Questions 1-10

Question 1

Acetaminophen (tylenol)

Answer 1

1 cause of acute liver failure U.S.

Antipyretic, analgesic
COX inhibitor

NOT anti-inflammatory/no effect on platelets

Use appropriate strength for children to avoid toxicity
NEVER use if consuming alcohol- hepatotoxic

Poisoning symptoms:

• Anorexia
• Nausea
• Vomiting
• dizziness
• Lethargy

Question 2

Asthma attack rescue inhaler options

Answer 2

Quick relief: short and intermediate Beta-2 adrenergic agonists, anticholinergics, systemic corticosteroids

Long term: Inhaled corticosteroids, mast cell stabilizers, Leukotriene modifiers, long acting beta-2 adrenergic agonists, methylxanthines, immunomodulators

Question 3

Chemo agents treatment goals/strategies

Answer 3

Cure
Control
Pallation

Adjuvant chemotherapy: antineoplastic drugs after surgery or radiation

Question 4

Acyclovir (Zovirax)

Answer 4

Antiviral for herpes
topical PO or IV

Can be administered up to 5 times/day
Administer around clock even if interrupting sleep

If IV may cause painful inflammation

Nephrotoxicity and neurotoxicity are possible when given IV

Can be given for prophylaxis to decrease flare ups

Question 5

HIV treatment goals

Answer 5

Reduce HIV related morbidity and prolong survival

Improve quality of life

Restore and preserve immune function

Suppress plasma HIV load to max extent

Prevent HIV transmission

Question 6

Viral Load

Answer 6

HIV RNA in blood

Most important indicator of how virus is replicating in body, assess pharmacotherapy proficiency

Question 7

Montelukast (Singulair) for asthma

Answer 7

Anti-inflammatory
Asthma prophylaxis

Leukotriene modifier

Used for chronic asthma control
Given PO, acts rapidly- not for acute instances though

Only drug in this class for pediatric

Take 2 hours BEFORE activity if for exercise-induced bronchospasm

AE:

• Suicidal ideation
• Hallucination
• HA, nausea, diarrhea

Question 8

Beclomethasone (Beconase) for asthma

Answer 8

Inhaled corticosteroid

First line for long term management of asthma in children and adults

Not for use in asthma attacks
Reduces nasal rhinitis

AE:

• Observe pt for corticosteroid toxicity
• Hoarseness/dry mouth
• Cataracts
• Can mask signs of infection
• Oropharyngeal candidiasis
• Pediatric growth stunting

Question 9

Fluticasone (Flonase) for allergic rhinitis, asthma. Decreases local inflammation

Answer 9

Corticosteroid spray

2 sprays each nostril/day, twice daily
Decreases to one dose per day

Can mask signs of infection

Question 10

Dextromethorphan (Robitussin) for coughs

Answer 10

Cough suppressant antitussive

Rapid onset of action
Lacks analegesic and euphoric effects of opioids. No dependence.

If cough not relieved after several days, notify provider

Avoid pulmonary irritants, MAOIs

AE:
-Can cause CNS toxicity if abused

Don’t use if cough due to bronchial secretions (asthma, emphysema etc.)
Caution with children

Question 11

Ipratropium (Atrovent, Combivent) for asthma and COPD

Answer 11

Bronchodilator anticholinergic

When paired w/albuterol first line for COPD bronchospasm.

Prescribed off label for asthma (alternative to SABAs)

relief of runny nose from common cold and rhinitis
Treatment limited to 3 weeks

wait 2-3 min between doses

AE:

• Can cause upper respiratory irritation
• Bitter taste
• Epistaxis