Advanced Pharm Exam 3 Instructions

Advanced Pharm Exam 3 Instructions

Advanced Pharm Exam 3 Instructions

Instructions from Instructor:  

I have broken down Exam 3 by module and topic. I have also included the beginning of each question to give an idea of question format.

Instructions for Completion: (me lol)

  • Provide a short, clear and concise response to the following questions
  • Answer should only be 1-2 sentences
    • Only need the sentence completed (may be one word or a full sentence to compl)
  • Instructor gave us 1st part of question & we have to find the info to finish the question
  • PP attached should be sufficient to answer questions, but text reference is also below just in case
  • Does not need a title page, running head, “does not need to be in APA format 
  • It needs to “clearly” address “each” the question
  • Due by July 9th @ 11pm Central/Standard time
  • Thanks! 😊

Diabetes Mellitus (Module 10)

  1. A patient who is prescribed an α-glucosidase inhibitor
  2. A patient with diabetes mellitus has hypertension. In
  3. A patient with type 1 diabetes mellitus takes 2/3 of the
  4. A patient with type 1 diabetes will have insulin switched
  5. A patient with type 2 diabetes also has cardiac problems
  6. A patient with type 2 diabetes who has little income to
  7. For the patient who will take Novolin R (regular insulin)
  8. For the patient with type 2 diabetes who is overweight
  9. The nurse practitioner (NP) plans to prescribe the biguanide
  10. The nurse practitioner plans to initiate combined therapy
  11. The nurse practitioner plans to prescribe medication to manage
  12. The nurse practitioner wants to prescribe a drug that increases
  13. A patient with type 2 diabetes self-injects insulin. What should

Hematology (Module 9)

  1. A patient who receives anticoagulation therapy has an INR
  2. Epoetin alfa (Epogen), a hematopoietic growth factor, is
  3. The nurse practitioner identifies that recombinant epoetin
  4. The nurse practitioner (NP) notes an elevation in reticulocytes
  5. The hospitalized patient who receives anticoagulation with
  6. The patient has several risk factors for a stroke. There is no
  7. The patient in her first trimester of pregnancy has a history
  8. The nurse practitioner will prescribe iron supplements as

Oncology (Module 9)

  1. The medication list of the newly admitted patient with cancer
  2. The patient with cancer receives doxorubicin (Adriamycin), an

Thyroid (Module 10)

  1. The patient with a history of angina has a new diagnosis
  2. The patient with hyperthyroidism is prescribed the anti-thyroid

Gastrointestinal (GI) (Module 11)

  1. A patient who develops a dystonic reaction takes medication
  2. An older patient with chronic constipation drinks about four
  3. For the client who has gastric reflux, an over the counter drug
  4. The pregnant patient requests medication for nausea and
  5. Why does the nurse practitioner prescribe the colloidal product
  6. The nurse practitioner (NP) will prescribe the prostaglandin
  7. When selecting a drug to manage a man’s gastroesophageal
  8. The nurse practitioner (NP) prescribes the proton pump inhibitor
  9. The nurse practitioner (NP) will advise the pregnant woman to
  10. When providing patient education, the nurse practitioner will

Genitourinary (GU) (Module 12)

  1. The nurse practitioner (NP) determines that a patient has urge
  2. The nurse practitioner (NP) determines that a patient has over-

Reproductive (Module 12)

  1. The patient at a health center requests oral contraception. Which
  2. The nurse practitioner (NP) must include information regarding
  3. The androgen hormone inhibitor finasteride may be used to
  4. The nurse practitioner (NP) recognizes that use of the estrogen
  5. When prescribing hormone therapy for a woman who has not
  6. For the patient with a history of migraine headache without
  7. The nurse practitioner (NP) coordinates care for a patient who
  8. The nurse practitioner (NP) recognizes that progestin-only
  9. What will the nurse practitioner (NP) prescribe for the patient
  10. A patient with severe vasomotor symptoms related to early
  11. A patient with sickle cell anemia requests birth control advice
  12. The nurse practitioner (NP) considers prescribing the phospho-

Endocrine (Module 12)

  1. An athlete asks about adverse effects of anabolic steroids.

Modules:

Module 9: Pharmacologic Management of Hematologic Disorders and Cancer

  • Cancer Chemotherapy Case Study
  • NOTE:
    • Textbook Error: The book lists Xarelto under the antiplatelet section in the table on page 418. It is not an antiplatelet drug. It is an anticoagulant, as mentioned on page 416.
    • Textbook Error: In Chapter 18, page 423, 2nd paragraph, the book reads, “Inhibitors of CYP 1A2, 2C9, or 3A4 isoenzymes increase the effect of warfarin. Inhibitors of CYP 1A2,2C9, or 3A4 decrease the effectiveness of warfarin.” It should read, “Inhibitors of CYP 1A2, 2C9, or 3A4 isoenzymes increase the effect of warfarin. Inducers of CYP 1A2,2C9, or 3A4 decrease the effectiveness of warfarin.”
    • Update: Your textbooks says that there is no antidote for dabigatran (Pradaxa) overdose. The FDA approved idarucizumab (Praxabind) in October, 2015.
    • Textbook Omission: There is some important information about dabigatran that your textbook fails to mention. Because it disintegrates rapidly, patients should be notified to:
    • Keep it in the specially designed bottle. It has specialized diskette to inhibit disintegration.
    • Do not put the tables in a pillbox or medication organizer. (Suggest that they put an M&M or other small candy in the organizer as a reminder to take pradaxa.)
    • Discard tablets 120 days after opening. (If prescribed appropriately and if taken as prescribed, this should not be a problem.)

Module 10: Pharmacologic Management of Endocrine Disorders

  • Chapter 21 – Drugs Affecting the Endocrine System – omit bisphosphonates and exocrine pancreatic enzymes
  • Chapter 33 – Diabetes Mellitus
  • Chapter 41 – Hyperthyroidism and Hypothyroidism
  • Attached Files:
  • Additional readings:
  • Each year in January, the American Diabetes Association releases new guidelines. In the Standards of Care for Diabetes – 2020, section 9 Pharmacologic Approaches to Glycemic Treatment  at  https://care.diabetesjournals.org/content/diacare/43/Supplement_1/S98.full.pdf please read the sections on Noninsulin Treatment for Type 1 Diabetes and Pharmacologic Therapy for Type 2 Diabetes. Both are on page S101. 
    • Not attached, see link
  • Textbook Error: In Chapter 33 page 998 it says, “Insulin production is necessary for metformin to be effective.” Insulin does not have to be produced by beta cells; it can be provided from an exogenous source. Although metformin does not currently have FDA approval for management of type 1 DM, it has been used in research for management of type 1 DM. You can read about this in the ADA guidelines for DM management. 
  • Update: First-generation sulfonylureas have been discontinued in the U.S.
  • Side note: An important item that I am not finding in your readings is this: Sulfonylureas lose their effectiveness over time. After 10 years of therapy, only 50% of patient who responded well initially will have adequate glycemic control. For a large number of patients, this decline in efficacy occurs much sooner. 
  • A Note:  On page 998 in your text, 2nd paragraph under Biguanides, reads, “Insulin production is necessary for metformin to be effective” which is sort of correct; however, when exogenous insulin is given, this is no longer true. Although metformin does not currently have FDA approval for management of type 1 DM, it has been used in research for management of type 1 DM. 

Module 11: Pharmacologic Management of Gastrointestinal Disorders

Module 12: Pharmacologic Management of Genitourinary Disorders and Reproduction

  • Chapter 14 – (not attached)
    • Drugs Affecting the Autonomic Nervous System – read Urinary Retention beginning page 202 and Antispasmodic for Bladder Instability and Overactivity beginning page 220
  • Chapter 22 – Drugs Affecting the Reproductive System
  • Chapter 31 – Contraception
  • Chapter 38 – Hormone Replacement Therapy – read through page 1112
  • Chapter 44 – Sexually Transmitted Infections and Vaginitis
  • Chapter 47 – Urinary Tract Infections
  • Chapter 48 – Women as Patients (PP not attached, refer to chapter)
  • Chapter 49 – Men as Patients (PP not attached, refer to chapter)
  • Chapter 22 Omission: Chapter 22 doesn’t mention that finasteride is a teratogen (perhaps because the focus in this chapter is on BPH which, of course, doesn’t afflict women). The reason this is important is because pregnant women shouldn’t even handle these drugs.
    • Here is the excerpt from the derm module where it is discussed related to management of baldness. “Finasteride should be prescribed with caution in patients with hepatic dysfunction because the drug is metabolized extensively in the liver. It causes a decrease in serum prostate specific antigen (PSA) levels, even in the presence of prostate cancer. It is Pregnancy Category X. Finasteride exposure during pregnancy, even in small quantities, may produce abnormalities of the external genitalia in male offspring. Pregnant women or a woman planning a pregnancy should not handle crushed tablets. Finasteride may be potentially absorbed from the semen. When a male patient’s sexual partner is pregnant or may become pregnant, the patient should either avoid exposing his partner to his semen or discontinue finasteride.” (Woo & Robinson page 988)
  • Attached Files:
  • Appropriate Drug Therapy for Urinary Incontinence  
  • http://pharmacologycorner.com/animation-oral-contraceptives-mechanism-of-action (This is a Flash object that will not run on the Chrome browser. You can use the Firefox or Edge browser.  Enable Adobe Flash at the prompt.)
    • Not attached, see link
  • Anabolic Steroids – Click and Reveal  
  • 12 Quick Questions Testosterone 
  • Reproduction Jeopardy  
  • BCP Considerations 

Text Reference:

Pharmacotherapeutics for advance practice nurse prescribers

Author:Teri Moser WooMarylou V Robinson
Publisher:Philadelphia : F.A. Davis Company, [2016] ©2016
Edition/Format: Print book : English : Fourth edition
Summary:Presents the in-depth information you need to be a safe and effective prescriber of medications. This exceptional text builds your knowledge of pharmacology by first providing an overview of