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Pharmacology Final Review-2

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which of the following is a primary benefit of the use of computerized physician order entry (CPOE) for patient medications
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decreases prescribing and transcription errors
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incorporating IT into a patient encounter takes skill and tact. durign the encounter, the provider can make the pt more comfortable with the IT the provider is using by
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both A and B-turning the screen around so the patient can see material being recorded
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actions taken to reduce drug-drug interaction problems include all of the following except
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prescribing a 3rd drug to counteract the adverse reaction of the combination
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Sarah developed a rash after using a topical medication. this is a type__ allergic drug reaction
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IV
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cost effectiveness analysis compares 2 or more tx or programs that are
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not necessarily therapeutically equivalent
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herbs and supplements are regulated by the Food and Drug administration
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false
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drug antagonism is best defined as an effect of a drug that
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is modified by the concurrent administration of another drug
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which of the following patients would be at higher risk of experiencing adverse drug reactions
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3 month old female
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the 1st step in the prescribing process according to the world health organizations is
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diagnosing the patient’s problem
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pharmacogenetic testing is required by the FDA prior to prescribing
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cetuximab
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drugs that are receptor agonists may demonstrate what property
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desensitization or down regulation with continuous use
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which of the following statements about bioavailability are true
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bioavailability issues are especially important for drugs with narrow therapeutic ranges or sustained release mechanisms
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a potential harmful effect to patients who take some herbal medication is
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lead poisoning
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pharmacokinetic factors that affect prescribing include
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bioavailability
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a provider may consider testing for cyp2d6 variants prior to starting tamoxifen for breast cancer
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reduce the likelihood of therapeutic failure with tamoxifen treatment
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the role of the NP in the use of herbal medication is to
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educate patients and guide them to appropriate sources of care
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the point in time on the drug concentration curve that indicates the first sign of a therapeutic effect is the
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onset of action
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david presents to the clinic with symptoms of allergic conjunctivitis. he is rxd cromolyn sodium (opticrom) eye drops. education regarding cromolyn eye drops includes
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he should not wear his soft contacts while using the cromolyn eye drops
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the pediatric research equity act requires
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all applications for new active ingredients, new indications, new dosage forms, or new routes of administration require pediatric studies
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influenza vaccine may be administered annually to
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pregnant patients
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if a patient is allergic to sulfonamide antibiotics he or she will most likely have cross sensitivity to
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all of the above-loop diuretics, sulfonylureas, thiazide diuretics
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there is often cross sensitivity and cross resistance between penicillins and cephalosporins due to
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both drug classes contain a beta lactam ring that is vulnerable to beta lactamase producing organisms
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Liza is breastfeeding her 2 mth old son and has an infection that requires an abx. what drug factors influence the effect of the drug on the infant
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all of above-maternal drug levels, half-life, lipid solubility
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monitoring for patients who are on long term antifungal therapy with ketoconazole includes
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AST, ALT, alkaline phosphatase, and bilirubin
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drugs that are absolutely contraindicated in lactating women include
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antineoplastic drugs such as methotrexate
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tuberculin purified protein derivative PPD
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may be administered the same day as the MMR and or varicella vaccine
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attenuated vaccines are also known as
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live vaccines
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developmental variation in renal fxn has what impact on rxing for infants and children
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lower doses of renally excreted drugs may be prescribed to infants younger than 6 mths
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Lauren is a 13yr old who comes to clinic with a 4 day history of cough, low grade fever, and rhinorrhea. when she blows her nose or cough the mucous is greenish yellow. the appropriate abx to prescribe would be
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none
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patients who are taking antiretroviral ART need to have the following monitored
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lipid levels
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to prevent the development of peripheral neuropathy in patients taking isonizid for TB, the pt is also prescribed
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pyridoxine(Vitamin B 6)
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the centers for disease control recommends all newborn infants receive prophylactic administration of __ within 1 hr of birth
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erythromycin opthalmic ointment
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Janie presents to clinic with hard ear wax in both ear canals. instructions regarding home removal of hard cerumen includes
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instill carbamide peroxide (Debrox) twice daily until canals are clear
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resistance to antiretroviral ART therapy is measured by
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determining plasma viral RNA on two successive measurements
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predictors for successful treatment with antiretroviral therapy in HIV positive patients includes
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the patient is strictly adherent to ART regimen
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at which stage/classification of htn should drug therapy be instituted according to JNC-7 report
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stage 1
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if not chosen as the first drug in htn tx, which drug class should be added as second step becuase it will enhance the effects of most other agents
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diuretics
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because of its action on various body systems, the patient taking a thiazide or loop diuretic may also need to receive
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potassium supplements
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in teaching about the use of sublingual nitroglycerine, the patient should be instructed
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to place on tablet under the tongue if chest pain occurs and allow it to dissolve
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despite good blood pressure control, a NP might change a patient’s drug from an ACEI to an angiotensin II receptor blocker ARB because the ARB
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does not produce a dry hacky cough
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felicity has been prescribed colesipol to tx her hyperlipidemia. unlike other antilipidemics, this drug
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exchanges chloride ions for negatively charged acids in the bowel
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furosemide is added to a tx regimen for heart failure which includes digoxin. monitoring for this combination includes
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serum potassium
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Jacob has htn for which a calcium channel blocker has been prescribed. this drug helps control blood pressure because it
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decreases the amount of calcium inside the cell
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the NP orders a thyroid panel for a pt on amiodarone. the pt tells the NP that he does not have thyroid disease and wants to know why the test is ordered. which is the correct response
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amiodarone inhibits an enzyme that is important in making thyroid hormone and cause hypothroidism
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increased life expectancy for pts with heart failure has been associated with the use of
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ace inhibitors, especially when started early in the disease process
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when considering which cholesterol lowering drug to prescribe which factor determines the type and intensity of treatment
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coronary artery disease risk level
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janice has elevated LDL, VLDL, and trigyceride levels. Niaspan an extended relsease form of niacin is chosen to treat her hyperlidemia. due to its metabolism and excretion, which of the following labs should be monitored
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serum creatinine
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while taking an ARB, pts need to avoid certain OTC meds without first consulting the provider because
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both A and B-cimetidine is metabolized by the CYP3A4 isoenzymes and non steroidal anti inflammatory drugs reduce prostaglandin levels
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when starting a pt on a statin, education would include
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all of above-if they stop med, their lipid levels will return to pretreatment, medication is a supplement to diet therapy and exercise, if they have any muscle aches or pain, they should contact their provider
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angina is produced by an imbalance b/t o2 supply and demand in myocardium. which of the following drugs help to correct this imbalnce by increasing MOS
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ACE inhibitor
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which of the following drugs has been associated with increased risk for MI in women
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estrogen replacement
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TX for heart failure including drug therapy are based on the stages developed by the ACC/AHA. stage A pts are tx with
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drugs for hypertension and hyperlipidemia if they exist
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monitoring of a pt who is on a lipid lowering drug includes
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lipid profile with attention to serum LDL, 6-8 wks after starting therapy then again in 6 wks
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to reduce mortality all pts with angina regardless of class, should be on
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aspirin 81-325mg/d
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which of the following is true about procainamide and its dosing schedule
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dose of this drug should be taken evenly spaced around the clock to keep an even blood level
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serum digoxin level are monitored for potential toxicity, monitoring should occur
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because a reference point is needed in adjusting a dose
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dulcea has type 2 DM and high tricglycerides. she has gemfibrozil prescribed to tx her hypertriglycerideemia. A hx of the following might contraindicate the use of the drug
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gall bladder disease
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pts how have angina, regardless of class, who are also diabetic should be on
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ACE inhibitors
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art is a 55y/o smoker who has been dx with angina and placed on nitrates. he c/o HA after using nitrate. appropriate reply would be
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“Headaches are common side effects with these drugs. how severe are they?”
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Pt teaching r/t amplopidine includes
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avoid grapefruit juice as it affects the metabolism of this drug
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the choice of diuretic use in tx htn is based on
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level of kidney fxn with a thiazide diuretic being used for an estimated glomerular filtration rate higher than the mid 40 range
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some research supports that testosterone replacement therapy may be indicated in which of the following dx in men
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all of above- age related decrease in cognitive fxn, metabolic syndrome, decreased muscle mass in aging men
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while on testosterone replacement, H/H levels should be monitored. levels suggestive of excessive erythorcytosis or abuse are
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hemoglobin 17.5g/dl or hematocrit 54%
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when treating suspected gonorrhea in a non-pregnant pt, the pt should be concurrently tx for chlamydia with
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azithromycin 1 gm PO x1
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the goal of testosterone replacement therapy is
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testosterone levels in the mid-normal range in 1 week after an injection
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when rxing phosphodiesterase type 5 (PDE-5) inhibitors such as sildenafil, viagra, pts should be screened for use of
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nitrates
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ongoing monitoring is essential after tx for gonorrhea. the pt should be rescreened for gonorrhea and chlamydia in
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3-6 mths
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monitoring of an older male pt on testosterone replacement therapy includes
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digital rectal prostate screening exam at 3 and 6 mths after starting therapy
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men who are rxd PDE-5 inhibitors for erectile dysfunction should be educated regarding the adverse effects of the drug which include
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hearing loss
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the choice of diuretic use in tx htn is based on
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level of kidney funciton with a thiazide diuretic being used for an estimated glomerular filtration rate higher that the mid 40 range
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male pts who should not be rxd PDE-5 inhibitors include
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those who have had an acute myocardial infarction in the past 6 mths
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Sophie presents to the clinic with a malodorous vaginal discharge and is confirmed to have trichomonas infections. tx for her would include
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metronidazole 2 gm PO x 1 dose
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monitoring of male pts who are using PDE-5 inhibitors includes
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blood pressure
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Helima presents with a c/o vaginal discharge that when tested meets the criteria for bacterial vaginosis. tx of bacterial vaginosis in a non-pregnant symptomatic women would be
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metronidazole 500mg PO BID x 7days
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A test of cure is recommended after tx chlamydia in which pt population
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pregnant patients