing; drug interactions: calcium, iron, PPIs, estrogens; monitoring: TSH every 6-8 weeks until stable, then annually; overtreatment risks: atrial fibrillation, osteoporosis; myxedema coma management: IV levothyroxine, IV liothyronine, supportive care), hyperthyroidism (methimazole: first-line, hepatotoxicity risk, agranulocytosis; propylthiouracil: second-line, black box warning for hepatotoxicity; radioactive iodine therapy: definitive treatment, hypothyroidism post-treatment; beta-blockers: symptom management; thyroid storm management: methimazole or PTU, beta-blockers, corticosteroids, iodine) Adrenal Disorders: Addison's disease (glucocorticoids: hydrocortisone, prednisone; mineralocorticoids: fludrocortisone; stress dosing, adrenal crisis management: IV hydrocortisone, IV fluids), Cushing's syndrome (pharmacotherapy: ketoconazole, metyrapone, pasireotide), adrenal insufficiency Osteoporosis Pharmacotherapy: Bisphosphonates (alendronate, risedronate, ibandronate, zoledronic acid: antiresorptive, administration: fasting, full glass water, remain upright for 30-60 minutes; adverse effects: esophagitis, hypocalcemia, osteonecrosis of the jaw, atypical femoral fractures; monitoring: calcium, vitamin D, DEXA; drug holiday after 3-5 years), denosumab (RANKL inhibitor: subcutaneous injection every 6 months, hypocalcemia risk, osteonecrosis of the jaw, atypical femoral fractures, no drug holiday), teriparatide (anabolic agent: daily injection, limited to 2 years duration), raloxifene (SERM: vertebral fracture reduction, thromboembolism risk), calcitonin (nasal spray: mild analgesic effect for vertebral fractures) Calcium & Vitamin D Disorders: Vitamin D supplementation (cholecalciferol D3, ergocalciferol D2: dosing for deficiency, maintenance), calcium supplementation (calcium carbonate: take with food; calcium citrate: take without food), hypercalcemia management (IV fluids, calcitonin, bisphosphonates, denosumab), hypocalcemia management (calcium gluconate IV, oral calcium, vitamin D) Each question includes expert rationales explaining the "why" behind correct and incorrect answers, reinforcing pharmacotherapeutic principles, clinical decision-making, and evidence-based practice essential for NU 578 success. 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