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ADVANCE PHARMACOLOGY FINAL EXAM REVIEW QUESTIONS AND ANSWERS
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ADVANCE PHARMACOLOGY FINAL EXAM REVIEW QUESTIONS AND ANSWERS
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ADVANCED PHARMACOLOGY FINALEXAM QUESTIONS AND ANSWERS
Parkinson'ssdisease,spharmacotherapy,spatientsteachings-sans---
ssymptomsjournalings(onsandsoff stimes,sdyskinesia,smood/memoryschanges,snausea/consti
pationsfromsmedicationsSE
-foodsconsistencyschangessforsswallowingsissues,sincreasedsfluidsandsfibersforsconstipation
-takesmedicationswithsfoods(initially)stosavoidsnausea/anorexia
-limitsdietarysproteinstos3-
4souncesspersmeals(sizesofsasdecksofscards)sduestosinterferenceswithslevodopas(takesmedsins
morning,seatsproteinsfoodsinsevening)
-avoidstakingslevodopaswithsmealssorswithins2shourssofsiron
-avoidstyraminesrichsfoodss(agedscheese,ssoybean,scuredsmeats)swithsMAO-
Bsinhibitorss(rasagaline,sselegiline,ssafinamide)stosavoidsserotoninssyndrome
-inc.scalcium,svitaminsd,sweightsbearingsexercise
-patientseducationssources:sPDsfoundation,sMichaelsJsfoxsfoundation
Alzheimer'ssdisease,spharmacotherapy,sgoalssofstreatments-sans---
maintain/maximizespatientsfunctionalsabilitysandsqualitysofslifeswhilesminimizingsAEsandscos
tsofsdrugs
-multidisciplinarysteamsapproach
-drugstherapyschoicessforscognitivessymptoms:scholinesterasesinhibitorss&smemantines
-
noscuresforsAD;sgoalsofstreatmentsisstosslowsdiseasesprogressionsandsmanagessymptomss(I
ncreasingslengthsofstimesofsself-
sufficiency,sdelayingsneedsforsnursingshomesplacement,sreducingsburdensonsthescaregiver)
Alcoholsusesdisorder,spharmacotherapy,ssideseffectss-sans--
Naltrexones(notstosbesusedsinshepaticsdysfunction/opioidsusesorsactiveswithdrawal/drinking)
sSE-
,usuallyswellstolerated,smayscausesHA,snausea,sinjectionssitesreaction,shepaticstoxicitysinsal
s
cohol-dependentspt,smayshavesCVseffectssbutsnotscommon
Acamprostates(notstosbesusedsinsrenalsdysfunction/sulfitessensitivity)sSE-
sdiarrhea,sinsomnia,snausea,spruritus,sasthenia,sanxiety/depression,sCVseffectss
Disulfirams(deterrentsproducingseffectssifstakensevenswithsslightsamountsofsalcoholslikesmou
thwash)sAEsofsdrug-
sdrowsiness,sfatigue,sHA,shepaticsdys.,speripheral/opticsneuropathy,smetallic/garlic staste,sr
ash/acne
ADHD,sstimulants,ssideseffectss-sans--
Neuro:sinsomnia,sHA,sdizziness,sabusespotential,sgrowthsretardations(highsdoses),sseizures
activity,sagitation,snervousness,stics,sdyskinesia
GI:slosssofsappetite,sweightsloss,sN/V
Cardiac:spalpitations,stachycardia,shypertension,sarrythmias
maysbesablestosminimizesSEswiths"drugsholidays"ssummers/weekendsswithoutsdrug
Insomnia,spharmacotherapy,sfirstslinesagentss-sans---
Benzodiazepines:salprazolam,sestazolam,sflurazepam,slorazepam,squazepam,stemazepa
m,striazolams(ENDsINsLAMsANDsPAM)
-BZRA:szolpidem,szaleplon,sescitalopram
-ramelteon
-1stsgen.santihistamine:sdoxylaminessuccinates(onlysagentsapprovedsforspregnancy)
-
Flurazepamsandsquazepamsassistswithsfallingsasleep,swhilesTemazepamshelpssstaysaslee
psduestoslongershalf-life
Depression,spharmacotherapy,streatmentsorder:sFirstsline-s-sans--
FirstsLine:sSSRIssandsSNRIss-
sFluoxetinesandssertralinesforspatientsswithssomnolencesParoxetinesmaysbesgoodsforspatien
tsswithsinsomnia.s
Selectionsofsagentssshouldsbesbasedsonspatient'sspastsexperiences,smedicationssandsdrugs
interactions/cost
IfsthespatientsisstakingsdrugssmetabolizedsbysCYP3A4,sthensavoidsfluoxetines(Prozac)
, Ifsdepression-
relatedssymptomssincludessexualsdysfunction,sSSRIssandsSNRIssshouldsbesavoided
Ifsweightsgainsneedsstosbesavoided,sthensbupropionsbettersoptionsthansSSRIss(likesparoxeti
ne,swhichshassthesgreatestspotentialsforsweightsgain)sorsmirtazapine
Combiningspsychotherapyswithspharmacotherapy,sinspatientsswithspsychosocialsstressors,
sleadsstosbettersshort-termsoutcomesscomparedstossingle-optionstreatment
Depression,spharmacotherapy,streatmentsorder:sSecondsline-s-sans---
Ansinc.sinsdosesmaysbesneededsifssomesclinicalsbenefitsfromsfirstslinestherapys
OR
-
addingsanothersagentstosfirstslinestherapys(augmentation)swithslithium,sthyroidshormonesorss
timulantsmedications(notscommonsanymoresthough)
-
ifsptsgetssnosbenefitsfromsSSRIsorsSNRIsorscannotstoleratesthesdrugsanothersdrugscansbesch
osensfromssamesclass
-Atypicalsantidepressantssconsideredssecondslines(bupropion,smirtazapine)
-
combinationstherapyswith:strazodone,sbupropions(thoughsthississoftensusedsassinitialstherap
y),smirtazapine,sbuspirone,sandsthesatypicalsantipsychoticss(AAPs)
Depression,spharmacotherapy,streatmentsorder:sThirdsline-s-sans---TCAssorsMAOIs
-
inexperiencedspractitionerssshouldsnotsprescribesMAOIsdrugssduestosdangerousssideseffect
s,sfood/drugsinteractions
Antiarrhythmics,spharmacotherapy,sexpectedsEKGsfindingsswithstreatments(Quinidine)s-
sans--prolongedsQTsinterval sandsasslightlysprolongedsQRSscomplexsonsthesECG
Antiarrhythmics,spharmacotherapy,sexpectedsEKGsfindingsswithstreatments(Procainamide
)s-sans--
widenssthesQRSscomplex,sprolongssthesQTsinterval,sandsslightlysprolongssthesPRsinterval
Antiarrhythmics,spharmacotherapy,sexpectedsEKGsfindingsswithstreatments(Disopyramide
)s-sans--ProlongedsQTsintervalsandsasslightlysprolongedsQRSscomplex
Antiarrhythmics,spharmacotherapy,sexpectedsEKGsfindingsswithstreatments(Flecainide)s-
sans--
Becausesofsthesslowedscardiacsconduction,sincreasessinsthesPRsintervalsandsQRSsdurations
maysbesseensonsthesEKG
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