Mods 6-9 Questions

• Glucotrol

  Medication that cannot be used in gestational diabetes
• Non cardioselective beta blockers

  Impair glycogenolysis, which is a means the body can respond to and counteract a fall in blood glucose
• Canagliflozin

  May increase risk of UTIs
• Levothyroxine dosage adjustment

  Thyroid stimulating hormone (TSH) should be reassessed at 6-8 weeks
• Amiodarone

  Can induce thyroid dysfunction
• Levothyroxine dosage for 80 year old with CAD, elevated TSH, low free T4, 80 kg

  12.5-25 mcg
• Hyperthyroidism in first trimester of pregnancy

  Endocrinologist will prescribe Propylthiouracil
• Postmenopausal woman with severe vasomotor symptoms, has uterus

  NP will start her on estrogen and progesterone
• Oral contraceptive pills, wanting to discontinue in 1 year to try for pregnancy

  NP will prescribe Beyaz
• Missed birth control pill, 28 day cycle

  Take the pill as soon as possible and continue the pack. Use another form of contraception for 7 days
• Migraines with Aura

  Recommend Mirena IUD for contraception
• Progestin only pills

  One of the main reasons women stop is breakthrough bleeding
• Post menopausal frequent UTIs

  NP will prescribe vaginal estrace 1 gram vaginally weekly
• Sildenafil for ED

  Delayed ejaculation is not a side effect
• Testosterone does not cause hair loss as a side effect
• Alpha adrenergic agents

  Mechanism of action is blockade of alpha 1 receptors and relaxes smooth muscle in the bladder neck
• Type 1 diabetic, insulin glargine and lispro, wisdom teeth removal

  Continue the glargine and take lispro only as a supplement
• Glyberide

  Should be used with caution in a person with Sulfa allergy
• Alpha-glucosidase inhibitor

  Most common adverse effect is GI upset
• Thiazolidinediones (TZDs)

  ALT should be monitored
• Meglitinides

  Helpful adjuncts in Type 2 diabetes to minimize risk of postprandial hyperglycemia
• Levothyroxine dosage for elderly 82 year old

  75% less than what is needed by a young adult
• Methimazole

  Primarily excreted via urine
• Patients taking anti-thyroid drugs

  Should avoid seafood
• Oral decongestants

  Should be discouraged in patients with cardiovascular disease
• Treating severe bronchospasm in a 19 year old asthmatic in the ED

  Order nebulized short acting beta 2 agonist
• LABAs cannot be used as monotherapy to relieve bronchospasms in asthma
• Dextromethorphan


  Suppresses the cough reflex by direct action on the cough center
• Beta 2 stimulants

  • Frequently cause increased pulse rate
• Tiotropium bromide

  An inhaled anticholinergic used for the treatment of COPD
• Beclomethasone/formoterol

  Needs to be used every day to treat asthma
• Montelukast

  May be prescribed for a 2 year old child with moderate persistent asthma
• Codeine-based antitussives

  Commonly cause constipation as an adverse reaction
• Carvedilol

  Most likely to cause bronchoconstriction in an asthma patient
• H2 receptors

  Play a role in secretion of gastric acid
• H1 receptors

  Play a role in vasodilation and bronchoconstriction
• Insomnia is not an adverse effect of first generation H1 antagonists
• Second generation H1 antagonists

  Are virtually void of all anticholinergic actions
• Diphenhydramine is a first generation H1 antagonist
• Fluticasone does not cause course dry skin