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Pharmacology ATI Test: The Endocrine System

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When talking with a patient who is about to begin exenatide (Byetta) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions? (Select all that apply)
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*1. Inject the drug subcutaneously* inject exenatide (incretin mimetic) into subcutaneous tissue of the thigh, upper arm, or abdomen *2.Expect the peak effect in two hours* peak 2 hr; half life 2.4 hrs *3. Use the drug as a supplement to an oral hypoglycemic* exenatide supplements the action of an oral hypoglycemic, such as a sulfonylurea or metformin (Glucophage)
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A health care professional administers pramlintide (Symlin) at 0800 to a patient who has type 1 diabetes mellitus. At which of the following times should the patient expect the drug to exert its peak action?
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0820 amylin mimetic’s peak 20 min after administration. HCP should monitor for hypoglycemia (like tremors and diaphoresis)
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A patient who is taking propylthiouracil (PTU) contacts the health care professional to report weight gain, drowsiness, and depression. The health care professional should suspect which of the following adverse reactions to the propylthiouracil?
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*Hypothyroidism* propylthiouracil (antithyroid drug) can cause hypothyroidism, manifesting as drowsiness, weight gain, edema, and bradycardia. HCP should rx a lower dose
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When talking with a patient who is about to begin repaglinide (Prandin) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions?
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*Do not drink more than 1 L of grapefruit juice per day* the grapefruit juice will incrase the hypoglycemic effects of repaglinide, a meglitinide
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A health care professional is caring for a patient who is about to begin taking pioglitazone (Actos) to treat type 2 diabetes mellitus. The health care professional should explain to the patient the need to monitor which of the following laboratory tests? (Select all that apply)
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*1. Alanine aminotransferase (ALT)* pioglitazone can cause liver injury. monitor ALT at the start of therapy and Q 3 to 6 mo thereafter. Report jaundice, dark-colored urine, or abdominal pain *2. LDL* can cause elevations in both high-density lipoproteins aka HDLs (beneficial effect) and LDL (detrimental effect). Monitor lipid levels at baseline and periodically thereafter throughout drug therapy
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When considering replacement therapy options for a patient who has chronic adrenocortical insufficiency, the primary care provider should chose which of the following drugs?
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Hydrocortisone (Cortef) hydrocortisone (glucocorticoid) provides replacement therapy for acute and chronic adrenocortical insufficiency, such as Addison’s disease. Hydrocortisone is identical to cortisol (the primary glucocorticoid the adrenal cortex generates).
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A health care professional is caring for a patient who is taking repaglinide (Prandin) 15 to 30 minutes before each meal to treat type 2 diabetes mellitus. The patient asks the health care professional what to do if he skips a meal. Which of the following is the appropriate response?
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Skip the dose to avoid sudden and serious drop in blood glucose level. Skip a dose when you skip a meal but try to avoid skipping meals
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Which of the following drugs should a health care professional have available for a patient who is experiencing an insulin overdose?
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Glucagon (GlucaGen) Give subcutaneous, IM, or IV. Tx hypoglycemia from insulin OD in patients who are unconcious, and for whom IV glucose is not readily avaliable. If no response, administer glucose solution IV
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A patient who is taking metformin (Glucophage) to treat type 2 diabetes mellitus plans to undergo angiography using iodine-containing contrast dye. The health care professional should recognize that an interaction between metformin and the IV contrast dye can increase the patient’s risk for which of the following?
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Acute renal failure interaction causes acute renal failure and lactic acid acidosis. withhold metformin for 48 hr prior to the procedure SE to look for: reduced UO, hyperventilation, and abdominal pain
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A health care professional is caring for a patient who is about to begin taking propylthiouracil (PTU) to treat hyperthyroidism. The health care professional should tell the patient to report which of the following adverse effects? (Select all that apply)
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*1. Sore throat* can cause agranulocytosis (low WBC count, causing increased susceptability to disease) *2. Muscle pain* can cause arthralgia (joint pain) and myalgia (muscle pain). Report these SE and take OTC analgesic *3. Bradycardia* can cause hypothyroidism manifesting as bradycardia, drowsiness, and weight gain. Report these SE *4. Rash* can cause urticaria (hives) or skin rash- Report these SE
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When talking with a patient about taking fludrocortisone to treat adrenocortical insufficiency, the health care professional should tell the patient to do which of the following to reduce the risk of adverse reactions? (Select all that apply)
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*1. Weigh yourself daily* can cause fluid and electrolyte imbalances *2. Report weakness or palpitations* can cause hypokalemia- monitor K levels and report muscle weakness or palpitations *3. Have your blood pressure checked regularly* can cause fluid retention and hypertension- monitor fluid balance and BP to expedite any essential interventions
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A health care professional is caring for a patient who is about to begin taking radioactive iodine-131 (Iodotype) to treat Grave’s disease. Which of the following instructions should the health care professional include when talking with the patient about this drug?
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*Expect full effects in 2 to 3 months* successful Tx: hypothyroidism can result
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A patient who is taking glipizide (Glucotrol) to treat type 2 diabetes mellitus contacts the health care professional to report feeling shaky, hungry, and fatigued. The health care professional should tell the patient to do which of the following?
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Perform a fingerstick blood glucose check can cause hypoglycemia, manifesting as diaphoresis, shakiness, hunger, and fatigue. Tell pt to check blood glucose level, and if it indicates hypoglycemia, consume a snack of 15 to 20 g of carbs. Retest in 15 to 20 min later and repeat if blood glucose is still low
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A primary care provider should prescribe a lower dose of sitagliptin (januvia) for a patient who has type 2 diabetes mellitus and who also has which of the following?
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Renal impairment the kidney;s eliminate the drug virtually intact so caution in pt.’s with renal dysfunction and low creatine. HCP should rx a lower dose or a different hypoglycemic drug
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When talking to a patient who is about to begin glipizide (Glucotrol) therapy to treat type 2 diabetes mellitus, the health care professional should include which of the following instructions?
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Avoid drinking alcohol the two drugs taken together will produce a reaction similar to antabuse manifesting nausea, palpitations, and flushing. Etoh will also increase the drug’s hypoglycemic effects
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A patient who is taking metformin (Glucophage) to treat type 2 diabetes mellitus contacts the health care professional to report muscle pain. The health care professional should suspect which of the following adverse reactions?
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Lactic acidosis this is a life threatening complication menifesting as muscle aches, sleepiness, malaise (general feeling of discomfort, illness, or uneasiness), and hyperventilation. Stop drug and seek medical attention immediately.
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A health care professional is caring for a patient who is about to begin taking somatropin (Genotropin). The health care professional should explain the need to monitor which of the following laboratory tests? (Select all that apply)
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*1. Urine calcium* can cause hypercalciuria- tell pt to report flank pain, urinary frequency, or hematuria *2. Blood glucose* can cause hyperglycemia. Tell pt to report polyphagia (excessive or increased hunger), polydipsia (excessive thirst, often accompanies by temporary or prolonged dry mouth), and polyuria (abnormally large volumes of dilute urine)
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A health care professional is caring for a patient who is about to begin acarbose (Precose) therapy to treat type 2 diabetes mellitus. Which of the following instructions should the health care professional include when talking with the patient about the drug?
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Eat more iron rich foods acarbose can cause iron-deficiency enemia. Iron rich foods: meat, spinach, grains Monitor CBC
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A health care professional is caring for a patient who is taking pioglitazone (Actos) to treat type 2 diabetes mellitus. The health care professional should monitor for which of the following findings that indicates an adverse effect?
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Weight gain can cause fluid retention or Hf. SE include: dyspnea, crackles, and wheezing
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A health care professional is caring for a patient who is about to begin insulin glargine (Lantus) therapy. The health care professional should recognize the need for additional precautions because the patient also takes which of the following types of drugs?
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Beta blockers insulin and beta blocker combined increases a person’s risk for not noticing s/s of hypoglycemia becuase they mask s/s like tachycardia and tremors. They also increase hypoglycemic effects
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To determine the effectiveness of desmopressin (DDAVP), a health care professional should monitor a patient’s
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Urine output Tx diabetes insipidus. Monitor: I/Os, urine, serum osmolarity, and BP
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A health care professional is caring for a patient who is about to begin pramlintide (Symlin) therapy to treat type 1 diabetes mellitus. Which of the following instructions should the health care professional include when talking with the patient about using the drug?
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Inject pramlintide before meals inject pramlintide (amylin mimetic) 20 min before a meal that contains at least 30 g of carbohydrates
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A health care professional is talking to a patient about self-injecting Regular insulin (Humulin). The health care professional should tell the patient to rotate injection sites to prevent which of the following?
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Lipohypertrophy also called lipodystrophy, is a proliferation of fat at the sites of repeated insulin injections. It affects skin sensitivity and appearance. To prevent it, the patient should rotate sites, keeping them at least 1 inch apart, and avoid using the same spot within the same month
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A health care professional is caring for a patient who is about to begin levothyroxine (Synthroid) therapy to treat hypothyroidism. Which of the following instructions should the health care professional include when talking with the patient about taking the drug?
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Expect life-long therapy with the drug due to no other therapies available to restore thyroid function
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A health care professional should question the use of levothyroxine (Synthroid) for a patient who has
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A myocardial infarction levothyroxine, a thyroid replacement hormone, can cause tachycardia, palpitations, and hypertension, especially when the patient requires a dosage adjustment; therefore, it is contradicted for patients who have recently had an MI