NR565 MIDTERM WEEK 4 QUESTIONS WITH CORRECT ANSWERS

NR565 MIDTERM, WEEK 4 QUESTIONS
WITH CORRECT ANSWERS
whatXmakesXclopidogrelXuniqueXamongXotherXP2Y12Xinhibitors?X-XCORRECTXANSWERX-
reliesXonXcytochromeXP450XenzymeXtoXconvertXintoXactiveXmetaboliteX(CYP2C19)XthusXrequiringXthisXgeneX
toXbeXpresentXtoXbeXanXeffectiveXdrugXinXclotXformation



AlternativesXtoXclopidogrelX-XCORRECTXANSWERX-
BrilintaX(ticagrelor)XorXEffientX(Prasugrel)XbecauseXtheyXareXnotXdependentXonXCYP2C19Xgenotype



NameXtheX4XmedicationsXthatXREQUIREXpharmacogeneticXtestingX-XCORRECTXANSWERX-
Cetuximab,Xtrastuzumab,Xmaraviroc,Xdasatinib



2XmedicationsXprescribedXtogetherXthatXareXhighlyXproteinXbound,XwhatXisXclinicalXoutcome?X-
XCORRECTXANSWERX-

TheXtwoXdrugsXcompeteXforXavailabilityXofXplasmaXproteinsXandXoneXorXtheXotherXbecomesXincreasinglyXeff
ective,XthinkXextraXmedicationXisXfloatingXaroundXasXitXcannotXbindXtoXplasmaXproteins.XWarfarinXisXhighlyXp
roteinXbound.



WhatXareasXofXhealthcareXmostXheavilyXintegrateXpharmacogeneticsXintoXclinicalXpractice?X-
XCORRECTXANSWERX-OncologyX&XcysticXfibrosisXpopulation



ThinkXHER2XwithXbreastXcancerXandXCFXhaveX2XdefectiveXCFTRXgenes



BarrierXinXunderstandingXracialXdifferencesXinXdrugXpharmacokineticsXwithXAmericanXIndianXorXAlaskanXNa
tives?X-XCORRECTXANSWERX-LimitedXtoXnoXresearchXinXracialXconsiderations



PurposeXofXgeneticXtestingXwithXTamoxifen?X-XCORRECTXANSWERX-
ReduceXtheXriskXofXtherapeuticXfailureXasXvariationXofXCYP2D6XwillXnotXallowXforXactivationXandXconversionX
toXendoxifenXwhichXisXnecessaryXforXtreatingXestrogenXsensitiveXcancers.



LiverXandXKidneyXfunctionsXlabsXforXmonitoring?X-XCORRECTXANSWERX-
Creatinine,XBUN,XGFR,XAST,XALT,XBilirubin



DoseXofXpropranololXinXmigraineXreductionX-XCORRECTXANSWERX-20-80mgX3-4XXdaily

, increasesXlevelsXofXserotonin,XpreventsXbetaXreceptorXvasodilation

allowX4-6XweeksXtoXtrialXtreatment



FirstXconsiderationXinXselectingXmostXappropriateXbetaXblocker?X-XCORRECTXANSWERX-CardioXselectivity



PregnancyXCategoriesXBXvsXDXwithXbetaXblockersX-XCORRECTXANSWERX-AtenololX-XD

betaxolol,Xacebutolol,Xmetoprolol,Xnadolol,Xnebivolol,Xtiolol,XpropranololX-XC



WhereXareXbetaX2XreceptorsXlocatedXandXwhatXdoXtheyXdo?X-XCORRECTXANSWERX-
smoothXmuscleXofXeye,Xarterioles,Xvenules,Xbronchioles,Xliver,Xpancreas,XGI,XGU

StimulateXadneylylXcyclase,XincreaseXcAMP,XactivateXcardiacXG1



DrugXofXchoiceXforXHTNXwithXconcomitantXBPHX-XCORRECTXANSWERX-AlphaX1XadrenergicXantagonist



BetaXblockersXthatXrequireXdosageXadjustmentXinXpatientsXwithXrenalXimpairmentX-XCORRECTXANSWERX-
acebutolol,Xatenolol,Xnadolol,XandXnebivolol



DosingXscheduleXofXdonepizilX-XCORRECTXANSWERX-5mgXnightlyXatXbedtime,XincreaseXatX4-
6XweekXintervals,XmaxXdoseXisX10XmgXdaily.



ElicitsXparasympatheticXresponseX-XCORRECTXANSWERX-Acetylcholine,XACh



SympatheticXnervousXsystemXresponsesXelicitedXby:X-XCORRECTXANSWERX-Epi,XNorepi,XDopa



FirstXlineXtreatmentsXforXHTNX-XCORRECTXANSWERX-CCB,XACEI,XARB,XorXthiazide

considerXcomorbidities



PatientsXwithXHTNXandXcomorbiditiesXofXessentialXtremor,Xmigraine,Xarryhthmia,XCAD,XsymptomaticXHFXwit
hXreducedXEFXcanXbeXtreatedXwith?X-XCORRECTXANSWERX-betaXblocker