NR565 FINAL EXAM/NR 565 ADVANCED PHARMACOLOGY
CARE OF THE FUNDAMENTALS E XAM 2023-2024 ACTUAL
EXAM 200 QUESTIONS AND CORRECT DETAILED
ANSWERS||AGRADE
What labs are used to diagnose hypo/hyper thyroid? - ANSWER- TSH, T3, and T4. High TSH = hypo and low TSH = hyper. Opposites.
Timeframe for re-check of labs after starting levothyroxine - ANSWER- 6-8 weeks (long half-life). Yearly after stable.
Signs and symptoms of hypothyroidism - ANSWER- Dry hair, puffy face, goiter in the neck, slow heartbeat, weight gain, constipation, infertility, increased risk of miscarriages, irregular menstrual cycle, cold intolerance.
Drug of choice for hypothyroidism - ANSWER- Levothyroxine (Synthroid)
§ Signs and symptoms of hyperthyroidism - ANSWER- Hair loss, bulging eyes, goiter, rapid heartbeat, weight loss, diarrhea, menstrual periods loss often or longer.
Drug of choice for hyperthyroidism - ANSWER- Methimazole (Tapazole)
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Treatment of thyroid storm - ANSWER- high doses of potassium iodide or strong iodine solution are given to suppress thyroid hormone release.Methimazole is given to suppress thyroid hormone synthesis. Beta blocker given to reduce HR. additional measures include sedation, cooling, and giving glucocorticoids and IV fluids.
Result of not treating hypothyroidism during pregnancy: - ANSWER-
Permanent neuro-psychological deficits in the child. Decrease IQ/neuropsychological function. First trimester.
Symptoms associated with severe-persistent asthma frequency - ANSWER- Several times a day
SABA drug class examples - ANSWER- Albuterol (proair, ventolin, Proventil), levalbuterol (Xopenex).
LABA drug class examples - ANSWER- Aclidinium bromide, arformoterol (brovana), formoterol, indacaterol, olodaterol, salemetrol.
ICS (Inhaled corticosteroids) drug class examples - ANSWER- Beclomethasone dipropionate (QVAR), Budesonide (Pulmicort), Ciclesonide (Alvesco), Flunisolide (Aerospan), fluticasone propionate (Flovent), Mometasone furoate (asmanex).
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SABA Benefits of use - ANSWER- Used PRN for prophylaxis of exercise-induced bronchospasm and to relieve ongoing asthma attacks and COPD exacerbations.
Patient instructions for SABA - ANSWER- Proper use/technique of inhaler.Consider spacer in difficulty with hand-breath coordination.Patients keep a record of symptom frequency, intensity, nighttime awakenings, effect on normal activity, and SABA use.Report CP or changes in rhythm.When two inhalations are needed, an interval of at least 1 minute should elapse between inhalations.Warn against exceeding recommended doses.
Why is it important to know the frequency a patient is using their SABA? - ANSWER- SABA use is a marker of inadequate asthma control
LABA (long acting beta2-agonists) - ANSWER- Should be taken on a fixed schedule, not PRN and always in combination with an inhaler glucocorticoid.
Examples of LABA - ANSWER- Aclidinium bromide, arformoterol, formoterol, indacaterol, olodaterol, salmeterol.
Benefits of use - LABA - ANSWER- Maintenance therapy.
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Use in COPD - LABA - ANSWER- May be used alone in patients with COPD. Drug therapy is minimal and limited to a small improvement in symptoms.
Inhaled ICS examples - ANSWER- Beclomethasone dipropionate, Budesonide, Ciclesonide, Flunisolide, Fluticasone proprionate, Mometasone furonate.
Benefits of use - ICS - ANSWER- Suppresses inflammation, reduce bronchial hyperreactivity and decrease airway mucus production.
At what point would an oral steroid be prescribed? - ANSWER- Patients with moderate to severe persistent asthma or for management of acute exacerbations of asthma or COPD. Only prescribed when symptoms cannot be controlled with safer meds (inhaler glucocorticoids, inhaled B2 agonists).
When would roflumilast be indicated for a COPD patient? (PDE4 inhibitor) - ANSWER- Severe cases of COPD with a primary component of chronic bronchitis. COPD exacerbations.
Smoking cessation - what works best? - ANSWER- one drug and counseling work best together. Chantix most effective (cardiovascular risk).
Nicotine replacement s/e - ANSWER- local irritation where the substance enters the body
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