1|Pag e
NR 565 FINAL EXAM|| ADVANCED
PHARMACOLOGY FUNDAMENTALS FINAL EXAM
ALL QUESTIONS AND CORRECT ANSWERS ||
LATEST AND FULL COVERED VERSION 2024-
2025|| ASSURED PASS!!!
What labs are used to diagnose Thyroid dysfunction? - ANSWER: TSH, free T3,
total T3, free T4 and total T4.
Thyroid function in hypothyroidism? - ANSWER: T3 and T4 are lower, TSH is
higher.
Thyroid function in hyperthyroidism? - ANSWER: TSH low, free T4 is normal
and T3 is high.
What is the timeframe for re-check of labs after starting Levothyroxine? -
ANSWER: Check TSH 6-8 weeks after initiating therapy and after dosage
changes. Check TSH annually once TSH is stablizied.
Signs and symptoms of hypothyroidism? - ANSWER: Pale, puffy, expressionless
face, cold, dry skin, brittle hair, hair loss, low temperature/HR, lethargy, fatigue,
constipation, weight gain, intolerance to cold, menstruation impairment, thyroid
enlargement.
Signs and symptoms of hyperthyroidism? - ANSWER: Rapid strong heartbeat,
dysrhythmias, angina, CNS stimulation, nervousness, insomnia, rapid thought
process, rapid speech, skeletal muscles weaken, atrophy, metabolic rate increased,
increased heat production, increased body temperature, increased appetite, weight
loss, exophthalmos.
,2|Pag e
What is the treatment of thyroid storm? - ANSWER: High doses of potassium
iodide or strong iodine solution, methimazole suppresses hormone synthesis, beta
blockers reduce heart rate, sedation, cooling, and giving glucocorticoids and IV
fluids can also help.
First line treatment for hypothyroidism? - ANSWER: Levothyroxine.
First line treatment for hyperthyroidism? - ANSWER: Methimazole.
Why does the FDA recommend against using PTU as first line treatment of
Thyroid storm? - ANSWER: Hepatic toxicity.
What can happen if hypothyroidism is not treated during pregnancy? - ANSWER:
Permanent neuropsychological deficits in the child, congenital hypothyroidism,
decreased IQ (mainly occurs during the 1st trimester and increases up to 50%).
What medication is used to treat symptoms associated with hyperthyroidism? -
ANSWER: Beta blockers to suppress tachycardia.
Medications that accelerate metabolism of Levothyroxine (may need to increase
their levothyroxine dosage)? - ANSWER: phenytoin (Dilantin), carbamazepine
(Tegretol, Carbatrol), rifampin (Rifadin), sertraline (Zoloft).
Think about the CYP450 inducers that increase medication metabolism: CRAP
GPS
Medications that reduce Levothyroxine absorption? - ANSWER: Histamine 2
receptor blockers (cimetidine [Tagamet], PPIs (lansoprazole [Prevacid], sucralfate
[carafate], colestipol [colestid]), aluminum containing antacids (Maalox, Mylanta),
, 3|Pag e
calcium supplements (Tums, Os-cal), iron supplements (ferrous sulfate),
magnesium salts, Orlistat (Xenical).
Medications whose metabolism is altered by Levothyroxine? - ANSWER:
Warfarin (doses of medication may need to be reduced), catecholamines, insulin,
digoxin (may need to be increased).
How to confirm a diagnosis of DM prior to beginning treatment? - ANSWER:
Fasting plasma greater than or equal to 126 (on 2 occasions), random plasma
glucose greater than or equal to 200 plus symptoms of DM, oral glucose tolerance
test 2 hr. plasma glucose greater than or equal to 200, and hemoglobin A1C 6.5%
or higher.
General Goals and older adult goals for A1C? - ANSWER: General Goals: less
than 7%
Older Adult Goals: less than 8%
When should insulin be considered in DM? - ANSWER: After the 3 drug
combination is unsuccessful or patients who have A1C 10% or greater, fasting
glucose greater than 300 or are markedly symptomatic.
What time interval should A1C be re-checked? - ANSWER: 3-6 months.
MOA of insulin? - ANSWER: Anabolic, promotes energy conservation and
storage of glycogen, cell growth, and division, and transport of glucose, amino
acids, nucleotides, and potassium. It stimulates the synthesis of complex organic
molecules.
What are the contraindications of Pioglitazone? - ANSWER: Avoid in those with
CHF (causes water retention and edema), with or history of bladder cancer, active
NR 565 FINAL EXAM|| ADVANCED
PHARMACOLOGY FUNDAMENTALS FINAL EXAM
ALL QUESTIONS AND CORRECT ANSWERS ||
LATEST AND FULL COVERED VERSION 2024-
2025|| ASSURED PASS!!!
What labs are used to diagnose Thyroid dysfunction? - ANSWER: TSH, free T3,
total T3, free T4 and total T4.
Thyroid function in hypothyroidism? - ANSWER: T3 and T4 are lower, TSH is
higher.
Thyroid function in hyperthyroidism? - ANSWER: TSH low, free T4 is normal
and T3 is high.
What is the timeframe for re-check of labs after starting Levothyroxine? -
ANSWER: Check TSH 6-8 weeks after initiating therapy and after dosage
changes. Check TSH annually once TSH is stablizied.
Signs and symptoms of hypothyroidism? - ANSWER: Pale, puffy, expressionless
face, cold, dry skin, brittle hair, hair loss, low temperature/HR, lethargy, fatigue,
constipation, weight gain, intolerance to cold, menstruation impairment, thyroid
enlargement.
Signs and symptoms of hyperthyroidism? - ANSWER: Rapid strong heartbeat,
dysrhythmias, angina, CNS stimulation, nervousness, insomnia, rapid thought
process, rapid speech, skeletal muscles weaken, atrophy, metabolic rate increased,
increased heat production, increased body temperature, increased appetite, weight
loss, exophthalmos.
,2|Pag e
What is the treatment of thyroid storm? - ANSWER: High doses of potassium
iodide or strong iodine solution, methimazole suppresses hormone synthesis, beta
blockers reduce heart rate, sedation, cooling, and giving glucocorticoids and IV
fluids can also help.
First line treatment for hypothyroidism? - ANSWER: Levothyroxine.
First line treatment for hyperthyroidism? - ANSWER: Methimazole.
Why does the FDA recommend against using PTU as first line treatment of
Thyroid storm? - ANSWER: Hepatic toxicity.
What can happen if hypothyroidism is not treated during pregnancy? - ANSWER:
Permanent neuropsychological deficits in the child, congenital hypothyroidism,
decreased IQ (mainly occurs during the 1st trimester and increases up to 50%).
What medication is used to treat symptoms associated with hyperthyroidism? -
ANSWER: Beta blockers to suppress tachycardia.
Medications that accelerate metabolism of Levothyroxine (may need to increase
their levothyroxine dosage)? - ANSWER: phenytoin (Dilantin), carbamazepine
(Tegretol, Carbatrol), rifampin (Rifadin), sertraline (Zoloft).
Think about the CYP450 inducers that increase medication metabolism: CRAP
GPS
Medications that reduce Levothyroxine absorption? - ANSWER: Histamine 2
receptor blockers (cimetidine [Tagamet], PPIs (lansoprazole [Prevacid], sucralfate
[carafate], colestipol [colestid]), aluminum containing antacids (Maalox, Mylanta),
, 3|Pag e
calcium supplements (Tums, Os-cal), iron supplements (ferrous sulfate),
magnesium salts, Orlistat (Xenical).
Medications whose metabolism is altered by Levothyroxine? - ANSWER:
Warfarin (doses of medication may need to be reduced), catecholamines, insulin,
digoxin (may need to be increased).
How to confirm a diagnosis of DM prior to beginning treatment? - ANSWER:
Fasting plasma greater than or equal to 126 (on 2 occasions), random plasma
glucose greater than or equal to 200 plus symptoms of DM, oral glucose tolerance
test 2 hr. plasma glucose greater than or equal to 200, and hemoglobin A1C 6.5%
or higher.
General Goals and older adult goals for A1C? - ANSWER: General Goals: less
than 7%
Older Adult Goals: less than 8%
When should insulin be considered in DM? - ANSWER: After the 3 drug
combination is unsuccessful or patients who have A1C 10% or greater, fasting
glucose greater than 300 or are markedly symptomatic.
What time interval should A1C be re-checked? - ANSWER: 3-6 months.
MOA of insulin? - ANSWER: Anabolic, promotes energy conservation and
storage of glycogen, cell growth, and division, and transport of glucose, amino
acids, nucleotides, and potassium. It stimulates the synthesis of complex organic
molecules.
What are the contraindications of Pioglitazone? - ANSWER: Avoid in those with
CHF (causes water retention and edema), with or history of bladder cancer, active
