Final MN 650 Specialized Pharmacology
for the AGACNP
___ adults are more likely to have serious side effects from chemotherapy. - ANSOlder
adults
___ laboratory monitoring is necessary for patients on SSRIs. - ANSNO laboratory
monitoring
___ panels need to be ordered prior to amiodarone tx. - ANSOrder thyroid panels bc amio
can cause hypothyroidism
Patients with heart disease should exercise caution when taking tricyclic antidepressants.
____ have a greater effect on COPD exacerbation reduction compared to LABAs and
decrease hospitalizations. - ANSLAMAs
____ is a contraindication to a liver transplant. - ANSHepatitis C
______ is used to treat mild to moderate ulcerative colitis. - ANSMesalamine
(Great for ETOH abusers with hepatitis with c/o upset stomach.)
"Diabetic Renal Protection" in DM patients using angiotensin-converting enzyme (ACE)
medications: - ANS patients have a lower rate of renal progression, but medications still
need to be stopped when advanced renal issues are present. •Screen patients if new
medication for suicidal ideations if states - ANSthey are having "strange thoughts" or
behavioral changes
• When first prescribed, SSRIs can cause ___. - ANSnausea ▪An antibiogram is: -
ANSoverall profile of antimicrobial susceptibility testing results of a specific microorganism to
a battery of antimicrobial drugs
▪Rxs, such as nadolol, may need to have their dosing intervals extended when patients
have increase ____. - ANScreatinine clearance
You are reviewing a report on a pyelonephritis-afflicted 55-year-old woman's urine culture.
E. coli growth was observed in the culture. The minimum inhibitory concentration (MIC)
scores for Ciprofloxacin, Levafloxacin, Ceftriaxone, and Nitrofurantoin were 1 and 16
respectively. Taking into account the MIC score, ciprofloxacin would be the best antibiotic to
prescribe. - ANSGo with a lower MIC score. Black adults receive CCB and thiazide diuretics
as the first-line treatment for HTN, according to ANS. A 43 yo patient with a recent history of
breast cancer received her first chemotherapy infusion 24 hours ago. The patient has been
having syncopal episodes, nausea/vomiting and mild edema. The patient is diagnosed with
Tumor Lysis Syndrome. The ACNP would order: - ANScontinuous NS (hypovolemia) and
Lasix (improve diuresis and prevent edema).
A patient with a new onset systolic murmur should be assessed for a ____ deficiency as
part of their workup. - ANSfolate deficiency
Coughing more frequently, worsening shortness of breath, and an increase in sputum
quantity and purulence are all symptoms of COPD. The patient has not been hospitalized or
given antibiotics multiple times in the past year. He clearly has a COPD exacerbation,
despite the fact that the CXR does not indicate any obvious pneumonia. What would be the
MOST appropriate management plan? - ANSadd a short course of oral steroids, a course of
, a second or third generation cephlasporin antibiotic, increase use of bronchodilators and
supplemental O2 as appropriate
ABX use in COPD exacerbation options: - ANSFirst-line:
- Bactrim DS one tablet PO BID
- Doxycycline 100mo PO TID
- Amoxicillin 500mg PO TID
Acute asthma exacerbation tx: - ANS- Inhaled bronchodilators
- Corticosteroids for the whole body - Supplemental O2
Acute pain is pain that lasts for less than six months. Acute Visceral Pain tx: ANS: opiates
are most effective. "May also utilize" ▪Corticosteroids
▪NSAIDs
Adrenal Insufficiency
Lab features:
Causes: - ANSLab features: Cortisol low, ACTH high
Causes: Ds additives Afib tx - ANS-Tx w conscious sedation synchronized cardioversion
(assess echocardiogram first for clot, chock could dislodge clot)
- Diltiazem- great choice CCB for dysrhythmia (metoprolol for breakthrough)
- Pt can be dangerous or symptomatic. resulting in PE or CVA Aim to keep 50% of BGs
within the desired range: A1C - ANSHgbA1C goal = less than 7% AKD is more commonly:. -
ANSreversible
MRSA is uncommon in animal bites, but due to the oral flora of cats, ABX Tx is necessary in
cat bites. A thorough ANSA cleansing and debridement, an X-ray, and a seven-day regimen
of amoxicillin-clavulanic acid would be the initial treatment for a cat bite. Anemia initial
treatment - ANS325mg ferrous sulfate TID
Antibiotics in COPD Exacerbations - ANSProtocol: Two parenteral drug combination
- Drug 1: Cephalosporin (ex Ceftriaxone) or Antipseudomonal Penicillin (ex
Piperacillin-Tazobactam)
- Drug 2: Fluoroquinolone (ex Levofloxacin) or Aminoglycoside (Tobramycin)
Reversal of anticoagulation in SAH for: ADP Inhibitors (e.g. Clopidogrel) - ANS- Historical:
Transfuse 2 units (equivalent to 12 pack) of platelets
- Repeat every 12-24 hours for a large Hemorrhage
- Platelet Transfusion associated with worse outcomes (see above, under Aspirin)
-Desmopressin (DDAVP) 0.3 mcg/kg
Anticoagulation reversal in SAH for:
Aspirin - ANS- Platelet Transfusion associated with worse outcomes (death and worse
neurologic function)
Desmopressin is an option. Not many options.
Anticoagulation reversal in SAH for:
Inhibitors of Factor Xa (e.g. Rivoroxaban or Xarelto, Apixaban or Eliquis) or Direct Thrombin
Inhibitors (e.g. Dabigatran) - ANS-Factor VII Inhibitor Bypass Activity (FEIBA)
-Activated recombinant coagulation factor VII (rFVIIa or NovoSeven) -Prothrombin Complex
Concentrate 4 (PCC4, Kcentra or outside U.S. Octaplex, Beriplex)
Reversal of anticoagulation in SAH for: Heparin - ANSProtamine
Anticoagulation reversal in SAH for:
Warfarin - ANS-Prothrombin Complex Concentrate 4 (PCC4) or if not available, Fresh
Frozen Plasma (FFP) AND
-Vitamin K 10 mg IV
for the AGACNP
___ adults are more likely to have serious side effects from chemotherapy. - ANSOlder
adults
___ laboratory monitoring is necessary for patients on SSRIs. - ANSNO laboratory
monitoring
___ panels need to be ordered prior to amiodarone tx. - ANSOrder thyroid panels bc amio
can cause hypothyroidism
Patients with heart disease should exercise caution when taking tricyclic antidepressants.
____ have a greater effect on COPD exacerbation reduction compared to LABAs and
decrease hospitalizations. - ANSLAMAs
____ is a contraindication to a liver transplant. - ANSHepatitis C
______ is used to treat mild to moderate ulcerative colitis. - ANSMesalamine
(Great for ETOH abusers with hepatitis with c/o upset stomach.)
"Diabetic Renal Protection" in DM patients using angiotensin-converting enzyme (ACE)
medications: - ANS patients have a lower rate of renal progression, but medications still
need to be stopped when advanced renal issues are present. •Screen patients if new
medication for suicidal ideations if states - ANSthey are having "strange thoughts" or
behavioral changes
• When first prescribed, SSRIs can cause ___. - ANSnausea ▪An antibiogram is: -
ANSoverall profile of antimicrobial susceptibility testing results of a specific microorganism to
a battery of antimicrobial drugs
▪Rxs, such as nadolol, may need to have their dosing intervals extended when patients
have increase ____. - ANScreatinine clearance
You are reviewing a report on a pyelonephritis-afflicted 55-year-old woman's urine culture.
E. coli growth was observed in the culture. The minimum inhibitory concentration (MIC)
scores for Ciprofloxacin, Levafloxacin, Ceftriaxone, and Nitrofurantoin were 1 and 16
respectively. Taking into account the MIC score, ciprofloxacin would be the best antibiotic to
prescribe. - ANSGo with a lower MIC score. Black adults receive CCB and thiazide diuretics
as the first-line treatment for HTN, according to ANS. A 43 yo patient with a recent history of
breast cancer received her first chemotherapy infusion 24 hours ago. The patient has been
having syncopal episodes, nausea/vomiting and mild edema. The patient is diagnosed with
Tumor Lysis Syndrome. The ACNP would order: - ANScontinuous NS (hypovolemia) and
Lasix (improve diuresis and prevent edema).
A patient with a new onset systolic murmur should be assessed for a ____ deficiency as
part of their workup. - ANSfolate deficiency
Coughing more frequently, worsening shortness of breath, and an increase in sputum
quantity and purulence are all symptoms of COPD. The patient has not been hospitalized or
given antibiotics multiple times in the past year. He clearly has a COPD exacerbation,
despite the fact that the CXR does not indicate any obvious pneumonia. What would be the
MOST appropriate management plan? - ANSadd a short course of oral steroids, a course of
, a second or third generation cephlasporin antibiotic, increase use of bronchodilators and
supplemental O2 as appropriate
ABX use in COPD exacerbation options: - ANSFirst-line:
- Bactrim DS one tablet PO BID
- Doxycycline 100mo PO TID
- Amoxicillin 500mg PO TID
Acute asthma exacerbation tx: - ANS- Inhaled bronchodilators
- Corticosteroids for the whole body - Supplemental O2
Acute pain is pain that lasts for less than six months. Acute Visceral Pain tx: ANS: opiates
are most effective. "May also utilize" ▪Corticosteroids
▪NSAIDs
Adrenal Insufficiency
Lab features:
Causes: - ANSLab features: Cortisol low, ACTH high
Causes: Ds additives Afib tx - ANS-Tx w conscious sedation synchronized cardioversion
(assess echocardiogram first for clot, chock could dislodge clot)
- Diltiazem- great choice CCB for dysrhythmia (metoprolol for breakthrough)
- Pt can be dangerous or symptomatic. resulting in PE or CVA Aim to keep 50% of BGs
within the desired range: A1C - ANSHgbA1C goal = less than 7% AKD is more commonly:. -
ANSreversible
MRSA is uncommon in animal bites, but due to the oral flora of cats, ABX Tx is necessary in
cat bites. A thorough ANSA cleansing and debridement, an X-ray, and a seven-day regimen
of amoxicillin-clavulanic acid would be the initial treatment for a cat bite. Anemia initial
treatment - ANS325mg ferrous sulfate TID
Antibiotics in COPD Exacerbations - ANSProtocol: Two parenteral drug combination
- Drug 1: Cephalosporin (ex Ceftriaxone) or Antipseudomonal Penicillin (ex
Piperacillin-Tazobactam)
- Drug 2: Fluoroquinolone (ex Levofloxacin) or Aminoglycoside (Tobramycin)
Reversal of anticoagulation in SAH for: ADP Inhibitors (e.g. Clopidogrel) - ANS- Historical:
Transfuse 2 units (equivalent to 12 pack) of platelets
- Repeat every 12-24 hours for a large Hemorrhage
- Platelet Transfusion associated with worse outcomes (see above, under Aspirin)
-Desmopressin (DDAVP) 0.3 mcg/kg
Anticoagulation reversal in SAH for:
Aspirin - ANS- Platelet Transfusion associated with worse outcomes (death and worse
neurologic function)
Desmopressin is an option. Not many options.
Anticoagulation reversal in SAH for:
Inhibitors of Factor Xa (e.g. Rivoroxaban or Xarelto, Apixaban or Eliquis) or Direct Thrombin
Inhibitors (e.g. Dabigatran) - ANS-Factor VII Inhibitor Bypass Activity (FEIBA)
-Activated recombinant coagulation factor VII (rFVIIa or NovoSeven) -Prothrombin Complex
Concentrate 4 (PCC4, Kcentra or outside U.S. Octaplex, Beriplex)
Reversal of anticoagulation in SAH for: Heparin - ANSProtamine
Anticoagulation reversal in SAH for:
Warfarin - ANS-Prothrombin Complex Concentrate 4 (PCC4) or if not available, Fresh
Frozen Plasma (FFP) AND
-Vitamin K 10 mg IV
