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Exam (elaborations)

NURP 424 Pharm Exam 1 Latest Update

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NURP 424 Pharm Exam 1 Latest Update ...

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  • September 22, 2024
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  • 2024/2025
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NURP 424 Pharm Exam 1 Latest
Update

Considerations when prescribing: - Answer I: Indication

C: contraindication

P: precautions or interactions

C: cost/compliance

E: efficacy

A: adverse effects

D: dose/duration/directions

Drug approval process: Phase I - Answer Phase I: safety and safe dosage- how the drug
is tolerated at different doses- does not determine efficacy; studies the
pharmacokinetics of the drug

(After the preclinical animal testing phase)

Drug Approval Process: Phase II - Answer Phase II: determine dosage and efficacy;
determine short-term risks

Drug Approval Process: Phase III - Answer Phase III: controlled and uncontrolled
clinical trials of safety and efficacy in multiple settings; submit a new drug application
(NDA) to the FDA

-Is it better than current treatment?

Drug Approval Process: Post Market - Answer Phase IV or Post market research: has no
fixed duration, further report adverse events

DEA Controlled Drug Schedules: Schedule 1 - Answer - No accepted medical use

-No legal use permitted

- For registered research facilities only

Heroin, LSD, mescaline, peyote, marijuana*(state to state)

DEA Controlled Drug Schedules: Schedule 2 - Answer -No refills permitted (only 30 day
supply)

,-No phone orders unless you have a written one within 7 days

-E-prescribe is OK

- expires in 72hrs id not filled

Narcotics, stimulants, depressants (phenobarbital, secobarbital)

DEA Controlled Drug Schedules: Schedule 3 - Answer -must be rewritten after 6 months
or five refills

-phone and fax OK

Some narcotics (Percocet, hydrocodone) Some stimulants (benzphetamine,
chlorpheniramine, diethylpropion)

Anabolic steroids, testosterone

DEA Controlled Drug Schedules: Schedule 4 - Answer -same as schedule 3, penalties for
illegal possessions are different

-low potential for abuse per DEA

pentazocine, phentermine, benzos, meprobamate

DEA Controlled Drug Schedules: Schedule 5 - Answer - same as all prescription drugs

-may be dispensed without prescription unless regulated by the state

loperamide, cough meds, pregabalin

Adverse Drug Reactions: Pharmacological - Answer - majority of adverse reactions

-predictable

-dose-related

-85-90% of ADRs

(Hypotension from antihypertensives)

Adverse Drug Reactions: Idiosyncratic - Answer -unpredictable

-Not dose-related

(Stevens-Johnson syndrome from lamictal or ibuprofen)

Immune-Mediated ADR: Type 1 - Answer -igE mediated, immediate type

-previously sensitize person

-hypersensitivity like atopic dermatitis, hives, angioedema or anaphylaxis

, Immune-Mediated ADR: Type 2 - Answer - antibody-dependent cytotoxicity

- "autoimmune response"

- improvement with removal of drug

- HIT or hemolytic anemia, neutropenia

Immune-Mediated ADR: Type 3 - Answer -immune complex hypersensitivity (Arthus
reaction to tetanus vaccine)

- "serum sickness"

-Aggregates of antigens and IgG create insoluble immune complexes in blood vessels
which can take a week to occur and cause vasculitis

- arthralgia, fever, swollen lymph nodes, and splenomegaly

-involvement of tissue

Immune-Mediated ADR: Type 4 - Answer -cell-mediated or delayed hypersensitivity

- Usually occurs more than 12 hours after exposure to the allergen, with a maximal
reaction time between 48 and 72 hrs

-Ex. drug rash, eosinophilia, and systemic syndrome (DRESS), Stevens Johnsons,
contact dermatitis

Time-Related ADR - Answer -Rapid: during or immediately following admin

-First-dose: occur immediately after the first dose

-Immediate: within one hour of exposure

-Delayed: one hour after exposure

-Early: occur early in treatment and generally resolves with continued treatment as
tolerance is developed

-intermediate: occur after repeated exposure to med

-Late: occur after prolonged exposure to an offending agent

Delayed: occur at variable points in time after exposure or even after stopping the drug

Severity of ADRs - Answer -Mild: typically can be managed by dose reduction,
discontinuation, or may subside as tolerance builds

-Moderate: often requires discontinuation and minimal medical intervention. Typically
does not cause permanent harm to the patient

Severe: may be life-threatening and result is hospitalization, birth defects, or even

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