Maryville Pharmacology Exam 1
What are the 5 WHO prescribing guidelines? correct answers 1. define the pt's problem
2. Specify therapeutic objectives
3. choose which drug or treatment is needed
4. Write the Rx and start tx
5. Educate and counsel the pt
6. monitor effect of treatment
WHO rx guideline 1 correct answers Define the pt's problem . This forms the basis for
choosing and rx-ing the correct treatment.
Consultation should include: complaints, symptoms, diagnosis and relevant
characteristics like co-morbidities, co-medication, pregnancy, drug allergies
WHO rx guideline 2 correct answers Specify the therapeutic objective. What needs to
be treated?
WHO rx guideline 3 correct answers 3a. select the p-drug (prescribers personal drug of
first choice for the indication.)
3b. Is the p-drug appropriate? checking for contraindications, interactions, pregnancy,
allergies, etc.
WHO rx guideline 4 correct answers Write rx and start the treatment.
WHO rx guideline 5 correct answers Educate and counsel the pt. Intructions and
warnings about the tx.
WHO rx 6 correct answers Monitor the treatment.
Coreg (Carvedilol) correct answers *beta blocker used to treat mild to severe CHF, left
ventricular dysfunction following MI, HTN.
*works by causing vasodilation to the peripheral vasculature to decrease the workload
on the heart.
*Non selective beta blocker and Alpha-1 blocker
*3rd generation beta blocker
*particularly useful in African Americans
*Dose: 0.625 mg-25mg PO BID with food
*administering with food helps prevent postural hypotension
*Education: don't skip doses, take with food
hypersensitivty reactions: mnemonic ACID correct answers 1. A-allergic
2.C-cytotoxic
3.I- Immune complex deposition
, 4. D-delayed
Type I hypersensitivity correct answers A-allergic
*IgE mediated- quick onset after exposure
*production of IgE after antigen exposure.
*urticaria, wheezing, rhinitis, anaphylaxis
Type II hypersensitivity correct answers C-cytotoxic
*cytotoxic/antibody mediated
* drug binds to RBCs and is recognized by antibody-usually IgG
*complement and cytotoxic T cells are activated
*Rare response
Type III hypersensitivity correct answers I-immune complex/IgG/IgM mediated
*antibodies are formed against soluble antigens. ANtigen-antibody complexes are
deposited in tissues such as joints and lungs.
*cause serum sickness. Ex: ceclor (antibiotic)
Type IV hypersensitivity correct answers D-delayed- delayed or cell mediated
*cytotoxic T cells are activated
*poison ivy, latex, etc
*causes contact dermatitis
*cytokine storm if there is repeated exposure
Grapefruit juice correct answers *increases drug toxicity
*don't drink with SSRIs, calcium channel blockers, statins, benzos
*increases absorption and decreases the metabolism
Atropine-class/mechanism of action correct answers *anticholinergic
*inhibits action of acetylcholine and blocks the PNS.
*Increases HR by increasing conduction int eh SA and AV node
atropine- indications correct answers *symptomatic bradycardia (sinus, junctional, AV
blocks, causing significant hypotension, ventricular ectopy, angina, etc.)
*organphosphate poisoning
* RSI in peds
*beta blocker and calcium channel blocker overdose
atropine- contraindications correct answers *tachycardia
*HTN
*hypothermic bradycardia
*narrow angle glaucoma
atropine adverse reactions correct answers drowsiness, confusion, HA, tachycardia,
palpitations, dysrhythmias, N/V, paradoxical bradycardia if pushed too slowly or given in
low doses
What are the 5 WHO prescribing guidelines? correct answers 1. define the pt's problem
2. Specify therapeutic objectives
3. choose which drug or treatment is needed
4. Write the Rx and start tx
5. Educate and counsel the pt
6. monitor effect of treatment
WHO rx guideline 1 correct answers Define the pt's problem . This forms the basis for
choosing and rx-ing the correct treatment.
Consultation should include: complaints, symptoms, diagnosis and relevant
characteristics like co-morbidities, co-medication, pregnancy, drug allergies
WHO rx guideline 2 correct answers Specify the therapeutic objective. What needs to
be treated?
WHO rx guideline 3 correct answers 3a. select the p-drug (prescribers personal drug of
first choice for the indication.)
3b. Is the p-drug appropriate? checking for contraindications, interactions, pregnancy,
allergies, etc.
WHO rx guideline 4 correct answers Write rx and start the treatment.
WHO rx guideline 5 correct answers Educate and counsel the pt. Intructions and
warnings about the tx.
WHO rx 6 correct answers Monitor the treatment.
Coreg (Carvedilol) correct answers *beta blocker used to treat mild to severe CHF, left
ventricular dysfunction following MI, HTN.
*works by causing vasodilation to the peripheral vasculature to decrease the workload
on the heart.
*Non selective beta blocker and Alpha-1 blocker
*3rd generation beta blocker
*particularly useful in African Americans
*Dose: 0.625 mg-25mg PO BID with food
*administering with food helps prevent postural hypotension
*Education: don't skip doses, take with food
hypersensitivty reactions: mnemonic ACID correct answers 1. A-allergic
2.C-cytotoxic
3.I- Immune complex deposition
, 4. D-delayed
Type I hypersensitivity correct answers A-allergic
*IgE mediated- quick onset after exposure
*production of IgE after antigen exposure.
*urticaria, wheezing, rhinitis, anaphylaxis
Type II hypersensitivity correct answers C-cytotoxic
*cytotoxic/antibody mediated
* drug binds to RBCs and is recognized by antibody-usually IgG
*complement and cytotoxic T cells are activated
*Rare response
Type III hypersensitivity correct answers I-immune complex/IgG/IgM mediated
*antibodies are formed against soluble antigens. ANtigen-antibody complexes are
deposited in tissues such as joints and lungs.
*cause serum sickness. Ex: ceclor (antibiotic)
Type IV hypersensitivity correct answers D-delayed- delayed or cell mediated
*cytotoxic T cells are activated
*poison ivy, latex, etc
*causes contact dermatitis
*cytokine storm if there is repeated exposure
Grapefruit juice correct answers *increases drug toxicity
*don't drink with SSRIs, calcium channel blockers, statins, benzos
*increases absorption and decreases the metabolism
Atropine-class/mechanism of action correct answers *anticholinergic
*inhibits action of acetylcholine and blocks the PNS.
*Increases HR by increasing conduction int eh SA and AV node
atropine- indications correct answers *symptomatic bradycardia (sinus, junctional, AV
blocks, causing significant hypotension, ventricular ectopy, angina, etc.)
*organphosphate poisoning
* RSI in peds
*beta blocker and calcium channel blocker overdose
atropine- contraindications correct answers *tachycardia
*HTN
*hypothermic bradycardia
*narrow angle glaucoma
atropine adverse reactions correct answers drowsiness, confusion, HA, tachycardia,
palpitations, dysrhythmias, N/V, paradoxical bradycardia if pushed too slowly or given in
low doses
