University of Texas, Arlington: NURS 5334 Quiz 1 Pharm bone,
urology, eye and ears.
1. Question: What is the mechanism of action (MOA) of bisphosphonates?
Answer/Explanation: Bisphosphonates inhibit osteoclast-mediated bone
resorption. They bind to hydroxyapatite in bone and are internalized by
osteoclasts, where they disrupt the mevalonate pathway (nitrogen-containing
bisphosphonates) or form toxic ATP analogs (non-nitrogen-containing), leading
to osteoclast apoptosis and reduced bone breakdown.
2. Question: A patient with a history of GERD cannot take oral medications. What IV
medication can be given?
Answer/Explanation: IV proton pump inhibitor (e.g., pantoprazole) or IV H₂
blocker (e.g., famotidine). IV PPIs are preferred for rapid acid suppression when
oral administration is not possible.
3. Question: What are the required components of a prescription? (Note: “no sex”
means sex/gender is not a required field.)
Answer/Explanation: Standard components include: patient name and address,
date, drug name, strength, dosage form, quantity, directions for use, prescriber’s
name, signature, and DEA number (if controlled). Sex is not a mandatory element.
4. Question: Which drugs can cause bone loss?
Answer/Explanation: Long-term glucocorticoids, chronic proton pump
inhibitors (PPIs), anticonvulsants (phenytoin, phenobarbital), aromatase inhibitors,
GnRH agonists, thiazolidinediones (rosiglitazone), loop diuretics, heparin, and
medroxyprogesterone acetate.
5. Question: Which bisphosphonates are used for both osteoporosis and Paget’s
disease?
Answer/Explanation: Alendronate, risedronate, and zoledronic acid.
Pamidronate is also used for Paget’s but less commonly for osteoporosis.
6. Question: How are T-scores and Z-scores interpreted on a DEXA scan for
osteoporosis?
Answer/Explanation:
o T-score: > -1 = normal; -1 to -2.5 = osteopenia (low bone mass); ≤ -2.5 =
osteoporosis; ≤ -2.5 with fragility fracture = severe osteoporosis.
o Z-score: compares to age-matched peers; a Z-score < -2 suggests a
secondary cause of bone loss.
7. Question: When is prescription vitamin D₃ (cholecalciferol) indicated for
osteomalacia?
Answer/Explanation: Prescription high-dose vitamin D (D₂ or D₃, e.g., 50,000 IU
urology, eye and ears.
1. Question: What is the mechanism of action (MOA) of bisphosphonates?
Answer/Explanation: Bisphosphonates inhibit osteoclast-mediated bone
resorption. They bind to hydroxyapatite in bone and are internalized by
osteoclasts, where they disrupt the mevalonate pathway (nitrogen-containing
bisphosphonates) or form toxic ATP analogs (non-nitrogen-containing), leading
to osteoclast apoptosis and reduced bone breakdown.
2. Question: A patient with a history of GERD cannot take oral medications. What IV
medication can be given?
Answer/Explanation: IV proton pump inhibitor (e.g., pantoprazole) or IV H₂
blocker (e.g., famotidine). IV PPIs are preferred for rapid acid suppression when
oral administration is not possible.
3. Question: What are the required components of a prescription? (Note: “no sex”
means sex/gender is not a required field.)
Answer/Explanation: Standard components include: patient name and address,
date, drug name, strength, dosage form, quantity, directions for use, prescriber’s
name, signature, and DEA number (if controlled). Sex is not a mandatory element.
4. Question: Which drugs can cause bone loss?
Answer/Explanation: Long-term glucocorticoids, chronic proton pump
inhibitors (PPIs), anticonvulsants (phenytoin, phenobarbital), aromatase inhibitors,
GnRH agonists, thiazolidinediones (rosiglitazone), loop diuretics, heparin, and
medroxyprogesterone acetate.
5. Question: Which bisphosphonates are used for both osteoporosis and Paget’s
disease?
Answer/Explanation: Alendronate, risedronate, and zoledronic acid.
Pamidronate is also used for Paget’s but less commonly for osteoporosis.
6. Question: How are T-scores and Z-scores interpreted on a DEXA scan for
osteoporosis?
Answer/Explanation:
o T-score: > -1 = normal; -1 to -2.5 = osteopenia (low bone mass); ≤ -2.5 =
osteoporosis; ≤ -2.5 with fragility fracture = severe osteoporosis.
o Z-score: compares to age-matched peers; a Z-score < -2 suggests a
secondary cause of bone loss.
7. Question: When is prescription vitamin D₃ (cholecalciferol) indicated for
osteomalacia?
Answer/Explanation: Prescription high-dose vitamin D (D₂ or D₃, e.g., 50,000 IU
