NR 568 EXAM PREP LATEST
ADVANCED PHARMACOLOGY FOR
THE ADULT GERONTOLOGY
PRIMARY CARE NURSE
PRACTITIONER
ANSWERED
2023/2024
,1. What is the mechanism of action of angiotensin-converting enzyme (ACE)
inhibitors? How do they affect blood pressure and renal function?
Answer: ACE inhibitors block the conversion of angiotensin I to angiotensin
II, a potent vasoconstrictor that also stimulates aldosterone secretion. By
reducing angiotensin II levels, ACE inhibitors lower blood pressure and
decrease sodium and water retention. They also prevent the degradation of
bradykinin, a vasodilator that enhances renal blood flow and natriuresis.
2. What are the indications and contraindications for using nonsteroidal anti-
inflammatory drugs (NSAIDs)? What are the most common adverse effects
and drug interactions of NSAIDs?
Answer: NSAIDs are indicated for the treatment of pain, inflammation, fever,
dysmenorrhea, osteoarthritis, rheumatoid arthritis, gout, and other
conditions. They are contraindicated in patients with hypersensitivity, peptic
ulcer disease, bleeding disorders, renal impairment, heart failure, or aspirin-
induced asthma. The most common adverse effects of NSAIDs are
gastrointestinal irritation, ulceration, bleeding, nephrotoxicity, hepatotoxicity,
and increased risk of cardiovascular events. NSAIDs can interact with
anticoagulants, corticosteroids, lithium, methotrexate, diuretics,
antihypertensives, and other drugs.
3. What are the differences between selective serotonin reuptake inhibitors
(SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)? How do
they affect mood and cognition?
Answer: SSRIs and SNRIs are both antidepressants that inhibit the reuptake
of serotonin in the synaptic cleft, increasing its availability and enhancing its
neurotransmission. SNRIs also inhibit the reuptake of norepinephrine,
another neurotransmitter involved in mood regulation. Both SSRIs and
SNRIs can improve mood, anxiety, sleep, appetite, and energy levels in
patients with depression and other psychiatric disorders. They can also have
positive effects on cognition, such as memory, attention, and executive
function.
4. What are the pharmacokinetic properties of warfarin? How is its dosage
determined and monitored? What are the factors that can alter its efficacy
and safety?
, Answer: Warfarin is an oral anticoagulant that inhibits the synthesis of
vitamin K-dependent clotting factors. It has a variable bioavailability, a long
half-life (20 to 60 hours), and a narrow therapeutic index. Its dosage is
determined by the patient's baseline prothrombin time (PT) and international
normalized ratio (INR), which reflect the degree of anticoagulation. The
target INR range depends on the indication for warfarin therapy, but it is
usually between 2 and 3. Warfarin's efficacy and safety can be affected by
many factors, such as genetic variations, diet, drug interactions, liver
function, age, comorbidities, and compliance.
5. What are the main classes of antibiotics? How do they differ in their
spectrum of activity, mechanism of action, resistance mechanisms, and
adverse effects?
Answer: The main classes of antibiotics are beta-lactams (penicillins,
cephalosporins, carbapenems), macrolides (erythromycin, azithromycin),
tetracyclines (doxycycline), aminoglycosides (gentamicin), quinolones
(ciprofloxacin), sulfonamides (trimethoprim-sulfamethoxazole), and others
(vancomycin,
metronidazole). They differ in their spectrum of activity against gram-positive
or gram-negative bacteria,
anaerobes or aerobes,
and specific pathogens. They also differ in their mechanism of action,
such as inhibiting cell wall synthesis,
protein synthesis,
DNA synthesis,
or folate metabolism.
Resistance mechanisms include producing enzymes that degrade or modify
antibiotics,
altering target sites or membrane permeability,
or expressing efflux pumps or resistance genes.
Adverse effects include allergic reactions,
gastrointestinal disturbances,
superinfections,
nephrotoxicity,
ototoxicity,
hepatotoxicity,
neurotoxicity,
and others.
6. What are the benefits and risks of hormone replacement therapy (HRT)
for menopausal women? What are the factors that influence the choice of
ADVANCED PHARMACOLOGY FOR
THE ADULT GERONTOLOGY
PRIMARY CARE NURSE
PRACTITIONER
ANSWERED
2023/2024
,1. What is the mechanism of action of angiotensin-converting enzyme (ACE)
inhibitors? How do they affect blood pressure and renal function?
Answer: ACE inhibitors block the conversion of angiotensin I to angiotensin
II, a potent vasoconstrictor that also stimulates aldosterone secretion. By
reducing angiotensin II levels, ACE inhibitors lower blood pressure and
decrease sodium and water retention. They also prevent the degradation of
bradykinin, a vasodilator that enhances renal blood flow and natriuresis.
2. What are the indications and contraindications for using nonsteroidal anti-
inflammatory drugs (NSAIDs)? What are the most common adverse effects
and drug interactions of NSAIDs?
Answer: NSAIDs are indicated for the treatment of pain, inflammation, fever,
dysmenorrhea, osteoarthritis, rheumatoid arthritis, gout, and other
conditions. They are contraindicated in patients with hypersensitivity, peptic
ulcer disease, bleeding disorders, renal impairment, heart failure, or aspirin-
induced asthma. The most common adverse effects of NSAIDs are
gastrointestinal irritation, ulceration, bleeding, nephrotoxicity, hepatotoxicity,
and increased risk of cardiovascular events. NSAIDs can interact with
anticoagulants, corticosteroids, lithium, methotrexate, diuretics,
antihypertensives, and other drugs.
3. What are the differences between selective serotonin reuptake inhibitors
(SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)? How do
they affect mood and cognition?
Answer: SSRIs and SNRIs are both antidepressants that inhibit the reuptake
of serotonin in the synaptic cleft, increasing its availability and enhancing its
neurotransmission. SNRIs also inhibit the reuptake of norepinephrine,
another neurotransmitter involved in mood regulation. Both SSRIs and
SNRIs can improve mood, anxiety, sleep, appetite, and energy levels in
patients with depression and other psychiatric disorders. They can also have
positive effects on cognition, such as memory, attention, and executive
function.
4. What are the pharmacokinetic properties of warfarin? How is its dosage
determined and monitored? What are the factors that can alter its efficacy
and safety?
, Answer: Warfarin is an oral anticoagulant that inhibits the synthesis of
vitamin K-dependent clotting factors. It has a variable bioavailability, a long
half-life (20 to 60 hours), and a narrow therapeutic index. Its dosage is
determined by the patient's baseline prothrombin time (PT) and international
normalized ratio (INR), which reflect the degree of anticoagulation. The
target INR range depends on the indication for warfarin therapy, but it is
usually between 2 and 3. Warfarin's efficacy and safety can be affected by
many factors, such as genetic variations, diet, drug interactions, liver
function, age, comorbidities, and compliance.
5. What are the main classes of antibiotics? How do they differ in their
spectrum of activity, mechanism of action, resistance mechanisms, and
adverse effects?
Answer: The main classes of antibiotics are beta-lactams (penicillins,
cephalosporins, carbapenems), macrolides (erythromycin, azithromycin),
tetracyclines (doxycycline), aminoglycosides (gentamicin), quinolones
(ciprofloxacin), sulfonamides (trimethoprim-sulfamethoxazole), and others
(vancomycin,
metronidazole). They differ in their spectrum of activity against gram-positive
or gram-negative bacteria,
anaerobes or aerobes,
and specific pathogens. They also differ in their mechanism of action,
such as inhibiting cell wall synthesis,
protein synthesis,
DNA synthesis,
or folate metabolism.
Resistance mechanisms include producing enzymes that degrade or modify
antibiotics,
altering target sites or membrane permeability,
or expressing efflux pumps or resistance genes.
Adverse effects include allergic reactions,
gastrointestinal disturbances,
superinfections,
nephrotoxicity,
ototoxicity,
hepatotoxicity,
neurotoxicity,
and others.
6. What are the benefits and risks of hormone replacement therapy (HRT)
for menopausal women? What are the factors that influence the choice of
