NSG 520 Exam 1 Pharmacology and Pathophysiology
Questions with Correct Answers
• Which patients should not take timolol? (Module 05.04.04)
o Contraindicated in patients with bronchial asthma, severe COPD, sinus
bradycardia, 2nd/3rd degree AV block, cardiac failure, or cardiogenic shock
o Beta blockers have sufficient systemic effects – 1 drop of 0.05% Timolol eye
drops is the same as 10mg timolol PO.
o Timolol is a beta1 and beta2 blocker
▪ Because beta blockers are primarily used for CV diseases like
hypertension, patients with low function are at risk
▪ Blockade of beta1 produces bradycardia and AV heart block
▪ Blockade of beta2 can cause bronchospasms
• When do we use glucocorticoids? (Module 03.03.01)
o Glucocorticoids – steroidal anti-inflammatory drugs, mainly used for short-term
treatment of many inflammatory disorders
▪ Glucocorticoids are natural hormones produced by the adrenal cortex
which effect carbohydrate metabolism and mineralocorticoids that impact
salt and water balance
o Used for adrenal insufficiency (small doses) and inflammatory disorders, cancers,
and suppress immune response in organ transplant recipients
▪ These drugs are helpful but have significant undesirable effects that can
affect patient care
• How are most drugs metabolized? (Module 01.04.01)
o A drug enters the body by the chosen route, travels into the bloodstream and
eventually arrives at the desired site of action. It then exerts is effect and is
metabolized.
o Most drugs are metabolized and inactivated in the liver and excreted by the
kidneys
▪ Few drugs are excreted in bile or feces
• Vesicles (Module 05.01.01)
o Vesicles- elevated, thin-walled lesion containing clear fluid (think blister)
▪ Vesicles are less than 0.5cm in diameter (bullae are greater than 0.5cm,
pustules are vesicles with purulent or cloudy fluid)
• Immune system (Module 02.07.01 & 02.07.03)
o Nonspecific (innate) – inflammation
▪ Occurs because of any threat or known injury with no specific target,
defenses which you were born with
▪ Skin, mucous membranes, reflexes, nonspecific chemical deterrents,
nonspecific defense cells (macrophages, basophils, natural killer t-cells)
o Specific (adaptive) – response to a particular substance, cell, toxin, or protein
▪ Specialized immunity for specific pathogens
, ▪ Helper t-cells, cytotoxic t-cells, b-cells
o Structures – lymphoid structures, immune cells, tissues concerned with immune
cell development, and chemical mediators
• How does morphine work? (Module 05.06.07)
o The prototype of the strong opioid analgesics and remains the standard by which
newer opioids are measures
o Relieve pain by mimicking the actions of endogenous opioid peptides at the mu
receptors
▪ Opioid peptides and morphine bind to the same receptors in the CNS
▪ Opioid peptides have a severe physiologic role as modulators of pain
perception, and are subject to abuse due to their ability to cause
pleasurable experiences of euphoria, sedation and orgasm-like sensations
• Penicillin (Module 04.02.01 & 04.02.02)
o MOA - Penicillin weakens the cell wall, causing bacteria to take up excessive
amounts of water and rupture. They are bactericidal to cells that are undergoing
growth and division
▪ Resistance occurs when penicillin can’t reach the target, inactivation of
penicillin by bacterial enzymes and production of penicillin binding
proteins that have a low affinity for penicillins
▪ Beta-lactamases produces primarily by gram-positive (sometimes by
gram-negative) inactivate penicillin
▪ Beta-lactamase enzymes that bind and inactivate the beta lactam ring main
mechanism on penicillin – penicillinases
• Narrow-spec: penicillinase sensitive – Pen G & Pen V
• Narrow-spec: penicillinase resistant – nafcillin, oxacillin,
dicloxacillin
• Broad-spec penicillins – ampicillin and amoxicillin
• Extended-spec penicillin – piperacillin
• Types of burns and burn response (Module 05.03.01)
o Superficial burns – damage to the epidermis and possible upper dermis. Examples
are sunburn or mild scald, usually are red/painful but heal readily w/ no scarring
o Partial- thickness burns – involve destruction of the epidermis and part of the
dermis. Area is red, edematous, blistered, and often hypersensitive/painful
o Full-thickness burns – result in destruction of all skin layers and in cases of 4th-
degree, often underlying tissues. The area is coagulated or charred, hard and dry
on surface. Damaged tissue shrinks, causing pressure on edematous tissue under it
o Effects
▪ Serious burns can affect both local and systemic systems
▪ Main problems include respiratory problems (carbon monoxide and smoke
inhalation injuries to respiratory system), pain, infection (main barrier to
Questions with Correct Answers
• Which patients should not take timolol? (Module 05.04.04)
o Contraindicated in patients with bronchial asthma, severe COPD, sinus
bradycardia, 2nd/3rd degree AV block, cardiac failure, or cardiogenic shock
o Beta blockers have sufficient systemic effects – 1 drop of 0.05% Timolol eye
drops is the same as 10mg timolol PO.
o Timolol is a beta1 and beta2 blocker
▪ Because beta blockers are primarily used for CV diseases like
hypertension, patients with low function are at risk
▪ Blockade of beta1 produces bradycardia and AV heart block
▪ Blockade of beta2 can cause bronchospasms
• When do we use glucocorticoids? (Module 03.03.01)
o Glucocorticoids – steroidal anti-inflammatory drugs, mainly used for short-term
treatment of many inflammatory disorders
▪ Glucocorticoids are natural hormones produced by the adrenal cortex
which effect carbohydrate metabolism and mineralocorticoids that impact
salt and water balance
o Used for adrenal insufficiency (small doses) and inflammatory disorders, cancers,
and suppress immune response in organ transplant recipients
▪ These drugs are helpful but have significant undesirable effects that can
affect patient care
• How are most drugs metabolized? (Module 01.04.01)
o A drug enters the body by the chosen route, travels into the bloodstream and
eventually arrives at the desired site of action. It then exerts is effect and is
metabolized.
o Most drugs are metabolized and inactivated in the liver and excreted by the
kidneys
▪ Few drugs are excreted in bile or feces
• Vesicles (Module 05.01.01)
o Vesicles- elevated, thin-walled lesion containing clear fluid (think blister)
▪ Vesicles are less than 0.5cm in diameter (bullae are greater than 0.5cm,
pustules are vesicles with purulent or cloudy fluid)
• Immune system (Module 02.07.01 & 02.07.03)
o Nonspecific (innate) – inflammation
▪ Occurs because of any threat or known injury with no specific target,
defenses which you were born with
▪ Skin, mucous membranes, reflexes, nonspecific chemical deterrents,
nonspecific defense cells (macrophages, basophils, natural killer t-cells)
o Specific (adaptive) – response to a particular substance, cell, toxin, or protein
▪ Specialized immunity for specific pathogens
, ▪ Helper t-cells, cytotoxic t-cells, b-cells
o Structures – lymphoid structures, immune cells, tissues concerned with immune
cell development, and chemical mediators
• How does morphine work? (Module 05.06.07)
o The prototype of the strong opioid analgesics and remains the standard by which
newer opioids are measures
o Relieve pain by mimicking the actions of endogenous opioid peptides at the mu
receptors
▪ Opioid peptides and morphine bind to the same receptors in the CNS
▪ Opioid peptides have a severe physiologic role as modulators of pain
perception, and are subject to abuse due to their ability to cause
pleasurable experiences of euphoria, sedation and orgasm-like sensations
• Penicillin (Module 04.02.01 & 04.02.02)
o MOA - Penicillin weakens the cell wall, causing bacteria to take up excessive
amounts of water and rupture. They are bactericidal to cells that are undergoing
growth and division
▪ Resistance occurs when penicillin can’t reach the target, inactivation of
penicillin by bacterial enzymes and production of penicillin binding
proteins that have a low affinity for penicillins
▪ Beta-lactamases produces primarily by gram-positive (sometimes by
gram-negative) inactivate penicillin
▪ Beta-lactamase enzymes that bind and inactivate the beta lactam ring main
mechanism on penicillin – penicillinases
• Narrow-spec: penicillinase sensitive – Pen G & Pen V
• Narrow-spec: penicillinase resistant – nafcillin, oxacillin,
dicloxacillin
• Broad-spec penicillins – ampicillin and amoxicillin
• Extended-spec penicillin – piperacillin
• Types of burns and burn response (Module 05.03.01)
o Superficial burns – damage to the epidermis and possible upper dermis. Examples
are sunburn or mild scald, usually are red/painful but heal readily w/ no scarring
o Partial- thickness burns – involve destruction of the epidermis and part of the
dermis. Area is red, edematous, blistered, and often hypersensitive/painful
o Full-thickness burns – result in destruction of all skin layers and in cases of 4th-
degree, often underlying tissues. The area is coagulated or charred, hard and dry
on surface. Damaged tissue shrinks, causing pressure on edematous tissue under it
o Effects
▪ Serious burns can affect both local and systemic systems
▪ Main problems include respiratory problems (carbon monoxide and smoke
inhalation injuries to respiratory system), pain, infection (main barrier to
