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Exam 2: NURS 615/ NURS615 (Latest 2024/ 2025 Update) Advanced Pharmacotherapeutics Complete Review |Qs & As| 100% Correct| Grade A (Verified Answers)- Maryville

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Exam 2: NURS 615/ NURS615 (Latest 2024/ 2025 Update) Advanced Pharmacotherapeutics Complete Review |Qs & As| 100% Correct| Grade A (Verified Answers) Q: Phenelzine (Nardil) is an MAO inhibitor. What are the cautions and contraindications? How is it used to treat recalcitrant depression? Answer: •Contraindications Liver or kidney disease Hypersensitivity Congestive heart failure or arteriosclerotic disease Age over 60 years Pregnancy category C; excreted in breastmilk safety not established Not approved for use with children Postural hypotension and suppression of myocardial pain may occur. •MAOIs exert their effect by irreversibly inactivating the enzymes that metabolize norepinephrine, serotonin, and dopamine, thereby increasing the bioavailability of these neurotransmitters. FUll 2 weeks to clear from system should wait that long to start a different therapy Q: What are the symptoms of hypertensive crisis? Answer: •MAOIs inhibit the metabolism of norepinephrine and can cause hypertensive crisis. Foods high in tyramine should be restricted because of this risk as well as they are the precursor to dopamine, norepinephrine, and epinephrine. •Treatment of hypertensive crisis needs to be managed immediately, and the patient should remain standing until it is. Usual treatment is phentolamine (Regitine) 5mg IV and then 0.25mg to 0.5mg IM every 4 to 6 hours. •Hypertensive crisis symptoms include: Headache Heart palpitations Stiff/sore neck Chest tightness Tachycardia Sweating Dilated pupils Q: How long does it take for selective serotonin reuptake inhibitors to produce an effect in patients with depression? Answer: These drugs may take as long as 2 to 6weeks until their full therapeutic benefits become evident and the initial adverse reactions, commonly, nausea, intermittent light-headedness, sedation, muscle restlessness, and sleep disruptions, should be minor and transient. Q: When are buspirone (Buspar) and an SSRI combined? Answer: Although buspirone can used as the sole pharmacotherapeutic modality for anxiety, it is frequently used adjunctively with SSRIs in treatment-resistant depression because of the combined serotonergic mechanisms, that is, postsynaptic reuptake inhibition and receptor agonism. Q: What type of diet is recommended with the administration of lithium? Answer: Patients should ensure adequate salt intake when taking lithium. Q: What factors will place the patient at risk for antibiotic resistance? Answer: The leading risk factors for having a drug resistant pathogen include recent use of antibiotics, age younger than 2 years old or older than 65 years old, day-care center attendance, exposure to young children, multiple medical comorbidities, recent hospitalization, and immunosuppression. Q: What factors place the patient at risk for hypersensitivity reactions with penicillins and cephalosporins? Answer: A history of serious hypersensitivity reaction (e.g., anaphylaxis, serum sickness, exfoliative dermatitis, hemolysis, or other blood dyscrasia) to a penicillin contraindicates the use of any penicillin on account of cross sensitivity. Severe, type I allergic reactions to cephalosporins, carbapenems, or beta-lactamase inhibitors may contraindicate use of penicillins. Patient with a history of allergy to other substances (e.g., atopic skin conditions) should also use these drug with caution. Q: What are the safest antibiotics to prescribe to a woman who is pregnant?

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ExamI2:INURSI615/INURS615I(LatestI2024
/I2025IUpdate)IAdvancedI
PharmacotherapeuticsICompleteIReviewI|Qs
I&IAs|I100%ICorrect|IGradeIAI(VerifiedI
Answers)

Q:IPhenelzineI(Nardil)IisIanIMAOIinhibitor.IWhatIareItheIcautionsIandIcontraindications?IH
owIisIitIusedItoItreatIrecalcitrantIdepression?


Answer:
•Contraindications


LiverIorIkidneyIdisease
Hypersensitivity
CongestiveIheartIfailureIorIarterioscleroticIdisease
AgeIoverI60Iyears
PregnancyIcategoryIC;IexcretedIinIbreastmilkIsafetyInotIestablishedI
NotIapprovedIforIuseIwithIchildrenI
PosturalIhypotensionIandIsuppressionIofImyocardialIpainImayIoccur.I

•MAOIsIexertItheirIeffectIbyIirreversiblyIinactivatingItheIenzymesIthatImetabolizeInorepinephr
ine,Iserotonin,IandIdopamine,ItherebyIincreasingItheIbioavailabilityIofItheseIneurotransmitters.

FUllI2IweeksItoIclearIfromIsystemIshouldIwaitIthatIlongItoIstartIaIdifferentItherapy




Q:IWhatIareItheIsymptomsIofIhypertensiveIcrisis?

Answer:
•MAOIsIinhibitItheImetabolismIofInorepinephrineIandIcanIcauseIhypertensiveIcrisis.IFoodsIhi
ghIinItyramineIshouldIbeIrestrictedIbecauseIofIthisIriskIasIwellIasItheyIareItheIprecursorItoIdo
pamine,Inorepinephrine,IandIepinephrine.I

,•TreatmentIofIhypertensiveIcrisisIneedsItoIbeImanagedIimmediately,IandItheIpatientIshouldIre
mainIstandingIuntilIitIis.IUsualItreatmentIisIphentolamineI(Regitine)I5mgIIVIandIthenI0.25mgI
toI0.5mgIIMIeveryI4ItoI6Ihours.I


•HypertensiveIcrisisIsymptomsIinclude:

HeadacheI
HeartIpalpitations
Stiff/soreIneck
ChestItightness
TachycardiaI
Sweating
DilatedIpupils




Q:IHowIlongIdoesIitItakeIforIselectiveIserotoninIreuptakeIinhibitorsItoIproduceIanIeffectIinI
patientsIwithIdepression?


Answer:
TheseIdrugsImayItakeIasIlongIasI2ItoI6weeksIuntilItheirIfullItherapeuticIbenefitsIbecomeIevide
ntIandItheIinitialIadverseIreactions,Icommonly,Inausea,IintermittentIlight-
headedness,Isedation,ImuscleIrestlessness,IandIsleepIdisruptions,IshouldIbeIminorIandItransient
.




Q:IWhenIareIbuspironeI(Buspar)IandIanISSRIIcombined?

Answer:
AlthoughIbuspironeIcanIusedIasItheIsoleIpharmacotherapeuticImodalityIforIanxiety,IitIisIfreque
ntlyIusedIadjunctivelyIwithISSRIsIinItreatment-
resistantIdepressionIbecauseIofItheIcombinedIserotonergicImechanisms,IthatIis,IpostsynapticIre
uptakeIinhibitionIandIreceptorIagonism.

, Q:IWhatItypeIofIdietIisIrecommendedIwithItheIadministrationIofIlithium?

Answer:
PatientsIshouldIensureIadequateIsaltIintakeIwhenItakingIlithium.




Q:IWhatIfactorsIwillIplaceItheIpatientIatIriskIforIantibioticIresistance?

Answer:
TheIleadingIriskIfactorsIforIhavingIaIdrugIresistantIpathogenIincludeIrecentIuseIofIantibiotics,I
ageIyoungerIthanI2IyearsIoldIorIolderIthanI65IyearsIold,Iday-
careIcenterIattendance,IexposureItoIyoungIchildren,ImultipleImedicalIcomorbidities,IrecentIhos
pitalization,IandIimmunosuppression.




Q:IWhatIfactorsIplaceItheIpatientIatIriskIforIhypersensitivityIreactionsIwithIpenicillinsIandIc
ephalosporins?


Answer:
AIhistoryIofIseriousIhypersensitivityIreactionI(e.g.,Ianaphylaxis,IserumIsickness,IexfoliativeIde
rmatitis,Ihemolysis,IorIotherIbloodIdyscrasia)ItoIaIpenicillinIcontraindicatesItheIuseIofIanyIpen
icillinIonIaccountIofIcrossIsensitivity.I

Severe,ItypeIIIallergicIreactionsItoIcephalosporins,Icarbapenems,IorIbeta-
lactamaseIinhibitorsImayIcontraindicateIuseIofIpenicillins.I

PatientIwithIaIhistoryIofIallergyItoIotherIsubstancesI(e.g.,IatopicIskinIconditions)IshouldIalsoIu
seItheseIdrugIwithIcaution.




Q:IWhatIareItheIsafestIantibioticsItoIprescribeItoIaIwomanIwhoIisIpregnant?

Answer:
IsoniazidsIareIpregnancyIcategoryIAIantibioticsIandIareIsafestIprescribeIinIpregnancy.

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