Exam (elaborations)
2024 NR565 ADVANCED PHARMACOLOGY FUNDAMENTALS EXAM WITH CORRECT ANSWERS
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2024 NR565 ADVANCED PHARMACOLOGY FUNDAMENTALS EXAM WITH CORRECT ANSWERS
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2024 NR565 ADVANCEDPHARMACOLOGY
FUNDAMENTALS EXAM WITH
CORRECT ANSWERS
Acute Somatic Pain - CORRECT ANSWERS--Arises from connective tissue,
muscle, bone and skin.
-Sharp and localized or dull and non-localized
-Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates, local
anesthetics, ice, massage
Acute Visceral Pain - CORRECT ANSWERS-Pain in the internal organs and
abdomen
Poorly localized (C-fibers)
Radiates
Most responsive to opiates
May also use corticosteroids, NSAIDs
Cytochrome P450 (CYP450) - CORRECT ANSWERS-xenobiotic-metabolizing
enzymes necessary for the production of cholesterol and steroids and the
detoxification of chemicals and drug metabolism.
Function of Cytochrome P450 (CYP450) - CORRECT ANSWERS-responsible for
phase 1 metabolism in which drugs are oxidized, reduced, or hydrolyzed
Factors Affecting Drug Absorption - CORRECT ANSWERS-Rate of dissolution
Surface area
Blood flow
Lipid solubility
pH partitioning
Factors Affecting Drug Distribution - CORRECT ANSWERS-Blood flow to
tissues
Ability to exit the vascular system
Blood-brain barrier
Protein-binding capacity
,Bisphosphonates Patient Education - CORRECT ANSWERS-minimize the risk
for esophagitis, instruct patients to swallow the tablet whole with a full glass
of water while sitting or standing upright. Explain that it is important to
remain upright for at least 30 min-60mins
Therapeutic Action for Angina - CORRECT ANSWERS-Nitrates, Beta-Blockers,
Ranalozine, CCB
Antiplatelets Considerations - CORRECT ANSWERS-CBC, consider testing for
variants of the CYP2C19; Concurrent PPI use
Warfarin considerations - CORRECT ANSWERS-PT, CBC. Genetic testing for
variants of CYP2C9 and VKORC1
Nicotinic Acid (Niacin) - CORRECT ANSWERS-has practical use to treat severe
hypertriglyceridemia not recommended for use in combination with statin
medications
Pharmacokinetics - CORRECT ANSWERS-The process by which drugs are
absorbed, distributed within the body, metabolized, and excreted.
Pharmacodynamics - CORRECT ANSWERS-The study of what the drug does to
the body
Bisphosphonates AE - CORRECT ANSWERS-can cause severe esophagitis,
sometimes resulting in ulceration. Avoid these drugs in patients with
esophageal disorders that could impede swallowing and in patients who are
unable to sit or stand for 30 min
Rheumatoid arthritis - CORRECT ANSWERS-symmetric joint stiffness and pain
DMARDS (Methotrexate/Leflunomide) - CORRECT ANSWERS-(1) Relieve RA
symptoms (pain, inflammation, and stiffness), (2) maintain joint function and
range of motion, (3) minimize systemic involvement, and (4) delay disease
progression.
Conventional DMARDs - CORRECT ANSWERS-Indication for RA; Benefits of
this drug class result from immunosuppression
Methotrexate MOA - CORRECT ANSWERS--DMARD of first choice owing to its
efficacy, relative safety, low cost, and extensive use in RA
-Benefits appear to be the result of immunosuppression secondary to
reducing the activity of B and T lymphocytes.
, Methotrexate AE - CORRECT ANSWERS--Major toxicities are hepatic fibrosis,
bone marrow suppression, GI ulceration, and pneumonitis.
-Can cause numerous and potentially fatal toxicities of the bone marrow,
liver, lungs, and kidneys. Other fatalities have occurred associated with skin
reactions and due to hemorrhagic enteritis and gastrointestinal perforation.
Methotrexate Contraindication - CORRECT ANSWERS-can cause fetal death
and congenital abnormalities and therefore is contraindicated during
pregnancy.
Methotrexate Drug Interaction - CORRECT ANSWERS--increases the risk for
hepatotoxicity when other drugs that contribute to liver injury (including
alcohol) are taken;
-greatly increases the risk for serious myelosuppression when it is prescribed
for patients taking other drugs that can decrease bone marrow function.
Leflunomide (Arava) MOA - CORRECT ANSWERS-powerful
immunosuppressant indicated for adults with active RA; Second Line Use in
comparison to other conventional DMARDS due to toxicity and cost.
Leflunomide (Arava) AE - CORRECT ANSWERS-diarrhea, respiratory infection,
reversible alopecia, and rash.
Hepatotoxic; Immunosuppressive and can increase risk for infection
Leflunomide (Arava) Contraindications - CORRECT ANSWERS-can inhibit the
metabolism of certain NSAIDs (e.g., ibuprofen, diclofenac), causing their
levels to rise.
is contraindicated during pregnancy
initial medication management of AF - CORRECT ANSWERS-beta-blockers,
calcium channel blockers (CCBs), and digoxin.
Xenobiotics - CORRECT ANSWERS-substances that are foreign to the body,
usually synthetic chemical compounds; medications are a common example
Phase 1 Metabolism of Drugs via P450 - CORRECT ANSWERS-Oxidation;
Reduction; Hydrolysis
Three possible outcomes of phase 1 drug metabolism. - CORRECT
ANSWERS--Drug becomes completely inactive
-Drug becomes partially inactive but one or more metabolites remain active
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