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NR 566 / NR566 Chamberlain College Of Nursing -NR
Midterm Study Guide: Advanced Pharmacology Questions With
Complete Answers 2025
Common CAP pathogens - ANSWERS-S. Pneumoniae (most common) H. Influenzae (smokers/COPD) P. Aeruginosa (CF) CAP first line treatment - ANSWERS-Macrolides, Doxycyline, Amoxicillin what to give if 1st CAP treatment doesn't work? - ANSWERS-Respiratory Fluoroquinolone if not received abx in the past 3 months Mycoplasma pneumoniae - ANSWERS-atypical pneumonia; commonly seen in children pediatric atypical pneumonia treatment - ANSWERS-Macrolides (Erythromycin), if failed then Respiratory fluoroquinolone CAP treatment during pregnancy - ANSWERS-Amoxicillin, cephalosporins, or Erythromycin Treatment of chlamydial pneumonia in infant - ANSWERS-Macrolide (Azithromycin): 500mg orally on day 1 followed by 250 mg once daily on days 2- When to use broad/empiric spectrum antibiotics? - ANSWERS-Before cultures are resulted/ critically ill patient after first culture obtained, based on NP knowledge of patient history, local susceptibility/geographic location When to use narrow spectrum antibiotics? - ANSWERS-Used when the culture and sensitivity is resulted, and pathogen is known. how to treat C.diff - ANSWERS-Stop the antibiotic that may have caused it 1st: Vancomycin 125 mg PO QID x 10 days. 2nd: Metronidazole 500mg PO TID x 10 days address hydration Drug class known for ALL drugs in class to promote development of C. Diff - ANSWERS-2nd and 3rd generation Cephalosporins Penicillin: Cross-sensitivity reactions with which drug classes - ANSWERS-
Cephalosporins & Carbapenems (Allergy may be mild or severe) Safe penicillin during pregancy - ANSWERS-Amoxicillin patient education for Cephalosporins - ANSWERS-Report to provider any loose stools, complete full course of antibiotics, s/s of allergy Cephalosporins in pregnancy - ANSWERS-All appear safe for use patient education for Tetracyclines - ANSWERS-photosensitivity (wear sunscreen!), complete full course, s/s of allergy Tetracyclines in pregnancy - ANSWERS-Can lead to fetal death; avoided for use Patient education for macrolides - ANSWERS-Take with meals to avoid GI upset, contraindicated w/ warfarin Aminoglycoside patient teaching - ANSWERS-Patients should report tinnitus, high- frequency hearing loss, persistent headache, nausea, dizziness or vertigo sulfonamides patient teaching - ANSWERS-Finish full course Increase fluid intake to 8-10 cups/day Take on empty stomach Avoid sun exposure/wear sunscreen Sulfonamides during pregnancy - ANSWERS-not to be used during 1st trimester, can cause kernicterus in infants Gentamicin renal dose adjustments - ANSWERS-decreased dosage for renal impaired tinea capitis treatment - ANSWERS-oral griseofulvin drug to treat aspergillosis (Fungal Pneumonia) - ANSWERS-Voriconazole Which Anthelmintics carry risk for hypotension with patients on antihypertensives? - ANSWERS-Ivermectin and Moxidectin Which Anthelmintics can cause bone marrow suppression and liver impairment? - ANSWERS-Mebendazole and Albendazole Which Anthelmintic is generally safe to give w/out baseline data? - ANSWERS- Which Anthelmintic is safe for use in pregnancy? - ANSWERS-Praziquantel, Moxidectin Risks associated with Didanosine - ANSWERS-pancreatitis, neuropathy, lactic
and other cleaning devices cerumen impaction treatment - ANSWERS-can be removed by irrigation w/ warm water/saline or OTC Debrox ear drops to soften for removal or suction Treatment of Otomycosis (fungal otitis externa) - ANSWERS-2% acetic acid solution 3-4x/day x 7 days. If this not work, 1% clotrimazole [Lotrimin] can be applied BID for 7 days. If the infection fails to respond, oral antifungal therapy may be needed. Options: itraconazole (Sporanox) and fluconazole (Diflucan). otitis media (middle ear infection) symptoms: - ANSWERS-otalgia, fever, n/v/d, irritability, sleep disturbance Otitis media (middle ear infection) treatment - ANSWERS-<6mos old: antibiotics and pain relief 6mos- 2yrs: antibiotics when diagnosis is confirmed
2yrs: observation x 2-3 days; or if severe symptoms/confirmed diagnosis--> antibiotics Antibiotic preferred for otitis media treatment: - ANSWERS-Amoxicillin 40- mg/kg bid x 5-10 days if allergic to PCN (mild: Cephalosporin; severe: Macrolide) Monoclonal antibody drug treatment option for Allergic Rhinitis - ANSWERS- Omalizumab: biologic therapy How to treat glaucoma in someone with COPD or asthma - ANSWERS-Betaxolol (B1 selective beta blocker): does not affect the bronchi latanoprost side effects - ANSWERS-Darkens color of iris (browning) Therapeutic action of glucocorticoids for the eyes - ANSWERS-Inhibit the production of prostaglandins, leukotrienes, and thromboxane for relief of eye inflammation, redness, irritation MOA for antihistamines - ANSWERS-block histamine release in the small blood
vessels, capillaries and nerves during allergic reactions to relieve itching, sneezing and rhinorrhea MOA of cromolyn - ANSWERS-Prevents release of leukotrienes & histamine; Inhibits activity of leukocytes & eosinophils MOA of sympathomimetics - ANSWERS-activate alpha adrenergic receptors on nasal blood vessels---> reduction of nasal congestion Therapeutic action of Guafenesin - ANSWERS-Expectorant: thins secretions to stimulate release of congestion Patient education of benzoyl peroxide: - ANSWERS-Continue to use the prescription on irritated or sunburned skin, avoid sunlight and UV light exposure side effects of Benzoyl Peroxide: - ANSWERS-Skin redness, stinging, dryness, peeling, photosensitivity hypersensitivity reaction in asthma patients Organic sunscreen needs what ingredient to be effective: - ANSWERS-Avobenzone (to absorb UVA light rays) 1st line treatment of acne: - ANSWERS-Benzoyl Peroxide of topical retinoid salicylic acid patient education - ANSWERS-photosensitivity teaching/awareness, side effects (dryness/peeling/sensitivity), avoid harsh soaps, wash hands after applying Isotretinoin Patient Education - ANSWERS-may affect night vision (avoid driving), periodic blood tests/monitoring, photosensitivity, cannot donate blood during treatment, avoid vitamin A supplements, report symptoms to provider, avoid alcohol ingestion When to prescribe an intranasal glucocorticoid? - ANSWERS-(Fluticasone) seasonal allergic rhinitis Which weight loss drug(s) are associated with a suicide risk in children, adolescents, and young adults? - ANSWERS-Naltrexone/Bupropion (Contrave) & Liraglutide What would happen if Lorcaserin is given with a CYP2D6 substrate? - ANSWERS- Can increase substrate levels, may need to lower dose of substrate to prevent toxicity Which weight loss drugs are DEA scheduled drugs? - ANSWERS-Lorcaserin, Diethyloprione, Phentermine/Topiramate On-going monitoring needs with long-term use of Phentermine? - ANSWERS-
Amoxicillin prescription writing - ANSWERS-For Adults 250-750mg po q8 hours For children 20-90 mg/kg q8 hours Tetracycline prescription writing - ANSWERS-Adult 1000-2000mg po q6 hours Pediatric 25-50 mg/kg po q6 hours Benzoyl peroxide prescription writing: - ANSWERS-concentrations range from 2.5%
- 10%. For initial therapy once daily application is recommended. Over time, the frequency can be increased to three times a day. Timolol ophthalmic prescription writing - ANSWERS-.25%-.5% solution, - 1 drop daily or BID .25%-.5% gel - 1 drop daily
