Pharmacology Flashcards

A patient with atrial fibrillation is started on digoxin. The FNP should counsel the patient to report which EARLY sign of toxicity?

Answer: Nausea, vomiting, and visual disturbances

Early digoxin toxicity classically presents with GI symptoms (nausea, vomiting) and yellow-green visual halos before more serious cardiac arrhythmias occur.

The FNP prescribes an oral fluoroquinolone. Which patient education point is MOST critical?

Answer: Avoid antacids within 2 hours of the dose and report tendon pain immediately

Fluoroquinolones chelate with divalent cations in antacids reducing absorption, and carry a Black Box Warning for tendinopathy and tendon rupture.

A patient with hypothyroidism is also started on cholestyramine. The FNP should advise that levothyroxine be taken:

Answer: At least 4 hours before or after cholestyramine

Cholestyramine binds levothyroxine in the GI tract and significantly impairs its absorption, requiring a 4-hour separation.

Which medication used for type 2 diabetes is associated with the highest risk of hypoglycemia?

Answer: Glipizide (sulfonylurea)

Sulfonylureas stimulate insulin secretion regardless of blood glucose levels, making hypoglycemia their primary adverse effect.

A patient taking allopurinol for gout asks about alcohol use. The FNP explains that:

Answer: Alcohol raises uric acid levels and can trigger gout flares, undermining treatment

Alcohol, especially beer and spirits, increases uric acid production and decreases renal excretion, worsening gout control.

The FNP is treating an uncomplicated UTI in a non-pregnant woman. Which antibiotic is preferred as FIRST-LINE according to current guidelines?

Answer: Nitrofurantoin or trimethoprim-sulfamethoxazole

IDSA guidelines recommend nitrofurantoin (5 days) or TMP-SMX (3 days) as first-line for uncomplicated UTI to preserve fluoroquinolones for more serious infections.