NR565 Advanced Pharmacology Final Exam Study Guide |
Actual verified study complete Solutions | 2026/27
Updates | 100% correct | Passed on First Attempt
Exam Format: Non-Cumulative Exam
Question Type: Multiple Choice
Number of Questions: 100
Time Allotted: 120 minutes (1.2 minutes per question)
Testing Timeframe: The final exam will be available starting on
Wednesday Week 8 at 12:01 am MT until Saturday Week 8 at 11:59 pm
MT.
1. Exam Coverage
Content Areas:
• Week 5: Pharmacotherapy for Endocrine Disorders
• Week 6: Pharmacotherapy for Respiratory Conditions
• Week 7: Pharmacotherapy for Gastrointestinal Conditions
• Week 8: Complementary and Alternative Therapies
2. Key Concepts to Study
Week 5: Pharmacotherapy for Endocrine Disorders, Chapters 48-49
• Radioactive iodine adverse effects
Procedure for hyperthyroidism where pt swallowing capsule/liquid that
destroys thyroid tissue
Adverse effects= effect is delayed taking several months for full
therapeutic effect, associated w/ delayed hypothyroidism, not used if
pregnant, breastfeeding/lactating, in young children (cx risk), can
cause corrosive injury to GI tract- notify provider if abd pain
• Methimazole indication and MOA
1st line tx for hyperthyroidism, safer than PTU, avoid during 1st
trimester pregnancy
,MOA= inhibits enzyme peroxidase -> prevents oxidation of iodide
which inhibits incorporation of iodide into tyrosine -> also prevents
, iodinated tyrosines from coupling -> blocks synthesis of thyroid
hormone
Doesn’t destroy existing stores of thyroid hormone, after tx has started
it may take 3-12wks to produce euthyroid state
Adverse effects= agranulocytosis- at increased risk during 1st 2
months of tx, if occurs then d/c immediately, first s/s may be sore
throat/fever, hypothyroidism may occur if decreased dosage is needed
• Levothyroxine education, population considerations,
monitoring, drug interactions, dosing, adjustments
Synthetic preparation of thyroxine/T4- although some is converted into
T3, has narrow therapeutic range, IV dosage used for myxedema
coma, caution in pts w/ cardiovascular disease & start w/ lower doses
in older adults
Pharmacokinetics- Absorption is decreased by food- take on empty
stomach in the morning 30-60mins before breakfast, highly protein
bound & has long half-life (7 days), takes 1 month for levels to plateau
Interactions- Decreased levothyroxine absorption (separate admin of
these drugs by 4hrs)= H2 receptor blockers (cimetidine), PPI,
sucralfate, cholestyramine, colestipol, aluminum-containing antacids
(Maalox, Mylanta), calcium supplements, iron supplements,
magnesium salts, orlistat
Accelerate levothyroxine metabolism (may need to increase
levothyroxine dose)= phenytoin, carbamazepine, rifampin, sertraline,
phenobarbital
May need to decrease warfarin dose d/t levothyroxine enhancing
effects by accelerating degradation of vit K- dependent clotting factors
Can increase cardiac responsiveness to catecholamines, increased risk
for catecholamine-induced cardiac arrythmias
Can increase requirements of insulin & digoxin
Patient education- Maintain same brand name product, if brand is
switched then recheck serum TSH in 6wks & adjust dosage as needed,
advise pts to check with their prescriber before allowing pharmacist to
switch to different brand name, pt will likely need lifelong tx
Adverse effects- OD can cause thyrotoxicosis- s/s= tachycardia,
angina, tremor, nervousness, insomnia, hyperthermia, heat
intolerance, sweating
Chronic overdosage associated w/ accelerated bone loss/fx risk & A-fib,
especially in older adults
Evaluation- Monitor serum TSH 6-8wks after starting tx- some pts
may remain with increased TSH so success is indicated if T4 levels are
Actual verified study complete Solutions | 2026/27
Updates | 100% correct | Passed on First Attempt
Exam Format: Non-Cumulative Exam
Question Type: Multiple Choice
Number of Questions: 100
Time Allotted: 120 minutes (1.2 minutes per question)
Testing Timeframe: The final exam will be available starting on
Wednesday Week 8 at 12:01 am MT until Saturday Week 8 at 11:59 pm
MT.
1. Exam Coverage
Content Areas:
• Week 5: Pharmacotherapy for Endocrine Disorders
• Week 6: Pharmacotherapy for Respiratory Conditions
• Week 7: Pharmacotherapy for Gastrointestinal Conditions
• Week 8: Complementary and Alternative Therapies
2. Key Concepts to Study
Week 5: Pharmacotherapy for Endocrine Disorders, Chapters 48-49
• Radioactive iodine adverse effects
Procedure for hyperthyroidism where pt swallowing capsule/liquid that
destroys thyroid tissue
Adverse effects= effect is delayed taking several months for full
therapeutic effect, associated w/ delayed hypothyroidism, not used if
pregnant, breastfeeding/lactating, in young children (cx risk), can
cause corrosive injury to GI tract- notify provider if abd pain
• Methimazole indication and MOA
1st line tx for hyperthyroidism, safer than PTU, avoid during 1st
trimester pregnancy
,MOA= inhibits enzyme peroxidase -> prevents oxidation of iodide
which inhibits incorporation of iodide into tyrosine -> also prevents
, iodinated tyrosines from coupling -> blocks synthesis of thyroid
hormone
Doesn’t destroy existing stores of thyroid hormone, after tx has started
it may take 3-12wks to produce euthyroid state
Adverse effects= agranulocytosis- at increased risk during 1st 2
months of tx, if occurs then d/c immediately, first s/s may be sore
throat/fever, hypothyroidism may occur if decreased dosage is needed
• Levothyroxine education, population considerations,
monitoring, drug interactions, dosing, adjustments
Synthetic preparation of thyroxine/T4- although some is converted into
T3, has narrow therapeutic range, IV dosage used for myxedema
coma, caution in pts w/ cardiovascular disease & start w/ lower doses
in older adults
Pharmacokinetics- Absorption is decreased by food- take on empty
stomach in the morning 30-60mins before breakfast, highly protein
bound & has long half-life (7 days), takes 1 month for levels to plateau
Interactions- Decreased levothyroxine absorption (separate admin of
these drugs by 4hrs)= H2 receptor blockers (cimetidine), PPI,
sucralfate, cholestyramine, colestipol, aluminum-containing antacids
(Maalox, Mylanta), calcium supplements, iron supplements,
magnesium salts, orlistat
Accelerate levothyroxine metabolism (may need to increase
levothyroxine dose)= phenytoin, carbamazepine, rifampin, sertraline,
phenobarbital
May need to decrease warfarin dose d/t levothyroxine enhancing
effects by accelerating degradation of vit K- dependent clotting factors
Can increase cardiac responsiveness to catecholamines, increased risk
for catecholamine-induced cardiac arrythmias
Can increase requirements of insulin & digoxin
Patient education- Maintain same brand name product, if brand is
switched then recheck serum TSH in 6wks & adjust dosage as needed,
advise pts to check with their prescriber before allowing pharmacist to
switch to different brand name, pt will likely need lifelong tx
Adverse effects- OD can cause thyrotoxicosis- s/s= tachycardia,
angina, tremor, nervousness, insomnia, hyperthermia, heat
intolerance, sweating
Chronic overdosage associated w/ accelerated bone loss/fx risk & A-fib,
especially in older adults
Evaluation- Monitor serum TSH 6-8wks after starting tx- some pts
may remain with increased TSH so success is indicated if T4 levels are
