Pharm NPTE and Class Questions Exam 1

PT reviews the medical record of a 77-year-old patient who was prescribed a non-steroidal anti-inflammatory medication for pain post-arthroscopic surgery. If toxicity is the primary concern, the physician would have likely prescribed an analgesic that possesses which of the following drug characteristics?

A short half-life

An 89-year-old individual who is living independently in the home has a history of 3 falls in the last 3 months. A referral was initiated to a home health agency for PT evaluation and intervention. The visiting therapist begins the initial visit by obtaining an accurate history including medications. Which of the following types of drugs are strongly linked to falls in the elderly?

Antidepressants

An elderly patient presents to PT after a fall onto an outstretched arm, now complaining of (L) wrist pain. The patient states current medications are Aricept, Lasix, and warfarin but cannot recall what each is for. The patient has difficulty describing the exact incident and is withdrawn and distant. Upon examination of the wrist, the PT notes multiple contusions along the wrist and forearm, as well as limited AROM with pain into extension. What is the therapist's next BEST step?

Continue with the examination

A physical therapist enters the home of a patient recently discharged from the hospital. The patient provided a printed list of medications the hospital provided with her discharge paperwork. The patient then brings out a straw basket of medications. There were 17 different medications in the basket, some dating about 10 years old. What is the FIRST STEP the physical therapist should take?

Create a list of medications (prescription and OTC) that the patient is currently taking

A PT is reviewing the medication list of a patient with osteoarthritis during an initial visit. All the medicines and supplements they are taking were prescribed by their physician. Which combination of medications or supplements is a red flag?

Naproxen 500 mg 2x/day and Aleve 500 mg 2x/day

A home care PT receives a referral to evaluate the fall risk potential of an elderly community-dweller with chronic coronary artery disease. The patient has fallen 3 times in the past 4 months, with no history of fall injury except minor bruising. The patient is currently taking a number of medications. What is the drug that is MOST LIKELY to contribute to dizziness and increased fall risk?

Nitroglycerin

A female patient underwent a total knee replacement 2 weeks ago and is seen for the first outpatient PT appointment to regain locomotor mobility. In addition to post-surgical knee pain, the patient is upset and complains of some considerable low back pain (LBP) since surgery. There was no history of previous LBP. The patient also reports bloating and passing small amounts of liquid stool, which is not usual. Past medical history includes HTN, HLD, OA, and T2DM. Her BMI is 32. The only medication change is oxycodone for pain. Based on this information, what is the MOST LIKELY cause of the patient's LBP?

Opioid-induced constipation

A note in a patient's medical record indicates a specific drug is taken through enteral administration. Which of the following is an example of enteral administration?

Oral

A patient with a history of interstitial lung disease is being evaluated for treatment of chronic back pain. The patient has been administered opioids for the pain. What potential side effect of opioids should be a concern?

Respiratory depression, which could reduce the patient's tolerance to exercise

A physical therapist reviews a patient's medical record prior to beginning treatment. The record indicates the patient was recently placed on amitriptyline (Elavil). Which of the following responses is the MOST COMMON SIDE EFFECT associated with this tricyclic antidepressant?

Sedation.

Medication information gathering should be performed during which portion of the PT examination?

The history

üNSAIDs can be effective in treating arthritic pain because these drugs inhibit the __________ enzyme that initiates __________ synthesis.

cyclooxygenase; prostaglandin

Early and aggressive use of __________ can slow the progression of rheumatoid arthritis in many patients before there is extensive damage to affected joints.

disease-modifying antirheumatic agents.

The most common problem associated with NSAIDs such as aspirin (Bayer) is:

gastrointestinal damage

When crossing cell membranes, drugs will diffuse more readily through the lipid layer if they are:

in a neutral, nonionized form

The first pass effect is of particular concern when drugs are administered

orally (PO)

A drug that fails to evoke a maximal response even though it occupies all available receptors is known as a:

partial agonist

Certain patients can develop "tolerance" to opioid analgesics, which is indicated by

the need to progressively increase the dosage of the drug to achieve a therapeutic effect when the drug is used for prolonged periods.