NR565 FINAL EXAM/NR 565 ADVANCED PHARMACOLOGY
CARE OF THE FUNDAMENTALS EXAM 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 – ANSWER6-8 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)
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: – ANSWERPermanent 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 – ANSWERBeclomethasone dipropionate (QVAR), Budesonide (Pulmicort),
Ciclesonide (Alvesco), Flunisolide (Aerospan), fluticasone propionate
(Flovent), Mometasone furoate (asmanex).
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.
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