NR566 Midterm Study Guide – Complete With Solutions
Albuterol Right Ans - -increases levels of digoxin
-safe if children
-first line therapy
Etidronate (Didronel) Right Ans - Bisphosphonates
-90 day half life
-preg cat B
reduces bone reabsorption
TX: low bone density, d/t cystic fibrosis, pagets disease (monitor xrays and
labs), heterotropic ossification, hip replacement, spinal cord injury
CI: entercolitis
Alendeonate (fosamax) Right Ans - Biphosphonates
-10 yr. half life
( $cheapest)
TX: osteoporosis men, postmenopausal women, gluccorticoids induced, pagets
diseae
bioavailability of biphosphonates Right Ans - histamine 2 blocking,
ranitadine agents double ALENDRONATE
TILUDRONATE decrease 50 % by aspirin and is increased by
INDOMENTHACIN *consider each nsaid individually
Anastozole, letroxole, exemestane Right Ans - aromatase inhibitors
*hormone therapy to tx hormone receptor positive breast cancer.
AE: vertigo, insomnia, sleepiness, confusion, LIFE THREATENING BLOOD
CLOTTING, LOSS BONE MASS,
*take Ca+ vit D supplementation
*measure bone density
GH (somatotropin) Right Ans - *used in children with GH deficiency treats
hypoglycemia
Biophosphanates pt education Right Ans - *empty stomach 8 oz water
avoid anitacids/ alcohol
ETIDRONATE increase in fx with pagets disease monitor labs and xrays
,drugs associated with bone loss that should be monitored Right Ans -
aromatase inhibitors, thyroid hormones, gluccocorticoid, PPI, SSRI
Antidiabetic mediations to avoid in elderly Right Ans - Sulfonylureas -
hypoglycemia
Glimpride
Glyburide- most likely to cause hypo
metformin *renal insuffiency HF
Alpha-glycosidase inhibitors- not well tolerated
Screening of Type 2 DM Right Ans - >45 yrs old BMI >25 *test yearly
>45 yrs old BMI WNL *q 3 yrs
<45 yrs old VMI >25* test more frequent.
Lispro, Aspart, Glulisine Right Ans - rapid acting insulin
15 min peak 1 hr duration
Regular insulin
Regular U -500 Right Ans - short acting insulin * used as bolus to correct
hyperglycemia
Regular insulin onset 30-60- peak 2-3 dura. 3-7
U-500 onset 30-45, peak 2-4, duration 8-24 hr
Neutral Protamine Hagedorn (NPH) Right Ans - NPH onset 30-60 peak 4-
10 duration 10-16
Inhaled human insulin (afrezza) Right Ans - most rapid
less weight gain
onset 12 min peak 1 hr duration 2-3 hrs
Acarbose, miglitol, voglibose Right Ans - Alpha Glucosidase inbitors
-no weight gain
-can give in combination with sulfonyureas
-CI digoxin
-reduce A1C
Propythouracil PTU Right Ans - TX hyperthyroidism
-safe in pregnancy
-risk for hepatic toxicity
,Hyperthyroidism
cause
s/s
lab testing Right Ans - -overactie thyroid gland r/t graves disease (mc)
anterior pituitary disorder, plummers disease, amiodarone therapy
-s/s: tachycardia, cardiac arrythmias, chest pain, tremors, nervousness,
insomnia, irritability, diarrhea, vomiting, weight loss, menstural irregularites,
heat intolerance
-labs increase free T4 decrease TSH
Hypothyroidism S/S Right Ans - fatigue, memory impairment, depression,
swollen face, decrease sv, hr, increase periph resistance, macrocytic anemia
(ass. B12 def.) decrease appetite, weight gain, enlarged thyroid glad
Diabetic meds that need renal adjustment Right Ans - Metformin
Diabetic medications with increased risk for genital mycotic infections
Right Ans - SGLT-2 selective sodium glucose co -transporter
Diabetic meds to avoid when taking digoxin Right Ans - metformin * dig
increases effects leading to lactic acidosis
Biguanides (Metformin) Right Ans - -used in children >10
*INITAL DRUG OF CHOICE
*insulin production is necessary for metformin to be productive.
calculate appropriate daily dose of insulin Right Ans - 0.3-0.5 units kg day
DM diagnosis Right Ans - 2 hr post load >200mg/dl
fasting plasma glucose >126
HBA1C >6.5
A1C monitoring Right Ans - 2x per year- meeting goals
every 3 mo- not meeting goals
goal A1c <7 or 6.5
Insulin Gargine
Insulin determir
, Insulin degludec Right Ans - Long acting:
gargine and determir
onset 60 min duration 24 hrs
degludec 42 hrs.
Metaproteronol Right Ans - -nebulizer formula for infants
Terbutaline Right Ans - Off label inhibits uterine contractions
Preg B
Formoterol and Salmeterol Right Ans - Black box not used as monotherapy
-not used for acute exacerbations
-*can worsen symptoms of asthma if pt is deteriorating
-CI children < 4 yrs.
Drug interactions with Beta agonists Right Ans - Tricyclic antidepressants
and MAOIs potentiate effects on the vascular system
Digoxin increase the risk arrhythmias (albuterol and levalbuterol
beta agonist contraindications Right Ans - Cardiac arrythmias, tachycardia,
heart block, dig toxicity, angina, narrow angle glaucoma, organic brain
damage, shock during anesthesia
-diabetics cause hyperglycemia
-phechormocytoma cause hypertension
beta agonists clinical use Right Ans - treat bronchospasm, associated with
asthma, bronchitis, COPD.
beta agonists side effects Right Ans - Seziures, hypokalemia, angina, HTN,
tachy, tremors, h/a, gi upset, inform provider if.. palpatations tachy, angina,
tremors, dizziness, flushing, h/a
Inhaled Anticholinergics Right Ans - Muscarinic receptor blocker resulting
in bronchodilation. Used to prevent bronchospasm, manage allergen or
exercise-induced asthma, or COPD. Maximum effects may take up to 2 weeks,
shake inhaler well before administration, when using two different inhaled
medications, wait 5 minutes between, if administered via nebulizer, use
within 1 hour of reconstitution.
Albuterol Right Ans - -increases levels of digoxin
-safe if children
-first line therapy
Etidronate (Didronel) Right Ans - Bisphosphonates
-90 day half life
-preg cat B
reduces bone reabsorption
TX: low bone density, d/t cystic fibrosis, pagets disease (monitor xrays and
labs), heterotropic ossification, hip replacement, spinal cord injury
CI: entercolitis
Alendeonate (fosamax) Right Ans - Biphosphonates
-10 yr. half life
( $cheapest)
TX: osteoporosis men, postmenopausal women, gluccorticoids induced, pagets
diseae
bioavailability of biphosphonates Right Ans - histamine 2 blocking,
ranitadine agents double ALENDRONATE
TILUDRONATE decrease 50 % by aspirin and is increased by
INDOMENTHACIN *consider each nsaid individually
Anastozole, letroxole, exemestane Right Ans - aromatase inhibitors
*hormone therapy to tx hormone receptor positive breast cancer.
AE: vertigo, insomnia, sleepiness, confusion, LIFE THREATENING BLOOD
CLOTTING, LOSS BONE MASS,
*take Ca+ vit D supplementation
*measure bone density
GH (somatotropin) Right Ans - *used in children with GH deficiency treats
hypoglycemia
Biophosphanates pt education Right Ans - *empty stomach 8 oz water
avoid anitacids/ alcohol
ETIDRONATE increase in fx with pagets disease monitor labs and xrays
,drugs associated with bone loss that should be monitored Right Ans -
aromatase inhibitors, thyroid hormones, gluccocorticoid, PPI, SSRI
Antidiabetic mediations to avoid in elderly Right Ans - Sulfonylureas -
hypoglycemia
Glimpride
Glyburide- most likely to cause hypo
metformin *renal insuffiency HF
Alpha-glycosidase inhibitors- not well tolerated
Screening of Type 2 DM Right Ans - >45 yrs old BMI >25 *test yearly
>45 yrs old BMI WNL *q 3 yrs
<45 yrs old VMI >25* test more frequent.
Lispro, Aspart, Glulisine Right Ans - rapid acting insulin
15 min peak 1 hr duration
Regular insulin
Regular U -500 Right Ans - short acting insulin * used as bolus to correct
hyperglycemia
Regular insulin onset 30-60- peak 2-3 dura. 3-7
U-500 onset 30-45, peak 2-4, duration 8-24 hr
Neutral Protamine Hagedorn (NPH) Right Ans - NPH onset 30-60 peak 4-
10 duration 10-16
Inhaled human insulin (afrezza) Right Ans - most rapid
less weight gain
onset 12 min peak 1 hr duration 2-3 hrs
Acarbose, miglitol, voglibose Right Ans - Alpha Glucosidase inbitors
-no weight gain
-can give in combination with sulfonyureas
-CI digoxin
-reduce A1C
Propythouracil PTU Right Ans - TX hyperthyroidism
-safe in pregnancy
-risk for hepatic toxicity
,Hyperthyroidism
cause
s/s
lab testing Right Ans - -overactie thyroid gland r/t graves disease (mc)
anterior pituitary disorder, plummers disease, amiodarone therapy
-s/s: tachycardia, cardiac arrythmias, chest pain, tremors, nervousness,
insomnia, irritability, diarrhea, vomiting, weight loss, menstural irregularites,
heat intolerance
-labs increase free T4 decrease TSH
Hypothyroidism S/S Right Ans - fatigue, memory impairment, depression,
swollen face, decrease sv, hr, increase periph resistance, macrocytic anemia
(ass. B12 def.) decrease appetite, weight gain, enlarged thyroid glad
Diabetic meds that need renal adjustment Right Ans - Metformin
Diabetic medications with increased risk for genital mycotic infections
Right Ans - SGLT-2 selective sodium glucose co -transporter
Diabetic meds to avoid when taking digoxin Right Ans - metformin * dig
increases effects leading to lactic acidosis
Biguanides (Metformin) Right Ans - -used in children >10
*INITAL DRUG OF CHOICE
*insulin production is necessary for metformin to be productive.
calculate appropriate daily dose of insulin Right Ans - 0.3-0.5 units kg day
DM diagnosis Right Ans - 2 hr post load >200mg/dl
fasting plasma glucose >126
HBA1C >6.5
A1C monitoring Right Ans - 2x per year- meeting goals
every 3 mo- not meeting goals
goal A1c <7 or 6.5
Insulin Gargine
Insulin determir
, Insulin degludec Right Ans - Long acting:
gargine and determir
onset 60 min duration 24 hrs
degludec 42 hrs.
Metaproteronol Right Ans - -nebulizer formula for infants
Terbutaline Right Ans - Off label inhibits uterine contractions
Preg B
Formoterol and Salmeterol Right Ans - Black box not used as monotherapy
-not used for acute exacerbations
-*can worsen symptoms of asthma if pt is deteriorating
-CI children < 4 yrs.
Drug interactions with Beta agonists Right Ans - Tricyclic antidepressants
and MAOIs potentiate effects on the vascular system
Digoxin increase the risk arrhythmias (albuterol and levalbuterol
beta agonist contraindications Right Ans - Cardiac arrythmias, tachycardia,
heart block, dig toxicity, angina, narrow angle glaucoma, organic brain
damage, shock during anesthesia
-diabetics cause hyperglycemia
-phechormocytoma cause hypertension
beta agonists clinical use Right Ans - treat bronchospasm, associated with
asthma, bronchitis, COPD.
beta agonists side effects Right Ans - Seziures, hypokalemia, angina, HTN,
tachy, tremors, h/a, gi upset, inform provider if.. palpatations tachy, angina,
tremors, dizziness, flushing, h/a
Inhaled Anticholinergics Right Ans - Muscarinic receptor blocker resulting
in bronchodilation. Used to prevent bronchospasm, manage allergen or
exercise-induced asthma, or COPD. Maximum effects may take up to 2 weeks,
shake inhaler well before administration, when using two different inhaled
medications, wait 5 minutes between, if administered via nebulizer, use
within 1 hour of reconstitution.
