Semester 2 Pharmacology Final

Question 1

Which WBCs are considered the “soldiers” of the immune system?

Answer 1

Neutrophils

Question 2

What is the normal range for ANC?

Answer 2

1.5 - 8 (1,500 - 8,000)

Question 3

What is the normal range for platelets?

Answer 3

150,000 - 400,000

Question 4

Epoetin alfa therapy is most commonly used/most successful for anemia cause by which three problems?

Answer 4

Chronic kidney disease, chemotherapy, and HIV patients taking zidovudine

Question 5

Why are ESAs (erythropoiesis-stimulating agents) never taken PO?

Answer 5

Because digestive enzymes would destroy the drug

Question 6

If Hgb is _____ or over or increases more than _____ in one week, decrease epoetin alfa dosage by ____%

Answer 6

12 g/dL
1 g/dL
25%

Question 7

Which BRM is not given IM if the patient’s platelet count is <50,000 and why?

Answer 7

Interferon Alpha, because giving it IM will cause bleeding. In these cases, subQ is the preferred route

Question 8

What blood-related adverse effect is caused by Interferon Alpha?

Answer 8

Pancytopenia (leukopenia, anemia, thrombocytopenia)

Question 9

What are the dose-limiting adverse effects for Interferon Alpha?

Answer 9

Fatigue, anorexia, depression, SI/suicide attempts, increased BUN/Cr, proteinuria

Question 10

What test will be done before administering Interferon Alpha and why?

Answer 10

EKG, to determine if any underlying cardiac problems (the drug can cause tachycardia, tachypnea, pallor, orthostatic hypotension, MI)

Question 11

What are the most serious adverse effects of Interleukin-2?

Answer 11

Capillary leak syndrome and sepsis/bacterial endocarditis

Question 12

What would you monitor prior to administering Epoetin Alfa?

Answer 12

CBC, cardiac history, iron stores

Question 13

What nursing assessments should be done when administering Epoetin Alfa?

Answer 13

Monitor BP, CBC (treatment is reduced once Hgb ≥12), signs of MI or stroke, and side effects such as n/v/d, joint pain, and headache

Question 14

What supplement will patients also take when taking Epoetin Alfa?

Answer 14

Iron

Question 15

What are the ESA contraindications?

Answer 15

Patients who have uncontrolled HTN or sensitivity to human albumin/polysorbate/mammalian cell-derived products

Question 16

What are the two primary indications for filgrastim?

Answer 16

Chemo-related neutropenia and to increase stem cell production for collection in cancer patients

Question 17

What is the only CONSISTENTLY observed side effect of filgrastim?

Answer 17

Bone pain

Question 18

What is the dose-limiting toxicity side effect of filgrastim?

Answer 18

Fatigue

Question 19

What is the rarest but most serious adverse effect of filgrastim?

Answer 19

Splenic enlargement/rupture

Question 20

Filgrastim dosing is dependent on what?

Answer 20

Absolute neutrophil count (ANC)

Question 21

Why should patients not take lithium if they are taking pegfilgrastim?

Answer 21

It increases the risk of stroke and heart attack due to the increase in WBCs

Question 22

Which lab tests are required for monitoring function throughout administration of interferon alfa?

Answer 22

CBC, platelet count, Cr, ALT/AST

Question 23

What is an important patient teaching point if a patient is taking ribivirin with interferon alfa?

Answer 23

Use two birth control methods–ribavirin can cause congenital anomalies if EITHER parent is taking it

Question 24

What is peginterferon alpha primarily used for?

Answer 24

Chronic hepatitis C

Question 25

Which types of proteins stimulate and regulate the growth, maturation, and differentiation of bone marrow stem cells?

Answer 25

Colony-stimulating factors (CSF)

Question 26

What is Interferon-beta primarily used for?

Answer 26

Multiple sclerosis

Question 27

What s/s indicate that a patient should immediately stop taking interleukin-2 (aldesleukin)?

Answer 27

Lethargy, hypotension, GI bleed, infection, capillary leak syndrome

Question 28

Which class of drug should be avoided when taking oprelvekin and why?

Answer 28

Diuretics. They increase the risk of hypokalemia, decreased Hgb, and increased plasma fibrinogen

Question 29

What is the most serious side effect of oprelvekin?

Answer 29

Anaphylaxis

Question 30

What s/s indicate oprelvekin should be discontinued?

Answer 30

Bronchospasm, wheezing, chest tightness, swelling of the face/lips/throat, itching, rash, or fever

Question 31

What is the most serious adverse effect of sargramostim?

Answer 31

Pleural and pericardial effusion

Question 32

Liver damage, pleural/pericardial effusion, dyspnea, and renal dysfunction are the dose-limiting toxicity adverse effects of which drug?

Answer 32

Sargramostim

Question 33

Which class of drug is oprelvekin?

Answer 33

Thrombopoietic growth factor

Question 34

What type of hormonal contraceptive is indicated for breastfeeding patients and why?

Answer 34

Progestin only, because estrogen decreases milk production

Question 35

What are the absolute contraindications for combined oral contraceptives?

Answer 35

Age ≥35 and >15 cigs a day, CV disease, hepatic disease, history of thromboembolitic events, breast cancer/estrogen-dependent cancer, liver disease, known or suspected pregnancy, undiagnosed vaginal bleeding

Question 36

What is anastrazole and what is its function?

Answer 36

It inhibits the synthesis of estrogen and is used to treat breast cancer

Question 37

What type of hormonal contraceptive is used to treat endometriosis?

Answer 37

Progestin-only

Question 38

Why is estrogen-only replacement therapy ONLY appropriate for people who no longer have a uterus?

Answer 38

It increases the risk of uterine cancer

Question 39

What vitamins should be taken with hormonal contraceptives to help prevent bone density loss?

Answer 39

Calcium and Vitamin D

Question 40

Which class of drugs are most commonly used to treat endometriosis and what are they called?

Answer 40

GnRH agonists. Leuprolide and nefarelin. They cause "pseudomenopause" due to interfering with the hormones needed for ovulation.

Question 41

What are the contraindications of HRT?

Answer 41

Family history of breast cancer, hx of coagulation disorders, hx of CVD

Question 42

During which trimesters is iron taken?

Answer 42

2nd and 3rd (fetus starts storing iron during the 2nd trimester)

Question 43

What is the main side effect of iron supplements?

Answer 43

Constipation

Question 44

What is the firstline drug of choice for hyperemesis gravidarum?

Answer 44

Diclegis (doxylamine/pyridoxine)

Question 45

Why are NSAIDs contraindicated during pregnancy?

Answer 45

They cause fetal kidney problems, low amniotic fluid, and the ductus arteriosus to close (the blood vessel which connects the pulmonary artery to the aorta, bypassing the lungs since they aren't developed yet)

Question 46

What are the adverse effects of terbutaline?

Answer 46

Tachycardia, tremors, and palpitations

Question 47

What reverses the effects of terbutaline?

Answer 47

Propanalol

Question 48

What does magnesium sulfate do for the fetus when given as a drip?

Answer 48

It is a neuroprotectant and can help protect against CP and intraventricular hemorrhage

Question 49

What is the antidote to magnesium sulfate?

Answer 49

Calcium gluconate

Question 50

What VS is monitored during administration of magnesium sulfate?

Answer 50

Respiratory rate (and lung sounds)

Question 51

What is a common side effect of nifedipine if given as a tocolytic?

Answer 51

Hypotension (assess BP before administering)

Question 52

What is the purpose of administering betamethasone or dexamethasone during pregnancy?

Answer 52

To help mature the fetus's lungs as much as possible before a premature delivery

Question 53

Why might a diabetic patient need more insulin when taking betamethasone?

Answer 53

Corticosteroids increase blood glucose levels

Question 54

What does HELLP syndrome stand for and what causes it?

Answer 54

Hemolysis, elevated liver enzymes, and low platelets. It is caused by eclampsia