Midterm Exam: NR565/ NR 565 Advanced Pharmacology Care of the Fundamentals Exam | Questions and Verified Answers (2023/ 2024 Update)- Chamberlain

Midterm Exam: NR565/ NR 565 Advanced Pharmacology Care of the Fundamentals Exam | Questions and Verified Answers (2023/ 2024 Update)- Chamberlain Q: When is it used - ASCVD Risk Score Answer: In children a screening should be done between ages 9 and 11 and then again at ages 19 and 21. For adults every 5 years after the age of 20. Some people are at greater risk like those with diabetes and a risk score greater than 7.5% and should be screened more often Q: ezetimibe- when can it be used? Answer: pregnancy/breastfeeding can be use in monotherapy or as adjunct therapy with a statin or a fibrate Q: What is ezetimibe? Answer: Cholesterol Absorption Inhibitor- lowers cholesterol levels by decreasing the amount of cholesterol that is absorbed from the small intestine, so that there is less intestinal cholesterol delivered to the liver. Does not affect triglycerides Q: lifestyle changes for high cholesterol Answer: Lifestyle changes are non drug measures used to lower LDL. Four main issues are diet, exercise, weight control, and smoking cessation Q: If a patient wanted to minimize side effects, which drug classification is a good choice? Answer: Non-statins- fibrates, Ezetimibe, Bile acid sequestrants. Statins are generally well tolerated and side effects are uncommon. Some patients develop headache, flatulence, constipation, or GI disturbances, but these effects are usually mild and transient Q: Therapeutic action of organic nitrates (nitroglycerin) Answer: direct relaxant effect on vascular smooth muscles, and the dilation of coronary vessels improves oxygen supply to the myocardium. The dilation of peripheral veins, and in higher doses peripheral arteries, reduces preload and afterload, and thereby lowers myocardial oxygen consumption. promote vasodilation Q: Contraindications for ranolazine Answer: Agents that inhibit CYP3A4 can increase the levels of ranolazine and thereby increase the risk of torsades de pointes. These things include: grapefruit juice, HIV protease inhibitors, macrolide antibiotics, azole antifungal drugs, and some CCB. Most CCB but not amlodipine can increase levels of ranolazine. Drugs that prolong the QT interval can increase the risk of torsades de pointes. (quinidine, sotalol). Q: At what age can statins be prescribed? Answer: avoid statin use in children under the age of 10 Q: CCB role with variant angina Answer: promote relaxation of coronary artery spasm, increasing cardiac oxygen supply Q: what medication can be added for patients with worsening symptoms of HF? Answer: aldosterone antagonist- promotes myocardial remodeling and fibrosis, help with symptoms Q: CCB stable angina Answer: promote relaxation of peripheral arterioles, decreasing afterload and reducing cardiac oxygen demand Q: A 41 year old patient comes into the clinic complaining of increased heart rate after starting nitro patches for stable angina. What would an appropriate response be? 1. lets lower the dose and frequency of use 2. I will prescribe a BB to help with this 3. Next time this happens, lie down and practice deep breathing, this will bring your heart rate down Answer: 2- I will prescribe a BB to help with this Q: What do CYP450 inhibitors and reducers do when not used correctly/what would patient experience? Answer: increased side effects, adverse reactions and toxicity Q: A 55 year old male comes into the clinic with a gouty arthritis. He states that he has one flareup a year. Your response is: 1. I will prescribe you glucocorticoids to help with inflammation 2. Lets start you on prophylactic therapy colchicine. 3. It will be helpful to take an NSAID to start with to help relive some inflammation. I'll prescribe naproxen. Answer: 3- in patients with infrequent flareups, being less than three per year, treatment of symptoms is all thats needed. NSAIDS are the first line agent for relieving pain of an acute gout attack. Q: A patient comes in stating that he tried NSAIDS to relieve a gouty attack but it hasnt helped. He asks,