2024 NR 565 - ADVANCED
PHARMACOLOGY MIDTERM –
CHAMBERLAIN EXAM WITH
CORRECT ANSWERS
Which drugs are safe for pregnancy with RA ? - CORRECT ANSWERS-NSAIDs,
corticosteroids, plus several DMARDs, including sulfasalazine and
hydroxychloroquine
NSAID black box warning - CORRECT ANSWERS-NSAIDs may increase the risk
for myocardial infarction, stroke, and other thromboembolic events. NSAIDs
increase the risk for dangerous gastrointestinal adverse effects such as
bleeding, ulceration, and perforation.
During what trimester is a pregnant woman most at risk for adverse drug
reactions with potential long term consequences? - CORRECT ANSWERS-1st
trimester (fetus most at risk d/t rapid growth)
What is BEERS criteria? - CORRECT ANSWERS-Recommendations of
medications inappropriate for elderly (65 and older), prescriber ultimately
decides
Colchicine is considered for long term treatment if a person has how many
gouty attacks per year? - CORRECT ANSWERS-three or more
Colchicine should not be taken with what medications? - CORRECT
ANSWERS-statins, CYP3A4 inhibitors
adverse effects of colchicine - CORRECT ANSWERS-nausea, vomiting,
diarrhea, myelosuppression, myopathy, rhabdomyolysis
what condition can develop with long term allopurinol - CORRECT ANSWERS-
SCAR (severe cutaneous adverse reaction - rash, fever, eosinophilia, liver
and kidney function)
What should be co-administered with febuxostat? - CORRECT ANSWERS-
NSAIDS or colchicine
,Complications of untreated gout - CORRECT ANSWERS-Erosion and
irreversible joint damage, renal damage, tophi (stone deposits in joints and
tissues)
Alendronate patient education - CORRECT ANSWERS-minimize risk of
esophagitis by swallowing the pill whole with a full glass of water, then sit up
for at least 30 min but 60 min preferred. intake of food prevents absorption,
take this med 30 min prior to other intake
Which dietary supplement interferes with Ibandronate absorption? -
CORRECT ANSWERS-calcium, magnesium, iron
1st line treatment of osteoporosis - CORRECT ANSWERS-alendronate
Is allopurinol safe to use in a patient with renal dysfunction? - CORRECT
ANSWERS-yes - drug of choice for patients with renal dysfunction or who
over produce uric acid
Baseline diagnostics for DMARDS - CORRECT ANSWERS-CBC with WBC
differential
s/s of infection (TB and hepatitis)
malignancies
rule out pregnancy
ALT, AST, serum creatinine
comprehensive history and physical exam
assess risk for immunocompetence and liver and renal status
Baseline data for Methotrexate (DMARD) - CORRECT ANSWERS-chest x-ray,
emphasis on pulm and GI status
which DMARD needs ophthalmologic and cardiac exam? - CORRECT
ANSWERS-hydroxychloroquine
black box warning for Raloxifene - CORRECT ANSWERS-risk for venous
thromboembolic events (DVT, PE, stroke)
Behaviors that should predict controlled substance addiction - CORRECT
ANSWERS-reinforcing properties of drugs - pleasurable (euphoria) or reduce
unpleasant experience (reduce anxiety and stress
physical dependence
physiological dependence (well-being depends on drug)
social factors (peer pressure)
drug availability (Drugs in hospitals - reason for nurses or pharmacist abuse)
vulnerability of individual
impulsive
low tolerance for frustration
, rebellious against social norms
depressive, anxiety, and anti-social personality disorders
abuse other drugs
Treatment of chronic pain with pregabalin - CORRECT ANSWERS-adjuvant
analgesic for neuropathic pain
Effective in diabetic neuropathy, seizures, central neuropathy, postherpetic
neuralgia, and fibromyalgia
adverse effects of pregabalin - CORRECT ANSWERS-Sedation/drowsy,
dizziness, and ataxia, blurred vision, difficulty thinking
GI bleeding is linked to - CORRECT ANSWERS-COX-2 inhibitors and NSAID
patient education with colchicine - CORRECT ANSWERS-only when needed to
relieve an attack: Start taking this medicine at the first sign of the attack for
best results. Stop taking this medicine as soon as the pain is relieved or at
the first sign of nausea, vomiting, stomach pain, or diarrhea.
longer you wait to start with attack, less effective it might be
Which drugs are high risk in pregnancy with RA? - CORRECT ANSWERS-
methotrexate
leflunomide
biologics: anti-TNF agents, rituximab and abatacept (end in -mab)
What is the CYP450 (cytochrome P450) - CORRECT ANSWERS-liver enzyme
system where medications are metabolized, can either be inducers or
inhibitors and create drug-drug interactions
CYP450 inducers - CORRECT ANSWERS-Speed up metabolism of drugs (drug
is cleared faster), drug has lesser effect (decrease blood levels of drug),
elevate CYP450 enzymes
CYP450 inducers pneumonic - CORRECT ANSWERS-"Bullshit Crap GPS
INDUCES rage"
CYP450 inducer drug names - CORRECT ANSWERS-Barbituates, St John wort,
Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin, phenobarbital,
sulfonylureas
CYP450 inhibitors - CORRECT ANSWERS-inhibit metabolism, increase blood
levels of medications
CYP450 pneumonic - CORRECT ANSWERS-"VISA credit card debt INHIBITS
spending on designers like CK to look GQ"