NR 565 Advanced Pharmacology Final Exam Study Guide Questions And Answers| Updated 2026/2027

NR 565 Advanced Pharmacology Final Exam Study Guide Questions And Answers| Updated 2026/2027 Dipeptidyl Peptidase-4 Inhibitors Adverse effects - ANSWER --Upper respiratory infection -Headache and inflammation of nasal passages and throat -Pancreatitis -hypersensitivity reactions Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors - ANSWER Canagliflozin Dapagliflozin Empagliflozin Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors - ANSWER -- SGLT2 is expressed in the proximal renal tubules which is responsible for the majority of the reabsorption of filtered glucose from the tubular lumen. By inhibiting SGLT2, these agents reduce reabsorption of filtered glucose, which increase urinary glucose excretion. Sodium Glucose Co-Transporter-2 (SGLT2) Inhibitors adverse effects - ANSWER -UTI, genitalia fungal infections, increased urination, weight loss. Hypotension and dizziness when used concurrently with diuretics. Which diabetic medication(s) is beneficial for patients with heart failure? - ANSWER -SGLT-2 inhibitors 2/2 diuretic effect. Glucagon-like peptide 1 (GLP-1) - ANSWER -semaglutide, dulaglutide Glucagon-like peptide 1 (GLP-1) MOA - ANSWER -Mimic and augment the effects of the incretin hormones GLP-1. Slow gastric emptying, stimulate glucose dependent release of insulin, suppress appetite, inhibit post meal release of glucagon from liver, induce weight loss. Glucagon-like peptide 1 (GLP-1) adverse effects and contraindications - ANSWER -Pancreatitis, renal impairment, thyroid tumors, fetal harm. Contraindicated for pregnant patients, those with renal impairment or history of pancreatitis or endocrine tumors. How do we treat hypothyroidism in infants? - ANSWER -Treat with levothyroxine for 3years. Cessation of replacement therapy for 4 weeks- if TSH rises, thyroid hormone production is low so we continue replacement therapy; if TSH decreases, we know the hypothyroidism is transient and we can stop replacement therapy. Lvothyroxine MOA - ANSWER -Synthetic levothyroxine is identical to naturally occurring thyroid hormone. Levothyroxine administration - ANSWER -Take on empty stomach, 30-60 minutes before breakfast. Don't take with mineral supplements, PPI, or antacids. Levothyroxine monitoring - ANSWER -TSH and T4 every 6 weeks until euthyroid then yearly. Levothyroxine overdose - ANSWER -Nervousness, tachycardia, tremors, thyrotoxosis. Low dose, chronic overdose causes bone loss and increased risk of a fib. Levothyroxine drug interactions - ANSWER -Warfarin (accelerates the degradation of Vitamin K- dep clotting factors = Warfarin's anticoagulant effects enhanced) Minerals/supplements/PPIs Methimazole MOA - ANSWER -Blocks thyroid peroxidase inhibiting the coupling of iodine with tyrosine. This prevents new thyroid hormone synthesis. Methimazole Indications - ANSWER -First line drug for the treatment of hyperthyroidism. May be used short term in preparation for a thyroid come if radioactive iodine therapy, or long term to treat hyperthyroidism. Methimazole contraindications - ANSWER -1st trimester of pregnancy- teratogenic. Give PTU. May give Methimazole during second and third trimesters. Thyroid storm - ANSWER -a relatively rare, life-threatening condition caused by exaggerated hyperthyroidism. Severe hyperthermia, restlessness, agitation, tremor, coma, hypotension, heart failure, and death. Bronchodilators - ANSWER -Relax smooth muscle in lungs, prevent bronchi spasms, make it easier for air to move. Include the following drug classes: long acting beta 2 agonists, short acting beta 2 agonists, xanthine derivatives, and anticholinergics (muscarinic agonists or LAMAs) Anti-inflammatory agents for respiratory disease - ANSWER -Decrease inflammatory mechanisms in the airway. Include medications such as inhaled and systemic glucocorticoids, leukotriene receptor antagonists, mast cell stabilizers, and phosphodiesterase-4 inhibitors. Inhalation Devices - ANSWER -Metered-dose inhalers (MDIs)- pressurized device that delivers a measured dose of the drug with each actuation; activated by breath so must have hand/breath coordination. Begin inhaling before activation the device. Spacer can help with drug delivery and hand/breath coordination Dry-powder inhalers (DPIs)- need quick, deep breath. Difficult to use for patients with advanced disease. Nebulizers- take a long time. Soft mist inhalers - longer, slower delivery of a fine mist. Activated by user . Ipatropium - ANSWER -anticholinergic muscarinic antagonist used to treat COPD. Bronchodilator. Can be used off label for asthma. Can be combined with a beta 2 agonists because the two medications promote bronchodilation via different mechanisms. Ipatropium adverse effects - ANSWER -paradoxic acute bronchospam, cough hoarseness, throat irritation Monoclonal antibodies - ANSWER -Manage airway inflammation; specifically, antagonist of IgE or interleukin receptors. Monoclonal antibodies indications - ANSWER -For allergic asthma not responsive to glucocorticoids. How are monoclonal antibodies administered? - ANSWER -SubQ Example of a monoclonal antibody for asthma - ANSWER -Omalizumab Monoclonal antibodies black box warning - ANSWER -Anaphylaxis may occur at any time during treatment. Carry an epi pen.