NR 565 Advanced Pharmacology Midterm –
Comprehensive Practice Questions,
Detailed Explanations, and Exam
Preparation Guide.
1st trimester (fetus most at risk d/t rapid During what trimester is a pregnant woman most at risk for
growth) adverse drug reactions with potential long term
consequences?
Recommendations of medications What is BEERS criteria?
inappropriate for elderly (65 and older),
prescriber ultimately decides
liver enzyme system where medications What is the CYP450 (cytochrome P450)
are metabolized, can either be inducers
or
inhibitors and create drug-drug interactions
Speed up metabolism of drugs (drug is CYP450 inducers
cleared faster), drug has lesser effect
(decrease blood levels of drug), elevate
CYP450 enzymes
,"Bullshit Crap GPS INDUCES rage" CYP450 inducers pneumonic
Barbituates, St John wort, Carbamazepine, CYP450 inducer drug names
rifampin, alcohol, phenytoin, griseofulvin,
phenobarbital, sulfonylureas
inhibit metabolism, increase blood levels of CYP450 inhibitors
medications
"VISA credit card debt INHIBITS spending CYP450 pneumonic
on designers like CK to look GQ"
Valproate, isoniazid, sulfonamides, CYP450 inhibitors drug names
amiodarone, chloramphenicol,
ketoconazole, grapefruit juice, quinidine
increase glomerular filtration rate leads to Physiological changes during pregnancy that impact
increase durg excretion pharmacodynamics and pharmacokinetic properties of
increase hepatic metabolism drugs?
decrease tone and motility of bowel
increase drug absorption
Antiepileptic drugs, antimicrobials such as Examples of medications that can be teratogenic
tetracyclines and fluoroquinolones, vitamin
A in large doses, some anticoagulants, and
hormonal medications such as
diethylstilbestrol (DES).
slow and erratic due to low blood flow in How is absorption of intramuscular medications different in
muscles first few days of life neonates?
delayed gastric emptying Why is absorption of medication in the stomach increased in
infancy?
glucocorticoids, discoloration of Some medications that should be avoided in the pediatric
developing teeth with tetracyclines, and patient?
kernicterus with sulfonamides, levofloxacin
(antibiotics)
aspirin (Severe intoxication from acute
overdose)
dosage size and timing what should be included in medication administration patient
route and technique of education?
administration duration of
treatment
drug storage
nature and time course of desired responses
nature and time course of adverse
responses
finish taking antibiotic
, reduced renal function What are some things that put the elderly patient at higher risk
polypharmacy (the use of five or more for adverse drug reactions?
medications daily)
greater severity of
illness presence of
comorbidities
use of drugs that have a low therapeutic
index (e.g., digoxin)
increased individual variation secondary to
altered pharmacokinetics
inadequate supervision of long-term
therapy
poor patient adherence
obtaining a thorough drug history that How can healthcare providers decrease likelihood of an
includes over-the-counter medications elderly patient experiencing an adverse drug reaction?
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
simplifying drug regimens How can we promote medication adherence with elderly
providing clear and concise verbal and patients?
written instructions
using an appropriate dosage form
clearly labeling and dispensing easy-to-
open containers
developing daily reminders
monitoring frequently
affordability of drugs
support systems
Need nitrate free interval so tolerance Why do nitrates need to be taken no later than 4 PM?
doesn't develop
Gender and race Nine factors that impact outcome of medication?
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight
yes Do you need informed consent for genetic testing?
Comprehensive Practice Questions,
Detailed Explanations, and Exam
Preparation Guide.
1st trimester (fetus most at risk d/t rapid During what trimester is a pregnant woman most at risk for
growth) adverse drug reactions with potential long term
consequences?
Recommendations of medications What is BEERS criteria?
inappropriate for elderly (65 and older),
prescriber ultimately decides
liver enzyme system where medications What is the CYP450 (cytochrome P450)
are metabolized, can either be inducers
or
inhibitors and create drug-drug interactions
Speed up metabolism of drugs (drug is CYP450 inducers
cleared faster), drug has lesser effect
(decrease blood levels of drug), elevate
CYP450 enzymes
,"Bullshit Crap GPS INDUCES rage" CYP450 inducers pneumonic
Barbituates, St John wort, Carbamazepine, CYP450 inducer drug names
rifampin, alcohol, phenytoin, griseofulvin,
phenobarbital, sulfonylureas
inhibit metabolism, increase blood levels of CYP450 inhibitors
medications
"VISA credit card debt INHIBITS spending CYP450 pneumonic
on designers like CK to look GQ"
Valproate, isoniazid, sulfonamides, CYP450 inhibitors drug names
amiodarone, chloramphenicol,
ketoconazole, grapefruit juice, quinidine
increase glomerular filtration rate leads to Physiological changes during pregnancy that impact
increase durg excretion pharmacodynamics and pharmacokinetic properties of
increase hepatic metabolism drugs?
decrease tone and motility of bowel
increase drug absorption
Antiepileptic drugs, antimicrobials such as Examples of medications that can be teratogenic
tetracyclines and fluoroquinolones, vitamin
A in large doses, some anticoagulants, and
hormonal medications such as
diethylstilbestrol (DES).
slow and erratic due to low blood flow in How is absorption of intramuscular medications different in
muscles first few days of life neonates?
delayed gastric emptying Why is absorption of medication in the stomach increased in
infancy?
glucocorticoids, discoloration of Some medications that should be avoided in the pediatric
developing teeth with tetracyclines, and patient?
kernicterus with sulfonamides, levofloxacin
(antibiotics)
aspirin (Severe intoxication from acute
overdose)
dosage size and timing what should be included in medication administration patient
route and technique of education?
administration duration of
treatment
drug storage
nature and time course of desired responses
nature and time course of adverse
responses
finish taking antibiotic
, reduced renal function What are some things that put the elderly patient at higher risk
polypharmacy (the use of five or more for adverse drug reactions?
medications daily)
greater severity of
illness presence of
comorbidities
use of drugs that have a low therapeutic
index (e.g., digoxin)
increased individual variation secondary to
altered pharmacokinetics
inadequate supervision of long-term
therapy
poor patient adherence
obtaining a thorough drug history that How can healthcare providers decrease likelihood of an
includes over-the-counter medications elderly patient experiencing an adverse drug reaction?
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
simplifying drug regimens How can we promote medication adherence with elderly
providing clear and concise verbal and patients?
written instructions
using an appropriate dosage form
clearly labeling and dispensing easy-to-
open containers
developing daily reminders
monitoring frequently
affordability of drugs
support systems
Need nitrate free interval so tolerance Why do nitrates need to be taken no later than 4 PM?
doesn't develop
Gender and race Nine factors that impact outcome of medication?
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight
yes Do you need informed consent for genetic testing?
