2024 NR565 ADVANCED
PHARMACOLOGY MIDTERM EXAM
WITH 100% CORRECT ANSWERS
what condition can long term use of allopurinol cause - CORRECT-
ANSWERSsevere cutaneous adverse reaction (SCAR)
rash
fever
eosinophilia
liver and kidney dysfunction
allopurinol drug interactions - CORRECT-ANSWERSwarfarin, theophylline,
ampicillin,
mercaptopurine and azathioprine (immunosuppressants)
what should be coadministered with febuxostat - CORRECT-
ANSWERSprophylactic NSAIDs or colchicine therapy
NSAIDs black box warning - CORRECT-ANSWERSAll NSAIDs (except aspirin)
share a black box warning regarding an increased risk of adverse
cardiovascular thrombotic events, including fatal MI and stroke.
NSAIDs may counteract the cardioprotective effects of aspirin.
NSAIDs drug interactions - CORRECT-ANSWERSother NSAIDs, alcohol,
warfarin (blood thinners), ACE inhibitors, and diuretics
NSAID MOA - CORRECT-ANSWERSInhibit COX and thus decrease production
of thromboxanes, prostaglandins and prostacyclins
Anti-inflammatory action: inhibits prostaglandins
Analgesic action: inhibits PGE2 sensitization of nerve endings
Antipyretic action: inhibit PGE2 from effecting anterior hypothalamus
What baseline diagnostics are needed for all DMARDs - CORRECT-
ANSWERSCBC w/diff
s/s of infection such as Tb/hepatitis
screen for skin malignancies
r/o pregnancy
, liver/renal function
immunocompetence
comprehensive h&p to allow for monitoring changes from baseline
therapeutic response for methotrexate - CORRECT-ANSWERS3-6 weeks for
symptom improvement, 12 weeks to feel full effects
RA tx during pregnancy - CORRECT-ANSWERShigh risk in pregnancy with
RA?-methotrexatele flunomide biologics: anti-TNF agents, rituximab and
abatacept (end in -mab)
safe for pregnancy with RA ?-NSAIDs, corticosteroids, plus several DMARDs,
including sulfasalazine and hydroxychloroquine
Osteoporosis
Alendronate - Patient education
Ibandronate - Which dietary supplement can interfere with absorption? -
CORRECT-ANSWERSAlendronate patient education on the risk of esophagitis
by swallowing the pill whole with a full glass of water, then sitting up for at
least 30 min, but 60 min preferred.
intake of food prevents absorption, take this med 30 min prior to other
intakes
Which dietary supplement interferes with Ibandronate absorption?
-calcium, magnesium, iron
Lisinopril (ACE Inhibitor) - CORRECT-ANSWERSHTN- 10-40 mg once/d
HF- 20-40 mg once/day
Acute MI- 10 mg once/day for at least 6 weeks
What schedule drugs can APRNs prescribe? - CORRECT-ANSWERSIt depends
on the governing body in each state. In AZ there are no restrictions on APRN
prescribing by schedule.
Who determines and regulates prescriptive authority? - CORRECT-
ANSWERSAZ - State Board of Nursing
How does limited prescriptive authority impact patients within the healthcare
system? - CORRECT-ANSWERSCreates numerous barriers to quality
affordable and acessible patient care.
What are the key responsibilities of prescribing? - CORRECT-ANSWERS1. Be
prudent and deliberate in your decision-making process
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