PASSPOINT PRO • CHAMBERLAIN
NR565
NR565 Final Exam Study Guide
& Rapid Review
High-Yield Medication Selection • Monitoring •
Contraindications • Interactions • Patient Teaching
Designed for fast final-review use • Organized by system and prescribing decision points
HIGH-YIEL
4 FAST
D
Review Core Systems Revision
Original study and revision material • Clean print-ready format
, PASSPOINT PRO | NR565 ADVANCED PHARMACOLOGY FUNDAMENTALS
NR565 Final Exam Study Guide & Rapid Review
This review condenses the recurring prescribing decisions tested throughout the practice exams. Prioritize the why behind each
choice: indication, mechanism, patient-specific risk, monitoring, and what the patient must know before leaving the visit.
Endocrine
Metformin
Class/role: biguanide.
Best-use cue: first-line pharmacotherapy for many adults with type 2 diabetes when tolerated.
Mechanism: reduces hepatic glucose production and improves insulin sensitivity.
Major safety issue: gastrointestinal upset; rare lactic acidosis risk rises with severe renal dysfunction or hypoxia.
Monitor: renal function (eGFR) and glycemic response.
Teaching: take with meals; report severe weakness or breathing difficulty; clinicians may hold it around selected iodinated-contrast
situations when renal risk is present.
Avoid/caution: severe renal impairment or acute conditions associated with hypoxia/poor perfusion.
Interaction pearl: heavy alcohol use can increase lactic acidosis risk.
Insulin Glargine
Class/role: long-acting basal insulin.
Best-use cue: basal insulin coverage for diabetes requiring sustained background insulin.
Mechanism: forms a subcutaneous depot that releases insulin slowly with minimal peak.
Major safety issue: hypoglycemia and weight gain.
Monitor: fasting glucose trends and episodes of hypoglycemia.
Teaching: use once daily at a consistent time and do not mix glargine in the same syringe with other insulins.
Avoid/caution: unrecognized hypoglycemia or unsafe dosing without meal/glucose planning.
Interaction pearl: other glucose-lowering drugs can increase hypoglycemia risk.
Insulin Lispro
Class/role: rapid-acting insulin.
Best-use cue: mealtime and correction insulin coverage.
Mechanism: rapidly promotes cellular glucose uptake and suppresses hepatic glucose output.
Major safety issue: hypoglycemia, especially if food intake is delayed or reduced.
Monitor: premeal/postmeal glucose and symptoms of hypoglycemia.
Teaching: coordinate dosing closely with meals and keep a rapid source of glucose available.
Avoid/caution: giving a meal dose when the patient cannot eat unless specifically directed in a correction plan.
Interaction pearl: beta blockers can mask adrenergic warning symptoms of hypoglycemia.
Semaglutide
Class/role: GLP-1 receptor agonist.
Best-use cue: type 2 diabetes when additional glucose lowering and often weight reduction are desired.
Mechanism: enhances glucose-dependent insulin secretion, suppresses glucagon, slows gastric emptying, and increases satiety.
Major safety issue: nausea/vomiting; risk of gallbladder disease and rare pancreatitis; class warning for thyroid C-cell tumors in
susceptible patients.
Monitor: A1C/glucose, weight, hydration, and persistent severe abdominal symptoms.
Teaching: eat smaller meals during titration and seek care for persistent severe abdominal pain.
Avoid/caution: personal/family history of medullary thyroid carcinoma or MEN2.
Interaction pearl: delayed gastric emptying may alter absorption timing of some oral drugs.
Empagliflozin
Class/role: SGLT2 inhibitor.
Best-use cue: type 2 diabetes, especially when cardiovascular or kidney benefits are desirable in an appropriate patient.
Mechanism: blocks renal glucose reabsorption in the proximal tubule, increasing urinary glucose excretion.
Major safety issue: genital mycotic infections, volume depletion, and rare euglycemic ketoacidosis.
Monitor: renal function, volume status, glucose, and symptoms of ketoacidosis even if glucose is not markedly elevated.
Teaching: maintain hydration and report nausea, abdominal pain, or rapid breathing; follow sick-day/perioperative holding instructions.
Avoid/caution: active ketoacidosis and use caution in marked volume depletion.
Interaction pearl: diuretics can increase risk of volume depletion and hypotension.
Glipizide
Class/role: sulfonylurea.
Best-use cue: type 2 diabetes when an insulin secretagogue is appropriate.
Mechanism: stimulates pancreatic beta cells to release insulin independent of current glucose level.
Major safety issue: hypoglycemia and weight gain.
Monitor: glucose patterns and hypoglycemic episodes.
Teaching: take in relation to meals as prescribed and do not skip meals after dosing.
Avoid/caution: patients with recurrent severe hypoglycemia or inability to maintain regular food intake.
Interaction pearl: other glucose-lowering agents can add to hypoglycemia risk.
Original practice material for study and review Page92
Page 2
NR565
NR565 Final Exam Study Guide
& Rapid Review
High-Yield Medication Selection • Monitoring •
Contraindications • Interactions • Patient Teaching
Designed for fast final-review use • Organized by system and prescribing decision points
HIGH-YIEL
4 FAST
D
Review Core Systems Revision
Original study and revision material • Clean print-ready format
, PASSPOINT PRO | NR565 ADVANCED PHARMACOLOGY FUNDAMENTALS
NR565 Final Exam Study Guide & Rapid Review
This review condenses the recurring prescribing decisions tested throughout the practice exams. Prioritize the why behind each
choice: indication, mechanism, patient-specific risk, monitoring, and what the patient must know before leaving the visit.
Endocrine
Metformin
Class/role: biguanide.
Best-use cue: first-line pharmacotherapy for many adults with type 2 diabetes when tolerated.
Mechanism: reduces hepatic glucose production and improves insulin sensitivity.
Major safety issue: gastrointestinal upset; rare lactic acidosis risk rises with severe renal dysfunction or hypoxia.
Monitor: renal function (eGFR) and glycemic response.
Teaching: take with meals; report severe weakness or breathing difficulty; clinicians may hold it around selected iodinated-contrast
situations when renal risk is present.
Avoid/caution: severe renal impairment or acute conditions associated with hypoxia/poor perfusion.
Interaction pearl: heavy alcohol use can increase lactic acidosis risk.
Insulin Glargine
Class/role: long-acting basal insulin.
Best-use cue: basal insulin coverage for diabetes requiring sustained background insulin.
Mechanism: forms a subcutaneous depot that releases insulin slowly with minimal peak.
Major safety issue: hypoglycemia and weight gain.
Monitor: fasting glucose trends and episodes of hypoglycemia.
Teaching: use once daily at a consistent time and do not mix glargine in the same syringe with other insulins.
Avoid/caution: unrecognized hypoglycemia or unsafe dosing without meal/glucose planning.
Interaction pearl: other glucose-lowering drugs can increase hypoglycemia risk.
Insulin Lispro
Class/role: rapid-acting insulin.
Best-use cue: mealtime and correction insulin coverage.
Mechanism: rapidly promotes cellular glucose uptake and suppresses hepatic glucose output.
Major safety issue: hypoglycemia, especially if food intake is delayed or reduced.
Monitor: premeal/postmeal glucose and symptoms of hypoglycemia.
Teaching: coordinate dosing closely with meals and keep a rapid source of glucose available.
Avoid/caution: giving a meal dose when the patient cannot eat unless specifically directed in a correction plan.
Interaction pearl: beta blockers can mask adrenergic warning symptoms of hypoglycemia.
Semaglutide
Class/role: GLP-1 receptor agonist.
Best-use cue: type 2 diabetes when additional glucose lowering and often weight reduction are desired.
Mechanism: enhances glucose-dependent insulin secretion, suppresses glucagon, slows gastric emptying, and increases satiety.
Major safety issue: nausea/vomiting; risk of gallbladder disease and rare pancreatitis; class warning for thyroid C-cell tumors in
susceptible patients.
Monitor: A1C/glucose, weight, hydration, and persistent severe abdominal symptoms.
Teaching: eat smaller meals during titration and seek care for persistent severe abdominal pain.
Avoid/caution: personal/family history of medullary thyroid carcinoma or MEN2.
Interaction pearl: delayed gastric emptying may alter absorption timing of some oral drugs.
Empagliflozin
Class/role: SGLT2 inhibitor.
Best-use cue: type 2 diabetes, especially when cardiovascular or kidney benefits are desirable in an appropriate patient.
Mechanism: blocks renal glucose reabsorption in the proximal tubule, increasing urinary glucose excretion.
Major safety issue: genital mycotic infections, volume depletion, and rare euglycemic ketoacidosis.
Monitor: renal function, volume status, glucose, and symptoms of ketoacidosis even if glucose is not markedly elevated.
Teaching: maintain hydration and report nausea, abdominal pain, or rapid breathing; follow sick-day/perioperative holding instructions.
Avoid/caution: active ketoacidosis and use caution in marked volume depletion.
Interaction pearl: diuretics can increase risk of volume depletion and hypotension.
Glipizide
Class/role: sulfonylurea.
Best-use cue: type 2 diabetes when an insulin secretagogue is appropriate.
Mechanism: stimulates pancreatic beta cells to release insulin independent of current glucose level.
Major safety issue: hypoglycemia and weight gain.
Monitor: glucose patterns and hypoglycemic episodes.
Teaching: take in relation to meals as prescribed and do not skip meals after dosing.
Avoid/caution: patients with recurrent severe hypoglycemia or inability to maintain regular food intake.
Interaction pearl: other glucose-lowering agents can add to hypoglycemia risk.
Original practice material for study and review Page92
Page 2
