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Pharmacology > PHARM TEST > Flashcards

PHARM TEST Flashcards

1
Q

Scenario 1

  1. 1 A 49-year-old patient is diagnosed of having depression and fluoxetine is prescribed for his management. With regard to fluoxetine, mention the
    following:
  2. 1.1 The class of drugs in which fluoxetine belongs to (2)
A

1.1.1. Selective Serotonin re-uptake inhibitors (SSRIs

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2
Q

Scenario 1

  1. 1 A 49-year-old patient is diagnosed of having depression and fluoxetine is prescribed for his management. With regard to fluoxetine, mention the
    following:

1.1.2 Other two (2) conditions in which it is indicated (2)

A
  • Obsessive-compulsive disorder

* Bulimia nervosa (fluoxetine)

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3
Q

Scenario 1

  1. 1 A 49-year-old patient is diagnosed of having depression and fluoxetine is prescribed for his management. With regard to fluoxetine, mention the
    following:

1.1.3 At least two (2) conditions in which it is contraindicated (2)

A

1.1.3. • Co-administration with metoprolol in Cardiac failure.
• Hypersensitivity to the active ingredient and its excipients

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4
Q

Scenario 1

  1. 1 A 49-year-old patient is diagnosed of having depression and fluoxetine is prescribed for his management. With regard to fluoxetine, mention the
    following:

1.1.4 At least two (2) adverse effects associated with using this drug (2)

A 
1.1.4. • Drowsiness
• Nausea & Vomiting
• Emotional liability 
• Weight gain
• Insomnia
• Palpitations/ Chest pains/ chills/ confusion
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5
Q

Scenario 1
1.1 A 49-year-old patient is diagnosed of having depression and fluoxetine is
prescribed for his management. With regard to fluoxetine, mention the
following:

1.1.5 Discuss drug interactions associated with using this drug (4)

A

1.1.5. • Antidepressants (tricyclics, trazodone): Blood concentrations may be elevated significantly with potentiation of effects & toxicity

• Carbamezapine & phenytoin: Increased serums concentrations of these agents occurs with concomitant fluoxetine

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6
Q

Scenario 1

  1. 1 A 49-year-old patient is diagnosed of having depression and fluoxetine is prescribed for his management. With regard to fluoxetine, mention the
    following:

1.1.6 Alternative drug if it is poorly tolerated (2)

A

1.1.6. Citalopram

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7
Q

Scenario 1

  1. 1 A 49-year-old patient is diagnosed of having depression and fluoxetine is prescribed for his management. With regard to fluoxetine, mention the
    following:

1.1.7 Another drug if a sedating antidepressant is required (2)

A

1.1.7. Amitriptyline

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8
Q

What is the MOA of SSRIs

A

Selectively block serotonin re-uptake at presynaptic neurons – increase serotonin concentration in synapse

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9
Q

Scenario 2

  1. 1 A 21-year-old patient, has been brought to the emergency department in status epilepticus. Measures are taken to ensure her safety and prevent injury, and an intravenous (IV) line is started.
  2. 1.1 Mention three (3) drugs belonging to the class Benzodiazepines which you can use to treat this patient (6)
A

2.1.1. • Lorazepam
• Clonazepam
• Midazolam

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10
Q

Scenario 2
2.1 A 21-year-old patient, has been brought to the emergency department in status epilepticus. Measures are taken to ensure her safety and prevent injury, and an intravenous (IV) line is started.

  1. 1.2 Soon after treatment with one of the drugs mentioned above, the patient’s seizures stop, and she regains consciousness. She is then admitted to a medical-surgical unit, and the admitting order calls for an initial IV dose of the drug for maintenance therapy.
  2. 1.2.1 Mention the name of the drug used for maintenance therapy (2)
A

2.1.2.1. Phenytoin

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11
Q

Scenario 2
2.1 A 21-year-old patient, has been brought to the emergency department in status epilepticus. Measures are taken to ensure her safety and prevent injury, and an intravenous (IV) line is started.

  1. 1.2 Soon after treatment with one of the drugs mentioned above, the patient’s seizures stop, and she regains consciousness. She is then admitted to a medical-surgical unit, and the admitting order calls for an initial IV dose of the drug for maintenance therapy.
  2. 1.2.2 Regarding the above-mentioned drug, list at least three (3) adverse effects associated with using this drug (3)
A 
2.1.2.2
• Nausea & Vomiting
• Dizziness 
• Nystagmus 
• Ataxia
•Mental confusion
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12
Q

MOA of Benzodiazepam

A
  • Binding of GABA to its receptor on the cell membrane triggers an opening of a chloride channel which leads to an increase in chloride conductance.
  • Benzodiazepines bind to specific, high-affinity sites on the cell membrane, which are separate from but adjacent to the receptor for GABA.
  • Binding of GABA is enhanced by benzodiazepines, resulting in a greater entry of chloride that hyperpolarizes the cell, making it more difficult to depolarize & therefore reduces neural excitability
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13
Q

Scenario 3
3.1 Sarah Sedibe, a 30-years-old lawyer is diagnosed as having hypertension. Both her mother and sister have hypertension, and both were also in their thirties when it was diagnosed. Sarah’s most current blood pressure reading is 150/96 mmHg.

3.1.1 Explain what the nurse practitioner will recommend for the patient taking into consideration the duration required for blood pressure reduction. (9)

A

3.1.1. The Nurse will recommend Lifestyle modification which entails the following:

  • Sarah has to have a low-salt diet or salt-free diet because high salt levels could increase the BP more and could cause a stroke.
  • Sarah has to maintain an ideal body weight that has a BMI< 24,5kg/m2 so that she does not predispose herself to life-threatening BP levels.
  • Sarah would also have to cut down on carbohydrates and fatty infested foods as this may exacerbate her hypertension and result in Coronary artery diseases.
  • Lastly, she would have to exercise by doing 30-45 minutes of Brisk-walking without stopping at least 3 times a week.
  • This treatment plan of trying to decrease hypertension with lifestyle modification must all be done in within 6 months ••••
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14
Q

Scenario 3

  1. 2 Sarah’s blood pressure is consistently elevated (159/99 mmHg) whenever she measures it at work. At the next follow-up visit, she is also given a prescription for a diuretic to help with her blood pressure control. With regards to the prescribed diuretic, mention:
  2. 2.1 The drug example (1)
  3. 2.2 At least two (2) conditions in which the drug is contraindicated (2)
A

3.2.1. Hydrochlorothiazide

3.2.2.• Severe renal impairment
• Hypokalemia
• Hypercalcemia

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15
Q

Scenario 3
3.3 Eight months later during her follow-up visit, Sarah’s blood pressure is still elevated despite adherence to therapy.

3.3.1 Discuss her treatment mentioning the class of drugs used, and for each class at least one (1) drug example. (9)

A

3.3.1. •Hydrochlorothiazide- Diuretic- 12.5mg, oral daily.
•Amlodipine- Calcium channel blocker- 5mg,oral, daily

•Enalapril- ACE inhibitor- 10mg oral, daily

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16
Q

Scenario 4

  1. 1 Mr Kheswa, 48-years old, was diagnosed with type 2 diabetes mellitus. Regarding management of this patient:
  2. 1.1 Mention the name of the drug and the class it belongs to (4)
  3. 1.2 Regarding the above-mentioned drug, list at least three (3) conditions in which it is contraindicated (3)
  4. 1.2 Apart from the drug, what can you also recommend for this patient? (2)
A

4.1.1. Metformin- Biguanide class

4.1.2. • Renal impairment- GFR<30mL/min
• Recent myocardial infarction 
•Hepatic dysfunction
• Pancreatitis
• Uncontrolled cardiac failure

4.1.2. Lifestyle modification:
•Weight loss
•Well balanced diet (Veg 50% of the plate, whilst proteins & starch are 25%)
•Exercise to redu ce weight

17
Q

Scenario 4
4.1.3 Mr kheswa’s hemoglobin A1C level is 9% six months later after the above-mentioned treatment and recommendations were implemented.

4.1.3.1 Mention drugs that you can prescribe for Mr Kheswa (6)

A

• Sulphonyureas e,g Glimeperide or Glibenclamide
OR
• Intermediate-acting insulin e.g Actraphane (↑ dose in the morning & ↓ dose at night)
OR
• Biphasic insulin

18
Q

Scenario 5

  1. 1 A 45-years old, Mr Makhwenzi is being treated for an infected stage IV sacral pressure ulcer. The wound cultures have indicated the presence of Methicillin- Resistant Staphylococcus aureus (MRSA).
  2. 1.1 Mention the name of the drug you will administer to treat this patient (2)
A

5.1.1

19
Q

Scenario 5
5.1 A 45-years old, Mr Makhwenzi is being treated for an infected stage IV sacral pressure ulcer. The wound cultures have indicated the presence of Methicillin- Resistant Staphylococcus aureus (MRSA).

  1. 1.2 Mention at least two (2) adverse effects associated with using the above-mentioned drug (2).
  2. 1.3 Mention the reason for recommending therapeutic drug monitoring for the above-mentioned drug. (2)
A
  1. 1.2.

5. 1.3.

20
Q

Scenario 6
6.1 An 60-year old man with type 2 diabetes mellitus and ischemic pain in the lower extremity is scheduled for femoral-to popliteal artery bypass surgery. He has a history of hypertension and coronary artery disease with symptoms of stable angina. He can walk only half a block before pain in his legs forces him to stop. He has a 50-pack-year smoking history but stopped 2 years ago. Medications include atenolol, atorvastatin, and hydrochlorothiazide. The following preoperative vital signs are recorded: temperature 36.8°C (98.2°F), blood pressure 168/100 mm Hg, heart rate 78 bpm, oxygen saturation by pulse oximeter 96% while breathing room air, and pain 5/10 in the right lower leg after walking into the hospital.

6.1 Discuss anesthetic agents you will choose for his anesthetic plan (12)

A

6.1.

21
Q

Scenario 7
7.1 A 48-year-old man presents with complaints of bilateral morning stiffness in his wrists and knees and pain in these joints on exercise. On physical examination, the joints are slightly swollen. The rest of the examination is unremarkable. His laboratory findings are also negative except for slight anaemia, elevated erythrocyte sedimentation rate, and positive rheumatoid factor. Diagnosis of rheumatoid arthritis has been made.

7.1.1 Discuss the treatment of this patient, describing the analgesic drug and maintenance therapy, the mechanism of action of these drugs, and mentioning at least two (2) adverse effects for each drug (12).

A

7.1.1

Pharmacology (5 decks)

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