NR-566 Advanced Pharmacology for Care of the Family

Final Exam Review Study Guide

1. know INR target for stroke/afib

a. (INR) target of 2.0 to 3.0 for preventing ischemic stroke in atrial

fibrillation.

2. who can get hep B vaccine

a. The current recommendations for childhood immunizations include

administering the three-dose HBV series to newborns or at age 11 to

12 years to children not previously vaccinated. The series can be

started at any age, although it is recommended that preterm infants

be at least 1 month of age before starting HPV series

b. Vaccination with HBV is recommended for all ages, particularly

patients at high risk of contracting hepatitis B. Those at high risk

include IV drug users, infants born to mothers who are HbsAgpositive, hemodialysis patients, sexually active people with multiple

partners, incarcerated people, international travelers, household

contacts of hepatitis B carriers, and sexual contacts of hepatitis B

carriers. Patients who are getting tattoos or who share razors,

toothbrushes, or body-piercing jewelry are also at risk of contracting

hepatitis B. Health-care workers, daycare staff, and other people who

may have exposure to body fluids also have a greater risk of

contracting hepatitis B. Patients with diabetes are at increased risk of

contracting HBV and it is recommended they receive the HBV series

3. who can get tuberculin screening?

a. Targeted screening for TB is usually based on the patient's presenting

with an identified risk factor. In some areas of the country, routine TB

testing is part of all health maintenance visits because of an increased

incidence of TB in the area. 

b. Patients identified as being at risk are those with compromised

immune systems (e.g., HIV-positive or undergoing

immunosuppressive therapy or prolonged adrenocorticosteroid

therapy), close contacts of patients with newly diagnosed infectious

TB, injection drug users known to be HIV seronegative, foreign-born

persons from high-prevalence countries, medically underserved lowincome populations, and residents and staff of long-term-care

facilities or prisons. All health-care providers should be screened

routinely.

4. ultimate goal of therapy for HIV

(1) reduce HIV-associated morbidity and prolong the duration and quality of

survival

(2) restore and preserve immunological function

(3) achieve maximal and durable suppression of plasma HIV viral load, (4) and

prevent HIV transmission

o maximal suppression goal HIV RNA less than 50 copies/mL goal

• Improve quality of life

• Obtain maximal and durable suppression of HIV

• Prevent vertical HIV transmission

• Prolong survival

• Reduce HIV-related morbidity

• Reduce transmissibility of HIV

• Restore and preserve immunological function

5. t score and what to do

o T scores of less than 2.5 are the major focus of any prefracture

treatment. Those patients with BMD T scores between −1.0 and

−2.5 with other factors that increase fracture risk to more than 20%

in 10 years are also considered for drug interventions.

o The T-score on your bone density report shows how much your

bone mass differs from the bone mass of an average healthy 30 year

old adult. A bone density test is like any other medical test or

measurement. The results for the entire population will be

distributed around an average score (the mean). A T-score is a

standard deviation — a mathematical term that calculates how

much a result varies from the average or mean. The score that you

receive from your bone density (BMD or DXA) test is measured as a

standard deviation from the mean. The manufacturers of the DXA

machines have programmed them to use a formula to compute

these values.

o Most commonly, your BMD test results are compared to the ideal or

peak bone mineral density of a healthy 30-year-old adult, and you

are given a T-score. A score of 0 means your BMD is equal to the

norm for a healthy young adult. Differences between your BMD and

that of the healthy young adult norm are measured in units called

standard deviations (SDs). The more standard deviations below 0,

indicated as negative numbers, the lower your BMD and the higher

your risk of fracture.

o As shown in the table below, a T-score between +1 and −1 is

considered normal or healthy. A T-score between −1 and −2.5

indicates that you have low bone mass, although not low enough to

be diagnosed with osteoporosis. A T-score of −2.5 or lower indicates

that you have osteoporosis. The greater the negative number, the

more severe the osteoporosis.

6. metronidazole education

o When mixed with alcohol, metronidazole has the potential to cause

disulfiram-like reactions. Alcohol should not be consumed during or

for at least 1 day following completion of metronidazole therapy.

o The treatment regimen for trichomoniasis includes oral

metronidazole or tinidazole (CDC, 2010). Patients need to be advised

to avoid consuming alcohol during treatment with metronidazole.