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pharm quiz2 ch15
Terms in this set (50)
Patients taking Antacids should be educated regarding these drugs, including:
They May Cause Constipation and diarrhea
Many Are High in Sodium
Separate antacids from other medications by 1 hour
Kelly has diarrhea and is wondering if she can take loperamide (Imodium) for teh diarrhea. Loperamide:
Slows Gastric motility and reduces fluid and electrolyte loss from diarrhea.
Bismuth Subsalicylate (Pepto Bismol) is a common OTC remedy for gastrointestinal complaints. Bismuth Subsalicylate;
May lead to toxicity if taken with aspirin
Is contraindicated in children with flu like illness
Has antimicrobial effects against bacterial and viral enteropathogens.
Hannah will be traveling to Mexico with her church over Spring Break to build houses. She is concerned she may develop traveler's diarrhea. Advice includes normal food and water precautions as well as:
Bismuth Subsalicylate with each meal and bedtime.
Josie is a 5 year old who presents to the clinic with a 48 hour history of nausea, vomiting, and some diarrhea. She is unable to keep fluids down and her weight is 4 pounds less than her last recorded weight. Besides IV Fluids, her exam warrants the use of an antinausea medication. Which of the following would be appropriate for Josie?
Jim presents with complaints of "Heart burn" that is minimally relieved with Tums and is diagnosed with GERD. An appropriate first step therapy:
Ranitidine (zantac) twice a day
Sadie is a 72 year old who takes omeprazole for her chronic GERD. Chronic long-term omeprazole use places her at increased risk for:
Patrick is a 10 year old with chronic consitpation. Along with diet changes, what medication should be prescribed for more rapid relief of constipation?
Miralax (PEG 3350)
Metoclopramide improves GERD symptoms by:
Increasing Lower Esophageal tone
Antacids treat GERD by:
Increasing gastric PH
When treating patients with the "step down" approach with GERD is started on first?
Proton Pump Inhibitor
When using the "step up" approach in caring for patients with GERD, the "Step up" from OTC antacid us is:
Histamine 2 receptor antagonist (Ranitidine) for 4-8 weeks.
When using the "Step Up" approach in caring for patients with GERD the "Step up" from once daily proton pump inhibitor us is:
Proton Pump inhibitor (Omeprazole) Twice a day for 4-8 weeks
When Using the "step up" therapy for GERD the next step up in treatment when a patient has been on proton pump inhibitor for 12 weeks is"
Referral to endoscopy
Long term use of proton pump inhibitors may lead to:
Hip Fractures in at-risk persons
An acceptable first-line treatment for peptic ulcer disease with positive H. Pylori test is:
Proton pump inhibitor BID plus Clarithromycin plus amoxicillin for 14 days.
Treatment failure in patients with PUD associated with H. Pylori may be due to:
If a patient with H. Pylori positive peptic ulcer disease fails first-line treatment the second line treatment is:
PPI BID plus metronidazole plus tetracycline plus bismuth subsalicylate for 14 days.
Henry presents to clinic with a significantly swollen painful great toe and is diagnosed with gout. Best treatment choice is:
Patient education when prescribing colchinine includes:
Colchicine always causes some degree of diarrhea
Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes
BUN, Creatinine, and Creatinine clearance
Phil is starting treatment with febusostat (Uloric). Education of patients starting febuxostat includes:
Gout may worsen with therapy
Sallie has been taking 10 mg per day of prednisone for past 6 months. She should be assessed for:
Daniel has been on 60 mg of prednisone for 10 days to treat a severe asthma exacerbation. How is the prednisone discontinued:
Develop a tapering schedule to slowly wean Daniel off the prednisone
All NSAIDs have an FDA black box warning regarding:
Potential for causing life threatening GI Bleeds.
Patients prescribed aspirin therapy require education regarding the signs of aspirin toxicity. An early sign of aspirin toxicity is:
Patients who are on long term aspirin therapy should have what drawn annually?
Sarah a 42 year old female, requests a prescription for an anorexiant to treat her obesity. A trial of phenteramine is prescribed. Prescribing precautions include:
Anorexiants may cause tolerance and should only be prescribed for 6 months.
Before prescribing phenteramine to Sarah, a thorough drug history should be taken and assessing for the use of serotonergic agents such as SSRI and St. john's wort due to:
The risk of Serotonin syndrome
Antonia is a 3 year old who has history of status epilepticus. Along with her routine antiseizure medications, she should also have a home prescription for ____ to be used for an episode of status epilepticus
Rectal Diazepam (Diastat)
Rabi is being prescribed phenytoin for seizures. Monitoring includes:
Assessing for phenytoin hypersensitivity syndrom 3-8 weeks after starting treatment
Dwayne has recently started on carbamazepine to treat seizures. He comes to see you and you note that while his carbamazepine levels had been in therapeutic range, they are now low. The possible cause for low levels include:
Carbamazepine auto-induced metabolism, leading to lower levels in spite of good compliance
Carbamazepine has a Black Box warning due to life threatening:
Dematologic reaction including Steven Johnson and toxic epidermal necrolysis.
Long term monitoring of patients who are taking carbamazepine includes:
CBC every 3-4 months
Sook has been prescribed gabapentin to treat neuropathic pain and is complaining of feeling depressed and having strange thoughts. The appropriate action would be:
Assess for suicidal ideation
Selma who is overweight, recently started taking topiramate for seizures and at her follow up visit you note she has lost 3 kg. The appropriate action would be:
Reassure her that this is a normal side effect of topiramate and continue to monitor her weight.
Monitoring of a patient on gabapentin to treat seizures includes:
Recording seizure frequency, duration and severity
Levetiracetam has known drug interaction with:
Few, if any drugs
Zainab is taking lamotrigine (Lamictal) and presents to the clinic with fever and lymphadenopathy. Initial evaluation and treatment includes
Ruling out a hypersensitivity reaction that may lead to multi-organ failure
The tricyclic antidepressants should be prescribed cautiously in patients with:
a 66 year old male is prescribed Nardil while in an acute pyschiatric unit for recalcitrant depression. The NP managing his primary health care needs to understand the following regarding phenelzine and other MAOI's:
He should not be prescribed serotonergic drugs such as Imitrex
MAOI's interact with many common foods, including yogurt, sour cream, and soy sauce
Symptoms of hypertensive crisis (HA, Tachycardia, sweating) require immediate treatment
Taylor is a 10 year old diagnosed with depression. The appropriate first line antidepressant for children is:
Suzanne is started on Paxil and SSRI for depression. Education regarding her antidepressant includes:
SSRI's may take 2-6 weeks before she will have maximum drug effects
Anticholinergic agents, such as Cogentin may be given with a phenothiazine to:
Reduce the chance of tardive dyskinesia
In choosing a benzodiazepam to treat anxiety the prescriber needs to be aware of the possibility of dependence. The Benzodiazepam with greatest likelihood of rapidly developing dependence is:
Tom is taking Lithium for bipolar disorder. He should be taught to :
Eat a diet with consistent levels of Salt.
Cynthia is taking valproate (Depakote) for seizures and would like to get pregnant. What advice would you give her?
Valproate is a known teratogen, but may be taken after the first trimester if necessary.
Kirk sprained his ankle and asking for pain medication for his mild-to-moderate pain. The appropriate first line medication would be:
Kasey fractured his ankle in two places and is asking for pain medication for his pain. The appropriate first line medication would be:
Acetaminophen with hydrocodone (Vicoden).
Monitoring for a child on methylphenidate for ADHD includes:
Routine height and weight checks
Amount of methylphenidate being used
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