CMS PHARMACOLOGY PROCTORED EXAM
FINAL PAPER 2026 COMPLETE SOLUTIONS
AND CORRECT ANSWERS GRADED A+
⩥ N-acetylcysteine (NAC). Answer: Antidote for acetaminophen
toxicity; protects liver by restoring glutathione.
⩥ Activated charcoal. Answer: Antidote/adsorbent (early ingestion);
binds toxin in GI tract; must be given early.
⩥ Atropine. Answer: Reverses cholinergic effects (e.g.,
organophosphates, bradycardia); increases HR; decreases secretions.
⩥ Opioid overdose with respiratory depression. Answer: Priority: 1.
Airway + oxygen 2. Naloxone 3. Continuous monitoring.
⩥ Benzodiazepine overdose. Answer: Priority: Airway protection,
Oxygen, Monitoring.
⩥ Beta-blocker overdose. Answer: No simple antidote; Support BP, HR;
IV fluids; Vasopressors; Glucagon (advanced care).
, ⩥ Calcium channel blocker overdose. Answer: Hypotension,
bradycardia; Supportive care (fluids, calcium, pressors).
⩥ Tricyclic antidepressant overdose. Answer: Sodium bicarbonate;
Cardiac monitoring; Airway protection.
⩥⩥ Absorption. Answer: How drug enters bloodstream; affected by
route, blood flow, GI motility, food, pH, and formulation (IR vs ER).
⩥ IV route absorption. Answer: No absorption step—drug is
immediately in bloodstream → fastest onset, highest risk for error.
⩥ First-pass effect. Answer: Oral drugs can be
metabolized/inactivated by liver before reaching circulation → less
bioavailability.
⩥ Bioavailability. Answer: Percent of drug that reaches systemic
circulation; IV = 100%.
⩥ Distribution. Answer: Movement of drug through body; influenced
by blood flow, body fat/water, capillary permeability, and protein
binding.
FINAL PAPER 2026 COMPLETE SOLUTIONS
AND CORRECT ANSWERS GRADED A+
⩥ N-acetylcysteine (NAC). Answer: Antidote for acetaminophen
toxicity; protects liver by restoring glutathione.
⩥ Activated charcoal. Answer: Antidote/adsorbent (early ingestion);
binds toxin in GI tract; must be given early.
⩥ Atropine. Answer: Reverses cholinergic effects (e.g.,
organophosphates, bradycardia); increases HR; decreases secretions.
⩥ Opioid overdose with respiratory depression. Answer: Priority: 1.
Airway + oxygen 2. Naloxone 3. Continuous monitoring.
⩥ Benzodiazepine overdose. Answer: Priority: Airway protection,
Oxygen, Monitoring.
⩥ Beta-blocker overdose. Answer: No simple antidote; Support BP, HR;
IV fluids; Vasopressors; Glucagon (advanced care).
, ⩥ Calcium channel blocker overdose. Answer: Hypotension,
bradycardia; Supportive care (fluids, calcium, pressors).
⩥ Tricyclic antidepressant overdose. Answer: Sodium bicarbonate;
Cardiac monitoring; Airway protection.
⩥⩥ Absorption. Answer: How drug enters bloodstream; affected by
route, blood flow, GI motility, food, pH, and formulation (IR vs ER).
⩥ IV route absorption. Answer: No absorption step—drug is
immediately in bloodstream → fastest onset, highest risk for error.
⩥ First-pass effect. Answer: Oral drugs can be
metabolized/inactivated by liver before reaching circulation → less
bioavailability.
⩥ Bioavailability. Answer: Percent of drug that reaches systemic
circulation; IV = 100%.
⩥ Distribution. Answer: Movement of drug through body; influenced
by blood flow, body fat/water, capillary permeability, and protein
binding.
