NR 566 WEEK 3, 4, 5, 6 AND 7 Exams with 354 Quizzes
and A+ Graded Solutions.
NR 566 WEEK 3, 4, 5, 6 AND 7 Exams with 354 Quizzes
and A+ Graded Solutions.
Glaucoma treatment - ANSWER-POAG: Primary open-angle glaucoma
TX directed at decreased IOP
Glaucoma: First line drugs - ANSWER-Beta blockers
A2 adrenergic agonists
Prostaglandin analogs
Glaucoma: Second line drugs - ANSWER-Cholinergic drugs
Carbonic anhydrase inhibitors
All glaucoma meds are - ANSWER-Topical!
Pros of beta blockers - ANSWER-Minimal vision disturbance, topical application
Cons of beta blockers - ANSWER-Can cause heart block, bradycardia, bronchospasm,
hypotension
Glaucoma TX for pt. with asthma/COPD - ANSWER-Betaxolol because it is Beta-1
selective
Otitis media treatment - ANSWER-All kids: analgesics
Some: abx
6mo-2years with certain dx: abx
> 2years with certain dx: abx if severe, observe if not
Otitis media abx of choice - ANSWER-High-dose amoxicillin x 5-10 days
Otitis externa treatment - ANSWER-"Swimmers ear"
Tx: analgesics, keep dry, topical 2% acetic acid, glucocorticoid/fluoroquinolone combo
(hydrocortisone/cipro)
Otitis externa: bacterial - ANSWER-Usually pseudomonas aeruginoa or staph areus
Otitis externa: fungal - ANSWER-"Otomycosis"
Aspergillus (80-90%)
Candida
Tx: cleansing/acidifying drops-2% acetic acid
If that fails, topical clotrimazole BID x 7 days
If that fails, oral diflucan
,NR 566 WEEK 3, 4, 5, 6 AND 7 Exams with 354 Quizzes
and A+ Graded Solutions.
Acne treatment: Mild - ANSWER-Benzoyl peroxide, topical retinoid, combo (BP + abx
OR retinoid)
Acne treatment: Moderate - ANSWER-Combo-oral abx + topical
Acne treatment: Severe - ANSWER-Oral abx + topical
Isotretinoin
Eczema treatment/complications - ANSWER-"Atopic dermatitis"
Topical immunosuppressants-tacrolimus, pimecrolimus (risk of skin cancer/lymphoma)
PDE4 inhibitor-crisaborole 2% ointment (eucrisa) (burning, stinging, hypersensitivity
reaction)
Topical glucocorticoids (skin atrophy, hypo pigmentation, telangiectasis, systemic
effects)
Local anesthetics
Key ingredient in organic sunscreen - ANSWER-Avobenzone
Expectorants MOA - ANSWER-Guaifenesin, ammonium cL, iodide
Increased productivity of cough by stimulating flow of respiratory tract secretions
Adverse effects/pt. teaching: Montelukast - ANSWER-Chur-strauss syndrome when
lower steroid dose
Neurophychiatric effects-mood changes, suicidal ideation
Adverse effects/pt. teaching: intranasal glucocorticoids - ANSWER-Drying of nasal
mucosa, burning/itching sensation, sore throat, nose bleed, headache
Systemic effects-adrenal suppression, decreased linear growth in children
Teach to administer properly!
Adverse effects/pt. teaching: Sympathomimetics - ANSWER-Phenylephrine-CNS
effects, more effective topically
Pseudoephedrine-oral administration, more effective, better absorbed, longer half-life
Adverse effects/pt. teaching: prostaglandin analogs - ANSWER-Blurred vision, eye
discomfort, ocular pruritus, allergic conjunctivitis, dry eye syndrome, light intolerance,
tearing, macular edema
Take meds on schedule to prevent vision loss
Sunglasses + wide hats when outdoors
Adverse effects/pt. teaching: Salicylic acid - ANSWER-Salicylate toxicity, local irritation,
peeling, can increase risk of sunburn
Adverse effects/pt. teaching: Benzoyl peroxide - ANSWER-Drying, peeling,
hypersensitivity reactions, use with dapsone may cause skin discoloration
,NR 566 WEEK 3, 4, 5, 6 AND 7 Exams with 354 Quizzes
and A+ Graded Solutions.
Adverse effects/pt. teaching: Isotretinoin - ANSWER-Nosebleeds, lip/eye inflammation,
itching/dryness of skin, nose + mouth, pain, tenderness, stiffness in muscles, bones,
joints, skin rash, headache, hair loss, skin peeling on palms and soles, depression,
suicidal ideation, increased triglycerides, increased risk of sunburn, TERATOGENIC
Intranasal glucocorticoids - ANSWER-Fluticasone
Most effective drugs for prevention/tx of seasonal and perennial allergies because they
suppress all major allergic rhinitis symptoms (congestion, rhinorrhea, sneezing, nasal
itching, erythema
Pseudoephedrine - ANSWER-Oral sympathomimetic
Used to decrease nasal congestion associated with allergic rhinitis
No effect on other symptoms
Loratidine - ANSWER-Oral antihistamine
Decreases sneezing, rhinorrhea, nasal itching
Less effective than intranasal glucocorticoids
Intranasal cromolyn - ANSWER-Moderately effective in treatment for allergic rhinitis
Benefits are lower than intranasal glucocorticoids
How to manage rebound congestion - ANSWER-Progressively larger/more frequent
doses
Break cycle with abrupt decongestant withdrawal
Or, stop one nostril, then the other
Or, use intranasal decongestant 1 week before d/c decongestants for 2-6 weeks
Can be avoided by limiting topical application to 3-5 days
Role of biologics in treating allergies - ANSWER-Monoclonal antibodies
Omalizumab (Xolair)-directed towards IgE
IgE plays a central role in allergic release of inflammatory mediators from mast cells and
basophils
NR 566 WEEK 4
treatment of obesity: evaluation of phentermine/topiramate - ANSWER-Schedule IV
drug indicated for chronic weight loss. Phetermine suppresses appetite which topirmate
increses satiety. Most common side efrects are dry mouth, constipation, blurred vision,
and numbness tingling.
-serious effects are memory loss, concentration, HTN, tachycardia, hypoglycemia
treatment of obesity: evaluation of phentermine/topiramate contraindications: -
ANSWER-Glaucoma or hyperthyroid
-Should not be given with MAOI. Stop MAOI 2 weeks before starting.
, NR 566 WEEK 3, 4, 5, 6 AND 7 Exams with 354 Quizzes
and A+ Graded Solutions.
-Carbonic anhydrase increases risk for metabolic acidosis
-diuretics that are not K+ sparing increases risk for hyperkalemia
Orlistat (Xenical) - ANSWER-- Is prescribed to morbidly obese pts to lose weight. It
prevents absorption of some of the fat in the pts diet.
- The med should be taken 3 times/day within 1 hour of a meal
- Its a lipase inhibitor, not an appetite suppressor.
Orlistat (Xenical) adverse effects: - ANSWER-Oily rectal leakage, sharting, fecal
urgency, and fatty or oily stools
-increased defecation and incontinence
-rare: severe liver damage —> itching, vomiting, anoxeria, dark urine, light colored
stools
-acute pancreatitis and kidney stones
Orlistat (Xenical) contraindications - ANSWER-Malabsorption syndrome and cholestasis
Lorcaserin (Belviq) - ANSWER-weight loss drug
Lorcaserin adverse effects - ANSWER-HA, back pain, decrease lymphocytes and URIs,
hypoglycemia in diabetics
Lorcaserin adverse reactions that are less common - ANSWER-Blood dye radios,
cognitive impairment, psychiatric disorders, priapism, HTN, valvular heart disease
Weight loss drugscontraindications for children - ANSWER-Not recommended.
- orlistat is not approved for kids under 12
Diethylpropion and phentermine are not for children under 16
Weight loss drugs contradictions: pregnancy - ANSWER-Not recommended
Can take diethylpropion- it's not teratogen; but neonates born to women who take this
drug May experience withdrawal
Weight loss drugs contradictions: breastfeeding - ANSWER-Not recommended for all
drugs
Weight loss drugs for older adults contradictions - ANSWER-Those with renal
impairment
-Naltrexone/bupropion should be limited to one tablet daily
- creatinine level is less than 50
-phentermine/topiramate should be limited to 7.5/46 capsule daily
-lorcaserin should not be given with 30 or less creatinine clearance
