Advanced Pharmacology NSG 533 Test 1 Questions with 100% Correct Answers Latest Version 2024 Verified
3 views 0 purchase
Course
Advanced Pharmacology NSG 533
Institution
Advanced Pharmacology NSG 533
Advanced Pharmacology NSG 533 Test 1
Questions with 100% Correct Answers |
Latest Version 2024 | Verified
EP is a 38-year-old female patient that comes in for diabetes education and management. She was
diagnosed 12 years ago and states lately she is not able to control her diet although she con...
advanced pharmacology nsg 533 test 1 questions wit
Written for
Advanced Pharmacology NSG 533
All documents for this subject (85)
Seller
Follow
hov
Content preview
Advanced Pharmacology NSG 533 Test 1
Questions with 100% Correct Answers |
Latest Version 2024 | Verified
EP is a 38-year-old female patient that comes in for diabetes education and management. She was
diagnosed 12 years ago and states lately she is not able to control her diet although she continues a 1600
calorie diet with appropriate daily carbohydrate intake (per dietitian prescription) and walks 40 minutes
every day of the week. She states compliance with all medications. She denies any history of
hypoglycemia despite being able to identify signs and symptoms and describe appropriate treatment
strategies.
PMH: T2DM, HTN, obesity, depression, s/p thyroidectomy due to thyroid cancer
FmHx: Noncontributory
SHx: (−) Smoking, alcohol use, past marijuana use while in high school
Vitals: BP 128/82 mg Hg; P 72 beats/min; BMI 31 m/kg2
Laboratory test results: Na 134 mEq/L, K 5.4 mEq/L, Cl 106 mEq/L, BU - ✔✔Exenatide - Exenatide
(Bydureon) once weekly has been able to demonstrate weight loss and decrease A1C% by 0.7% to 1.2%
in clinical trials; however it is contraindicated for EP due to the self-reported history of thyroid cancer.
Dapagliflozin - Dapagliflozin (Farxiga) is contraindicated in this patient due to hyperkalemia which could
be made worse by this drug. The package insert does not indicate a specific potassium concentration cut
off to no longer use this medication; however, there are better choices in this patient.
Sitagliptin - Sitagliptin (Januvia) is able to obtain an A1C goal of less than 7% based on clinical trials and
currently the patient does not have any cautionary objective measures to not use this medication. DPP-
IV inhibitors are weight neutral. DPP-IV inhibitors can be used in patients taking sulfonylureas; however,
it may be recommended to reduce or stop the sulfonylurea dose.
Acarbose - Acarbose (Precose) is not recommended for initial management and is associated with
significant GI side effects. More information would be needed regarding fasting and post-prandial
numbers. In addition, adding acarbose would only lower A1c by 0.8% at best and therefore would not
achieve the desired A1C goal of <7%
JR is a 68-year-old African American man with a new diagnosis of T2DM. He was classified as having
prediabetes (at risk for developing diabetes) 5 years before the diagnosis and has a strong family history
of type 2 diabetes. JR's blood pressure was 150/92 mm Hg. His laboratory results revealed an A1C of
,8.1%, normal cholesterol panel, and normal renal/hepatic function were noted with today's laboratory
test results.
Past medical history: Hypertension (diagnosed 4 y ago) Hyperlipidemia (diagnosed 2 y ago) Pancreatitis
(idiopathic) (acute hospitalization 3 y ago)
Despite improvements in the past six weeks due to lifestyle changes and exercise, drug therapy is to be
started for JR's di - ✔✔Metformin is the drug of choice recommended for most patients with diabetes in
addition to lifestyle modifications assuming no contraindications or intolerabilities are present upon
evaluation. Metformin has also shown to provide positive weight neutral/loss effects in obese patients. It
is crucial to know the renal status of patients commencing metformin therapy to limit the risk of lactic
acidosis (JR is without contraindication).
Since his entry A1C is >7.5%, dual therapy is indicated. There are several potential choices. The second
step can be a dipeptidyl peptidase-4 inhibitor, it can be a glucagon-like peptide-1 (GLP-1) receptor
agonist, it can be a TZD, it can be a sulfonylurea agent, it can be a SGLT2 inhibitor, or it could be basal
insulin. Anything next can be tried depending on what suits the circumstance
DPP4 inhibitors are weight neutral bet relatively benign side effect profile. Sitagliptin has been
associated with case reports of pancreatitis, so this specific agent should be avoided. $$$
GLP-1 analog and has data to support an A1C reduction necessary to gain glycemic control and may
assist with weight loss goals for this patient. New information suggests these agents may provide
benefits in those with ASCVD. JR has a past history of pancreatitis and GLP-1 analogs are not
recommended due to this contraindication
TZDs have data to support an A1C reduction necessary to gain glycemic control, but are associated with
weight gain, negative effects on lipids and increased risk of fracture. Until recently, TZDs have also been
linked to increased CV events and use has fallen out of favor
Sulfonylureas provide excellent A1C lowering, but are also associated with weight gain. They also have
the potential to cause hypoglycemia, so patient education is crucial. Because of his allergies to "sulfa",
use would be contr
A patient with type 1 diabetes reports taking propranolol for hypertension. What concern does this
information present for the provider? - ✔✔A patient with Type 1 DM is insulin dependent for glucose
, control and at high risk for hypoglycemic episodes. Propanolol causes prolonged hypoglycemic episodes.
Needs to switch to ACE or ARB.
A provider teaches a patient who has been diagnosed with hypothyroidism about a new prescription for
levothyroxine. Which statement by the patient indicates a need for further teaching?
a. "I should not take heartburn medication without consulting my provider first."
b. "I should report insomnia, tremors, and an increased heart rate to my provider."
c. "If I take a multivitamin with iron, I should take it 4 hours after the levothyroxine."
d. "If I take calcium supplements, I may need to decrease my dose of levothyroxine." - ✔✔D. Calcium
may reduce levothyroxine absorption. Further education is needed if the patient feels she can take half
of a prescribed medication.
MC has undiagnosed multiple gastric ulcers. Shortly after consuming a large meal and alcohol he
experiences significant GI distress. He takes an OTC heartburn remedy. Within a minute or two he
develops what he will later describe as "belching, nausea and a bad bloated feeling". Several of the
ulcers began to bleed and he becomes profoundly hypotensive from the blood loss and is taken to the
ED. Endoscopy confirms multiple bleeds; the endoscopist remarks that it appears as if the lesions had
been literally stretched apart causing additional tissue damage. What did the patient most likely take (i.e.
what was the OTC remedy)? - ✔✔I would accept Alka-Selzer. I contains NaHCO3 (as well as ASA). In the
presence of HCL it Liberates CO2, that can cause gastric distention, belching and nausea. The reaction is
fairly swift allowing little time for dissipation. Tums, its primary ingredient calcium carbonate which
when taken cause a reaction with the stomach acid such as production of carbon dioxide gas which can
cause bloating and the stomach to stretch to tear the ulcers open.
On your way to this examination, you experience the vulnerable feeling that an attack of acute diarrhea
is imminent! If you stop at a drug store, which anti-diarrheal drugs could you buy without a prescription
even though it is chemically related to the strong opioid analgesic meperidine (but acts only on the
peripheral opioid receptor)? - ✔✔Loperamide
JA has multiple medical problems and is taking several drugs including theophylline, warfarin and
phenytoin. His conditions were well controlled, but recently he started to experience some GI distress for
which of his "well intentioned friends" gave him some medication. He presents to you with toxic effects
of all his other medications and plasma levels of those medications elevated. What was most likely the
medication he took? - ✔✔Cimetidine
What lifestyle modifications should be recommended? - ✔✔-losing weight if overweight
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller hov. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $8.99. You're not tied to anything after your purchase.
