PC 707 Final Safety Exam Questions With Correct Answers Solved 100%!!

IgE mediated allergic reaction that happens after the 2nd exposure to the antigen? - Answer-Type I Immediate hypersensitivity Delayed Allergic reaction involving T cell in the skin? - Answer-Type IV Reaction Primary treatment for a Type 1 Allergic response? - Answer-Epinephrine Adjunctive treatment for a Type 1 Allergic response - Answer-‣ H1 Blockers ‣ Corticosteroids help prevent bi phasic reactions ‣ Bronchodilators provide some reliefOne of the most Severe forms of a Type IV allergic reactions. - Answer-‣ Stevens Johnson Syndrome ‣ Toxic epidermal necrolysis When considering a drug "re challenge" after reaction what are crucial factors the APRN must consider? - Answer-‣ What drug the patient reacted to ‣ The severity of the reaction (never again in Type I or severe type IV) *most important* What Black Box Warning does Carbamazepine & Lamictal carry? - Answer-Potential life-threatening dermatologic reaction, including Steven's Johnson and Toxic Epidermal Necrolysis What Black Box Warning does Promethazine (Phenergan) antiemetic carry? - Answer-Potential for life threatening respiratory depression in children. What Black Box Warning do Fluoroquinolones carry? - Answer-Potential for tendon rupture What Black Box Warning does SSRIs carry? - Answer-Potential increased risk of suicide in teens. What Black Box Warning does opioids carry? - Answer-Combining opioids & benzodiazepines can cause extreme sleepiness, slowed breathing & deathInsulin/Sulfonaureas adverse effect - Answer-Hypoglycemia! Tricyclic Antidepressants - Answer-Very risky for overdose Nitrofurantoin (Macrobid) adverse effect - Answer-Pulmonary Toxicity (rare ) Proton Pump Inhibitors Increases the risks for - Answer-‣ Upon starting: Community acquired pneumonia ‣ Over time more likely to get infections like TB ‣ Over time possible increased potential for fractures Bisphosphonates potential risk - Answer-osteonecrosis of the jaw As we age, our kidneys become smaller & there is a decrease in renal blood flow. Why is this a prescribing consideration? - Answer-Decreased renal clearance of drugs As we age, our liver become smaller, has decreased blood flow & first pass metabolism decreases. Why is this a prescribing consideration? - Answer-Decreased liver size also means decreased production of CYP 450 enzymes! So if you need to select a drug for the elderly, try to select drugs that use Phase 2 metabolism (not affected by age) Phase I is affected & involves the CYPs. AS we age, there is a decrease in total body water by 10-15%! Why is this a concern when prescribing for the elderly? - Answer-Decrease in total body water results in decreased distribution of water soluble medications & causes increased serum levels of drugs. Why are the elderly at higher risk of Torsades de Points? - Answer-Elderly tend to be on more drugs, so more of a chance to have multiple QT prolongation drugs. Additional risk of TdP with low potassium, *low magnesium* & bradycardia- more common in the elderly. Afib more likelyWhat are the concerns with anticholinergic drugs & the elderly? - Answer-In the elderly Anticholinergic drugs can cause: ‣ Memory impairment, ‣ confusion, ‣ falls, ‣ hallucinations, ‣ tachycardia & ‣ acute angle glaucoma