FOM 7.5.2 Flashcards
You have an 88 year old patient named Alma. Her medical record lists six different prescription drugs. Alma, however, is not entirely sure if she takes that many. She also told you that she takes some pills that her granddaughter Gwen bought at a health food store. What is one way to get an accurate assessment of all the medications that Alma is taking?
A. Call her granddaughter Gwen and ask her to compile a list of the drugs Alma is currently taking.
B. Call Alma’s pharmacy, and reconcile the medication list and last refill dates.
C. Ask Alma to put all her pill bottles in a bag and bring them to her next appointment.
D. Have a nurse or social worker call Alma when she is at home to get an inventory of the drugs.
E. Make a Home Visit and complete a medication reconciliation and home safety evaluation.
E
True or False: The genetic make-up of the individual can influence effect a drug has?
True
Primary beta receptor in the heart?
Beta1 receptor (ADRB1)
What effect on the heart (changes in force and rate) does a B-adrenergic receptor activating drug have?
Increase force, increase rate of contraction
Is there up regulation or down-regulation with GRK5 polymorphism (Gln41Leu “Leu41 allele”) regarding beta receptor signaling?
Increases down regulation
How might the L41 variant of GRK5 produce an increased down-regulation of beta receptor signaling?
A. L41 has a higher Km for ATP
B. L41 is less stable
C. L41 can utilize GTP as well as ATP
D. L41 has a higher turnover number
D
For a cardiomyoctye that is not currently being stimulated by the sympathetic nervous system, how would a beta blocker affect protein kinase A activity?
A. Increase
B. Decrease
C. No change
C. No change
How are strong are racial/ethnic health disparities affected by genetics?
Only modestly affected
When beta arrestin binds phosphorylated beta receptors, what is the effect regarding the receptor?
Shuts down receptor
The working hypothesis: “GRK5-L41 is functionally equivalent to having a what?”
“Built in” beta blocker
