PHARMACOLOGY REVIEW FOR NURS 5334 FINAL EXAM/EXAM QUESTIONS WITH ACCURATE ANSWERS 100%

Are you a Nurse Practitioner (NP) student facing the cumulative NURS 5334 Final Exam? This all-in-one pharmacology study guide compresses an entire semester of advanced drug therapy into high-yield, exam-style questions with 100% verified answers. Designed for last-minute review or deep content mastery, this resource covers every major drug class, mechanism of action (MOA), adverse effects, and clinical pearls you need to pass with confidence. What’s Inside – Complete Final Exam Blueprint: Pain Management & Substance Use Disorders: Naltrexone vs. Buprenorphine for opioid maintenance (antagonist vs. partial agonist) Hydrocodone side effects (constipation, respiratory depression) and dangerous combinations (benzodiazepines + CNS depressants) Sumatriptan MOA (5HT agonist → vasoconstriction), Feverfew for migraine prophylaxis (bleeding risk with warfarin/aspirin) Endocrine & Diabetes Medications (High Yield): Metformin MOA (↓ hepatic glucose production, ↑ insulin sensitivity) – GI upset & lactic acidosis Sulfonylureas (glipizide, glyburide, glimepiride) – stimulate insulin release, cause weight gain Meglitinides (repaglinide) – rapid short-term insulin secretion SGLT-2 inhibitors (canagliflozin) – ↑ urinary glucose excretion (UTI risk) GLP-1 agonists (liraglutide, semaglutide) – weight loss, slow digestion DPP-4 inhibitors (sitagliptin) – ↑ incretins, ↓ glucagon Levothyroxine starting doses: 50 mcg (51yo), 25 mcg (68yo), 12-25 mcg (CAD patients) Propylthiouracil (PTU) for hyperthyroidism in pregnancy Respiratory Pharmacology (Asthma, COPD, Allergies): Initial asthma treatment: low-dose ICS + LABA (e.g., budesonide-formoterol) COPD Groups: A (bronchodilator), B & E (LABA + LAMA) Inhaled corticosteroids side effects: oropharyngeal candidiasis, dysphonia, osteoporosis ASA/NSAIDs contraindicated in asthma (bronchospasm) Beta-2 agonists (albuterol) – ↑ pulse rate, tremor Anticholinergics for COPD: ipratropium (blocks muscarinic), tiotropium (long-acting) Neurology & Psychiatric Medications: Haloperidol & chlorpromazine – dopamine D2 antagonists → extrapyramidal symptoms (dystonia, tardive dyskinesia, akathisia) Atypical antipsychotics (‑pine, ‑idone, ‑zole) – serotonin + dopamine blockade; clozapine risks (agranulocytosis, weight gain, dyslipidemia) Valbenazine for tardive dyskinesia Levodopa/carbidopa – avoid high-protein meals; pyridoxine (vitamin B6) reduces levodopa effect Phenytoin adverse effects: nystagmus, ataxia, gingival hyperplasia (oral care education) Serotonin syndrome symptoms (2-72 hrs after treatment): confusion, myoclonus, hyperreflexia, sweating → stop drug ADHD non-stimulants: atomoxetine, viloxazine, clonidine, guanfacine, bupropion Erenumab – first monoclonal antibody for migraine prevention Women’s Health & Vaccines: Safe HTN meds in pregnancy: methyldopa, labetalol, nifedipine Folic acid: 400-800 mcg daily (childbearing age), 400-600 mcg/day (pregnant), 1-2 mg/day (deficiency) Tdap vaccine: 27-36 weeks gestation (every pregnancy) Gardasil 9: protects against HPV 6,11,16,18,31,33,45,52,58 – cervical, vaginal, vulvar cancers, genital warts Shingrix (recombinant, age 50+, 2 doses 6 months apart) vs. live vaccines contraindicated in immunocompromised Varicella/MMR/Proquad: breakthrough chickenpox still possible Musculoskeletal & Rheumatology: Methotrexate – first-line for moderate-severe RA; hydroxychloroquine for mild RA (regular eye exams for retinal toxicity) Gout management: low-purine diet, 3L fluids, allopurinol (first-line), NSAIDs/glucocorticoids for flares Bisphosphonates (‑dronate): alendronate for osteoporosis in men; adverse effects: atypical femur fractures, osteonecrosis of jaw, esophageal ulcers, AFib Denosumab (RANKL inhibitor) – decreases osteoclast maturation Osteoarthritis supplement: glucosamine/chondroitin (caution with shellfish allergy) GI & Genitourinary: GERD step therapy: lifestyle + antacid → H2 blocker (famotidine) → PPI (omeprazole) Long-term PPI risks: iron, B12, calcium deficiency Bethanechol (muscarinic agonist) – for urinary retention/post-op ileus; contraindicated in asthma & hyperthyroidism Atropine (muscarinic antagonist) – ↑ HR, ↓ secretions, dilates pupils; side effects: dry mouth, blurred vision, constipation Benign prostatic hyperplasia (BPH): finasteride (reduces prostate size), alpha-1 antagonists (terazosin, tamsulosin – causes orthostatic hypotension, ejaculation failure) Latanoprost (↑ aqueous humor outflow) – brown iris pigmentation Hematology & Vitamins: Vitamin B12 deficiency: neurologic damage, numbness/tingling, impaired WBC production CoQ10: treats statin-induced muscle injury, HF; antagonizes warfarin (structurally similar to vitamin K) Iron dosing: ferrous sulfate 15 mg/kg/day or 325 mg BID-TID; increase fluid intake to prevent constipation Vitamin A toxicity in pregnancy – teratogenic (liver injury, bone disorders) Drug Interactions & Special Populations: Sildenafil + nitrates → severe hypotension (absolute contraindication) Metronidazole + alcohol → disulfiram reaction Feverfew + anticoagulants/antiplatelets → bleeding risk Ginkgo biloba + warfarin → increased bleeding Statin + muscle pain → check creatine kinase (CK) Cardioselective beta blockers (metoprolol, atenolol, etc.) – safer in diabetes/COPD; non-selective may cause hypoglycemia Why This Guide is Your Final Exam Pass: Verified A+ Answers: Every question includes the correct, faculty-reviewed answer. Exam-Ready Format: Direct Q&A mirrors the style of NURS 5334 final exams. Complete Coverage: From adrenergic receptors (α1, α2, β1, β2, M1-M3) to teratogenic drugs, vaccines, and antidotes. Memorable Mnemonics & Endings: Learn drug class suffixes (-dronate, -pine, -idone) and key contraindications. Ideal for FNP, AGNP, and graduate nursing students preparing for advanced pharmacology finals, certification exams (ANCC, AANP), or clinical rotations.