611 2024 worksheet three

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Northern Kentucky University *

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611

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Biology

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Jun 13, 2024

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2

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Week three readings worksheet – MSN 611 * Unless otherwise noted, you must provide the answer from the Lehne’s Pharmacotherapeutics textbook. These questions are not considered test style questions. They are only to provide accountability that you have studied the assigned readings. You will not be given credit if the answer is correct but not found anywhere in the textbook. Questions are in the order of the assigned readings. * 9 points per question 1. Provide an example of a cholinesterase inhibitor. Pyridostigmine List five indications for this class of drugs? a. Treatment of Myasthenia Gravis b. Treatment of Glaucoma c. Treatment of Alzheimer’s Disease d. Treatment of Parkinson’s Disease Dementia e. Treatment of poisoning by muscarinic antagonists (p. 85) 2. Name three medications that activate beta adrenergic receptors but not alpha? a. Isoproterenol (p. 102 – Table 15.2) b. Dobutamine (p. 102 – Table 15.2) c. Albuterol (p. 102 - Table 15.2) 3. Alpha blockers are used for BPH and HTN. (Specify at least one each) a. Your book specifies which ones as being able to be used for HTN? Prazosin (p. 110) b. Your book specifies which ones as being able to be used for BPH? Tamsulosin (p. 110) c. Your book specifies which ones as being able to be used for both? (Terazosin (p. 110) 4. Explain why levodopa is only available in combination with carbidopa (with or without entacapone)? Levodopa is only available in combination preparations with carbidopa or carbidopa and entacapone because in combination, less levodopa is metabolized peripherally and more can enter the central nervous system by decreasing the amount of decarboxylation in the peripheral tissues and intestines making more levodopa available for the CNS. When given alone, only 2% of levodopa given enters the CNS/brain. (p.131/133) 5. What is the therapeutic goal of prescribing Donepezil for a patient with Alzheimer disease? How would you evaluate if this has been achieved? The goal for prescribing Donepezil in Alzheimer's patient is to improve symptoms and reverse cognitive decline. To evaluate if Donepezil is effective in helping to reach the therapeutic goal, an assessment of cognitive and functional status is needed, and if there has been improvement then Donepezil has been effective and is achieving the therapeutic goal which are short-lived. (p. 144) 6. Valproic acid is considered one of the first line agents for epilepsy. Name three major considerations for the APRN when prescribing this medication? a. Do not use valporic acid in conjunction with other drugs in children younger than 2 years b. Do not use valproic acid in patients with preexisting liver dysfunction. c. Evaluate baseline liver function and periodically throughout treatment. (p.160) 7. You have prescribed a child an inhaled corticosteroid for their asthma. What education would you provide the parents about its effect on the child’s growth? Adrenal suppression is possible with long-term use of inhaled corticosteroids. Parents should monitor for signs of adrenal insufficiency hypoglycemia, hypotension, and mental status alterations. Growth can be slowed and delayed it is not shown that adult growth is reduced, but it is delayed. However, no data is MSN 611 – Spring 2024
present to indicate if growth and development of brain, lungs, and other organs are delayed. (p.561) 8. Discuss the considerations of a metered dose inhaler versus a nebulizer for the delivery of albuterol? Nebulizers can be more effective in patients who are unresponsive to beta two agonist as the nebulizer delivers medication slower and allows the bronchi to gradually dilate, allowing the drug to gain deeper access to the lungs. Meter dose inhalers are difficult because they require patience to have hand breath coordination and without the help of a spacer, typically only 10% of the dose reaches the lung. So, patients hand breath coordination would be necessary to consider when prescribing. Nebulizers take longer to administer the same amount of drug as an inhaler taking several minutes to receive the same amount of medication through a nebulizer, as the patient would receive in one inhalation from the inhaler. From this, a patient's time and coordination are both factors that should be considered when choosing to prescribe a major dose inhaler versus a nebulizer. 9. What are the two conditions that would make it appropriate to start a patient with chronic asthma on omalizumab? a. Patient has allergy-related asthma after preferred option fail b. asthma cannot be controlled with an inhaled glucocorticoid (p.565) 10. List four drugs that the book teaches are used for acute asthma exacerbation? a. Giving oxygen b. Giving systemic glucocorticoid c. Giving a nebulized high dose SABA d. Giving nebulized ipratropium (p.574) 11. Review chapter 63 and answer this trick question: What antibiotic should be prescribed for a patient with rhinovirus (aka the common cold)? There is no cure for the cold, so treatment is purely symptomatic. Because colds are caused by viruses, there is no justification for the routine use of antibiotics. (p.586) MSN 611 – Spring 2024
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