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Pharmacology > Exam 2 Contra, Pain, DM > Flashcards

Exam 2 Contra, Pain, DM Flashcards

1
Q

Contraception oral combination
drug interactions

A

Anticonvulsants
Antibiotics
-Only rifampin(TB)
Antiretrovirals
-Covid, HIV
St. John’s worth
-Herbal OTC

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2
Q

Which of the following is a contraindication for COCs?
a. Type 1 diabetes
b. History of thromboembolic disorder
c. Orthostatic hypotension
d. Obesity

A

A

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3
Q

Which of the following are correct in managing 1-2 missed pills? SATA

a. Finish the active pills in the pack
b. May need emergency contraception
c. Avoid having sex until 7 active pills in a row have been taken
d. Skip placebos and start a new pack
e. Take the pill for that day ASAP + another active pill

A

b
e

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4
Q

Which of the following is the most common side effect of COCs?
a. Weight gain
b. Headaches
c. Worsening acne
d. Vaginal spotting

A

d

Weight can be changed whether gain or lose
Headaches is not the MOST common one

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5
Q

Which of the following drugs has antimineralocorticoid activity that claims to cause less water weight gain? SATA

a. Seasonale
b. Lybrel
c. Yasmin
d. Seasonique
e. Yaz

A

c,e

antimineralocorticoid activity

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6
Q

Match the following drugs to the correct description.
a. Lybrel
b. Seasonique and LoSeasonique
c. Sesonale

__ First approved for extended cycles
__ Causes less spotting and lighter period
__ Continuous use, no menstrual cycle

A

c 3-month cycle,
b No placebo/ take everyday
a No placebo/ take everyday

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7
Q

A patient tells you her Xulane was dislodged for >24 hours. How should she manage this
problem? SATA

a. Apply a new patch immediately
b. Use backup contraception for 5 days
c. Offer EC if she has had unprotected sex
d. Rinse with lukewarm water and re-insert

A

a,b,c

Patch

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8
Q

All of the following are true about Progestin-Only pills except:

a. Must take an active pill every day until the week of placebos
b. Must take at the same time every day
c. Escape ovulation can still occur similar to COCs
d. Primary MOA is inhibiting ovulation

A

a

NO placebo!
Must take at the same time every day

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9
Q

A patient starting POPs (Progestin-only Pills) should use a backup method of
contraception for _____ days if the medication is not started during the 1st five days of her period, or the day after she stops another hormonal method.

A

2

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10
Q

. Which of the following agents can be discontinued immediately? SATA

a. Progestin-Only Injections
b. Progestin-only Pills
c. Xulane
d. NuvaRing

A

b, c, d

a Take 20+ months for 100% of women to regain fertility
Depot medroxyprogesterone acetate

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11
Q

Which of the following forms of contraception is inserted in the arm, provides effective
contraception for at least 3 years and is the most effective form of contraception?

a. NuvaRing
b. Minera
c. Nexplanon
d. Anovera

A

c

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12
Q
  1. Match the following characteristics to the IUD:

__ Wound with fine copper.
__ Levonorgestrel intrauterine system
__ Slightly more effective with a first-year failure rate of 0.2% for both perfect and
typical use.
__ Impairs sperm function
__ Inhibits sperm survival, thickens cervical mucus, suppresses endometrium, suppresses ovulation in some women.

A. ParaGard
B. Mirena

A

a
b
b
a
b

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13
Q

All of the following statements about Phexxi are true except? SATA

a. Non-hormonal vaginal gel
b. Most effective if used after intercourse
c. Can be purchased over the counter
d. May decrease gonorrhea and/or chlamydia infections
e. Is a good option for women with a hx of recurrent UTIs

A

b,e

pH control
Non-hormonal vaginal gel
Not effective if used after intercourse
Requires prescription
Can’t use in women with a history of recurrent UTIs

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14
Q

What are the ADRs of COCs? (SATA)

a. Breast cancer
b. Vaginal spotting
c. Liver cancer
d. Headache
e. Weight loss

A

b, d

Headache - most serious

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15
Q

Which dose is recommended for a COC?
a. 50 mcg
b. 10 mcg
c. 30 mcg
d. 100 mcg

A

c

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16
Q

The main mechanism of action of a COC is:
a. Preventing sperm from entering the vagina
b. Prevent implantation
c. Thicken cervical mucus
d. Suppress ovulation

A

d

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17
Q

A patient misses 2 pills the first week of taking their COCs. What should the nurse instruct them to do?
a. Take 1 active pill for the day as soon as possible
b. Take 2 active pills and use emergency contraceptives as needed
c. Finish the active pack of pills, skip placebos and start a new active pack
d. Rinse the ring and insert it
e. Discontinue the pack and use strictly emergency contraceptives

A

b

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18
Q
  1. Which statement describes Yaz?
    a. 7 placebo pills in a pack
    b. No placebo pills and result in light periods every 3 months
    c. Approved for no menstrual cycles
    d. 4 placebo pills in a pack
A

d

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19
Q

The first COC approved by the FDA for continuous use and no menstrual periods is:
a. LoSeasonique
b. Yaz
c. Lybrel
d. Annovera
e. Mirena

A

c

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20
Q

What is the correct use of Xulane?
a. Apply and leave patch for 3 weeks
b. Replace the patch every week for 3 weeks and leave off for a weak
c. Reuse the ring for 13 cycles
d. Replace the patch every week for 4 weeks

A

b

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21
Q

T/F: Paraguard is the most effective IUD -

A

false, mirena is most effective IUD

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22
Q

Which of the following is the most effective form of emergency contraception?
a. Plan B one-step
b. Kyleena
c. Copper IUD
d. Ulipristal

A

c
Copper IUD - 99.9% effective

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23
Q

The most effective birth control is:
a. Yaz
b. Lybrel
c. Annovera
d. Nexplanon
e. Spermicide

A

d

Nexplanon - 0.05% failure rate

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24
Q

Aspirin inhibits:
a. COX 1 & 2 centrally
b. COX 2 peripherally and COX 1&2 centrally
c. COX 1 centrally
d. COX 1 & 2 peripherally and centrally

A

d

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25
Q

Which of the following are true of Aspirin? SATA

a. May cause dyspepsia and irritation
b. Can cause salicylism
c. Should be avoided in kids
d. May impair kidney perfusion
e. Risk for blood clots

A

a,b,c

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26
Q

What type of pain are somatic and visceral?

A

Nociceptive
-direct stimulation of pain receptors

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27
Q

Select the following statements that are true regarding NSAIDs:SATA

a. 1st gen May cause ulcers or renal dysfunction
b. Both generations can cause ulcers
c. Contain a black box warning
d. May impair renal function
e. Inhibits COX in the brain but not peripherally

A

b,c, d

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28
Q

A patient has Cirrhosis due to ETOH (hepatic impairment). The patient’s maximum dose of acetaminophen?
a. 4000mg
b. 3000mg
c. 2000mg
d. 650mg
e. 1000mg

A

c

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29
Q

Which of the following opioids results in less respiratory depression and may cause
withdrawal in patients who have developed tolerance to opioids? SATA
a. Pentazocine
b. Oxycodone
c. Naltrexone
d. Buprenorphine
e. Meperidine

A

a, d

30
Q

a. Morphine
b. Oxycodone
c. Meperidine
d. Fentanyl
e. Methadone

__ Caution with renal impairment
__ Has the longest duration of action
__ Only available orally

A

c
e
b

31
Q

a. Morphine
b. Oxycodone
c. Meperidine
d. Fentanyl
e. Methadone

__ First line for moderate/severe pain
__ Most potent opioid
__ Active metabolite can cause tremor

A

a
d
c

32
Q

Which of the following are true regarding Naloxone? SATA

a. Full agonist
b. Rapidly reverses respiratory depression
c. Can treat opioid induced pruritus
d. Affinity for most opioid receptors
e. May need to be given multiple times

A

b, c,e

33
Q

Which of the following statements are true regarding opioid ADRs? SATA
a. Drowsiness and sedation will resolve in a few days
b. Itching is most common when an opioid is taken orally
c. Respiratory depression is the most serious ADR
d. Constipation is the most common ADR but most people will develop tolerance to
it within a week

A

a, c

34
Q

Which of the following agents causes less respiratory depression than a natural opioid
and is classified as a schedule IV controlled substance?

a. Dantrolene
b. Gabapentin
c. Naltrexone
d. Tramadol

A

d

35
Q

Which of the following describes neuropathic pain? SATA
a. Dull, aching, throbbing
b. Results from nerve injury
c. Pain relief results from analgesic therapy
d. Diabetes is a risk factor

A

b, d

c—non analgesic therapy

36
Q

Breakthrough pain?

A
37
Q

Breakthrough pain?

A

Pain that might happen even though you are taking pain medicine regularly for chronic pain

38
Q

What kind of drugs are used in addition to a long-acting opioid for breakthrough pain?

A

Codeine/acetaminophen
(Tylenol #3, #4 ®)
Hydrocodone/acetaminophen
(Lortab ®, Lorcet ®, Vicoden ®, Norco ®)

Hydrocodone/ibuprofen
(Vicoprofen ®)
Hydrocodone/aspirin
(Damascon-P®)

39
Q

What kind of drugs do we want to avoid in a patient who is taking an
opioid?

A

CNS depressants
-Inc respiratory depression and sedation

Anticholinergic drugs
–Inc constipation and urinary retention

40
Q

Neuropathy can be
a) peripheral
b) Autonomic

A

a) numbness,thinking of extremities
b) gastroparesis(delay GI emptying)

41
Q

Gestational diabetes

A

Once pregnancy stop, diabetes stops
30-50% will develop type2 diabetes

42
Q

LADA

A

Type 1.5 diabetes
autoimmune diabetes that occurs in later life

43
Q

Which of the following meets ADA diagnostic criteria for diabetic patients?

a) A1C levels of 6%
b) FBG of 100
c) A random plasma glucose of greater than or equal to 200 with classic symptoms of hyperglycemia
d) An LDL of 90*<100

A

C

44
Q

Which of the following medications have a risk for hypoglycemia? (SATA)

a) Repaglinide
b) Metformin
c) Alogliptin
d) Glipizide
e) Humalog insulin

A

a Meglitinides:
c DPP-4 Inhibitors
d Sulfonylureas
e

45
Q
  1. Match the following to the correct category
    (1) Type 1 DM, (2) Type 2 DM, (3) Gestational DM, (4) LADA

____ Young onset
____ Occurs during pregnancy
____ Pt is typically obese
____ Autoimmune with low insulin levels like Type 1

A

1
3
2
4

46
Q
  1. Match the following to the correct category
    (1) Type 1 DM, (2) Type 2 DM, (3) Gestational DM, (4) LADA

____ B-cells are completely destroyed - no insulin is produced
____ Pt is symptomatic
____ Also called “Type 1.5 diabetes”
____ Symptoms & onset >30 like Type 2

A

1
1
4
4

47
Q
  1. Match the following to the correct category
    (1) Type 1 DM, (2) Type 2 DM, (3) Gestational DM, (4) LADA

____ 30-50% will develop type 2 diabetes or glucose intolerance
____ Micro/Macrovascular complications are present
____ The pt can take oral medications & doesn’t have to take insulin
____ Most common type (90% of cases)

A

3
2
2
2

48
Q

What are the actions of insulin? (SATA)

a. Suppresses hepatic glucose production
b. Increases blood glucose levels
c. Stimulates glucose uptake by peripheral tissues
d. Prevents absorption of carbohydrates

A

a, c

49
Q

How do you treat hypoglycemia?

a) ______g of __________
b) Recheck SMBG (serum blood glucose) in _____________
c) Once SMBG returns to normal → _______________ to prevent recurrence of ______________

A

a) 15-20g of glucose
b) 15 minutes
c) meal or snack
hypoglycemia

50
Q

Glucagon Nasal Powder (Baqsimi) is used to treat HYPOglycemia. (True/False)

  • What are 3 points of patient education you need to give to use this medication?
A

True
Don’t inhale
call 911 after use
2nd dose if no response after 15 min

51
Q

Fill in the blanks regarding the ADA treatment goals for the following categories.
Glycemic control:

a) A1C of ______
b) A fasting blood glucose between __________
c) 2 hr postprandial of ___________
Lipids:
d) LDL ________
Blood pressure:
e) Less than _________

A

a) <7%
b) 70-130
c) <180
d) <100
e) <130/80

52
Q

Fill in the blanks regarding the ADA treatment goals for the following categories.
Glycemic control:
- A1C of ______
- A fasting blood glucose between __________
- 2 hr postprandial of ___________
Lipids:
- LDL ________
Blood pressure:
- Less than _________

A
53
Q

Match the insulin to its type

a. Rapid acting
b. Short acting/regular
c. Intermediate acting
d. Long acting

____NPH (Humulin N, Novolin N)
____Aspart (Novolog)
____Glargine (Lantus, Basaglar)
____Regular (Humulin R, Novolin R)

A

c
a
d
b

54
Q

Match the insulin to its type

a. Rapid acting
b. Short acting/regular
c. Intermediate acting
d. Long acting

____Detemir (Levemir)
____Glulisine (Apidra)
____Degludec (Tresiba)
____Lispro (Humalog)

A

d
a
d
a

55
Q

All of the following are insulin administration sites except:
a) Lower back
b) Abdomen
c) Thigh
d) Breasts
e) Outer upper arm
f) Upper back

A

d

56
Q

Pt administers insulin into his abdomen and then his outer arm the following week. Is the statement correct or incorrect?

A

Incorrect
Rotate same area of body

57
Q

The insulin secretagogues include these agents except for:
a) Sulfonylureas
b) Meglitinides
c) Biguanides
Major concern with secretagogues??

A

C

Hypoglycemia
Weight gain

58
Q

Thiazolidinediones belong to:
a) Insulin secretagogues
b) Incretin mimetics
c) Insulin sensitizers

A

c

59
Q

Thiazolidinediones belong to:
a) Insulin secretagogues
b) Incretin mimetics
c) Insulin sensitizers

A

c

60
Q

. All of the following categories and drugs have little to no risk of hypoglycemia except for:
a) DPP-4 inhibitors
b) Meglitinides
c) Metformin
d) SGLT 2 inhibitors

A

a

61
Q

A drug that has a Black Box warning for diabetic foot ulcers and amputation is:

a. Dapagliflozin
b. Acarbose
c. Pioglitazone
d. Metformin

A

a

62
Q

Two medications that carry a risk for hypoglycemia are:

a. Repaglinide (Prandin®)
b. Metformin (Glucophage®)
c. Glipizide (Glucotrol®)
d. Pioglitazone (Actos®)
e. Pramlintide (Symlin®)

A

a, c

63
Q

Signs of hyperglycemia include: (SATA)
a) Increased thirst
b) Seizure activity
c) Sweating
d) Weight loss
e) Blurry vision

A

a,d,e

64
Q

An example of a rapid acting insulin includes:
a. Humulin R
b. Glargine (lantus)
c. Novolog (aspart)
d. Humulin N NPH

A

c

65
Q

BBW
Lactic acidosis

A

Biguanides
-Metoformin

66
Q

BBW
Sever HF

A

TZDs
pioglitazone
rosglitazone

67
Q

BBW
Diabetic food ulcers

A

SGL2 hibitor

68
Q

Precaution/ waring
Hypertension
Hyper kalmia

A

SGL2 hibitor

69
Q

Take before meal

A

Meglitinide

Rapaglinide
Nateglinide

70
Q

Take in the morning

A

Sulfonylureas
Glyburide

71
Q

BBW
Thyroid tumors

A

GLP-1

Exenatide
Liraglutide

72
Q

Sever anoroxia

A

Amylinomimetic

Pramlintide

Pharmacology (34 decks)

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