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Pharmacology Final Review-3

Pts need to be questioned about all pain sites because
pts tend to report the most severe or most important in their perception
Xi is a 54 y/o female, has a hx of migraine that does not respond well to OTC migraine med. she is asking to try Maxalt because it works well for her friend. appropriate decision making decision would be
prescribe maxalt and arrange to have her observed in the clinic or urgent care with the first dose
pain assessment to determine adequacy of pain management is important for all pts. this assessment is done to
all of the above- determine if the dx of source of pain is correct, determine if the current regimen is adequate or different combos are required, determine if the pt is willing and able to be an active participant in his pain management
pts with rheumatoid arthritis who are on chronic low dose prednisone will need co treatment with which medication s to prevent further adverse effects
all of above- bisphosphonate, calcium supplement, vitamin d
Sallie has been taking 10mg/day of prednisone for past 6 mths she should be assessed for
osteoporosis
pts who are on or who will be starting chronic corticosteroid therapy need monitoring of
serum glucose
daniel has been on 60mg of prednisone for 10 days to tx a severe asthma exacerbation. it is time to d/c the prednisone, how is it d/cd
develop a taperin schedule to slowly wean daniel off the prednisone
preventative therapy for a cluster HA includes
ergotamine nightly before bed
which of the following statements is true about chronic pain
referred pain is present in a distant site for the pain source and is based on activation of the same spinal segment as the actual pain site
Kasey fractured his ankle in 2 places and is asking for pain medication for his pain. appropriate 1st line medication would be
acetaminophen with hydrocodone (Vicoin)
chemical dependency assessment is integral to the initial assessment of chronic pain. which of the following raises a red flag about the potential chemical dependency
multiple times when prescriptions are lost with requests to refill
Phil is starting tx with febuxostat (Uloric). education of pts starting febuxostat include
Gout may worsen with therapy
when prescribing any HA therapy, appropriate use of medications needs to be discussed to prevent medication overuse HA. the clinical characteristics of medication overuse HA are
HA reoccur when the medication wears off
monitoring a pt on a high dose asa level includes
all of above- salicylate level, CBC, urine pH
tx plan for management of chronic pain should include
all of above- negotiation with the pt to set personal goals for pain management, discussion of ways to improve sleep and stress, an exercise program to improve fxn and fitness
Juanita presents to clinic with c/o HA off/on for mths. reports squeezing her head and occasionally takes Tylenol for the pain but usually toughs it out. initial tx for tension HA includes asking her to keep HA diary and rx for
Naproxen, aleve
pts whose total dose of prednisone will exceed 1 gm will most likely need a second rx for
omeprazole, PPI to prevent peptic ulcer disease
Kirk sprained his ankle and is asking for pain medication for his mild-moderate pain. appropriate 1st line medication would be
ibuprofen
the chemicals that promote the spread of pain locally include
neurokinin A
drug resistant TB is defined as TB that is resistant to
rifampin and isoniazid
if an adult pt with comorbitities cannot reliably take oral abx to tx PNA, an appropriate initial tx option would be
IV or IM ceftriaxone
1st generation antihistamines such as loratidine (Claritin) are prescribed for seasonal allergies because they are
less sedating than the 1st generation antihistamines
pts with COPD require monitoring of
Beta-2-agonist use
Leonard is completing a 6 mth regimen to treat TB. Monitoring of a pt on TB therapy includes
Monthly sputum cultures
Along with rxing ABX, adults with PNA should be instructed on lifestyle modifications to improve outcomes
adequate fluid intake
Instructions for the use of nicotine gum include
the gun should be “parked” in the buccal space between chewing
in children 5-11 yrs mild-peristenet asthma symptoms occur
at night time 3-4 x mth
Lila is 24wks pregnant and has been dx with TB. tx regimens for pregnant pt with TB include
pyridoxine
Nicotine replacement therapy should not be used in which pts
all of above
Long acting beta agonists (LTBAs) received a black box warning from the US FDA due to
increased risk of asthma related deaths when LTBAs are used
pts who are at risk of fatal asthma attack are
with a hx of requiring intubation or ICU administration for asthma
Giselle is a 14 yr old who presents to clinic with s/s consistent with mycoplasma pna. what is the tx for suspected mycoplasma pna in an adolescent
azithromycin
when prescribing montelukast (singulair) for asthma, pts or parents of pts should be instructed
aggression, anxiety and or suicidal thoughts may occur when taking montelukast
if a pt wants to quit smoking nicotine replacement therapy is recommended if the pt
smokes within 30 min of awakening in the morning
the bronchodilator of choice for pts taking propanolol
ipratropium
Montelukast singulair may be rxd for
2 yr old with moderate persistent asthma
adults with PNA who are responding to antimicrobial therapy should show improvement in their clinical status in
48-72hrs
pregnant pts with astham may safely use __ throughout their pregnancy
inhaled corticosteroids (budesonide)
if a pt is exhibiting s/s of nicotine toxicity when using trans dermal nicotine, they should remove the patch and
flush the area with clear water
goals of treatment when treating TB are
completion of recommended therapy
Kaleb has extensively resistant TB. TX would be
treatment with at least 2 drugs the TB is susceptible
prior to developing a plan for the tx of asthma, the pts asthma should be classified to the NHLBI panel guidelines. in adults, mild-persitant asthma is classified as asthma s/s that occur
more than twice a week and less than once a day
pts who choose the nicotine lozenge to assist in quitting tobacco should be instructed
use 1 lozenge every 1-2 hrs at least 9/day with max of 20/day
Li takes theophylline for his peristent asthma and calls the office with a complaint of nausea, vomiting, HA. the best advice would be
have him seen the same day for an assessment and theophylline level
JOhn is a 4 week old who has been dx with chlamydial pna. appropriate tx would be
erythromycin
pts with COPD exacerbation may require
systemic corticosteroid burst
james is a 52 yr old overweight smoker taking theophylline for his persistent asthma. he tells his provider is is going to start the atkins diet. appropriate response would be
schedule him for regular serum theophylline levels during his diet due to increased excretion of theophylline
Bilal is a 5 yr old who has been dx with TB. Tx would include
pyridoxine
A stepwise approach to the pharmacological management of asthma is
begins with determining the severity of asthma and assessing asthma control
the most appropriate smoking cessation prescription for pregnant women is
bupropion /Zyban
the known drug interactions with the inhaled corticosteroid beclomethasone QVAR include
none of the above
1st line abx choice for a pt with comorbidities or who is immunosuppresed who has pna and can be treated as an outpt would be
levofloxacin
tx for mild intermittent asthma is
short acting beta 2 agonists Albuterol as needed
transdermal nicotine replacement patch is an effective choice in tobacco cessation because
the patch provides a steady level of nicotine without reinforcing oral aspects of smoking
instructions for a pt who is starting nicotine replacement therapy include
nicotine replacement will help with the withdrawal cravings associated with quitting tobacco
Wing-Sing is a 4 yr old who has suspected bacterial pna. he has a temp of 102, o2 sat 95%, and is taking fluids adequately. what is the initial tx for pna
ceftriaxone
the most common bacterial pathogen in community acquired pna is
streptococcus pneumoniae
Harold is a 42 y/o AA with moderate persistent asthma. Which of the following asthma medications should be used cautiously if at all
salmeterol, an inhaled long acting beta agoinist
Samantha is 34 weeks pregnant and dx with PNA. she is stable enough to be tx as an outpt. what would appropriate abx be
azithromycin
Isabella has confirmed TB and is placed on a 6 mth treatment regimen. the 6 mth regimen consists of
2 mths of 4 drug therapy (INH, rifampin, pyrazaninamide and ethambutol) followed by 4 mths of INH and rifampin
medications used in the management of pts with COPD
all of the above
monitoring a pt with persistent asthma includes
evaluating the pt every 1-6 mths to determine if the pt needs to step down in their therapy
when educating pts who are starting on inhaled corticosteroids, the provider should include
pts should rinse their mouths out after using the inhaled corticosteroid to prevent thrush
if prescribing bupropion ZYBAN for tobacco cessation, the instructions to the pt include
bupropion/zyban is started 1-2 wks before the quit date
Verenicline (Chantix) may be rxd for tobacco cessation. instructions to the pt who us starting chantix include
neuropsychiatric symptoms may occur
Digoxin level need to be monitored closely when the following medication is started
albuterol
the 1st line drug choice for a previously healthy adult pt dx with community aquired pna is
azithromycin
tiotropium bromide Spiriva is an inhaled anticholinergic
used for tx of COPD
nicotine replacement therapy
delays healing of esophagitis and peptic ulcers
Infants with congenital hypothyroidism are tx with
levothyroxine
metformin is a primary choice of drug to treat hyperglycemia in type 2 dm pt b/c
decreases glycogenolysis in by the liver
hypoglycemia can result from the action of either insulin or an oral hypoglycemic. s/s of hypoglycemia include
dizziness, confusion, diaphoresis, tachycardia
bisphosphonates treat or prevent osteoporosis by
inhibiting osteoclastic activity
when bld glucose levels are difficult to control in DM2, some form of insulin may be added to tx regimen to control blood glucose and limit complications, which following statements are accurate based on research
premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia
all dm pts with hyperlipidemia should be treated with
HMG CoA reductase inhibitors

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