NURS549 FINAL EXAM LATEST QUESTIONS AND ANSWERS

NURS549 FINAL EXAM LATEST QUESTIONS AND ANSWERS Leukotriene Receptor Antagonists - Answer-Montelukast ( Singulair) - is indicated for the prophylaxis and chronic treatment of asthma in adults and pediatric patients 12 months of age and older. Zafirlucast ( Accolate ) - is indicated for the prophylaxis and chronic treatment of asthma in adults and children 5 years of age and older. Monoclonal Antibody for Asthma - Answer-Omalizumab ( Xolair) Xolair is indicated for adults and adolescents (12 years of age and above) with moderate to severe persistent asthma Phosphodiesterase-5 Inhibitor - Answer-: Sildenafil ( Revatio ) ( also Viagra) A phosphodiesterase type 5 inhibitor (PDE5 inhibitor) is a drug used to block the degradative action of cGMP- specific phosphodiesterase type 5 (PDE5) on cyclic GMP in the vascular smooth muscle cells lining the blood vessels supplying the corpus cavernosum erectile tissue of the penis also located in lungs prostate and bladder First Generation H1-Blockers - Answer-effective, cheap, and still widely used, BUT, most of these drugs penetrate the CNS blood brain barrier as well and cause sedation by blocking the wakefullness associated with central Histamine. Also interact with other receptors ( cholinergic, adrenergic, serotonin...etc) producing a variety of unwanted adverse effects Second Generation H1-Blockers - Answer-are more specific for H1 Receptors, ( less effect on cholinergic, adrenergic and serotonin) ( less unwanted adverse effects) because they also carry a polar group ( making them more water soluble) , they do not penetrate the CNS blood brain barrier and therefore cause less sedation than first generation H1 blockers First Generation H1 blocker drugs - Answer-Diphenhydramine ( Benadryl) Chlorpheniramine ( Chlor-Trimeton) Dimenhydrinate ( Dramamine) Hydroxyzine ( Atarax) ( Vistaril) Meclizine ( Antivert) Second Generation H1 blocker drugs - Answer-Cetrizine ( Zyrtec) Loratidine ( Claritin) Fexofenadine ( Allegra) H-2 Receptor Antagonist Drugs - Answer-Cimetidine ( Tagamet) Ranitidine ( Zantac) Famotidine ( Pepcid) Nizatidine ( Axid ) Proton Pump Inhibitors - Answer-Omeprazole ( Prilosec)- also OTC Lansoprazole (Prevacid )-also OTC Pantoprazole ( Protonix) Esomeprazole ( Nexium ) Rabeprazole ( Aciphex) Phenothiazines - Answer-Prochlorperazine ( Compazine ) Controls nausea and vomiting by blocking DOPAMINE receptors found in the CTZ. This stops the CTZ from sending the messages to the Vomiting Center that would otherwise cause nausea and vomiting. 5HT3 Serotonin Receptor Blockers - Answer-Odansetron ( Zofran) Selectively blocks SEROTONIN receptors at the Chemoreceptor Trigger Zone from sending the messages to the Vomiting Center that would otherwise cause nausea and vomiting Substituted Benzamides - Answer-Metoclopramide ( Reglan antagonism of central and peripheral dopamine receptors Bisacodyl (Dulcolax) - Answer-stimulant laxative that acts on nerve fibers in the colon Senna (Sennosoids) (Ex-lax) - Answer-stimulant laxative Lactulose (Enulose) - Answer-osmotic laxative - oral doses reach the colon and are degraded by colonic bacteria into lactic, formic and acetic acids. This ultimately increases osmotic pressure, causing fluid accumulation, colon distension, soft stools and defecation.. Docusate Sodium ( Colace) - Answer-becomes emulsified with the stool producing softer feces and ease of passage. ( often takes days to become effective and are often used for prophylaxis rather than acute treatment ) Polyethylene Glycol ( PEG) ( Miralax) ( Go-Lytely) - Answer-an osmotic agent which causes water to be retained with the stool Lubiprostone (Amitiza) - Answer-chloride channel activator in the intestinal lumen to increase fluid secretions producing a chloride rich fluid secretion Naloxegol (Movantik) - Answer-antagonist of opioid binding at the mu-opioid receptor. When administered at the recommended dose levels, functions as a peripherally-acting mu-opioid receptor antagonist in tissues such as the gastrointestinal tract, thereby decreasing the constipating effects of opioids Phosphodiesterase ( PDE-5) Inhibitors - Answer-Sildenafil ( Viagra) Tadalafil ( Cialis) Vardenafil ( Levitra) Avanafil ( Stendra) which is the enzyme responsible for degradation of cGMP in the corpus cavernosum, and this leads to an extended arterial vascular smooth muscle relaxation and prolonged increase in penile blood flow Doxazocin ( Cardura) Terazocin ( Hytrin) - Answer-BOTH high blood pressure and the urinary retention associated with benign prostatic hyperplasia (BPH). Blocks both Alpha-1A & Alpha -1B receptors Prazocin ( Minipress) - Answer-IS MORE SPECIFIC FOR HTN ( ALPHA 1B RECEPTORS) Tamsulosin ( Flomax) - Answer-MORE SPECIFIC FOR THE PROSTATE ( ALPHA 1A RECEPTORS) Finasteride ( Proscar) Dutasteride ( Avoda) - Answer-5 - Alpha Reductase Inhibitors for BPH By reducing hyperactive 5-Alpha Reductase and reducing DHT, the prostate shrinks and urine flow increases ( DHT), an androgen that stimulates prostate growth Treatment of Anemia - Answer-Cyanocobalamin ( B12) Epoetin Alfa ( Epogen, Procrit) Folic Acid Iron Treatment of Neutropenia - Answer-Filgrastim ( Neupogen) Pegfilgrastim ( Neulasta) Treatment of Sickle Cell Anemia - Answer-Hydroxyurea ( Hydrea) Pentoxyfylline ( Trental Anemia causes - Answer-chronic blood loss bone marrow abnormalities increased hemolysis infections Malignancy endocrine deficiencies renal failure dietary deficiencies disease states Iron Deficient Anemia - Answer-major component of Hemoglobin within the RBC. Iron Deficiency Causes: Blood loss Lack of iron in the diet ( meat, eggs, leafy greens) Insufficient intake during periods of accelerated growth in children Heavy Menstruation Pregnancy An inability to absorb iron----- intestinal disease / disorder - celiac dx. Drug - Ferrous Sulfate corrects deficiency Folic Acid( Folate) ( Vitamin B9) Deficiency Anemia - Answer-Essential for the maturation of RBC'S are two vitamins: 1. B12 and Folic Acid. Lack of either of these causes maturation failure in the process of erythropoiesis cAuses alcoholism malabsorption drug increased demand- pregnancy