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PC 707 FINAL SAFETY EXAM QUESTIONS
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PC 707 FINAL SAFETY EXAM QUESTIONS
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PC 707 FINAL SAFETY EXAM QUESTIONSIgE mediated allergic reaction that happens after the 2nd exposure to the antigen? -
Answers- Type I Immediate hypersensitivity
Delayed Allergic reaction involving T cell in the skin? - Answers- Type IV Reaction
Primary treatment for a Type 1 Allergic response? - Answers- Epinephrine
Adjunctive treatment for a Type 1 Allergic response - Answers- ‣ H1 Blockers
‣ Corticosteroids help prevent bi phasic reactions
‣ Bronchodilators provide some relief-
One of the most Severe forms of a Type IV allergic reactions. - Answers- ‣ Stevens
Johnson Syndrome
‣ Toxic epidermal necrolysis
When considering a drug "re challenge" after reaction what are crucial factors the APRN
must consider? - Answers- ‣ What drug the patient reacted to
‣ The severity of the reaction (never again in Type I or severe type IV) *most important*
What Black Box Warning does Carbamazepine & Lamictal carry? - Answers- Potential
life-threatening dermatologic reaction, including Steven's Johnson and Toxic Epidermal
Necrolysis
What Black Box Warning does Promethazine (Phenergan)
antiemetic carry? - Answers- Potential for life threatening respiratory depression in
children.
What Black Box Warning do Fluoroquinolones carry? - Answers- Potential for tendon
rupture
What Black Box Warning does SSRIs carry? - Answers- Potential increased risk of
suicide in teens.
What Black Box Warning does opioids carry? - Answers- Combining opioids &
benzodiazepines can cause extreme sleepiness, slowed breathing & death
Insulin/Sulfonaureas adverse effect - Answers- Hypoglycemia!
Tricyclic Antidepressants - Answers- Very risky for overdose
Nitrofurantoin (Macrobid) adverse effect - Answers- Pulmonary Toxicity (rare )
, Proton Pump Inhibitors Increases the risks for - Answers- ‣ Upon starting: Community
acquired pneumonia
‣ Over time more likely to get infections like TB
‣ Over time possible increased potential for fractures
Bisphosphonates potential risk - Answers- osteonecrosis of the jaw
As we age, our kidneys become smaller & there is a decrease in renal blood flow. Why
is this a prescribing consideration? - Answers- Decreased renal clearance of drugs
As we age, our liver become smaller, has decreased blood flow & first pass metabolism
decreases. Why is this a prescribing consideration? - Answers- Decreased liver size
also means decreased production of CYP 450 enzymes!
So if you need to select a drug for the elderly, try to select drugs that use Phase 2
metabolism (not affected by age) Phase I is affected & involves the CYPs.
AS we age, there is a decrease in total body water by 10-15%! Why is this a concern
when prescribing for the elderly? - Answers- Decrease in total body water results in
decreased distribution of water soluble medications & causes increased serum levels of
drugs.
Why are the elderly at higher risk of Torsades de Points? - Answers- Elderly tend to be
on more drugs, so more of a chance to have multiple QT prolongation drugs.
Additional risk of TdP with low potassium, *low magnesium* & bradycardia- more
common in the elderly.
Afib more likely
What are the concerns with anticholinergic drugs & the elderly? - Answers- In the
elderly Anticholinergic drugs can cause:
‣ Memory impairment,
‣ confusion,
‣ falls,
‣ hallucinations,
‣ tachycardia &
‣ acute angle glaucoma
What class of drugs do you have to assess & monitor for Rhabdomyolysis? - Answers-
Statins
Rhabdomyolysis S&S - Answers- ‣ muscle complaints do not involve joints,
‣ involve large muscle groups proximal to trunk, commonly legs, low back &
‣ are symmetrical.
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