W7 Exam NSAIDs, Osteo, Autoimmune/Inflamm DXs (PHARM musculoskeletal), (NSG 6005 WEEK 7 Pharmacology), (MU NURS 615: Advanced Pharm - Chapter 25 Study Guide) (Questions, Answers, Terminology - Complete Review)

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Aspirin (Ecotrin) ASA What should you remember? Acetaminophen (Tylenol) APAP What should you remember? Ibuprofen (Motrin) What should you remember? Naproxen Sodium (Aleve) What should you know?... Indomethacin (Indocin) CLASS: Indication: BLACK BOX: Indomethacin (Indocin) Routes: AE: Monitor: Celecoxib (Celebrex) CLASS: Indication: BLACK BOX: Celecoxib (Celebrex) Routes: AE: Monitor: Celecoxib (Celebrex) Drug Interactions: Which of the following is primary COX 1? 1. ASA 2. Motrin 3. Aleve 4. Indocin 5. Celebrex Which of the following is primary Cox 2? 1. ASA 2. Motrin 3. Aleve 4. Indocin 5. Celebrex Which of the following is slightly Cox 1 selective? 1. ASA 2. Motrin 3. Aleve 4. Indocin 5. Celebrex ************************************************************************************* Let’s review: COX 1 = RESPONSIBLE FOR THE BASELINE LEVELS OF PROSTAGLANDINS. Let’s review: COX 2 = PRODUCES PROSTAGLANDINS THROUGH STIMULATION Which of the following should you monitor on NSAID treatment? 1. CBC 2. LFTs 3. BUN & Cr 4. UA What is the first line treatment for arthritic pain? What is the second line treatment for arthritic pain? ************************************************************************************* Sulfasalazine (SSZ) CLASS: Indication: BLACK BOX: Sulfasalazine (SSZ) Routes: AE: Monitor: Methotrexate (MTX, Rheumatrex) CLASS: Indication: BLACK BOX: Methotrexate (MTX, Rheumatrex) Routes: AE: Monitor: Drug interactions: Methotrexate (MTX, Rheumatrex) Precautions/ Teaching: Etanercept (Enbrel) CLASS: Indication: BLACK BOX: Etanercept (Enbrel) Routes: AE: Monitor: Drug interactions: Hydroxychloroquine (Plaquenil) CLASS: Indication: BLACK BOX: Hydroxychloroquine (Plaquenil) Routes: AE: Monitor: Drug interactions: DMARDs Disease Modifying Antirheumatic Drugs: Infliximab (Remicade) CLASS: Indication: BLACK BOX: Infliximab (Remicade) Routes: AE: Monitor: Drug interactions: Probenecid (Benuryl) CLASS: Indication: BLACK BOX: Probenecid (Benuryl) Routes: AE: Monitor: Drug interactions: Probenecid (Benuryl) Teaching: Colchicine CLASS: Indication: BLACK BOX: Colchicine Routes: AE: Monitor: Drug interactions: Colchicine Teaching: Allopurinol (Zyloprim) CLASS: Indication: BLACK BOX: Allopurinol (Zyloprim) Routes: AE: Monitor: Drug interactions: Allopurinol (Zyloprim) Teaching: What is the first line treatment for gout? What is the second line treatment for gout? Chronic treatment for gout? Glucosamine and Chondroitin All NSAIDs have a black box warning of CV risks. True or False? Cyclobenzaprine (Flexeril) CLASS Indication BLACK BOX Cyclobenzaprine (Flexeril) Routes AE Monitor Drug interactions Baclofen (Lioresal) CLASS Indication BLACK BOX Baclofen (Lioresal) Routes AE Monitor Drug interactions Methocarbamol (Robaxin) CLASS Indication BLACK BOX Methocarbamol (Robaxin) Routes AE Monitor Drug interactions Methocarbamol (Robaxin) Teaching: Spasm= Spasticity = Alendronate (Fosamax) CLASS: Indication: BLACK BOX: Alendronate (Fosamax) Routes: AE: Monitor: Drug interactions: Bisphosphonates Teaching: Bisphosphonates Medications: Indications: Bisphosphonates Contraindication: Bisphosphonates AE: Complications: Bisphosphonates NOTES: Teriparatide (Forteo) CLASS: Indication: BLACK BOX: Teriparatide (Forteo) Routes: AE: Monitor: Drug interactions: Raloxifene (Evista) CLASS: Indication: BLACK BOX: Raloxifene (Evista): Routes: AE: Monitor: Drug interactions: Calcitonin (Miacalcin, Fortical) CLASS: Indication: BLACK BOX: Calcitonin (Miacalcin, Fortical) Routes: AE: Monitor: Drug interactions: Calcitonin (Miacalcin, Fortical) Teaching ************************************************************************************* Your patient is coming to you with arthritis. What would be your first line treatment? 1. Tylenol 2. Tylenol and chondroitin 3. ASA 4. Motrin All a patient need to build bone or help correct osteoporosis is the medication. True or False? Which of the following would you avoid in a patient with a hx of osteosarcoma? 1. Calcitonin. 2. Forteo. 3. Evista. 4. Fosamax. Which of the following would you eliminate from treatment if the patients has a hx of DVT? 1. Calcitonin. 2. Forteo. 3. Evista. 4. Fosamax. Which medication would be contraindicated in a patient with ongoing lithium therapy? 1. Calcitonin. 2. Forteo. 3. Evista. 4. Fosamax. Baclofen must be weaned. True or False? Which of the following increase the bleeding risk when given with Celebrex? 1. Glucosamine and chondroitin. 2. St. John's Wort. 3. Gingko biloba. 4. Garlic. Which of the following interacts with baclofen? 1. Glucosamine and chondroitin. 2. St. John's Wort. 3. Gingko biloba. 4. Garlic. Which of the following is the BEST for osteoporosis? 1. Evista. 2. Forteo. 3. Boniva. 4. Actonel. A woman who has migraine with aura: A. Should not be prescribed estrogen due to the interaction between triptans and estrogen, limiting migraine therapy choices. B. Should not be prescribed estrogen due to an increased incidence of migraines with the use of estrogen. C. Should not be prescribed estrogen due to an increased risk of stroke occurring with estrogen use. D. May be prescribed estrogen without any concerns. Inadequate vitamin D intake can contribute to the development of osteoporosis by: A. Increasing calcitonin production. B. Increasing calcium absorption from the intestine. C. Altering calcium metabolism. D. Stimulating bone formation. Infants with congenital hypothyroidism are treated with: A. Levothyroxine. B. Liothyronine. C. Liotrix. D. Methimazole. Selective estrogen receptor modifiers (SERMs) treat osteoporosis by selectively: A. Inhibiting magnesium resorption in the kidneys. B. Increasing calcium absorption from the gastrointestinal (GI) tract. C. Acting on the bone to inhibit osteoblast activity. D. Selectively acting on the estrogen receptors in the bone. Bisphosphonates treat or prevent osteoporosis by: A. Inhibiting osteoclastic activity. B. Fostering bone resorption. C. Enhancing calcium uptake in bones. D. Strengthening the osteoclastic proton pump. Shana is receiving her first medroxyprogesterone (Depo Provera) injection. Shana will need to be monitored for: A. Depression. B. Hypertension. C. Weight loss. D. Cataracts. Dosage changes of conjugated equine estrogen (Premarin) are made at ____ intervals. A. One to two weeks. B. Two to four weeks. C. Six to eight weeks. D. Twelve weeks. Angela is a black woman who has heard that women of African descent do not need to worry about osteoporosis. What education would you provide Angela about her risk? A. She is correct; black women do not have much risk of developing osteoporosis due to their dark skin. B. Black women are at risk of developing osteoporosis due to their lower calcium intake as a group. C. If she doesn't drink alcohol, her risk of developing osteoporosis is low. D. If she has not lost more than 10% of her weight lately, her risk is low. A twenty-two-year-old woman receives a prescription for oral contraceptives. Education for this patient includes: A. Counseling regarding decreasing or not smoking while taking oral contraceptives. B. Advising a monthly pregnancy test for the first three months she is taking the contraceptive. C. Advising that she may miss two pills in a row and not be concerned about pregnancy. D. Informing her that her next follow-up visit is in one year for a refill and "annual exam". Men who are prescribed sildenafil (Viagra) need ongoing monitoring for: A. The development of chest pain or dizziness. B. Weight gain. C. Priapism. D. Renal function. Prophylactic use of bisphosphonates is recommended for patients with early osteopenia related to long-term use of which of the following drugs? A. Selective estrogen-receptor modulators. B. Aspirin. C. Glucocorticoids. D. Calcium supplements. The drug recommended as primary prevention of osteoporosis in women over seventy years old is: A. Alendronate (Fosamax). B. Ibandronate (Boniva). C. Calcium carbonate. D. Raloxifene (Evista). Elderly patients who are started on levothyroxine for thyroid replacement should be monitored for: A. Excessive sedation. B. Tachycardia and angina. C. Weight gain. D. Cold intolerance. The ongoing monitoring of patients over the age sixty-five years taking alendronate (Fosamax) or any other bisphosphonate is: A. Annual dual energy X-ray absorptiometry (DEXA) scans. B. Annual vitamin D level. C. Annual renal function evaluation. D. Electrolytes every three months. When starting a patient with hypothyroidism on thyroid replacement hormones, patient education would include the following: A. He or she should feel symptomatic improvement in one to two weeks. B. Drug-related adverse effects such as lethargy and dry skin may occur. C. It may take four to eight weeks to get to euthyroid symptomatically and by lab testing. D. Due to the short half-life of levothyroxine, its doses should not be missed. A woman who is pregnant and has hyperthyroidism is best managed by a specialty team that will most likely treat her with: A. Methimazole. B. Propylthiouracil. C. Radioactive iodine. D. Nothing; treatment is best delayed until after her pregnancy ends. Absolute contraindications to estrogen therapy include: A. A history of any type of cancer. B. Clotting disorders. C. A history of tension headache. D. Orthostatic hypotension. The drug recommended as primary prevention of osteoporosis in men over seventy years is: A. Alendronate (Fosamax). B. Ibandronate (Boniva). C. Calcium carbonate. D. Raloxifene (Evista). Henry presents to the clinic with a significantly swollen, painful great toe and is diagnosed with gout. What would be the best treatment? Patient education when prescribing colchicine includes: Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes Phil is starting treatment with Febuxostat (Uloric). Education includes: Sallie has been taking 10 mg per day of prednisone for the past six months. She should be assessed for: Patients whose total dose of prednisone will exceed 1 gram will most likely need a second prescription for: Daniel has been on 60 mg of prednisone for 10 days to treat severe asthma exacerbation. It is time to discontinue the medication. How is it discontinued? [Show More]

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