demonstrate significant loss are - femoral neck 27. the beers criteria recommend which muscle relaxant for use in the elderly - none of the above 28. When using the step up approach in caring for pts with GERD, the step up from OTC antacid use is - histamine 2 receptor antagonist Rantidine for 4-8 wks 29. Metoclopramide improves GERD by - increasing lower esophageal tone 30. Isoniazid INH may induce a deficiency of which vitamin - Vitamin B 6 31. grapefruit juice contains furanocoumarins that have been found to - inhibit CYP3A4 leading to a decreased first pass metabolism of drugs 32. cruciferous vegetables may alter drug pharmocokinetics by - inducing CYP 1A2 possibly leading to therapeutic failure of drugs metabolized by CYP 1A2
33. Patrick is a 10yr old who presents with constipation. along with diet changes, a laxative is ordered to provide a more rapid relief. appropriate choice of med for a 10yr old would be - PEG 3350 Miralax 34. Tetracycline needs to be given on an empty stomach because it chelates with - all of the above 35. GERD may be aggrevated by the following medication that effects lower esophageal sphincter (LES) tone - estrogen 36. Glen is an 82 yr old who needs to be prescribed a new drug. what changes in elimination should be taken into consideration when rxing for Glen - decreased tubular secretion of medication will require dosage adjustments 37. when using the step up approach in caring for pts with GERD the step up from once daily ppi use is - PPI omeprazole 2 x daily for 4-8 wks 38. tx failure in pts with PUD associated with H pylori may be due to - antimicrobial resistance 39. Sadis is a 90 y/o pt who requires a new RX. what changes in drug distribution with aging would influence rxing for Sadie - decreased plasma proteins 40. Antacids tx GERD by - increasing gastric pH 41. Phenytoin decreases folic acid absorption by - inhibiting intestinal enzymes required for folic acid absorption 42. Josie is a 5yr old presenting with 48hr n/v/d. unable to keep fluids down and wt is 4 lbs less than last recorded wt. besides IV fluids, her exam warrants use of anti nausea med. which is appropriate - ondansetron Zofran 43. which of the following vitamin or mineral supplements may be teratogenic if a pregnant woman takes more then recommended - Vitamin A 44. many pts self medicate with antacid. which pts should be counseld to not take calcium carbonate antacids without discussing with their provider 1 st - pts with kidney stones 45. robert is c/o poor sleep. medications that may contribute to sleep problems in the elderly are - diuretics 46. fasting for an extended period can - cause vasoconstriction leading to decreased drug absorption 47. food in the gastrointestinal tract affects drug absorption by - altering gastric emptying time 48. infants with reflux are initially tx with - anti reflux maneuvers elevate head of bed 49. Sadie is a 72 yr old who takes omeprazole for chronic GERD. chronic long term omeprazole use places her at risk for - osteoporosis
50. when using a step up approach for GERD the next step up when a pt has been on PPI for 12 wks is -
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