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Grand Canyon University FNP 654


APEA Predictor Exam Study
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First-Pass Effect 1. CYP450 metabolizes the drug in the liver to release the drug to the body where it
can be used.
1. What cytochrome metabolizes a medication drug during 2. Active
the FIRST-PASS Effect? 3. True
2. CYP450 enzyme is the most _____________.
3. It can either be induced or inhibited (T/F)



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1. Increase in fat-to-water ratio, decrease in liver function, decrease in GFR
Pharmacokinetics


1. What are age-related changes?
(Distribution, Metabolism, Excretion)?


Pharmacology: Cardiac Glycosides 1. Second and Third
2. N/V, Hyperkalemia, Confusion, visual color changes
1. What order of line of treatment is Digoxin? 3. Digoxin level, CMP, EKG
2. Signs of Digoxin Overdose 4. Digoxin-specific antibodies
3. Laboratory tests
4. Treatment


Pharmacology: Warfarin (Coumadin) 1. X
2. 2.0-3.0, 2.5-3.5
1. Category ____ for pregnancy. 3. Cardiologist or anticoagulation clinic
2. Target INR for patients without mitral prosthetic valves? 4. Check every 2-4 weeks up to 12 weeks.
With prosthetic valves? 5. Continue warfarin dose, retest INR in 1-2 weeks.
3. Referral to ________ for initiation and stabilization of 6. Omit one dose, recheck INR.
warfarin dose. 7. Take the dose as soon as possible. Do not double dose.
4. How often do you check for consistently stable INR? 8. Vitamin K foods
5. How often do you check for single out-of-range INR?
6. What do you educate the patient to do if the INR less
than 5 with no significant bleeding risk?
7. If one dose is missed, what do you do?
8. What kind of foods to avoid messing up the INR?




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Pharmacology: Direct Oran Anticoagulants (DOAC) 1. Less monitoring and less side effects
2. Apixaban (Eliquis)
1. Why are DOACs better than Warfarin? 3. 10 days
2. Example of DOACs?
3. How long does it take for platelet function to return to
normal after a patient stops taking Plavix?


Pharmacology: Thiazide Diuretics 1. HCTZ, Chlorthalidone
2. Sulfa allergy
1. Examples 3. Hykpokalemia, increases uric acid and increases LDL
2. Contraindication 4. Calcium, True
3. Adverse effects
4. Patients with osteoporosis receive an extra benefit from
thiazide diuretics by reducing __________ excretion (T/F)


Pharmacology: Potassium-Sparing Diuretics 1. Triamterene, Amiloride
2. Hyperkalemia
1. Examples 3. Elevates K+ levels
2. Contraindication 4. ACEIs and ARBs
3. Adverse effects
4. Do not combine with which cardiac drugs to prevent
hyperkalemia?


Pharmacology: Loop Diuretics 1. Furosemide
2. Sulfa Allergy
1. Examples 3. Hypokalemia, Hyponatremia, hypomagnesemia
2. Contraindication/Allergy 4. Ototoxicity
3. Adverse effects
4. Which toxicity with loop diuretics can occur?




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