NR566 FINAL ADVANCED
PHARMACOLOGY FAMILY CARE
2026 TEST PAPER QUESTIONS
ANSWERS GRADED A+
◉ For combination OCs that use an extended or continuous cycle, up to
7 days can be missed?
Answer: with little or no increased risk for pregnancy provided that the
pills had been taken continuously for the prior 3 weeks.
◉ If one or more doses is missed or taken greater than 3 hours after the
scheduled dose, the following guidelines apply:
Answer: -If one pill is missed, it should be taken as soon as remembered
and backup contraception should be used for at least 2 days. The pills
should be resumed as scheduled on the next day.
-If two pills are missed, the regimen should be restarted and backup
contraception should be used for at least 2 days.
-If two or more pills are missed and no menstrual bleeding occurs, a
pregnancy test should be done.
◉ Types of contraceptives and which would be best for specific patient
scenarios
Answer: Combination OCs should be avoided by women with certain
cardiovascular disorders (see later) as well as by women older than 35
,years who smoke. For women in these categories, an alternative method
(e.g., diaphragm, progestin-only pill, or IUD) is preferable.
For women who engage in coitus frequently, OCs or a long-term method
(e.g., Nexplanon, Depo-Provera, IUD) are reasonable choices.
when sexual activity is limited, and if individual has multiple partners
use of a spermicide, condom, or diaphragm may be more appropriate.
Because barrier methods combined with spermicides can offer some
protection against STDs (as well as providing contraception)
If adherence is a problem (as it can be with OCs, condoms, and
diaphragms), usterm-16e of a long-term method (e.g., vaginal
contraceptive ring, IUD, Nexplanon, Depo-Provera) can confer more
reliable protection.
◉ What effect does CYP450 inhibitors or inducers have on OCs? o
Recall examples of CYP450 inhibitors and inducers from NR565
(Chapter 4 in textbook) o How does this impact prescribing of OCs?
Answer: Inhibitors: Inducers:
Acyclovir Carbamazepine
Ciprofloxacin Phenobarbital
Ethinyl estradiol Phenytoin
Fluvoxamine Primidone
Isoniazid Rifampin
Norfloxacin Ritonavir
, Oral contraceptives Tobacco
Zafirlukast St. John's wort
Zileuton
As a rule, high-estrogen OCs are reserved for women taking drugs that
induce P450.
◉ drugs that interact with oral contraceptives?
Answer: Products that induce hepatic cytochrome P3A4 can accelerate
OC metabolism and thereby reduce OC effects. indications are reduced
OC blood levels, such as breakthrough bleeding or spotting. If these
signs appear, it may be necessary to either (1) increase the estrogen
dosage of the OC, (2) combine the OC with a second form of birth
control (e.g., condom), or (3) switch to an alternative form of birth
control.
can decrease the benefits of warfarin and hypoglycemic agents. May
require increased dosage
OCs can impair the hepatic metabolism of several agents, including
theophylline, tricyclic antidepressants, diazepam, and chlordiazepoxide.
Can cause toxicity. if Toxicity occurs dosage may have to be reduced.
◉ Prevention of osteoporosis with hormone replacement therapy
Answer: prevention of osteoporosis requires lifelong HT, and hence the
risk for harm is higher.
labeling of HT products currently must carry the following advice:
When this product is prescribed solely to prevent postmenopausal
PHARMACOLOGY FAMILY CARE
2026 TEST PAPER QUESTIONS
ANSWERS GRADED A+
◉ For combination OCs that use an extended or continuous cycle, up to
7 days can be missed?
Answer: with little or no increased risk for pregnancy provided that the
pills had been taken continuously for the prior 3 weeks.
◉ If one or more doses is missed or taken greater than 3 hours after the
scheduled dose, the following guidelines apply:
Answer: -If one pill is missed, it should be taken as soon as remembered
and backup contraception should be used for at least 2 days. The pills
should be resumed as scheduled on the next day.
-If two pills are missed, the regimen should be restarted and backup
contraception should be used for at least 2 days.
-If two or more pills are missed and no menstrual bleeding occurs, a
pregnancy test should be done.
◉ Types of contraceptives and which would be best for specific patient
scenarios
Answer: Combination OCs should be avoided by women with certain
cardiovascular disorders (see later) as well as by women older than 35
,years who smoke. For women in these categories, an alternative method
(e.g., diaphragm, progestin-only pill, or IUD) is preferable.
For women who engage in coitus frequently, OCs or a long-term method
(e.g., Nexplanon, Depo-Provera, IUD) are reasonable choices.
when sexual activity is limited, and if individual has multiple partners
use of a spermicide, condom, or diaphragm may be more appropriate.
Because barrier methods combined with spermicides can offer some
protection against STDs (as well as providing contraception)
If adherence is a problem (as it can be with OCs, condoms, and
diaphragms), usterm-16e of a long-term method (e.g., vaginal
contraceptive ring, IUD, Nexplanon, Depo-Provera) can confer more
reliable protection.
◉ What effect does CYP450 inhibitors or inducers have on OCs? o
Recall examples of CYP450 inhibitors and inducers from NR565
(Chapter 4 in textbook) o How does this impact prescribing of OCs?
Answer: Inhibitors: Inducers:
Acyclovir Carbamazepine
Ciprofloxacin Phenobarbital
Ethinyl estradiol Phenytoin
Fluvoxamine Primidone
Isoniazid Rifampin
Norfloxacin Ritonavir
, Oral contraceptives Tobacco
Zafirlukast St. John's wort
Zileuton
As a rule, high-estrogen OCs are reserved for women taking drugs that
induce P450.
◉ drugs that interact with oral contraceptives?
Answer: Products that induce hepatic cytochrome P3A4 can accelerate
OC metabolism and thereby reduce OC effects. indications are reduced
OC blood levels, such as breakthrough bleeding or spotting. If these
signs appear, it may be necessary to either (1) increase the estrogen
dosage of the OC, (2) combine the OC with a second form of birth
control (e.g., condom), or (3) switch to an alternative form of birth
control.
can decrease the benefits of warfarin and hypoglycemic agents. May
require increased dosage
OCs can impair the hepatic metabolism of several agents, including
theophylline, tricyclic antidepressants, diazepam, and chlordiazepoxide.
Can cause toxicity. if Toxicity occurs dosage may have to be reduced.
◉ Prevention of osteoporosis with hormone replacement therapy
Answer: prevention of osteoporosis requires lifelong HT, and hence the
risk for harm is higher.
labeling of HT products currently must carry the following advice:
When this product is prescribed solely to prevent postmenopausal
