NR 566 / NR566 ADVANCED PHARMACOLOGY CARE OF THE FAMILY MIDTERM EXAM |
RATED A | LATEST, | CHAMBERLAIN COLLEGE
NR566 Advanced Pharmacology Care of the Family Midterm
Exam Rated A Latest, 2022 Chamberlain College
• Pneumonia goals of treatment
- Return to baseline respiratory status
- Fever resolves in 2 to 4 days
- Leukocytosis resolves by day 4 of treatment
- Chest x-ray may take 4 weeks or more to return
• Common bacterial pathogens of Adult pneumonia
- S. pneumoniae
- Patients with underlying lung disease
- Nontypeable Haemophilus influenza and Moraxella catarrhalis
- Staph aureus: co-pathogen with influenza
- Mycoplasma pneumoniae
- Viral pneumonia
• Common bacterial pathogens of Adult Community-Acquired Pneumonia
- Consult current treatment guidelines for the most recent treatment
guidelines for community acquired pneumonia (CAP)
• Common bacterial pathogens of CAP in pregnant women
- Main pathogens are S. pneumoniae
- H. influenzae, M. pneumoniae, and viruses
- Macrolides
- Pregnancy category B: erythromycin, azithromycin
- Pregnancy category category C: clarithromycin
- Comorbid conditions or recent antibiotics:
- Beta-lactam plus a macrolide
pg. 1
, NR 566 / NR566 ADVANCED PHARMACOLOGY CARE OF THE FAMILY MIDTERM EXAM |
RATED A | LATEST, | CHAMBERLAIN COLLEGE
• Common pediatric pneumonia pathogens
- S. pneumoniae is the most common cause of bacterial pneumonia in
patients of all ages
- Increase in viral pneumonia with PCV7 vaccine
- Infants 4 to 16 weeks
- Consider chlamydia
- Over 5 years through adolescence
- Consider mycoplasma
- Community-acquired methicillin-resistant staphylococcus aureus
- Virus
• Clinical practice guidelines for treatment of CAP
- Children under age 5 years
- Bacterial pneumonia (S. pneumoniae)
- Amoxicillin: 80 to 90 mg/kg/day
- Ceftriaxone: 50 mg/kg/day until able to take oral antibiotics
- Penicillin allergy: clindamycin or a macrolide
- Infant with suspected chlamydial pneumonia
- Azithromycin 20 mg/kg/day for 3 days OR erythromycin (EryPed) 50
mg/kg for 14 days
- Children 5 Years or Older
- Mycoplasma or other atypical most likely
- Azithromycin: 10 mg/kg on day 1 and 5 mg/kg on days 2 through 5
- Clarithromycin: 15 mg/kg per day in two divided doses (maximum 1 g/day)
- Erythromycin: 40 to 50 mg/kg/day
• CAP treatment in pregnancy
- abx treatment:
- 1st choice: Erythromycin or azithromycin cat B. or Clarythromycin cat C.
pg. 2
, NR 566 / NR566 ADVANCED PHARMACOLOGY CARE OF THE FAMILY MIDTERM EXAM |
RATED A | LATEST, | CHAMBERLAIN COLLEGE
• Radiologic findings during CAP treatment
- assist in confirming the dx of pneumonia vs other resp disorders such as
lung abscess or tuberculosis
• Treatment of chlamydial pneumonia
- he standard treatment for infants is erythomycin
• Nicotine patch teaching
- Advise patients to dispose of used nicotine patches out of the reach of
children or animals. Enough nicotine is left in a used patch to lead to toxic
levels in a child or small animal.
- The transdermal nicotine system, or "patch," provides a slow, cutaneous
absorption of nicotine over many hours. The patch is applied to clean,
nonhairy skin on the upper body or upper arm when the patient wakes up.
Peak nicotine levels occur in 2 to 6 hours (brand-dependent) and then
gradually decrease. Once the patch is removed, nicotine levels in the blood
reach a nondetectable level in 10 to 12 hours in nonsmokers.
• Nicotine gum patient teaching
- Patients complain about the taste of the nicotine gum. Suggest that the
patient try the flavored variety, which patients seem to tolerate better.
- The patient should not eat or drink for 15 minutes before or while the
lozenge is dissolving in the mouth. There may be a tingling sensation in
the mouth as the lozenge dissolves.
- Chewing too quickly causes an excess amount of nicotine to be released
into the bloodstream, producing nausea, throat irritation, and hiccoughs. The
patient should avoid
smoking while chewing nicotine gum because toxicity symptoms may
occur (nausea, vomiting, and headache).
pg. 3
, NR 566 / NR566 ADVANCED PHARMACOLOGY CARE OF THE FAMILY MIDTERM EXAM |
RATED A | LATEST, | CHAMBERLAIN COLLEGE
• Myocardial oxygen demand
- High systolic blood pressure, which increases the work the heart has to do
to move blood from the left ventricle to the systemic circulation. One focus
of anginal management is control of blood pressure. ACE inhibitors, beta
blockers, direct renin inhibitors, and both types of CCBs decrease blood
pressure.
o Increased ventricular volume, which increases the work the heart
has to do because the left ventricle must move more blood. ACE
inhibitors reduce sodium and water retention.
o Increased thickness of the myocardium (ventricular hypertrophy).
The same mechanism that facilitated growth of the vessel walls in
atherosclerosis also increases the thickness of the myocardium. ACE
inhibitors play a major role here to decrease the remodeling. Beta
blockers can assist in prevention of ventricular hypertrophy but play
a smaller role.
o Increased heart rate resulting from exercise, stress,
hyperthyroidism, fever, anemia, hyperviscosity of the blood, or
negative feedback systems' response to decreased cardiac output.
Beta blockers can assist in decreasing heart rate resulting from
conditions such as hyperthyroidism and from negative feedback
patterns secondary to decreased cardiac output.
o Conditions that heighten the myocardium's contractile response.
Beta blockers and CCBs both have negative inotropic effects.
• Bioavailability of bisphosphonate drugs and appropriate patient education
- Histamine2 blocking agents double alendronate bioavailability, but the
impact is unknown. Aspirin may decrease the bioavailability of
pg. 4
RATED A | LATEST, | CHAMBERLAIN COLLEGE
NR566 Advanced Pharmacology Care of the Family Midterm
Exam Rated A Latest, 2022 Chamberlain College
• Pneumonia goals of treatment
- Return to baseline respiratory status
- Fever resolves in 2 to 4 days
- Leukocytosis resolves by day 4 of treatment
- Chest x-ray may take 4 weeks or more to return
• Common bacterial pathogens of Adult pneumonia
- S. pneumoniae
- Patients with underlying lung disease
- Nontypeable Haemophilus influenza and Moraxella catarrhalis
- Staph aureus: co-pathogen with influenza
- Mycoplasma pneumoniae
- Viral pneumonia
• Common bacterial pathogens of Adult Community-Acquired Pneumonia
- Consult current treatment guidelines for the most recent treatment
guidelines for community acquired pneumonia (CAP)
• Common bacterial pathogens of CAP in pregnant women
- Main pathogens are S. pneumoniae
- H. influenzae, M. pneumoniae, and viruses
- Macrolides
- Pregnancy category B: erythromycin, azithromycin
- Pregnancy category category C: clarithromycin
- Comorbid conditions or recent antibiotics:
- Beta-lactam plus a macrolide
pg. 1
, NR 566 / NR566 ADVANCED PHARMACOLOGY CARE OF THE FAMILY MIDTERM EXAM |
RATED A | LATEST, | CHAMBERLAIN COLLEGE
• Common pediatric pneumonia pathogens
- S. pneumoniae is the most common cause of bacterial pneumonia in
patients of all ages
- Increase in viral pneumonia with PCV7 vaccine
- Infants 4 to 16 weeks
- Consider chlamydia
- Over 5 years through adolescence
- Consider mycoplasma
- Community-acquired methicillin-resistant staphylococcus aureus
- Virus
• Clinical practice guidelines for treatment of CAP
- Children under age 5 years
- Bacterial pneumonia (S. pneumoniae)
- Amoxicillin: 80 to 90 mg/kg/day
- Ceftriaxone: 50 mg/kg/day until able to take oral antibiotics
- Penicillin allergy: clindamycin or a macrolide
- Infant with suspected chlamydial pneumonia
- Azithromycin 20 mg/kg/day for 3 days OR erythromycin (EryPed) 50
mg/kg for 14 days
- Children 5 Years or Older
- Mycoplasma or other atypical most likely
- Azithromycin: 10 mg/kg on day 1 and 5 mg/kg on days 2 through 5
- Clarithromycin: 15 mg/kg per day in two divided doses (maximum 1 g/day)
- Erythromycin: 40 to 50 mg/kg/day
• CAP treatment in pregnancy
- abx treatment:
- 1st choice: Erythromycin or azithromycin cat B. or Clarythromycin cat C.
pg. 2
, NR 566 / NR566 ADVANCED PHARMACOLOGY CARE OF THE FAMILY MIDTERM EXAM |
RATED A | LATEST, | CHAMBERLAIN COLLEGE
• Radiologic findings during CAP treatment
- assist in confirming the dx of pneumonia vs other resp disorders such as
lung abscess or tuberculosis
• Treatment of chlamydial pneumonia
- he standard treatment for infants is erythomycin
• Nicotine patch teaching
- Advise patients to dispose of used nicotine patches out of the reach of
children or animals. Enough nicotine is left in a used patch to lead to toxic
levels in a child or small animal.
- The transdermal nicotine system, or "patch," provides a slow, cutaneous
absorption of nicotine over many hours. The patch is applied to clean,
nonhairy skin on the upper body or upper arm when the patient wakes up.
Peak nicotine levels occur in 2 to 6 hours (brand-dependent) and then
gradually decrease. Once the patch is removed, nicotine levels in the blood
reach a nondetectable level in 10 to 12 hours in nonsmokers.
• Nicotine gum patient teaching
- Patients complain about the taste of the nicotine gum. Suggest that the
patient try the flavored variety, which patients seem to tolerate better.
- The patient should not eat or drink for 15 minutes before or while the
lozenge is dissolving in the mouth. There may be a tingling sensation in
the mouth as the lozenge dissolves.
- Chewing too quickly causes an excess amount of nicotine to be released
into the bloodstream, producing nausea, throat irritation, and hiccoughs. The
patient should avoid
smoking while chewing nicotine gum because toxicity symptoms may
occur (nausea, vomiting, and headache).
pg. 3
, NR 566 / NR566 ADVANCED PHARMACOLOGY CARE OF THE FAMILY MIDTERM EXAM |
RATED A | LATEST, | CHAMBERLAIN COLLEGE
• Myocardial oxygen demand
- High systolic blood pressure, which increases the work the heart has to do
to move blood from the left ventricle to the systemic circulation. One focus
of anginal management is control of blood pressure. ACE inhibitors, beta
blockers, direct renin inhibitors, and both types of CCBs decrease blood
pressure.
o Increased ventricular volume, which increases the work the heart
has to do because the left ventricle must move more blood. ACE
inhibitors reduce sodium and water retention.
o Increased thickness of the myocardium (ventricular hypertrophy).
The same mechanism that facilitated growth of the vessel walls in
atherosclerosis also increases the thickness of the myocardium. ACE
inhibitors play a major role here to decrease the remodeling. Beta
blockers can assist in prevention of ventricular hypertrophy but play
a smaller role.
o Increased heart rate resulting from exercise, stress,
hyperthyroidism, fever, anemia, hyperviscosity of the blood, or
negative feedback systems' response to decreased cardiac output.
Beta blockers can assist in decreasing heart rate resulting from
conditions such as hyperthyroidism and from negative feedback
patterns secondary to decreased cardiac output.
o Conditions that heighten the myocardium's contractile response.
Beta blockers and CCBs both have negative inotropic effects.
• Bioavailability of bisphosphonate drugs and appropriate patient education
- Histamine2 blocking agents double alendronate bioavailability, but the
impact is unknown. Aspirin may decrease the bioavailability of
pg. 4
