NR 565
NR 565 - ADVANCED PHARMACOLOGY MIDTERM EXAM QUESTIONS
AND ANSWERS GRADED A+ LATEST UPDATE.
During what trimester is a pregnant woman most at risk for adverse drug
reactions with potential long-term consequences? ANS >> 1st trimester (fetes
most at risk d/t rapid growth)
What are BEERS criteria? ANS >> Recommendations of medications
inappropriate for elderly (65 and older), prescriber ultimately decides
What is the CYP450 (cytochrome P450) ANS >> liver enzyme system where
medications are metabolized, can either be inducers or inhibitors and create drug-
drug interactions
CYP450 inducers ANS >> Speed up metabolism of drugs (drug is cleared faster),
drug has lesser effect (decrease blood levels of drug), elevate CYP450 enzymes
,NR 565
CYP450 inducers pneumonic ANS >> “Bullshit Crap GPS INDUCES rage"
CYP450 inducer drug names ANS >> Barbiturates, St John wort, Carbamazepine,
revamping, alcohol, phenytoin, griseofulvin, phenobarbital, sulfonylureas
CYP450 inhibitors ANS >> inhibit metabolism, increase blood levels of
medications
CYP450 pneumonic ANS >> “VISA credit card debt INHIBITS spending on
designers like CK to look GQ"
CYP450 inhibitors drug names ANS >> Valproate, isoniazid, sulphonamides,
amiodarone, chloramphenicol, ketoconazole, grapefruit juice, quinidine
Physiological changes during pregnancy that impact pharmacodynamics and
pharmacokinetic properties of drugs? ANS >> increase glomerular filtration rate
leads to increase drug excretion
increase hepatic metabolism
decrease tone and motility of bowel
increase drug absorption
Examples of medications that can be teratogenic ANS >> Antiepileptic drugs,
antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large
doses, some anticoagulants, and hormonal medications such as diethylstilbesterol
(DES).
,NR 565
How is absorption of intramuscular medications different in neonates? ANS >>
slow and erratic due to low blood flow in muscles first few days of life
Why is absorption of medication in the stomach increased in infancy? ANS >>
delayed gastric emptying
Some medications that should be avoided in the paediatric patient? ANS >>
glucocorticoids, discoloration of developing teeth with tetracyclines, and
kernicterus with sulphonamides, levofloxacin (antibiotics)
aspirin (Severe intoxication from acute overdose)
what should be included in medication administration patient education? ANS
>> dosage size and timing
route and technique of administration
duration of treatment
drug storage
nature and time course of desired responses
nature and time course of adverse responses
finish taking antibiotic
What are some things that put the elderly patient at higher risk for adverse drug
reactions? ANS >> reduced renal function
polypharmacy (the use of five or more medications daily)
greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
, NR 565
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy
poor patient adherence
How can healthcare providers decrease likelihood of an elderly patient
experiencing an adverse drug reaction? ANS >> obtaining a thorough drug
history that includes over-the-counter medications
considering pharmacokinetic and pharmacodynamics changes due to age
monitoring the patient's clinical response and plasma drug levels
using the simplest regimen possible
monitoring for drug-drug interactions and iatrogenic illness
periodically reviewing the need for continued drug therapy
encouraging the patient to dispose of old medications
taking steps to promote adherence and to avoid drugs on the Beers list
How can we promote medication adherence with elderly patients? ANS >>
simplifying drug regimens
providing clear and concise verbal and written instructions
using an appropriate dosage form
clearly labelling and dispensing easy-to-open containers
developing daily reminders
monitoring frequently
affordability of drugs
support systems
NR 565 - ADVANCED PHARMACOLOGY MIDTERM EXAM QUESTIONS
AND ANSWERS GRADED A+ LATEST UPDATE.
During what trimester is a pregnant woman most at risk for adverse drug
reactions with potential long-term consequences? ANS >> 1st trimester (fetes
most at risk d/t rapid growth)
What are BEERS criteria? ANS >> Recommendations of medications
inappropriate for elderly (65 and older), prescriber ultimately decides
What is the CYP450 (cytochrome P450) ANS >> liver enzyme system where
medications are metabolized, can either be inducers or inhibitors and create drug-
drug interactions
CYP450 inducers ANS >> Speed up metabolism of drugs (drug is cleared faster),
drug has lesser effect (decrease blood levels of drug), elevate CYP450 enzymes
,NR 565
CYP450 inducers pneumonic ANS >> “Bullshit Crap GPS INDUCES rage"
CYP450 inducer drug names ANS >> Barbiturates, St John wort, Carbamazepine,
revamping, alcohol, phenytoin, griseofulvin, phenobarbital, sulfonylureas
CYP450 inhibitors ANS >> inhibit metabolism, increase blood levels of
medications
CYP450 pneumonic ANS >> “VISA credit card debt INHIBITS spending on
designers like CK to look GQ"
CYP450 inhibitors drug names ANS >> Valproate, isoniazid, sulphonamides,
amiodarone, chloramphenicol, ketoconazole, grapefruit juice, quinidine
Physiological changes during pregnancy that impact pharmacodynamics and
pharmacokinetic properties of drugs? ANS >> increase glomerular filtration rate
leads to increase drug excretion
increase hepatic metabolism
decrease tone and motility of bowel
increase drug absorption
Examples of medications that can be teratogenic ANS >> Antiepileptic drugs,
antimicrobials such as tetracyclines and fluoroquinolones, vitamin A in large
doses, some anticoagulants, and hormonal medications such as diethylstilbesterol
(DES).
,NR 565
How is absorption of intramuscular medications different in neonates? ANS >>
slow and erratic due to low blood flow in muscles first few days of life
Why is absorption of medication in the stomach increased in infancy? ANS >>
delayed gastric emptying
Some medications that should be avoided in the paediatric patient? ANS >>
glucocorticoids, discoloration of developing teeth with tetracyclines, and
kernicterus with sulphonamides, levofloxacin (antibiotics)
aspirin (Severe intoxication from acute overdose)
what should be included in medication administration patient education? ANS
>> dosage size and timing
route and technique of administration
duration of treatment
drug storage
nature and time course of desired responses
nature and time course of adverse responses
finish taking antibiotic
What are some things that put the elderly patient at higher risk for adverse drug
reactions? ANS >> reduced renal function
polypharmacy (the use of five or more medications daily)
greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g., digoxin)
, NR 565
increased individual variation secondary to altered pharmacokinetics
inadequate supervision of long-term therapy
poor patient adherence
How can healthcare providers decrease likelihood of an elderly patient
experiencing an adverse drug reaction? ANS >> obtaining a thorough drug
history that includes over-the-counter medications
considering pharmacokinetic and pharmacodynamics changes due to age
monitoring the patient's clinical response and plasma drug levels
using the simplest regimen possible
monitoring for drug-drug interactions and iatrogenic illness
periodically reviewing the need for continued drug therapy
encouraging the patient to dispose of old medications
taking steps to promote adherence and to avoid drugs on the Beers list
How can we promote medication adherence with elderly patients? ANS >>
simplifying drug regimens
providing clear and concise verbal and written instructions
using an appropriate dosage form
clearly labelling and dispensing easy-to-open containers
developing daily reminders
monitoring frequently
affordability of drugs
support systems
