Final Exam: NR565/ NR 565 (Latest 2023/2
8 8 8 8 8 8 8
024 Update) Advanced Pharmacology E
8 8 8 8
xam Review| Questions and Verified
8 8 8 8
Answers -Chamberlain 8
1. A8patient8has8a8TSH8of8.28,8a8free8T48of83,8and8a8free8T38over8650.8What8medication8
should8she8be8started8on?
Answer:8Methimazole,8PTU,8radioactive8iodine.8These8labs8indicate8hy
perthyroidism.8Treatment8for8thyroid8storm:8K8iodide8or8strong8iodine8so
lution8to8suppress8thyroid8release.8Methimazole8to8suppress8thyroid8synt
hesis.
2. When8is8it8appropriate8to8increase8insulin8needs?
Answer:8Pregnancy8(after8first8trimester),8stress,8infection,8weight8loss,8
adolescent8growth8spurt.8DECREASE8for8exercise8and8first8trimester.
3. What8is8the8TDD8of8a8person8that8weighs870kg?
IF8a8person8is8eating8a8508carb8meal,8how8much8insulin8will8be8needed8based8on8the8TDD8fr
om8the8above8question?
Answer:8428TDD8:8218basal8218bolus8(Wt8in8kg8x80.6;850%8long8acting8
and850%8rapid8acting)
5008divided8by8(the8TDD)8428=812.8(carb8to8insulin8ratio)8then8(meal8
carbs)8508divided812=84.18units8with8short8acting8insulin
,4. "As8long8as8the8short-
acting8insulin8is8drawn8up8first8I8can8mix8my8insulin8glargine8with8it."
Answer:8Of8the8long-
acting8medications,8ONLY8NPH8the8intermediate8duration8is8suitable8fo
r8mixing8with8the8short8action8insulins.
5. A8women8who8is8taking8Pioglitazone8states,8"I'm8glad8that8this8medication8promotes8
weight8loss."
Answer:8First8this8medication8promotes8increase8in8LDL8levels,8which8
increases8cardiovascular8risk.8Also,8she's8a8female8so8speak8about8exer
cise8and8weight8bearing8exercise8d/t8possible8increased8risk8for8fractur
es.
6. Glucocorticoid8MOA
Answer:8Most8effective8in8long-term8control8of8airway8inflammation
7. Cromolyn8MOA
Answer:8Used8as8prophylaxis8for8mild8to8moderate8asthma
8. Monoclonal8Antibodies8MOA
Answer:8Used8for8allergy-
related8asthma8and8Eosinophilic8asthma.8Omalizumab8for8allergy8rela
ted8and8Ben8ralizumab,8mepliz,8and8resliz8are8for8eosinophilic
9. Leukotriene8MOA
, Answer:8Second-
line8therapy8to8reduce8inflammation8and8bronchoconstricti
on
10. B28adrenergic8agonists8MOA
Answer:8Can8be8used8PRN,8for8EIB,8COPD8exacerbations,8and8
maintenance8therapy
11. methylxanthines8MOA
Answer:8Maintenance8therapy8for8chronic8stable8asthma8(theophylline).
P.8570.8Use8ONLY8if8B28or8anticholinergics8are8not8appropriate.
12. anticholinergic8MOA
Answer:8Approved8for8bronchospasm8related8to8COPD
13. •What8are8some8risk8factors8of8fatal8asthma8attacks?
Answer:8Uncontrolled,8hospitalized8recently,8triggers,
14. •Roflumilast8(select8all8that8apply)8
1.Reduces8inflammation
2.Not8intended8during8pregnancy8
3.Approved8for8asthma
4. First-line8drug8for8COPD
Answer:8Reduces8inflammation,8not8intended8for8pregnancy,8approved8
only8for8COPD,8Second-line8drug8for8COPD
, Uses8for8exacerbations8prophylaxis8in8pts8with8severe8COPD8with8a8
primary8chronic8bronchitis8component.
15. What8pt8education8can8you8provide8a8patient8for8ICS8use?
Answer:8Rinse8d/t8oropharyngeal8candidiasis8and8dysphonia8
(hoarseness,8difficulty8speaking).
16. What8patient8teaching8can8a8provider8give8when8prescribing8a8PPI?
Answer:8Hypomagnesia8symptoms:8muscle8cramps,8tremors,8cramps,8a
nd8palpitations.8Check8Mg8levels8periodically8especially8in8the8elderly.8
Get8enough8calcium8and8VIT8D.8call8if8having8diarrhea8(Cdiff)
17. What8patient8teaching8can8a8provider8give8when8prescribing8an8H2RA?
Answer:8Report8lethargy,8solmnolance,8restlessness,8confusion8or8hall
ucinations.8(CNS8effects).8Teach8about8possible8reduced8libido,8impot
ence,8gynecomastia,8pneumonia.8P.5948Cimetidine8interacts8with8CYP8
system8so8check8with8pt8if8they8are8taking8warfarin,8phenytoin,8theoph
ylline,8lidocaine.
18. A8patient8presents8with8a8complaint8of8reflux8and8constipation.8He8states8that8he8drinks8
enough8water,8and8admits8he8has8gained830lbs.8He8also8states8that8he8has8been8having8
"reflux"8type8symptoms.8What8are8your8next8steps8for8education?
Answer:8Educate8that8weight8gain8can8promote8reflux8symptoms,8ask8
about8any8otc8use8such8as8antacids8which8may8cause8constipation.
19. zollinger-Ellison8syndrome8is8due8to8a producing8tumor.8Treatment8is8long-
term8therapy8of8what8medication8class?
8 8 8 8 8 8 8
024 Update) Advanced Pharmacology E
8 8 8 8
xam Review| Questions and Verified
8 8 8 8
Answers -Chamberlain 8
1. A8patient8has8a8TSH8of8.28,8a8free8T48of83,8and8a8free8T38over8650.8What8medication8
should8she8be8started8on?
Answer:8Methimazole,8PTU,8radioactive8iodine.8These8labs8indicate8hy
perthyroidism.8Treatment8for8thyroid8storm:8K8iodide8or8strong8iodine8so
lution8to8suppress8thyroid8release.8Methimazole8to8suppress8thyroid8synt
hesis.
2. When8is8it8appropriate8to8increase8insulin8needs?
Answer:8Pregnancy8(after8first8trimester),8stress,8infection,8weight8loss,8
adolescent8growth8spurt.8DECREASE8for8exercise8and8first8trimester.
3. What8is8the8TDD8of8a8person8that8weighs870kg?
IF8a8person8is8eating8a8508carb8meal,8how8much8insulin8will8be8needed8based8on8the8TDD8fr
om8the8above8question?
Answer:8428TDD8:8218basal8218bolus8(Wt8in8kg8x80.6;850%8long8acting8
and850%8rapid8acting)
5008divided8by8(the8TDD)8428=812.8(carb8to8insulin8ratio)8then8(meal8
carbs)8508divided812=84.18units8with8short8acting8insulin
,4. "As8long8as8the8short-
acting8insulin8is8drawn8up8first8I8can8mix8my8insulin8glargine8with8it."
Answer:8Of8the8long-
acting8medications,8ONLY8NPH8the8intermediate8duration8is8suitable8fo
r8mixing8with8the8short8action8insulins.
5. A8women8who8is8taking8Pioglitazone8states,8"I'm8glad8that8this8medication8promotes8
weight8loss."
Answer:8First8this8medication8promotes8increase8in8LDL8levels,8which8
increases8cardiovascular8risk.8Also,8she's8a8female8so8speak8about8exer
cise8and8weight8bearing8exercise8d/t8possible8increased8risk8for8fractur
es.
6. Glucocorticoid8MOA
Answer:8Most8effective8in8long-term8control8of8airway8inflammation
7. Cromolyn8MOA
Answer:8Used8as8prophylaxis8for8mild8to8moderate8asthma
8. Monoclonal8Antibodies8MOA
Answer:8Used8for8allergy-
related8asthma8and8Eosinophilic8asthma.8Omalizumab8for8allergy8rela
ted8and8Ben8ralizumab,8mepliz,8and8resliz8are8for8eosinophilic
9. Leukotriene8MOA
, Answer:8Second-
line8therapy8to8reduce8inflammation8and8bronchoconstricti
on
10. B28adrenergic8agonists8MOA
Answer:8Can8be8used8PRN,8for8EIB,8COPD8exacerbations,8and8
maintenance8therapy
11. methylxanthines8MOA
Answer:8Maintenance8therapy8for8chronic8stable8asthma8(theophylline).
P.8570.8Use8ONLY8if8B28or8anticholinergics8are8not8appropriate.
12. anticholinergic8MOA
Answer:8Approved8for8bronchospasm8related8to8COPD
13. •What8are8some8risk8factors8of8fatal8asthma8attacks?
Answer:8Uncontrolled,8hospitalized8recently,8triggers,
14. •Roflumilast8(select8all8that8apply)8
1.Reduces8inflammation
2.Not8intended8during8pregnancy8
3.Approved8for8asthma
4. First-line8drug8for8COPD
Answer:8Reduces8inflammation,8not8intended8for8pregnancy,8approved8
only8for8COPD,8Second-line8drug8for8COPD
, Uses8for8exacerbations8prophylaxis8in8pts8with8severe8COPD8with8a8
primary8chronic8bronchitis8component.
15. What8pt8education8can8you8provide8a8patient8for8ICS8use?
Answer:8Rinse8d/t8oropharyngeal8candidiasis8and8dysphonia8
(hoarseness,8difficulty8speaking).
16. What8patient8teaching8can8a8provider8give8when8prescribing8a8PPI?
Answer:8Hypomagnesia8symptoms:8muscle8cramps,8tremors,8cramps,8a
nd8palpitations.8Check8Mg8levels8periodically8especially8in8the8elderly.8
Get8enough8calcium8and8VIT8D.8call8if8having8diarrhea8(Cdiff)
17. What8patient8teaching8can8a8provider8give8when8prescribing8an8H2RA?
Answer:8Report8lethargy,8solmnolance,8restlessness,8confusion8or8hall
ucinations.8(CNS8effects).8Teach8about8possible8reduced8libido,8impot
ence,8gynecomastia,8pneumonia.8P.5948Cimetidine8interacts8with8CYP8
system8so8check8with8pt8if8they8are8taking8warfarin,8phenytoin,8theoph
ylline,8lidocaine.
18. A8patient8presents8with8a8complaint8of8reflux8and8constipation.8He8states8that8he8drinks8
enough8water,8and8admits8he8has8gained830lbs.8He8also8states8that8he8has8been8having8
"reflux"8type8symptoms.8What8are8your8next8steps8for8education?
Answer:8Educate8that8weight8gain8can8promote8reflux8symptoms,8ask8
about8any8otc8use8such8as8antacids8which8may8cause8constipation.
19. zollinger-Ellison8syndrome8is8due8to8a producing8tumor.8Treatment8is8long-
term8therapy8of8what8medication8class?
