NURS 549 Pharm Final Exam Questions
and answers 2025
Dipeptidyl .peptidase-4 .(DPP4) .- .CORRECT .ANSWER-the .hormone .that .breaks
.GLP-1 .down .into .its .inactive .form. .GLP-1 .is .the .incretin .hormone .secreted .by
.the .small .intestine .that .slows .gastric .emptying, .suppresses .glucagon
.secretion, .enhances .insulin .secretion, .enhances .beta .cell .proliferation, .and
.decreases .beta .cell .apoptosis.
Glucagon .- .CORRECT .ANSWER-the .hormone .of .fuel .catabolism—it .increases
.blood .sugar .by .stimulating .stored .glycogen .in .liver .to .glucose .so .it .can .be
.released .into .the .blood .stream.
Incretin .Mimetics .- .CORRECT .ANSWER-- .class .of .drugs .that .are .synthetic .GLP-
1. .So .does .all .of .the .things .that .GLP-1 .does .(stimulates .glucose-dependent
.insulin .secretion, .lowers .glucagon .concentrations .during .period .of
.hyperglycemia, .inhibits .post-prandial .glucagon .release, .slows .gastric .emptying
.so .you .feel .full). .Reduces .HbA1c .by .1-2%. .Causes .NAUSEA. .Can .also .lead .to
.ENDOCRINE .MALIGNANCIES .and .PANCREATITIS. .You .need .a .functioning .beta
.cell .for .these .drugs.
Incretin .Mimetics .Drugs .- .CORRECT .ANSWER-Liraglutide .(Victoza), .Exenatide
.(Byetta)
DPP4 .Inhibitors .- .CORRECT .ANSWER--blocks .the .enzyme .that .degrades .GLP-1,
.so .you .have .an .enhanced .natural .GLP-1 .(the .patient .must .be .capable .of
.producing .his/her .own). .Same .adverse .effects—ENDOCRINE .CANCERS,
.PANCREATITIS, .GASTROPARESIS.
DPP4 .Inhibitors .Drugs .- .CORRECT .ANSWER-Sitagliptin .(Januvia), .Saxagliptin
.(Onglyza), .Linagliptin .(Tradjenta)
Metformin .- .CORRECT .ANSWER-- .primary .mechanism .of .action .is .suppression
.of .gluconeogenesis .in .liver. .First .drug .of .choice .for .Type .2 .DM. .The .only
.reason .a .patient .with .Type .2 .would .NOT .be .on .metformin .would .be .for
.decreased .renal .function .or .intolerance .of .adverse .effects .(GI .intolerance,
.person .with .IBS, .and .lactic .acidosis)
Patho .of .Type .2 .DM .- .CORRECT .ANSWER-Type .2 .DM: .circulating .insulin .is
.sufficient .to .prevent .acidosis, .but .inadequate .to .prevent .hyperglycemia.
.Peripheral .insulin .receptors .don't .work .properly. .Beta .cell .initially .tries .to
, .compensate .and .produces .more .insulin. .So .there .is .hyperinsulinemia .and
.normoglycemia .for .an .extended .period .of .time. .Eventually .the .beta .cell .fails
.and .there .is .insufficient .insulin .so .glucose .can't .get .into .cells. .Cells .think
.they're .hypoglycemic, .so .gluconeogenesis .occurs .putting .more .glucose .into
.the .blood. .When .the .beta .cells .die, .you .need .insulin
Insulinogenic .Drugs .- .CORRECT .ANSWER-—stimulate .the .beta .cell .to .release
.insulin. .Not .a .good .choice .for .early .on .in .T2DM .bc .beta .cell .is .already
.hyperfunctioning .or .very .late .bc .beta .cell .has .burn .out. .Sulfonylureas .and
.Meglitinides. .High .risk .of .hypoglycemia.
Thiazolidinediones .- .CORRECT .ANSWER-—Actose, .Avandia. .When .pts .need
.additional .help .to .improve .insulin .resistance .or .when .pt .cant .take .metformin.
.s/e: .hepatic .toxicity, .cardiac .disease, .bladder .cancer. .Pioglitazone,
.Rosiglitazone
Pramlintide .- .CORRECT .ANSWER-—amylin .analogue .(hormone .secreted .by
.pancreas. .For .type .1 .and .2. .Produces .satiety, .doesn't .stimulate .insulin .release.
.Nausea .and .hypoglycemia .are .side .effects.
Sodium .Glucose .Co-Transporters .- .CORRECT .ANSWER-—(--gligozin) .(Invokana,
.Farxiga, .Jardiance) .facilitates .renal .excretion .of .sodium .and .sugar .via .renal
.tubules. .Side .effects .are .urinary .symptoms .and .genital .fungal .infection.
Targets .of .Antibiotics .- .CORRECT .ANSWER-the .cell .wall, .bacterial .protein
.synthesis, .and .bacterial .DNA .replication
Community .Acquired .Pneumonia .Treatment .- .CORRECT .ANSWER-: .Need .to
.cover .Streptococcus .pneumoniae, .Mycoplasma .pneumoniae, .and
.Chlamydophila .pneumoniae. .Mycoplasma .pneumoniae .and .Chlamydophila
.pneumoniae .are .ATYPICAL .pathogens .bc .they .don't .have .a .cell .wall. .So .you
.can't .just .use .a .beta .lactam .bc .they .target .cell .walls. .Need .to .use .protein
.synthesis .inhibitors .too .(Macrolide .or .doxycycline .or .fluroquinilones). .CAP:
.Streptococcus .pneumoniae, .Haemophilus .influenzae, .Mycoplasma .pneumoniae
.(atypical), .and .Chlamydophila .pneumoniae .(atypical). .Need .a .beta .lactam .and .a
.2nd .drug .for .the .atypicals .(macrolide, .doxycycline .or .fluoroquinilone)
Difference .between .Gram .+ .and .Gram .- .- .CORRECT .ANSWER-Gram .+ .bacteria
.have .a .thinner .cell .wall. .Gram .- .bacteria .have .an .outer .membrane. .Gram .+
.antibiotics .are .the .cell .wall .antibiotics .like .the .beta .lactams .bc .they .can .easily
.get .to .their .site .of .action—the .peptidoglycan. .Gram .- .bacteria .are .harder .to .kill
.because .of .the .outer .membrane .protecting.
Antibiotic .that .is .CYP450 .Inhibitor .- .CORRECT .ANSWER-Macrolides
.(clarithryomycin .and .erythromycin) .are .CYP450 .inhibitors
Bacterial .URI .Treatment .- .CORRECT .ANSWER-: .Streptococcus .pneumoniae
.(most .common), .Haemophilus .influenzae .(more .likely .in .smokers), .Moraxella
and answers 2025
Dipeptidyl .peptidase-4 .(DPP4) .- .CORRECT .ANSWER-the .hormone .that .breaks
.GLP-1 .down .into .its .inactive .form. .GLP-1 .is .the .incretin .hormone .secreted .by
.the .small .intestine .that .slows .gastric .emptying, .suppresses .glucagon
.secretion, .enhances .insulin .secretion, .enhances .beta .cell .proliferation, .and
.decreases .beta .cell .apoptosis.
Glucagon .- .CORRECT .ANSWER-the .hormone .of .fuel .catabolism—it .increases
.blood .sugar .by .stimulating .stored .glycogen .in .liver .to .glucose .so .it .can .be
.released .into .the .blood .stream.
Incretin .Mimetics .- .CORRECT .ANSWER-- .class .of .drugs .that .are .synthetic .GLP-
1. .So .does .all .of .the .things .that .GLP-1 .does .(stimulates .glucose-dependent
.insulin .secretion, .lowers .glucagon .concentrations .during .period .of
.hyperglycemia, .inhibits .post-prandial .glucagon .release, .slows .gastric .emptying
.so .you .feel .full). .Reduces .HbA1c .by .1-2%. .Causes .NAUSEA. .Can .also .lead .to
.ENDOCRINE .MALIGNANCIES .and .PANCREATITIS. .You .need .a .functioning .beta
.cell .for .these .drugs.
Incretin .Mimetics .Drugs .- .CORRECT .ANSWER-Liraglutide .(Victoza), .Exenatide
.(Byetta)
DPP4 .Inhibitors .- .CORRECT .ANSWER--blocks .the .enzyme .that .degrades .GLP-1,
.so .you .have .an .enhanced .natural .GLP-1 .(the .patient .must .be .capable .of
.producing .his/her .own). .Same .adverse .effects—ENDOCRINE .CANCERS,
.PANCREATITIS, .GASTROPARESIS.
DPP4 .Inhibitors .Drugs .- .CORRECT .ANSWER-Sitagliptin .(Januvia), .Saxagliptin
.(Onglyza), .Linagliptin .(Tradjenta)
Metformin .- .CORRECT .ANSWER-- .primary .mechanism .of .action .is .suppression
.of .gluconeogenesis .in .liver. .First .drug .of .choice .for .Type .2 .DM. .The .only
.reason .a .patient .with .Type .2 .would .NOT .be .on .metformin .would .be .for
.decreased .renal .function .or .intolerance .of .adverse .effects .(GI .intolerance,
.person .with .IBS, .and .lactic .acidosis)
Patho .of .Type .2 .DM .- .CORRECT .ANSWER-Type .2 .DM: .circulating .insulin .is
.sufficient .to .prevent .acidosis, .but .inadequate .to .prevent .hyperglycemia.
.Peripheral .insulin .receptors .don't .work .properly. .Beta .cell .initially .tries .to
, .compensate .and .produces .more .insulin. .So .there .is .hyperinsulinemia .and
.normoglycemia .for .an .extended .period .of .time. .Eventually .the .beta .cell .fails
.and .there .is .insufficient .insulin .so .glucose .can't .get .into .cells. .Cells .think
.they're .hypoglycemic, .so .gluconeogenesis .occurs .putting .more .glucose .into
.the .blood. .When .the .beta .cells .die, .you .need .insulin
Insulinogenic .Drugs .- .CORRECT .ANSWER-—stimulate .the .beta .cell .to .release
.insulin. .Not .a .good .choice .for .early .on .in .T2DM .bc .beta .cell .is .already
.hyperfunctioning .or .very .late .bc .beta .cell .has .burn .out. .Sulfonylureas .and
.Meglitinides. .High .risk .of .hypoglycemia.
Thiazolidinediones .- .CORRECT .ANSWER-—Actose, .Avandia. .When .pts .need
.additional .help .to .improve .insulin .resistance .or .when .pt .cant .take .metformin.
.s/e: .hepatic .toxicity, .cardiac .disease, .bladder .cancer. .Pioglitazone,
.Rosiglitazone
Pramlintide .- .CORRECT .ANSWER-—amylin .analogue .(hormone .secreted .by
.pancreas. .For .type .1 .and .2. .Produces .satiety, .doesn't .stimulate .insulin .release.
.Nausea .and .hypoglycemia .are .side .effects.
Sodium .Glucose .Co-Transporters .- .CORRECT .ANSWER-—(--gligozin) .(Invokana,
.Farxiga, .Jardiance) .facilitates .renal .excretion .of .sodium .and .sugar .via .renal
.tubules. .Side .effects .are .urinary .symptoms .and .genital .fungal .infection.
Targets .of .Antibiotics .- .CORRECT .ANSWER-the .cell .wall, .bacterial .protein
.synthesis, .and .bacterial .DNA .replication
Community .Acquired .Pneumonia .Treatment .- .CORRECT .ANSWER-: .Need .to
.cover .Streptococcus .pneumoniae, .Mycoplasma .pneumoniae, .and
.Chlamydophila .pneumoniae. .Mycoplasma .pneumoniae .and .Chlamydophila
.pneumoniae .are .ATYPICAL .pathogens .bc .they .don't .have .a .cell .wall. .So .you
.can't .just .use .a .beta .lactam .bc .they .target .cell .walls. .Need .to .use .protein
.synthesis .inhibitors .too .(Macrolide .or .doxycycline .or .fluroquinilones). .CAP:
.Streptococcus .pneumoniae, .Haemophilus .influenzae, .Mycoplasma .pneumoniae
.(atypical), .and .Chlamydophila .pneumoniae .(atypical). .Need .a .beta .lactam .and .a
.2nd .drug .for .the .atypicals .(macrolide, .doxycycline .or .fluoroquinilone)
Difference .between .Gram .+ .and .Gram .- .- .CORRECT .ANSWER-Gram .+ .bacteria
.have .a .thinner .cell .wall. .Gram .- .bacteria .have .an .outer .membrane. .Gram .+
.antibiotics .are .the .cell .wall .antibiotics .like .the .beta .lactams .bc .they .can .easily
.get .to .their .site .of .action—the .peptidoglycan. .Gram .- .bacteria .are .harder .to .kill
.because .of .the .outer .membrane .protecting.
Antibiotic .that .is .CYP450 .Inhibitor .- .CORRECT .ANSWER-Macrolides
.(clarithryomycin .and .erythromycin) .are .CYP450 .inhibitors
Bacterial .URI .Treatment .- .CORRECT .ANSWER-: .Streptococcus .pneumoniae
.(most .common), .Haemophilus .influenzae .(more .likely .in .smokers), .Moraxella
