NSG 533 EXAM 1 (LATEST 2024
/ 2025): ADVANCED
PHARMACOLOGY QUESTIONS
& ANSWERS WITH
RATIONALES COMPLETE AND
WELL EXPLAINED BY EXPERTS
ALREADY PASSED 100%
CORRECT GRADED A+ LATEST
UPDATE 2024 100%
GUARANTEED SUCCESS AFTER
DOWNLOAD (ALL YOU NEED
TO PASS YOUR EXAMS)
,
, Despite improvements in the past six weeks due to lifestyle changes and exercise, drug therapy is to be
started for JR's diabet Metformin is the drug of choice recommended for most patients with diabetes
in addition to lifestyle modifications assuming no contraindications or intolerabilities are present upon
evaluation. Metformin has also shown to provide positive weight neutral/loss effects in obese patients.
It is crucial to know the renal status of patients commencing metformin therapy to limit the risk of lactic
acidosis (JR is without contraindication).
Since his entry A1C is >7.5%, dual therapy is indicated. There are several potential choices. The second
step can be a dipeptidyl peptidase-4 inhibitor, it can be a glucagon-like peptide-1 (GLP-1) receptor
agonist, it can be a TZD, it can be a sulfonylurea agent, it can be a SGLT2 inhibitor, or it could be basal
insulin. Anything next can be tried depending on what suits the circumstance
DPP4 inhibitors are weight neutral bet relatively benign side effect profile. Sitagliptin has been
associated with case reports of pancreatitis, so this specific agent should be avoided. $$$
GLP-1 analog and has data to support an A1C reduction necessary to gain glycemic control and may
assist with weight loss goals for this patient. New information suggests these agents may provide
benefits in those with ASCVD. JR has a past history of pancreatitis and GLP-1 analogs are not
recommended due to this contraindication
TZDs have data to support an A1C reduction necessary to gain glycemic control, but are associated with
weight gain, negative effects on lipids and increased risk of fracture. Until recently, TZDs have also been
linked to increased CV events and use has fallen out of favor
Sulfonylureas provide excellent A1C lowering, but are also associated with weight gain. They also have
the potential to cause hypoglycemia, so patient education is crucial. Because of his allergies to "sulfa",
use would be contr
A patient with type 1 diabetes reports taking propranolol for hypertension. What concern does this
information present for the provider? A patient with Type 1 DM is insulin dependent for glucose
control and at high risk for hypoglycemic episodes. Propanolol causes prolonged hypoglycemic episodes.
Needs to switch to ACE or ARB.
EP is a 38-year-old female patient that comes in for diabetes education and management. She was
diagnosed 12 years ago and states lately she is not able to control her diet although she continues a
1600 calorie diet with appropriate daily carbohydrate intake (per dietitian prescription) and walks 40
minutes every day of the week. She states compliance with all medications. She denies any history of
hypoglycemia despite being able to identify signs and symptoms and describe appropriate treatment
strategies.
PMH: T2DM, HTN, obesity, depression, s/p thyroidectomy due to thyroid cancer
FmHx: Noncontributory
SHx: (−) Smoking, alcohol use, past marijuana use while in high school
Medications: Metformin 850 mg tid, glipizide 20 mg bid, lisinopril 20 mg daily, sertraline 100 mg daily,
multivitamin daily
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
/ 2025): ADVANCED
PHARMACOLOGY QUESTIONS
& ANSWERS WITH
RATIONALES COMPLETE AND
WELL EXPLAINED BY EXPERTS
ALREADY PASSED 100%
CORRECT GRADED A+ LATEST
UPDATE 2024 100%
GUARANTEED SUCCESS AFTER
DOWNLOAD (ALL YOU NEED
TO PASS YOUR EXAMS)
,
, Despite improvements in the past six weeks due to lifestyle changes and exercise, drug therapy is to be
started for JR's diabet Metformin is the drug of choice recommended for most patients with diabetes
in addition to lifestyle modifications assuming no contraindications or intolerabilities are present upon
evaluation. Metformin has also shown to provide positive weight neutral/loss effects in obese patients.
It is crucial to know the renal status of patients commencing metformin therapy to limit the risk of lactic
acidosis (JR is without contraindication).
Since his entry A1C is >7.5%, dual therapy is indicated. There are several potential choices. The second
step can be a dipeptidyl peptidase-4 inhibitor, it can be a glucagon-like peptide-1 (GLP-1) receptor
agonist, it can be a TZD, it can be a sulfonylurea agent, it can be a SGLT2 inhibitor, or it could be basal
insulin. Anything next can be tried depending on what suits the circumstance
DPP4 inhibitors are weight neutral bet relatively benign side effect profile. Sitagliptin has been
associated with case reports of pancreatitis, so this specific agent should be avoided. $$$
GLP-1 analog and has data to support an A1C reduction necessary to gain glycemic control and may
assist with weight loss goals for this patient. New information suggests these agents may provide
benefits in those with ASCVD. JR has a past history of pancreatitis and GLP-1 analogs are not
recommended due to this contraindication
TZDs have data to support an A1C reduction necessary to gain glycemic control, but are associated with
weight gain, negative effects on lipids and increased risk of fracture. Until recently, TZDs have also been
linked to increased CV events and use has fallen out of favor
Sulfonylureas provide excellent A1C lowering, but are also associated with weight gain. They also have
the potential to cause hypoglycemia, so patient education is crucial. Because of his allergies to "sulfa",
use would be contr
A patient with type 1 diabetes reports taking propranolol for hypertension. What concern does this
information present for the provider? A patient with Type 1 DM is insulin dependent for glucose
control and at high risk for hypoglycemic episodes. Propanolol causes prolonged hypoglycemic episodes.
Needs to switch to ACE or ARB.
EP is a 38-year-old female patient that comes in for diabetes education and management. She was
diagnosed 12 years ago and states lately she is not able to control her diet although she continues a
1600 calorie diet with appropriate daily carbohydrate intake (per dietitian prescription) and walks 40
minutes every day of the week. She states compliance with all medications. She denies any history of
hypoglycemia despite being able to identify signs and symptoms and describe appropriate treatment
strategies.
PMH: T2DM, HTN, obesity, depression, s/p thyroidectomy due to thyroid cancer
FmHx: Noncontributory
SHx: (−) Smoking, alcohol use, past marijuana use while in high school
Medications: Metformin 850 mg tid, glipizide 20 mg bid, lisinopril 20 mg daily, sertraline 100 mg daily,
multivitamin daily
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
