Final Exam: NR567/ NR 567 (Latest 2026/ 2027 Update) Week 1-7 Advanced Pharmacology for the AGACNP Review| Questions and Verified Answers| 100% Correct – Chamberlain

Final Exam: NR567/ NR 567 (Latest 2026/ 2027 Update) Advanced Pharmacology for the AGACNP Review| Questions and Verified Answers| 100% Correct – Chamberlain Question: Your patient has been taking risperidone (Risperdal) but has developed hyperprolactinemia. Which of the following may help manage hyperprolactinemia?? Answer: Bromocriptine (Parlodel) b. Haloperidol (Haldol) c. Promethazine (Phenergan) d. Chlorpromazine (Thorazine) Question: A 35-year-old female with a long history of anxiety treated with diazepam (Valium) has increasingly become fearful and anxious about the Coronavirus pandemic and triples her daily dose. She is found extremely lethargic and obtunded two days after the increased dosing. Which of the following pharmaceutical agents should the nurse practitioner order to treat her condition?? Answer: Flumazenil (Romazicon) Naloxone (Narcan) Depakote (Divalproex sodium) Midazolam (Versed) Question: A 25-year-old male with a history of bipolar disease presents to the emergency department (ED) with acute agitation characteristic of mania. Non-pharmacological methods of de-escalation have been attempted without success. Which of the following is not recommended to treat this patient?? Answer: Haloperidol (Haldol) Olanzapine (Zyprexa) Aripiprazole (Abilify) Naltrexone (Vivitrol, ReVia) Question: Which of the following is a long-acting benzodiazepine that is used to treat anxiety?? Answer: Diazepam (Valium) Alprazolam (Xanax) Eszopiclone (Lunesta) Zolpidem (Ambien) Question: Acute dystonia can develop after early initiation of which of the following?? Answer: Clozapine (Clozaril) Haloperidol (Haldol) Aripiprazole (Abilify) Olanzapine (Zyprexa) Question: WEEK 2? Answer: ... Question: Adding epinephrine to a local anesthetic, such as 1% lidocaine for local infiltration, has which of the following benefits?? Answer: Extends the duration of the anesthesia block, useful for longer procedures Can be used in a digital block for extensive finger or toe laceration repair Shortens the duration of the anesthetic Eliminates the concern of systemic toxicity of lidocaine, even with inadvertent intravenous injection Question: Your patient reports a history of anaphylaxis to an "ester-type" local anesthetic. Which of the following, if given, would be most likely to provoke an allergic response in this patient?? Answer: Lidocaine (Xylocaine) Tetracaine (Pontocaine) Bupivacaine (Marcaine) Ropivacaine (Naropin) Question: An OR patient receives propofol for induction. What is the most likely adverse response associated with the administration of this pharmaceutical agent?? Answer: Laryngospasm Seizure Excessively prolonged skeletal muscle paralysis Hypotension and respiratory depression The double bond in the Propofol molecule is vulnerable to assault by the enzyme cytochrome P450. When this enzyme binds to the Propofol molecule, it creates a reactive intermediate that damages cell membranes, including those in the brain and respiratory area. Respiratory depression can result from this injury. Propofol depresses the central nervous system, which can lead to respiratory depression. This can result in a reduction in respiratory rate and an increase in blood carbon dioxide levels. Question: Which of the following medications should be given to patients presenting to the emergency department (ED) with an altered level of consciousness, seizures, or both, if a concern of Wernicke-Korsakoff syndrome exists?? Answer: Folate (Folic acid) Chlordiazepoxide (Librium) Thiamine (Vitamin B1) Lorazepam (Ativan) Question: Which of the following pharmaceutical agents is not recommended for treating methanol poisoning?? Answer: Ethanol intravenously Fomepizole (Antizole) Sodium Bicarbonate Disulfiram (Antabuse) Question: Which of the following pharmaceutical agents is the preferred antiseizure medication for a generalized seizure disorder in a 25-year -old pregnant female?? Answer: Phenobarbital (Solfoton) Valproate (Valproic acid) -This is known as a human teratogen. Exposure in first trimester isassociated with an approximately threefold increased risk of major congenital malformations,most commonly spina bifida. There is evidence that valproate exposure may be associated withan increased risk of autism spectrum disorder. Levetiracetam (Keppra) Topiramate (Topamax) Question: Which of the following is the least preferable initial treatment of choice for status epilepticus?? Answer: Lorazepam (Ativan) Diazepam (Valium) Propofol (Diprivan) Fosphenytoin (Cerebyx) Question: Which of the following statements is not true?? Answer: In patients with hypovolemic states, heart failure, and other diseases that impair cardiovascular function, normal doses of sedative-hypnotics may cause cardiovascular depression In patients with pulmonary disease, therapeutic doses of sedative-hypnotics can produce significant respiratory depression. Sedative hypnotics can be utilized as an anticonvulsant; zolpidem (Ambien) and lorazepam (Ativan) are excellent options for managing seizures. Benzodiazepines exert dose-dependent anterograde amnestic effects. Question: Which of the following is the least appropriate medication for a patient with suspected increased intracranial pressure?? Answer: Propofol (Diprivan) Ketamine (Ketalar) This option is correct because use of ketamine is limited due to the fear or myth that it may increase the intracranial pressure (ICP) in some cases. Thiopental sodium (Pentothal) Midazolam (Versed) Question: It is noted that a trauma ICU patient is receiving adequate pain relief during painful procedures, but has increased skeletal muscle tone, an elevation in HR and BP, and post-procedure hallucinations and agitation as the drug wears off. Which of the following pharmaceutical agents is likely to create these effects?? Answer: Midazolam (Versed) Fentanyl (Sublimaze) Succinylcholine chloride Ketamine (Ketalar) Question: You are managing a patient who presented to the emergency department with a severe headache. Shortly upon arrival, the patient's neurological status rapidly deteriorates requiring airway management. Rapid sequence intubation is performed, and the patient suddenly develops a fever, hypertension, tachycardia, metabolic acidosis, hyperkalemia, and muscle rigidity. Which induction agent was most likely used?? Answer: Succinylcholine chloride The patient's symptoms are consistent with malignant hyperthermia (MH): this is an inherited skeletal muscle disorder usually triggered in susceptible humans and animals exposed to succinylcholine. Early signs of MH: muscle rigidity tachycardia tachypnea metabolic and respiratory acidosis Later signs of MH: hyperthermia hyperkalemia Propofol (Diprivan) Midazolam (Versed) Etomidate (Amidate) Question: You are selecting a neuromuscular blocking agent with the least cardiovascular side effect profile for an elderly patient with coronary artery disease. Which of the following medications should be avoided?? Answer: Vecuronium (Norcuron) Pancuronium (Pavulon) Rocuronium (Zemuron) Cisatracurium (Nimbex) = least Question: Your ICU patient is admitted following multisystem trauma secondary to a motor vehicle collision. The patient is ventilated and will be maintained on a neuromuscular blocking continuous agent to maintain neuromuscular blockage and deep sedation. Which of the following is a true statement?? Answer: -NMBAs also offer analgesic and sedating properties -This is an ideal patient for a succinylcholine continuous infusion -Repair of superficial lacerations can now be accomplished without further anesthesia since the patient is on an NMBA -If dantrolene is needed postoperatively on the NMBA, care should be taken to ensure muscle strength has returned prior to extubation Question: Which of the following best describes the rationale for long-term methadone therapy in treating opioid addiction and abuse?? Answer: -Methadone has greater oral bioavailability than morphine -Withdrawal from methadone is more intense than heroin withdrawal but resolves quicker -Methadone has a shorter biological half-life -Methadone possesses opioid antagonist properties Question: Which of the following is a pure opioid antagonist that binds competitively to opioid receptors, does not produce analgesia or opioid side effects, and reverses the toxic effects of agonist and agonist-antagonist opioids?? Answer: Tramadol (Ultram) Naloxone (Narcan) Sufentanil (Sufenta) Disulfiram (Antabuse) Question: Week 3? Answer: ... Question: Your patient presents with essential hypertension, and in reviewing lab results, you note that the circulating plasma renin and catecholamine levels are high. You decide to lower blood pressure by reducing both cardiac output and systemic vascular resistance (blocking both alpha- and beta-adrenergic receptors) with a single pharmaceutical agent. Which of the following is most likely to achieve this goal?? Answer: Metoprolol (Lopressor) Timolol (Betimol) Nadolol (Corgard) Labetalol (Trandate) Question: A nonselective beta-blocker was initiated for your patient. Which of the following diagnoses warrants initiating this pharmaceutical agent?? Answer: Asthma Bradycardia Severe left ventricular heart failure Hyperthyroid crisis Question: You are managing a patient with a history of coronary artery disease and transient ischemic attacks. Low-dose aspirin treatment is considered, but the patient has a reported history of aspirin allergy. Which of the following is the best alternative?? Answer: Dipyridamole (Persantine) Clopidogrel (Plavix) Acetaminophen (Tylenol) Ketorolac (Toradol) Question: Which of the following adverse effects is likely when an angiotensin-converting enzyme inhibitor (ACEI) is used with spironolactone therapy?? Answer: Hypotension Hyperkalemia Renal insufficiency Proteinuria Question: All of the following are beneficial effects of beta-blocker therapy for use in patients with cirrhosis except ___.? Answer: Diminish portal hypertension Increase cardiac output Decrease the incidence of esophageal bleeding Decrease mortality rate Question: Reducing cardiovascular events in patients with moderate to severe uncomplicated hypertension is an important consideration when choosing initial therapy. Which of the following is not recommended as a first-line treatment to reduce cardiovascular events?? Answer: Angiotensin-converting enzyme inhibitors (ACEI) Angiotensin receptor blockers (ARB) Beta agonist receptor blockers Dihydropyridine calcium channel blockers (CCB) Question: Which medication class would be most advantageous to use in treating a patient with hypertension and symptomatic benign prostatic hyperplasia (BPH)?? Answer: Thiazide diuretic Calcium channel blocker Angiotensin-converting enzyme inhibitor Alpha-1 blocker Question: A 49-year-old female is treated with unfractionated heparin post-myocardial infarction. The patient has developed several episodes of epistaxis, and now has + occult blood guaiac testing per digital rectal exam. Records reveal that she may have received an overdose of the anticoagulant. Which of the following will counteract the effects of heparin?? Answer: Protamine sulfate Vitamin K Aminocaproic acid (Amicar) Dipyridamole (Persantine) Question: You are considering using an ACE inhibitor to treat a patient with essential hypertension. Which of the following patient-related contraindications must be investigated and excluded before prescribing this medication?? Answer: Heart failure Asthma Coronary artery disease Pregnancy Question: What is the most likely adverse response associated with aspirin for prophylaxis in patients with a high risk of atherosclerotic cardiovascular disease?? Answer: Hepatic necrosis Vasospastic angina Tachycardia and hypotension Hemorrhagic stroke Question: Week 4? Answer: ... Question: Which of the following agents is used for the treatment of neutropenia?? Answer: Erythropoietin (Epogen) Granulocyte colony-stimulating factor (G-CSF) Interleukin-11 Romiplostim (Nplate) Question: Which of the following patients is most at risk of iron deficiency anemia and may need iron replacement therapy?? Answer: A 48-year old male with hemochromatosis A 55-year-old with Ulcerative Colitis A 68-year old woman who has been menopausal since age 50 A 49-year old patient who underwent gastrectomy Question: Neurological symptoms such as paresthesias, weakness, ataxia, and spasticity may be seen in which of the following disorders?? Answer: Vitamin B12 deficiency Iron deficiency Folate deficiency Vitamin A deficiency Question: The biologic effects of high-dose methotrexate can be reversed with which of the following agents?? Answer: Vitamin D Aminocaproic acid (Amicar) Dipyridamole (Persantine) L-leucovorin Question: Cardiotoxicity limits the clinical usefulness of which of these natural product chemotherapy drugs?? Answer: Bleomycin (Blenoxane) Doxorubicin (Adriamycin) Vinblastine (Velban) Irinotecan (Camptosar) Question: A 32-year-old patient was diagnosed with neck cancer. He has a 20-pack year smoking history (two packs of cigarettes a day for 10 years) and his physical exam, chest x-ray, and pulmonary function tests indicate the presence of underlying COPD. Which of the following medications should be avoided?? Answer: Vinblastine (Velban) Doxorubicin (Adriamycin) Daunorubicin (Cerubidine) Bleomycin (Blenoxane) Question: Which of the following drugs is clinically indicated for the treatment of non-Hodgkin's lymphoma?? Answer: Irinotecan (Camptosar) Docetaxel (Taxotere) Daunorubicin (Cerubidine) Vinblastine (Velban) Question: Which of the following antimalarial drugs is also used to treat autoimmune disorders?? Answer: Cyclosporin Hydroxychloroquine (Plaquenil) Prednisone (Deltasone) Azathioprine (Azasan) Question: A 41-year-old female is started on treatment for breast cancer with tamoxifen following surgical resection. Following five years of completed tamoxifen therapy, which of the following medications should the patient receive?? Answer: Anastrozole (Arimidex) Thalidomide (Thalomid) Rituximab (Rituxan) Ofatumumab (Arzerra) Question: Principles that guide the selection of drugs of combination chemotherapy in the treatment of cancer include all of the following except___?? Answer: Optimum scheduling Mechanism of action Toxicity Arbitrary dose changes Question: Week 5? Answer: .... Question: Which of the following statements best describes why propranolol (Inderal) can be used as an adjunct for patients with side effects from thyroid replacement therapy?? Answer: The drug blocks thyroid hormone release directly on the gland The drug acts to lessen dangerous cardiovascular symptoms that occur with thyroid hormone excess The drug lowers thyroid-stimulating hormone levels The drug inhibits thyroid hormone synthesis Question: Following thyroidectomy, which medication is required indefinitely?? Answer: Levothyroxine (Synthroid) Methimazole (Tapazole) Propylthiouracil (PTU) Desiccated thyroid (Armor Thyroid) Question: Which of the following pharmacological agents can be used as a temporary inhibitor of corticosteroid synthesis in Cushing's disease?? Answer: Spironolactone (Aldactone) Fludrocortisone (Florinef) Ketoconazole (Nizoral) Fluconazole (Diflucan) Question: Which of the following adverse reactions should be monitored when prescribing propylthiouracil (PTU)?? Answer: Gout Rhabdomyolysis Agranulocytosis Renal tubular necrosis Question: Which of the following statements best describes the properties of Levothyroxine?? Answer: It is the drug of choice to treat hyperthyroidism It converts T4 to T3 intracellularly-administration of the drug produces both hormones so that separate T3 administration is unnecessary It has a short half-life and thyroid levels will need to be repeated within two days to assure appropriate dosing It can improve thyroid disease so that therapy can be discontinued when symptoms resolve Question: Glucocorticoids have which of the following actions?? Answer: Decrease sodium retention Decrease potassium excretion Decrease free water clearance Decrease antibody production Question: Which of the following insulins has the most rapid onset of action?? Answer: Lispro (Humalog) Glargine (Lantus) Human NPH (Novolin N) Detemir (Levemir) Question: A 28-year-old male presents with symptoms consistent with diabetic ketoacidosis. Serum glucose is 470mg/dL and serum potassium level is 4.0 mEq/L. Which of the following is the expected course of action?? Answer: Insulin infusion at 0.1units/kg/hr with intravenous 0.9% normal saline and potassium replacement Sliding scale insulin with intravenous 0.9% normal saline and potassium replacement Insulin infusion at 0.3 units/kg/hr with intravenous 0.9% normal saline and no potassium replacement Sliding scale insulin with intravenous 0.9% normal saline and no potassium replacement Question: Which of the following medication classes is the least likely to cause the adverse effect of hypoglycemia?? Answer: Sulfonylurea Meglitinide Biguanide Alpha-Glucosidase Inhibitor Question: Which of the following is included in the treatment of hyperosmolar, hyperglycemic syndrome?? Answer: Aggressive rehydration with D5W/0.9%NS intravenously and high dose insulin Aggressive rehydration with 0.9% NS intravenously and correction of electrolyte abnormalities Insulin infusion, limiting overcorrection with minimal intravenous fluid infusion Aggressive rehydration and bicarbonate therapy Question: Week 6? Answer: .... Question: When prescribing intravenous acyclovir (Zovirax), the nurse practitioner knows that:? Answer: The infusion should be ordered at a rapid rate of delivery Adequate hydration should also be maintained Stevens-Johnson Syndrome is likely to occur Clinical resistant infections do not occur Question: A 13-year-old male with moderately persistent asthma has been diagnosed with type A influenza. Which of the following statements is the most important to consider when prescribing treatment with oseltamivir (Tamiflu)?? Answer: The medication should be started within the first 48 hours of influenza symptoms The parent can be advised to stop administering the medication when the adolescent's symptoms have resolved The medication will cure the virus as long as the full course of treatment is taken The medication should be administered once daily for 5 days Question: If considering starting a patient on the nucleoside reverse transcriptase inhibitor abacavir (Ziagen) which of the following is recommended prior to prescribing the medication?? Answer: Renal function HLA B*5701 testing Pancreatic enzyme levels CYP 450 enzyme activity Question: The drug of choice for the treatment of disease due to Histoplasma?? Answer: Ketoconazole (Nizoral) Itraconazole (Sporanox) Fluconazole (Diflucan) Voriconazole (Vfend) Question: Which of the following statements is true regarding metronidazole (Flagyl)?? Answer: Alcohol should be avoided Phenytoin decreases the elimination of the drug Increased salivation is a common adverse effect The drug should be taken on an empty stomach Question: Which of the following drugs is the standard chemoprophylactic agent for the prevention of P jiroveci infection (the cause of human pneumocystosis) in an immunocompromised patient?? Answer: Trimethoprim-sulfamethoxazole (TMP-SMX) Azithromycin (Zithromax) Pyrimethamine (Daraprim) Metronidazole (Flagyl) Question: You are treating a patient for fungemia with amphotericin B. The nurse practitioner knows which of the following is a common complication of treatment?? Answer: Renal failure Seizures Steven Johnson syndrome Decompensated heart failure Question: Which of the following, used in combination with sulfadiazine, is considered first-line therapy to treat toxoplasmosis?? Answer: Atovaquone (Malarone) Mefloquine (Lariam) Pyrimethamine (Daraprim) Primaquine (Primaquine) Question: Which of the following drugs is the treatment of choice for uncomplicated non-falciparum and sensitive falciparum malaria?? Answer: Chloroquine (Aralen) Amodiaquine (Camoquin) Piperaquine (Eurartesim) Mefloquine (Lariam) Question: All of the following are goals of treatment of acute hepatitis B infection, except:? Answer: Suppression of HBV DNA to undetectable levels Viral eradication Reduction in serum aminotransferase levels Decreased risk of hepatocellular carcinoma Question: Week 7? Answer: .... Question: Which of the following is the first-line treatment for clostridium difficile colitis?? Answer: Intravenous vancomycin (Vancocin) Oral metronidazole (Flagyl) Intravenous metronidazole (Flagyl) Oral vancomycin (Vancocin) Question: Which of the following is an appropriate example of antibiotic stewardship?? Answer: Treatment of bacteria colonization Treatment with antibiotics for fever caused by connective tissue disease Providing one dose of antibiotics preoperatively then discontinuing Continuation of broad-spectrum antibiotics even after culture and sensitivity reports are available Question: The nurse practitioner suspects meningitis. Which of the following is the most appropriate antibiotic choice?? Answer: Cephalexin (Keflex) Cefuroxime (Zinacef) Cefazolin (Ancef) Ceftriaxone (Rocephin) Question: Which generation of cephalosporin is the best option to treat an Enterobacter infection?? Answer: First generation Second generation Third generation Fourth generation Question: Which of the following terms best describes the process by which an antibiotic capable of inhibiting or retarding bacterial growth allows the body's defense mechanisms to respond to the infection?? Answer: Bactericidal Bacteriopermeable Bacteriotonic Bacteriostatic Question: Which of the following statements best describes the use of gentamicin (Garamycin)?? Answer: Gentamicin (Garamycin) covers both aerobic and anaerobic bacteria Gentamicin (Garamycin) is the first drug of choice for the treatment of meningitis Gentamycin (Garamycin) is used to treat resistant gram-negative bacterial infections Renal complications from the use of gentamicin (Garamycin) are not reversible even once the medication is stopped Question: You are managing a patient with a dental abscess who is unable to get into the dentist until next week. The patient is stable for outpatient treatment. This patient also has a penicillin allergy. Which antibiotic should be prescribed?? Answer: Linezolid (Zyvox) Ciprofloxacin (Cipro) Amoxicillin/clavulanate (Augmentin) Clindamycin (Cleocin) Question: Surgical prophylactic treatment should include which of the following principles?? Answer: Broad antibiotic coverage should be administered to cover all organ systems Newest and latest generation antibiotics should be used to assure minimize the likelihood of post-operative infection The minimum duration for prophylaxis should be three days to decrease resistance patterns The shortest possible course of the most effective and least toxic antibiotic should be ordered, ideally as a single dose Question: Tetracyclines may cause which of the following adverse reactions/side effects?? Answer: Aplastic anemia Cholestatic jaundice Crystalluria Hepatic damage in pregnant females Question: The results of a Gram stain for a patient who underwent surgical debridement for osteomyelitis show Gram-negative bacteria. Which antibiotic should be initiated?? Answer: Nafcillin (Nafcil) Vancomycin (Vancocin) Cefepime (Maxipime) Clindamycin (Cleocin) Question: Amnestic medications used in the treatment of chronic pain? Answer: -Ketamine -venlafaxine -Milnacipran -Imipramine Question: Medications indicated for shock? Answer: IVF - 30ml/kg/hr Broad spectrum ATB - Zoysn and Vancomycin Vasopressin (Norepinephrine)(dobutamine is arguably the inotropic agent of choice when increased cardiac output is needed) Question: Alternative indication for glucagon use besides hypoglycemia? Answer: -Intravenous glucagon is commonly used in the endoscopic retrograde cholangiopancreatography procedure to facilitate the relaxation of the sphincter of Oddi. -sometimes used in the treatment of beta blocker overdose because of the drug's ability to increase cAMP production in the heart independent of β-receptor function. Question: Medications indicated for myocardial infarction (part 1)? Answer: Aspirin. The 911 operator might tell you to take aspirin, or emergency medical personnel might give you aspirin immediately. Aspirin reduces blood clotting, thus helping maintain blood flow through a narrowed artery. Thrombolytics. These drugs, also called clotbusters, help dissolve a blood clot that's blocking blood flow to your heart. The earlier you receive a thrombolytic drug after a heart attack, the greater the chance you'll survive and have less heart damage. Antiplatelet agents. Emergency room doctors may give you other drugs known as platelet aggregation inhibitors to help prevent new clots and keep existing clots from getting larger. Other blood-thinning medications. You'll likely be given other medications, such as heparin, to make your blood less "sticky" and less likely to form clots. Heparin is given by IV or by an injection under your skin. Question: Medications indicated for myocardial infarction (part 2)? Answer: Pain relievers. You might be given a pain reliever, such as morphine. Nitroglycerin. This medication, used to treat chest pain (angina), can help improve blood flow to the heart by widening (dilating) the blood vessels. Beta-blockers. These medications help relax your heart muscle, slow your heartbeat and decrease blood pressure, making your heart's job easier. Beta-blockers can limit the amount of heart muscle damage and prevent future heart attacks. ACE inhibitors. These drugs lower blood pressure and reduce stress on the heart. Statins. These drugs help control your blood cholesterol Question: Insulin infusion CSII therapy? Answer: appropriate for patients with type 1 diabetes who are motivated, mechanically inclined, educated about diabetes (diet, insulin action, treatment of hypoglycemia and hyperglycemia), and willing to monitor their blood glucose four to six times a day. Known complications of CSII include ketoacidosis, which can occur when insulin delivery is interrupted, and skin infections. Another disadvantage is its cost and the additional time needed by the clinician and staff to initiate therapy. Almost all patients use rapidly acting insulin analogs in their pumps. Question: Insulin Infusion V-Go? Answer: (Valeritas) is a mechanical patch pump designed specifically for people with type 2 diabetes who use a basal/bolus insulin regimen. The device is preset to deliver one of three fixed and flat basal rates (20, 30, or 40 units) for 24 hours (at which point it must be replaced) and there is a button that delivers two units per press to help cover meals. Question: Sedative-hypnotic agents uses? Answer: Question: First line medication for anxiety and insomnia? Answer: Lorazepam (Benzo) Question: First line appropriate medication to utilize for situational anxiety disorder? Answer: Lorazepam (Benzo) Question: First line for an uncooperative patient who is threatening harm and needs attention now, an oral medication? Answer: Olanzapine (Zyprexa) 10mg intramuscular (IM) Question: First line Drug of choice for status epilepticus? Answer: Lorazepam IV Midazolam IM or intranasally Question: 2nd line Drug of choice for status epilepticus? Answer: 2nd line: Fosphenytoin Rapid administration Decrease sodium ions across the cell in the motor cortex Also used for seizures during neurosurgery, prophylaxis with craniotomy Can be administered with a benzodiazepine in the treatment of status epilepticus May be given as a loading dose Preferred over phenytoin: better tolerated, faster administration Question: First line treatment for seizure disorder in first trimester intrauterine pregnancy? Answer: Order a serum phenytoin level and give a loading dose of phenytoin (if the level is non-therapeutic) and order a maintenance dose along with starting folic acid. Question: Opioid Conversions? Answer: 60 mg oxycodone X 1.5 MME = 90 mg oral morphine Question: Rapid sequence intubation (RSI) agent classes- mechanisms of action, indications for use, side effects, contraindications, and be able to identify by name? Answer: involves the administration of an induction agent for loss of consciousness and neuromuscular blockade for paralysis lidocaine or fentanyl, 3-5 minutes before intubation to facilitate the procedure. Paralytic and induction agents must be administered immediately before Succinylcholine (Anectine) Question: Treatments for Chronic Pain? Answer: buprenorphine patch (Butrans) Lidocaine and mexiletine Ziconotide, a blocker of voltage-gated N-type calcium channels, is approved for producing analgesia in patients with refractory chronic pain Multi modal approach