N5334 FINAL EXAM WITH 100% COMPLETE
SOLUTIONS RATED A (320 QUESTIONS AND
CORRECT ANSWERS) DETAILED ANSWERS |
2024 UPDATE
Christy has exercised-induced and mild persistent asthma and is prescribed 2
puffs of albuterol 15 minutes before exercised and as needed for wheezing. One
puff per day of beclomethasone is also prescribed. Education regarding her
inhalers includes:
Beclomethasone needs to be used every day to treat her asthma
Aspirin
Non-selective inhibitor of COX, therapeutic use analgesic, fever, mensural
cramps, anti-inflammatory, Alzheimer disease. Risk for bleeding is too high.
Increased secretion of acid and pepsin therefore ruins all the protective lining of
the stomaching. Pt at risk: alcoholics, smoking, older people, or people who
have had PUD. Risk of ASA is not advised in pt younger than 18 r/t Reyes
syndrome, pregnancy because it cause ductus arteriosis, if given with Ibuprofen
it can decrease effects of ASA.
Acetaminophen
Analgesic and antipyretic. Hepatotoxicity risk. No more than 3 g in 24 hr period.
for overdose: acetylesistine.
Can blunt immune response of vaccines
,first generation non-ASA NSAIDS
inhibit COX 1 and 2, given for RA and OA, no protection against MI or stroke. ex.
Ibuprofen, alieve, diclophinac. Indicated for mild to moderate pain,
antiinflammaroty and analgesic effects. risk of GI bleed
Sam, aged 65, is started on L-dopa for his Parkinson's disease (PD). He asks why
this is necessary. You tell him:
the primary goal of therapy is to replace depleted stores of dopamine
Celebrex
second generation non ASA nsaids, lower risk for GI but can still cause renal
impairment. given for OA, RA, dysmenorrhea. S/E: abdominal pain, renal
impairment, sulfa allergies.
Drug interaction: warfarin, Decrease effects of furosemide, (increases)lithium,
ACE inhibitors.
David is a 26 year old competitive runner who presents with a complaint of pain
in his hip since he fell running. Isotretinoin is the only medication he is taking. he
is for severe acne. What should you be concerned for?
He is at risk for bone injuries and needs to be evaluated for fracture
,glucocosteroids
Risk for Cushings disease, diabetes, OA, risk for GI bleeds. If given over 7 days,
needs to be tapered off unless on inhaled Corticorsteriods. Used in labor to
mature lungs of infants.
Therapeutic use: allergic condition, asthma and immune suppression.
RA
very different from OA. Autoimmune disease.Symmetrical morning stiffness
that last for over an hour. Shortens life span of patients. Increases risk for CVD
and stroke. When testing these patient, you want to do a full immunological
test because it comes with other autoimmune diseases.
* First line treatment are NSAIDS and first line DMARD (methotrexate,
minocycline)
Josie is a 5yr old presenting with 48hr n/v/d. unable to keep fluids down and wt is
4 lbs less than last recorded wt. besides IV fluids, her exam warrants use of anti
nausea med. which is appropriate
Ondansetron
Gout
Monoarticular arthritis, d/o r/t kidney don't excrete enough uric acid. Only way
to diagnosis is joint aspiration and look for the uric crystals
Prevention is best
, Migraines
trial and error of medication and triggers. start with over the counter and move
to more aggressive over time. +2 a month, preventative medication is okay.
Abortive medications: NSAIDS, ergoalcoloids (cause vasoconstriction), triptans
(Seratonin 1b1d receptor agonist) Sumitriptan, cause vasoconstrictions,
maximum dose is 200mg a day. can cause coronary vasospasm
Preventative: Beta blockers, antiseizure medications (depikote and topimax),
tricyclic antidepressants, Calcium Channel blockers, botox, vitamin b2/Co Q
enzyme and butterbur.
cluster headaches
intensely painful headaches that affect one side of the head and may be
associated with tearing of the eyes and nasal congestion, occur in series, 5-15
minutes
prophylaxis tx with regular Headaches
SSRIs
Fluoxetine, paroxetine, sertraline, citalopram.
effects don't start for several weeks (4-6 weeks) can cause weight gain, vivid
dreams, bruxism, bleeding disorders, ED/sexual dysfunction, hyponatriemia,
most can cause n/v that might go away.
need to taper off these meds.
