ACNP Pharm Questions & Answers
What are the ADRs with central acting skeletal muscle relaxants? What PT education would you
provide when prescribing? Correct Ans-CNS sedation, respiratory depression, sedation,
drowsiness, dizziness, confusion, seizures, headaches, dry mouth, GI upset, blurred vision,
palpatations, liver fuction.
PT education includes: Avoid alcohol, Avoid antihistamines, life-threatening interaction with
MOA inhibitors, risk of serotonin Syndrome with SSRI, SSNI, TCA, MAOIs, CYP2C19
inhibitors caution, CYP 1A2 caution.
Names of Muscle Relaxers: Correct Ans-Carisoprodol, Chlozaxazone, Cyclobenzaprine,
metaxalone, Methocarbamol, Tizanidine, Orphenadrine
Risk factors for Osteoporosis: Correct Ans-Older than 70, Glucocorticoid use 5mg or greater
for 3 months or longer, Anticonvulsants including phenobarbital, phenytoin, carbamazapine,
long-term PPI use more than 1 year, body weight less than 70 kg or weight loss more than 10%,
Heavy tobacco use, More than 14 alcohol drinks per week, Sedentary lifestyle, Deficits in
Vitamin D or Calcium intake, some cancer medications
In osteoporosis, what is the most common bones affected with bone demineralization?
Correct Ans-Vertebral, hip, wrist
By using treatment modalities such as biphosphenates, what type of activity is inhibited relative
to pharmacodynamics? Correct Ans-Inhibits Osteoclasts
,What are some of the ADRs of Biphosphenates? Correct Ans-Esophageal ulcers,
Osteonecrosis of the jaw, visionchanges, Atrial Fibrillation, Musculoskeletal pain
PT education: Take on empty stomach, remain upright for 30 minutes after taking
What are goals for migraine prevention? Correct Ans-Minimize impact on quality of life and
avoid medication overuse
List medication options for a simple migraine abortive therapy. Correct Ans-1st line OTC
analgesics work best taken early in migraine and simple migraine: Naproxen, Ibuprofen,
NSAIDS, Excedrin Migraine, Advil Migraine
43 year old male with recurrent duodenal ulcer. What do you prescribe? Correct Ans-
Amoxicillin
Clopidogrel (Plavix) Black Box Warning: Correct Ans-Interaction with Omeprazole
Sam, age 48,presents with c/o of depressive symptoms. HX includes DM for past 10 years with
Diabetic Neuropathy. In treating Sam's depression, which SSRI/SSNI would be the best choice?
Correct Ans-Cymbalta (SNRI)
In a PT on Warfain, what laboratory test should be monitored when starting an SSRI such as
Sertraline (Zoloft) or Fluoxetine (Prozac)? Correct Ans-INR
, In prescribing abortive therapy for a simple migraine headache, the NP prescribes: Correct
Ans-Naproxen: Simple analgesic for simple migraine
Lydia presents to PCP requesting Xanax, which she has been on for 'years' 'Everyone in my
family' she states has anxiety. In treating the PT, the NP explains: Correct Ans-SSRIs are a
better medication for long-term management of anxiety.
Oral Tx for Vulvovaginal Candidiasis: Correct Ans-Fluconazole
Oral TX for Trichomonas Vaginalis: Correct Ans-Metronidazole
What labs should be monitored in hypothyroidism? Correct Ans-TSH and Free T4
When adjusting hypothyroidism therapy, what is an optimal length of time before reassessing a
laboratory test? Correct Ans-4 weeks
In HYPERthyroidism which medication have a risk of hepatotoxicity? Correct Ans-Black
Box Warning: Propylthioracil-Liver Failure/Hepatoxicity
What class of medication is Clindamycin? Correct Ans-Macrolide-Macrolides end in MYCIN
and can be given to PTs with an allergy to PCN
ADR ClidaMYCIN/class Macrolides: Correct Ans-C-Diff, Rash, Cardiac Arrythmias(rapid
IV), GI distress(diarrhea), QT prolonation, Hepatitis
What are the ADRs with central acting skeletal muscle relaxants? What PT education would you
provide when prescribing? Correct Ans-CNS sedation, respiratory depression, sedation,
drowsiness, dizziness, confusion, seizures, headaches, dry mouth, GI upset, blurred vision,
palpatations, liver fuction.
PT education includes: Avoid alcohol, Avoid antihistamines, life-threatening interaction with
MOA inhibitors, risk of serotonin Syndrome with SSRI, SSNI, TCA, MAOIs, CYP2C19
inhibitors caution, CYP 1A2 caution.
Names of Muscle Relaxers: Correct Ans-Carisoprodol, Chlozaxazone, Cyclobenzaprine,
metaxalone, Methocarbamol, Tizanidine, Orphenadrine
Risk factors for Osteoporosis: Correct Ans-Older than 70, Glucocorticoid use 5mg or greater
for 3 months or longer, Anticonvulsants including phenobarbital, phenytoin, carbamazapine,
long-term PPI use more than 1 year, body weight less than 70 kg or weight loss more than 10%,
Heavy tobacco use, More than 14 alcohol drinks per week, Sedentary lifestyle, Deficits in
Vitamin D or Calcium intake, some cancer medications
In osteoporosis, what is the most common bones affected with bone demineralization?
Correct Ans-Vertebral, hip, wrist
By using treatment modalities such as biphosphenates, what type of activity is inhibited relative
to pharmacodynamics? Correct Ans-Inhibits Osteoclasts
,What are some of the ADRs of Biphosphenates? Correct Ans-Esophageal ulcers,
Osteonecrosis of the jaw, visionchanges, Atrial Fibrillation, Musculoskeletal pain
PT education: Take on empty stomach, remain upright for 30 minutes after taking
What are goals for migraine prevention? Correct Ans-Minimize impact on quality of life and
avoid medication overuse
List medication options for a simple migraine abortive therapy. Correct Ans-1st line OTC
analgesics work best taken early in migraine and simple migraine: Naproxen, Ibuprofen,
NSAIDS, Excedrin Migraine, Advil Migraine
43 year old male with recurrent duodenal ulcer. What do you prescribe? Correct Ans-
Amoxicillin
Clopidogrel (Plavix) Black Box Warning: Correct Ans-Interaction with Omeprazole
Sam, age 48,presents with c/o of depressive symptoms. HX includes DM for past 10 years with
Diabetic Neuropathy. In treating Sam's depression, which SSRI/SSNI would be the best choice?
Correct Ans-Cymbalta (SNRI)
In a PT on Warfain, what laboratory test should be monitored when starting an SSRI such as
Sertraline (Zoloft) or Fluoxetine (Prozac)? Correct Ans-INR
, In prescribing abortive therapy for a simple migraine headache, the NP prescribes: Correct
Ans-Naproxen: Simple analgesic for simple migraine
Lydia presents to PCP requesting Xanax, which she has been on for 'years' 'Everyone in my
family' she states has anxiety. In treating the PT, the NP explains: Correct Ans-SSRIs are a
better medication for long-term management of anxiety.
Oral Tx for Vulvovaginal Candidiasis: Correct Ans-Fluconazole
Oral TX for Trichomonas Vaginalis: Correct Ans-Metronidazole
What labs should be monitored in hypothyroidism? Correct Ans-TSH and Free T4
When adjusting hypothyroidism therapy, what is an optimal length of time before reassessing a
laboratory test? Correct Ans-4 weeks
In HYPERthyroidism which medication have a risk of hepatotoxicity? Correct Ans-Black
Box Warning: Propylthioracil-Liver Failure/Hepatoxicity
What class of medication is Clindamycin? Correct Ans-Macrolide-Macrolides end in MYCIN
and can be given to PTs with an allergy to PCN
ADR ClidaMYCIN/class Macrolides: Correct Ans-C-Diff, Rash, Cardiac Arrythmias(rapid
IV), GI distress(diarrhea), QT prolonation, Hepatitis
