1 NR565/ NR 565 ADVANCED
PHARMACOLOGY CARE OF THE
FUNDAMENTALS EXAM | QUESTIONS AND
VERIFIED ANSWERS (2024/ 2025 UPDATE)-
CHAMBERLAIN
When is it used - ASCVD Risk Score - ANSWER-In children a screening
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should be done between ages 9 and 11 and then again at ages 19 and 21.
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For adults every 5 years after the age of 20. Some people are at greater
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risk like those with diabetes and a risk score greater than 7.5%and should
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be screened more often
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ezetimibe- when can it be used? - ANSWER-pregnancy/breastfeeding can
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be use in monotherapy or as adjunct therapy with a statin or a fibrate
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What is ezetimibe? - ANSWER-Cholesterol Absorption Inhibitor-
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lowers cholesterol levels by decreasing the amount of cholesterol that is
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absorbed from the small intestine, so that there is less intestinal
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cholesterol delivered to the liver. Does not affect triglycerides
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lifestyle changes for high cholesterol - ANSWER-Lifestyle changes are
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non drug measures used to lower LDL. Four main issues are diet,
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exercise, weight control, and smoking cessation
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,2 If a patient wanted to minimize side effects, which drug classification is a
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good choice? - ANSWER-Non-statins- fibrates, Ezetimibe, Bile acid
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sequestrants. Statins are generally well tolerated and side effects are
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uncommon. Some patients develop headache, flatulence, constipation, or
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GI disturbances, but these effects are usually mild and transient
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,3
Therapeutic action of organic nitrates (nitroglycerin) - ANSWER-direct
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relaxant effect on vascular smooth muscles, and the dilation of coronary
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vessels improves oxygen supply to the myocardium. The dilation of
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peripheral veins, and in higher doses peripheral arteries, reduces preload
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and afterload, and thereby lowers myocardial oxygen consumption.
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promote vasodilation v
Contraindications for ranolazine - ANSWER-Agents that inhibit v v v v v v
CYP3A4 can increase the levels of ranolazine and thereby increase the
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risk of torsades de pointes. These things include: grapefruit juice, HIV
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protease inhibitors, macrolide antibiotics, azole antifungal drugs, and
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some CCB. Most CCB but not amlodipine can increase levels of
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ranolazine. Drugs that prolong the QT interval can increase the risk of
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torsades de pointes. (quinidine, sotalol).
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At what age can statins be prescribed? - ANSWER-avoid statin use in
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children under the age of 10
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CCB role with variant angina - ANSWER-promote relaxation of
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coronary artery spasm, increasing cardiac oxygen supply
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what medication can be added for patients with worsening symptoms of
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HF? - ANSWER-aldosterone antagonist- promotes myocardial
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remodeling and fibrosis, help with symptoms
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, 4
CCB stable angina - ANSWER-promote relaxation of peripheral
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arterioles, decreasing afterload and reducing cardiac oxygen demand
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A 41 year old patient comes into the clinic complaining of increased
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heart rate after starting nitro patches for stable angina. What would an
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appropriate response be?
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1. lets lower the dose and frequency of use
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2. I will prescribe a BB to help with this
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3. Next time this happens, lie down and practice deep breathing, this will
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bring your heart rate down - ANSWER-2- I will prescribe a BB to help
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with this
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What do CYP450 inhibitors and reducers do when not used
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correctly/what would patient experience? - ANSWER-increased side
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effects, adverse reactions and toxicity
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A 55 year old male comes into the clinic with a gouty arthritis. He states
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that he has one flareup a year. Your response is:
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1. I will prescribe you glucocorticoids to help with inflammation
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2. Lets start you on prophylactic therapy colchicine.
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3. It will be helpful to take an NSAID to start with to help relive some
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inflammation. I'll prescribe naproxen. - ANSWER-3- in patients with
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