2024 ADVANCED
PHARMACOLOGY EXAM WITH
CORRECT ANSWERS
A 70-year old male has a history of cardiac dysrhythmias and is prescribed
nadolol. Annual laboratory work reveals a CrCl of 25 ml/min. What action
should the nurse practitioner take related to his nadolol.
a) Decrease the dose by 75%
b) Extend the dosage interval
c) Schedule a serum creatinine level to validate the CrCl value
d) Take no action because this value is expected in the older adult -
CORRECT ANSWERS-b) Extend the dosage interval
In renal impairment, the nurse practitioner should increase the dosage
interval.
Beta-2 receptors produce which of the following effects?
a) Decrease cardiac contractility
b) Bronchoconstriction
c) Increase GI motility
d) Vasodilation - CORRECT ANSWERS-d) Vasodilation
Beta2 receptors are located in the smooth muscle of the eye, arterioles,
venules, bronchioles, liver, pancrease, and GI and GU systems. They
stimulate adenylyl cyclase, increase cAMP, and activate cardiac G1 under
certain conditions.
A 65-year-old male has been diagnosed with hypertension and benign
prostatic hyperplasia. Doxazosin was prescribed to treat his hypertension
and his BPH symptoms have improved. Why?
a) It decreases blood flow to the prostate gland
b) It decreases detrusor muscle contractility
c) It relaxes smooth muscle in the bladder neck
d) It increases urethral resistance - CORRECT ANSWERS-c) It relaxes smooth
muscle in the bladder neck
, The alphs1 antagonists reversibly block the effects of catecholamines at the
postsynaptic alpha1 receptors in vascular smooth muscle and in the smooth
muscle of the bladder nech and prostate. These drugs are useful in lowering
blood pressure as well as relieving outflow obstruction secondary to benign
prostatic hypertrophy. The reduction in symptoms and improved urine flow
rates in patient with BPH is related to relaxation of smooth muscle produced
by the blockade of the alpha1 receptors, which are densely located in the
bladder neck and prostate gland. Blockade of these receptors decreases
urethral resistance and may relieve the obstructions and improve urine flow
and BPH symptoms. Because there are a few alpha1 receptors in the body of
the bladder, these drugs are able to reduce bladder outflow obstruction
without affecting bladder contractility.
There is a narrow margin between first appearance of adverse reaction to
AChE inhibitors and serious toxic effects. Which of the following adverse
reactions require immediate action?
a) Fasciculations of voluntary muscles
b) Nausea
c) Dizziness and headache
d) Decreased salivation - CORRECT ANSWERS-a) Fasciculations of voluntary
muscles
The warning signs of overdose are very similar to common adverse
reactions, and there is a narrow margin between the first appearance of
adverse reactions and serious toxic effects. Adverse reactions such as
excessive GI stimulation, excessive salivation, miosis, fasciculations of
voluntary muscles should be reported to the health-care provider
immediately, and the drug will be temporarily discontinued. Atropine 0.5 to 1
mg IV may be required.
To reduce potential adverse effects, patients taking a peripherally acting
apha1 antagonist should do which of the following?
a) Monitor blood pressure and skip a dose if the pressure is less than 120/80
b) Always take the medication in the morning
c) Weigh daily and report weight gain of greater that 2 pounds in one day
d) Double the dose if on is missed - CORRECT ANSWERS-c) Weigh daily and
report weight gain of greater that 2 pounds in one day
1) What is a prominent CYP enzyme in the body and what is it responsible
for?
a) CYP2A4 - Responsible for metabolism of a number of medications
b) CYP3A4 - Responsible for metabolism of a number of medications
c) CYP2A4 - Responsible for metabolism of a number of medications
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