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N5334 FINAL QUESTIONS AND ANSWERS
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N5334 FINAL QUESTIONS AND ANSWERS
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N5334 FINAL QUESTIONS AND ANSWERSPrescribing basics - answer- Prescribing is regulated by state BON
Proper RX - answer- Providers name and address, Telephone
DEA
Pt name/DOB/Addres
Name of Drug, strength, SIG(directions) with indication/Route and frequency, Quantity
and signature.
Drug Schedules: Most addictive to least - answer- 1: Heroin,LSD, MJ
2: hydrocodone, cocaine, Methamphetamine, methadone, oxycodone, meperidine,
fentanyl, adderall, ritalin
3: codeine, ketamine, testosterone
4: xanax, valium, soma, ambient, tramadol
5: antidiarrheal, antitussives, lomotil, lyrica
Pharmicodyamics - answer- The effects of drug on the body. Receptors are large
molecules usually proteins, that interact and mediate the action of drugs
agonist - answer- produce receptor stimulation and a conformational change every time
they bind. Do not need all available receptors to produce a maximum response
Partial agonist - answer- drugs that have properties in b/w those of full agonist and
antagonist. They bind to receptors but when they occupy the receptor sites, they
stimulate only some of the receptors.
antagonist - answer- drugs with affinity for a receptor but with no intrinsic activity. Affinity
allows the antagonist to bind to receptors, but lack of intrinsic activity prevents the
bound antagonist from causing receptor activation. The block action of drugs (ex.
Narcan)
Bioavailabity - answer- % of administered dosage of the drug that survives the first pass
through the liver and reaches the blood stream
What is the most widely used local anesthetic? - answer- Lidocaine
What is a possible fatal reaction to benzocaine - answer- Methemoglobinemia
What is included in application guidelines for topical anesthetics - answer- avoid
wrapping the site and heating the site, avoid application to open skin
Which medication will not cause rebound headaches from overuse? - answer-
propranolol (preventative)
,What is the best option for menstural migraine? - answer- low dose estrogen about 3
days prior to menses
What food can trigger migraines? - answer- Hot dog d/t nitrates
What medication is a Seratonin 1B1D receptor agonist? - answer- Sumatriptan
Butterbur can help as prevention for migraine therapy. What side effect can occur? -
answer- Liver damage
What are the 3 main classes of opiod receptors? - answer- Mu kappa delta
Which of the following will reserve he effects caused by opioid agonist? - answer-
naloxone
Which of the medications are used to treat OIC? - answer- Naloxegol,
methylinaltrexone, lubiprostone
Tolerance is defined as - answer- increased does of a med needed to obtain the same
response
Which medication is used for opioid abuse? - answer- Naltrexone
Euphoria induced by morphine: - answer- An exaggerated sense of well-being caused
by the activation of mu receptors
Which medication is given nasally for migraines? - answer- Butorphanol
Which of the following describes the mechanism of NSAIDs? - answer- Inhibition of the
cyclo-oxygenase enzyme
Second generation COX 2 inhibitors: - answer- Suppress inflammation and cause less
risk for gastric ulceration than COX 1, increase risk for heart disease
Which of the following medications should not be given with ASA? - answer-
Glucocorticoids
Which medication is given for acetaminophen overdose? - answer- Acetylcysteine
What are non endocrine therapeutic uses for glucocorticoids? - answer- RA, SLE, IBS,
Bursitis, OA, Gout, disorders of the eye
What is the danger of prolonged use of glucocorticoids? - answer- adrenal insufficiency
Methotrexate can cause fatal toxicities of: - answer- Bone marrow, liver, kidneys, lungs.
Hemorrhagic enteritis and GI perforation
, Jane is on etanercept for RA. The NP knows - answer- Jane should be checked for TB
yearly
What is first line treatment for gout? - answer- Colchicine, indomethacin
When would you initiate a Uriosuric Medication? - answer- more than 3 gout attacks per
year
Antiinflammatories - answer- inhibition of COX 1: protects against MI and stroke
inhibition COX 2: surpasses inflammation, pain and protects against colorectal cancer
(less GI bleeding)
half life - answer- Time required for the amount of a drug in the body to decline by 50%,
drugs with shorter half lives must be administer frequently. 4.5-5.5 times the half life to
get steady state and to be limited from the body
what the body does to the drug - answer- absorption, distribution, metabolism, excretion
Distribution - answer- movement of absorbed drug in bodily fluids throughout the body
to target tissue. Properties affecting: lipid/water solubility, PH affects ionization of drug,
protein binding, size of molecule (smaller molecules are more able to diffuse)
Tissue: fat, bone, blood/brain barrier (only lipid soluble will pass), placental barrier
(many drugs can pass)
Protein binding - answer- unbound drug is free which is active, crosses membrane. Low
plasma proteins result in more free drug. Competition: when 2 highly bound drugs are
given it increases the level of both drugs
Metabolism - answer- take place in the liver mostly. Chemical change of a drug
structure to:
Enhance excretion, inactivate the drug, increase therapeutic action, active a prodrug
(inactive until metabolized in the body into the active compound, ex: levodopa), increase
or decrease toxicity
CYP450 - answer- enzymes constitutes the most important of the phase I metabolizing
enzymes (account for about 75% of drug metabolism in the liver)
Phase 2: conjugation reaction occur leading to large increases in hydrophilicity of the
substrates rendering them more readily excretable
Substrate - answer- an agent that is metabolized by an enzyme into a metabolite and
product and eventually excreted
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