NR 566 Week 4 MidTerm Review

Professor question: Why are statins recommended in the evening instead of morning? (pg 561) After starting John on insulin, he calls the office saying he feels bad. He said when he checked his blood sugar before calling ...

Professor question: Why are statins recommended in the evening instead of morning? (pg 561) After starting John on insulin, he calls the office saying he feels bad. He said when he checked his blood sugar before calling it was 52 mg/dl. What instructions should he be given? Professor question: What diabetic medications would be contraindicated in patients with heart failure? Which diabetic drug(s) may have beneficial effects in heart failure? (text has info on this but ADA 2020 guidelines has even more up to date info on this topic, so here is the page. See Recommendation 9.9 and 9.10) https://care.diabetesjournals.org/content/43/Supplement_1/S98 Professor question: What lab do we need to check prior to starting metformin? (hint: which organ function needs to be evaluated?) What other potential adverse effects are there associated with metformin? (Micromedex in the library is a good source for this info) Professor question: The GLP1RA class drugs end with “-tide”. They are highly recommended as a second agent after metformin by both ADA and AACE/ACE guidelines. Per ADA guidelines:…… continue…. According to the text, what effect does carbamazepine have on thyroid function tests? What is the difference b/w total and free T4? Professor question: Can you review in our text the sulfonylurea class? What is the MOA, what are some examples? What are the adverse effects? Thanks!! Professor question: If our patient had HF and Afib, he might … on digoxin. What medication for DM can decrease digoxin levels? (class and examples) Professor question: Jason- glad you recognized that contrast dye can be an issue for patients on metformin. Can you read this (older, I know) article that explains why it is a concern rather than binding with contrast dye? Professor question: Can you review for us what the ADA criteria for diagnosis of T2DM are? Professor question: If John’s A1C remains … and he does not have any indicators or at high-risk for ASCVD, CKD, or HF, a thiazolidinedione (TZD) could … (American Diabetes Association, 2020). How do thiazolidinediones help control blood sugar? Why is it important that there is little to no risk indicators for cardiovascular involvement when prescribing TZDs? Professor question: One class of diabetic drugs sometimes used is meglitinides. What is an important teaching point about this drug for patients to make sure the drug is most effective? Professor question: What side effects are most common for GLP-1 receptor agonists? What diseases would … to have with the administration of GLP-1 receptor agonists? Professor question: If John is started on insulin and he still struggles to meet A1C goals, a sodium–glucose cotransporter 2 (SGLT2) inhibitor to insulin therapy has shown the ability to improve A1C levels while also aiding in decreasing body weight when compared with insulin therapy alone (American Diabetic Association, 2020). How do SFLT2 drugs work and what are some examples of drugs in that class? Pg 589 Week 2 Professor FACTS: The current IDSA guidelines (2019) recommend the following 3 options when treating CAP in a previously healthy patient:……. Professor question: Can you tell us (from the text), what is the definition of drug-resistant TB? Professor question: From our text can you tell us the findings of the SMART trial regaring salmeterol use? Professor question: According to our text, what is the advantage of using transdermal nicotine over nicotine gum? Professor question: Theophylline is not … very often anymore but we may see it … by a specialist when inhaled therapy is insufficient. The reason is that this is a drug with a narrow therapeutic window- it is … with toxicities including seizures. It is a drug that requires monitoring of drug levels. According to our text, are there any considerations regarding theophylline and type of diet? Professor question: If a woman is pregnant and taking INH, what supplement do we need to advise? (see text) Professor question: What type of medication is Spiriva? What is the generic name? Week 3 Professor question: As we discuss medications for HTN this week let’s consider a pregnant women and women of childbearing age who might become pregnant. What classes are … for pregnant woman? Professor question: One of our reading topics this week is reduction of lipids. Can you tell us about fenofibric acid? What is it … for and how does it work? At what level of hypertriglyceridemia should it … considered to reduce the risk of pancreatitis? Professor question: Thanks! To help with our topic of lipid management this week, what lab test should we order if a patient on a statin develops muscle pain? Professor question: To help with our review of lipid therapies this week, will you tell us about ezetimibe (Zetia)? What is it MOA and is it a first line agent? Professor question: If a patient has heart failure why would we need to … cautious about prescribing calcium channel blockers? Which CCB have the strongest neg inotropic effect? Professor question: Can you review the discussion of angina which discusses imbalance between myocardial oxygen supply (MOS) and demand (MOD) in the myocardium. Which of the following drugs affect MOS? Which affect MOD? professor question: What antihypertensive class is … in a patient with DM who has microalbuminuria? According to the text, what are conditions would this class … for? Professor question: What is the dosing schedule for long acting isosorbide mononitrate and why? Professor question: According to our text, what lipid abnormality is most likely to benefit from omega 3 FA supplementation? Professor question: To help with this week’s study can you review from the text the causes of systolic heart failure? Professor question: What is the dosing schedule for ACEIs? (how many times per day are they taken?) Professor question: According to the text, what labs should … in a week after initiating an ACEI? Why? Professor question: What anti-arrhythmic medication in the reading this week requires pulmonary and thyroid function monitoring every 6 months? Professor question: Can you review the classes of angina from our text? Professor question: From our text, can you review the statin strength from weakest to highest? NR 566 Week 4 MidTerm Review Know what meds you would give for asthma and COPD (LABA and intermittent use) What to do when a patient calls you with hypoglycemia How many gms of carb is … during hypoglycemic episode how many mcg of dietary intake of iodine alendronate (Fosamax) patient education- osteoporosis what medication decreases the T4 First choice for hypertension – which diuretic Besides hypertension, BB are … for (I selected MI) Mechanism of action of Theophylline What should you test a patient c/o muscle pain, on atorvastatin 7 yo with pneumonia, what to give if already on amoxicillin What to give for high cholesterol if cannot take statins – name of medication Which inhaler to give on asthma exacerbation Nicotine replacement drugs– bupropion should … with what? INH – risk for liver toxicity Angina patient should be on ASA Angina and diabetic should be on what Which medication to take for SVT MOA of nitroglycerine sublingual Goal for HgA1C when on tx; Glucagon route; How glucagon is given MOA of insulin Stages of asthma adults (>12yrs) what to give pregnant pt with TB know what hgA1c percent is equal to blood sugar/ levels Aspirin is … to all patients with cardiovascular disease Which drug to give peds pt with chlamydial pneumonia Teaching for pancreatic enzymes pt has pneumonia, on doxycycline, and comes back 3 days later says he feels better but cxr is worse What to do about angina and SL nitro Fibric acid Most common pathogen for CAP Stages of angina