Pharmacology Final Review-3 – Flashcards
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Sallie has been taking 10mg/day of prednisone for past 6 mths she should be assessed for
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osteoporosis
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pts who are on or who will be starting chronic corticosteroid therapy need monitoring of
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serum glucose
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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
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develop a taperin schedule to slowly wean daniel off the prednisone
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preventative therapy for a cluster HA includes
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ergotamine nightly before bed
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which of the following statements is true about chronic pain
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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
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Kasey fractured his ankle in 2 places and is asking for pain medication for his pain. appropriate 1st line medication would be
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acetaminophen with hydrocodone (Vicoin)
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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
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multiple times when prescriptions are lost with requests to refill
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Phil is starting tx with febuxostat (Uloric). education of pts starting febuxostat include
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Gout may worsen with therapy
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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
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HA reoccur when the medication wears off
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monitoring a pt on a high dose asa level includes
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all of above- salicylate level, CBC, urine pH
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tx plan for management of chronic pain should include
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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
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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
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Naproxen, aleve
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pts whose total dose of prednisone will exceed 1 gm will most likely need a second rx for
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omeprazole, PPI to prevent peptic ulcer disease
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Kirk sprained his ankle and is asking for pain medication for his mild-moderate pain. appropriate 1st line medication would be
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ibuprofen
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the chemicals that promote the spread of pain locally include
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neurokinin A
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drug resistant TB is defined as TB that is resistant to
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rifampin and isoniazid
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if an adult pt with comorbitities cannot reliably take oral abx to tx PNA, an appropriate initial tx option would be
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IV or IM ceftriaxone
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1st generation antihistamines such as loratidine (Claritin) are prescribed for seasonal allergies because they are
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less sedating than the 1st generation antihistamines
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pts with COPD require monitoring of
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Beta-2-agonist use
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Leonard is completing a 6 mth regimen to treat TB. Monitoring of a pt on TB therapy includes
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Monthly sputum cultures
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Along with rxing ABX, adults with PNA should be instructed on lifestyle modifications to improve outcomes
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adequate fluid intake
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Instructions for the use of nicotine gum include
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the gun should be "parked" in the buccal space between chewing
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in children 5-11 yrs mild-peristenet asthma symptoms occur
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at night time 3-4 x mth
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Lila is 24wks pregnant and has been dx with TB. tx regimens for pregnant pt with TB include
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pyridoxine
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Nicotine replacement therapy should not be used in which pts
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all of above
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Long acting beta agonists (LTBAs) received a black box warning from the US FDA due to
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increased risk of asthma related deaths when LTBAs are used
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pts who are at risk of fatal asthma attack are
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with a hx of requiring intubation or ICU administration for asthma
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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
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azithromycin
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when prescribing montelukast (singulair) for asthma, pts or parents of pts should be instructed
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aggression, anxiety and or suicidal thoughts may occur when taking montelukast
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if a pt wants to quit smoking nicotine replacement therapy is recommended if the pt
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smokes within 30 min of awakening in the morning
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the bronchodilator of choice for pts taking propanolol
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ipratropium
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Montelukast singulair may be rxd for
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2 yr old with moderate persistent asthma
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adults with PNA who are responding to antimicrobial therapy should show improvement in their clinical status in
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48-72hrs
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pregnant pts with astham may safely use __ throughout their pregnancy
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inhaled corticosteroids (budesonide)
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if a pt is exhibiting s/s of nicotine toxicity when using trans dermal nicotine, they should remove the patch and
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flush the area with clear water
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goals of treatment when treating TB are
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completion of recommended therapy
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Kaleb has extensively resistant TB. TX would be
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treatment with at least 2 drugs the TB is susceptible
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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
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more than twice a week and less than once a day
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pts who choose the nicotine lozenge to assist in quitting tobacco should be instructed
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use 1 lozenge every 1-2 hrs at least 9/day with max of 20/day
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Li takes theophylline for his peristent asthma and calls the office with a complaint of nausea, vomiting, HA. the best advice would be
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have him seen the same day for an assessment and theophylline level
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JOhn is a 4 week old who has been dx with chlamydial pna. appropriate tx would be
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erythromycin
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pts with COPD exacerbation may require
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systemic corticosteroid burst
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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
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schedule him for regular serum theophylline levels during his diet due to increased excretion of theophylline
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Bilal is a 5 yr old who has been dx with TB. Tx would include
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pyridoxine
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A stepwise approach to the pharmacological management of asthma is
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begins with determining the severity of asthma and assessing asthma control
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the most appropriate smoking cessation prescription for pregnant women is
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bupropion /Zyban
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the known drug interactions with the inhaled corticosteroid beclomethasone QVAR include
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none of the above
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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
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levofloxacin
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tx for mild intermittent asthma is
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short acting beta 2 agonists Albuterol as needed
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transdermal nicotine replacement patch is an effective choice in tobacco cessation because
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the patch provides a steady level of nicotine without reinforcing oral aspects of smoking
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instructions for a pt who is starting nicotine replacement therapy include
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nicotine replacement will help with the withdrawal cravings associated with quitting tobacco
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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
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ceftriaxone
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the most common bacterial pathogen in community acquired pna is
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streptococcus pneumoniae
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Harold is a 42 y/o AA with moderate persistent asthma. Which of the following asthma medications should be used cautiously if at all
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salmeterol, an inhaled long acting beta agoinist
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Samantha is 34 weeks pregnant and dx with PNA. she is stable enough to be tx as an outpt. what would appropriate abx be
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azithromycin
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Isabella has confirmed TB and is placed on a 6 mth treatment regimen. the 6 mth regimen consists of
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2 mths of 4 drug therapy (INH, rifampin, pyrazaninamide and ethambutol) followed by 4 mths of INH and rifampin
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medications used in the management of pts with COPD
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all of the above
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monitoring a pt with persistent asthma includes
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evaluating the pt every 1-6 mths to determine if the pt needs to step down in their therapy
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when educating pts who are starting on inhaled corticosteroids, the provider should include
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pts should rinse their mouths out after using the inhaled corticosteroid to prevent thrush
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if prescribing bupropion ZYBAN for tobacco cessation, the instructions to the pt include
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bupropion/zyban is started 1-2 wks before the quit date
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Verenicline (Chantix) may be rxd for tobacco cessation. instructions to the pt who us starting chantix include
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neuropsychiatric symptoms may occur
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Digoxin level need to be monitored closely when the following medication is started
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albuterol
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the 1st line drug choice for a previously healthy adult pt dx with community aquired pna is
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azithromycin
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tiotropium bromide Spiriva is an inhaled anticholinergic
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used for tx of COPD
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nicotine replacement therapy
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delays healing of esophagitis and peptic ulcers
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Infants with congenital hypothyroidism are tx with
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levothyroxine
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metformin is a primary choice of drug to treat hyperglycemia in type 2 dm pt b/c
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decreases glycogenolysis in by the liver
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hypoglycemia can result from the action of either insulin or an oral hypoglycemic. s/s of hypoglycemia include
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dizziness, confusion, diaphoresis, tachycardia
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bisphosphonates treat or prevent osteoporosis by
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inhibiting osteoclastic activity
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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
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premixed insulin analogues are better at lowering HbA1C and have less risk for hypoglycemia
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all dm pts with hyperlipidemia should be treated with
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HMG CoA reductase inhibitors
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