NURS 615 WEEK 8: ADVANCED PHARMACOTHERAPEUTICS STUDY GUIDE QUESTIONS & COMPLETE DETAILED ANSWERS (LATEST 2025/2026 UPDATE)

NURS 615 WEEK 8: ADVANCED PHARMACOTHERAPEUTICS STUDY GUIDE QUESTIONS & COMPLETE DETAILED ANSWERS (LATEST 2025/2026 UPDATE) 1. Difference between low-dose and high-dose colchicine? a. Colchicine is used for Gout. Low-dose colchicine is given for the initial flare up at 1.2 mg, followed by 0.6 mg and hour later. High dose colchicine is 1.2 mg followed by 0.6 mg every 4-6 hours for a total of 4.8 mg until relief is achieved. Low dose colchicine is as effective as high dose colchicine with fewer side effects. i. Adverse effects of colchicine: N/V, diarrhea (even w/ low dose), but mostly placebo effects w/ low dose. May need to adjust dosage if renal or hepatic issues arise. 2. What lab values should be monitored with Gout? a. RFP (renal function panel) esp. BUN/Cr (renally excreted); Uric Acid (goal < 6); LFT Baseline/periodic (liver function test); and a CBC for possible anemia and Platelet count. 3. What patient education should you provide when prescribing colchicine? a. Educate on main GI side effects including GI Upset and severe diarrhea. Not indicated for patients with renal issues and can cause hepatotoxicity. b. Take medication as prescribed c. Take any missed doses as soon as you remember d. If you encounter any serious side effects call provider e. Take medication with food or milk may help relieve GI related effects f. Do Not stop medication suddenly without advice from prescriber g. Discuss alkaline diet, drink plenty of fluids, avoid alcohol, report any hypersensitivity i. Alkaline diet - increasing intake of cherries, citrus fruits, and vegetables, and drinking plenty of water. Limiting high-purine foods like red meat, certain seafood (mussels, scallops, & shrimp), and high-fructose corn syrup (sugary drinks). 4. What are the adverse effects of corticosteroids if administered for 6 months or more? a. Osteoporosis and worsening diabetes i. Topical steroids – thinning skin, ii. systemic absorption (hair loss, acne breakouts, poor healing [infections – viral or fungal], extra hair growth, muscle pain/weakness, muscle wasting, development of glaucoma, altered body fat distribution (moon face, truncal obesity), can cause peptic ulcer disease, can cause or exacerbate HTN, can cause delirium & agitation in elderly, emotional volatility (anger, crying), can cause depression, adrenal suppression. May mask symptoms of Diabetes iii. Will need to taper off – may take up to 12 months 5. Why is it important to taper corticosteroids? a. Gives the adrenal glands time to return to normal function. This will prevent an adrenal insufficiency crisis. i. Symptoms of adrenal crisis include – abdominal/flank pain, decreased LOC (level of consciousness), Coma, dehydration, dizziness, fatigue, severe weakness, headache, fever, loss of appetite, low BP, High HR, N/V, and rapid RR. 6. What are the BLACK BOX warnings on NSAIDS? a. Increased risk for cardiovascular thrombotic events and can also cause GI Bleeding ulceration, and perforation of stomach and/or intestines. 7. What are the recommendations in the treatment of pain? a. Start with non-opioid analgesics first and then work your way up to narcotics. i. Take all comorbidities into consideration, not to be taken for the long term 8. What is the Mechanism of Action of ibuprofen? a. Ibuprofen – a non-selective inhibitor of an enzyme called cyclooxygenase (COX). Cyclooxygenase is required to convert arachidonic acid into thromboxane, prostaglandins, and prostacyclin. INHIBITS COX 1 and COX 2. 9. What are the serious side effects associated with Acetaminophen? a. Liver Failure d/t Tylenol poisoning, liver damage can occur when a person exceeds the maximum daily dose of 4,000 mg. i. BOTH intentional and unintentional overdose can occur. 1. Can cause necrosis of the liver at 10-15 g, >25g death will occur. 2. N/V 3. Can become Obtunded (dulled or reduced level of consciousness), sleepy, renal failure, liver tenderness, pancytopenia, thrombocytopenia - Week 9 Study Guide Questions 1. Identify the symptoms of hypoglycemic, hyperglycemic, and ketoacidosis? a. Hypoglycemia – Tachycardia, dizziness, diaphoresis, confusion i. Activates the sympathetic nervous system – sweating, nervousness, feeling of impending doom, palpitations, tremors, and feeling hungry, trouble focusing, may progress to hallucinations, if not corrected, can become comatose and die. b. Hyperglycemia – Polyuria, polydipsia, polyphagia, blurry vision, and fatigue i. Hypovolemia d/t fluid loss in urine, similar neurological/cognitive deficits are seen in hypoglycemia, will feel tired, can also go into a comatose state & die. May also see hypotension, palpitations, and dry mucous membranes. All cases of hypoglycemia. - will show clinical signs of hypovolemia. c. Ketoacidosis – Abdominal pain, N/V, acetone/fruity breath, abnormally high blood sugar, may not have ketones in urine i. Life-threatening problems normally occur in patients with type 1 diabetes. Signs & Symptoms: N/V, Belly Pain, all symptoms of hypoglycemia. Fruity odor to breathe and rapid, shallow respirations. 2. What is the mechanism of action of the gliptins (DPP-4 Inhibitors)? a. Increase incretin levels that inhibit glucagon release, which will also increase insulin secretion and decrease gastric emptying. b. Prevents enzymes (DPP-4) from breaking down GLP-1 peptide c. Involved in an increase in heart failure, not hugely effective at lowering glycemia, and can be expensive.