APEA PREDICTOR EXAM STUDY SET WITH THE FULL PACKAGE
1.First-Pass vEffect
1. What vcytochrome vmetabolizes va vmedication vdrug vduring vthe vFIRST-
PASS vEffect?
2. CYP450 venzyme vis vthe vmost v .
3. It vcan veither vbe vinduced vor vinhibited v(T/F): v1. vCYP450 vmetabolizes vthe
vdrug vin vthe vliver vto vrelease vthe vdrug vto vthe vbody vwhere vit vcan vbe
vused.
2. Active
3. True
2. vPharmacokinetics
1. vWhat vare vage-related vchanges?
(Distribution, vMetabolism, vExcretion)?: v1. vIncrease vin vfat-to-water vratio,
vdecrease vin vliver vfunction, vdecrease vin vGFR
3. vPharmacology: vCardiac vGlycosides
1. What vorder vof vline vof vtreatment vis vDigoxin?
2. Signs vof vDigoxin vOverdose
3. Laboratory vtests
4. Treatment: v1. vSecond vand vThird
2.N/V, vHyperkalemia, vConfusion, vvisual vcolor vchanges
1 v/
v36
,3. Digoxin vlevel, vCMP, vEKG
4.Digoxin-specific vantibodies
4.Pharmacology: vWarfarin v(Coumadin)
1. Category v for vpregnancy.
2. Target vINR vfor vpatients vwithout vmitral vprosthetic vvalves? vWith
vprosthetic vvalves?
3. Referral vto v for vinitiation vand vstabilization vof vwarfarin vdose.
4. How voften vdo vyou vcheck vfor vconsistently vstable vINR?
5. How voften vdo vyou vcheck vfor vsingle vout-of-range vINR?
6. What vdo vyou veducate vthe vpatient vto vdo vif vthe vINR vless vthan v5
vwith vno vsignificant vbleeding vrisk?
7. If vone vdose vis vmissed, vwhat vdo vyou vdo?
8. What vkind vof vfoods vto vavoid vmessing vup vthe vINR?: v1. vX
2. v2.0-3.0, v2.5-3.5
3.Cardiologist vor vanticoagulation vclinic
4.Check vevery v2-4 vweeks vup vto v12 vweeks.
5.Continue vwarfarin vdose, vretest vINR vin v1-2 vweeks.
2 v/
v36
,6.Omit vone vdose, vrecheck vINR.
7.Take vthe vdose vas vsoon vas vpossible. vDo vnot vdouble vdose.
8.Vitamin vK vfoods
5.Pharmacology: vDirect vOran vAnticoagulants v(DOAC)
1. Why vare vDOACs vbetter vthan vWarfarin?
2. Example vof vDOACs?
3. How vlong vdoes vit vtake vfor vplatelet vfunction vto vreturn vto vnormal vafter va
vpatient vstops vtaking vPlavix?: v1. vLess vmonitoring vand vless vside veffects
2.Apixaban v(Eliquis)
3.10 vdays
6.Pharmacology: vThiazide vDiuretics
1. Examples
2. Contraindication
3. Adverse veffects
4. Patients vwith vosteoporosis vreceive van vextra vbenefit vfrom vthiazide
vdiuretics vby vreducing v excretion v(T/F): v1. vHCTZ, vChlorthalidone
2.Sulfa vallergy
3.Hykpokalemia, vincreases vuric vacid vand vincreases vLDL
4.Calcium, vTrue
7.Pharmacology: vPotassium-Sparing vDiuretics
1. Examples
2. Contraindication
3. Adverse veffects
4. Do vnot vcombine vwith vwhich vcardiac vdrugs vto vprevent
vhyperkalemia?: v1. vTriamterene, vAmiloride
2. Hyperkalemia
3.Elevates vK+ vlevels
4.ACEIs vand vARBs
8.Pharmacology: vLoop vDiuretics
1. Examples
2. Contraindication/Allergy
3. Adverse veffects
4. Which vtoxicity vwith vloop vdiuretics vcan voccur?: v1. vFurosemide
2.Sulfa vAllergy
3 v/
v36
, 3.Hypokalemia, vHyponatremia, vhypomagnesemia
4. Ototoxicity
9.Pharmacology: vACEIs vand vARBs
1. Examples
2. Black vBox vWarning/Contraindications
3. Adverse vEffects
4. ACEIs vare vfirst-line vtherapy vfor
5. ACEIs vand vARBs vprotect vthe vkidneys. vBut vif vsevere vCKD, vshould vyou
vcontinue vACEIs vand vARBs? vWhy?: v1. vLisinopril, vLosartan
2. Pregnancy
3.Dry vcough, vHyperkalemia, vAngioedema
4.Heart vFailure vw/ vleft vventricular vdysfinction v(HFrEF)
5.No, vbecause vsevere vCKD vand vACEIs vand vARBs vwill vlead vto
vincreased vrisk vof vhyperkalemia.
10.Pharmacology: vCCBs
1. Two vtypes vand vExamples vof vboth vtypes
2. Cardiac vcontraindications vfor vNondihydropyridines
3. Why vdoes vpedal vedema voccur vwith vdihydropyridines?: v1.
vDihydropyridines: vAmlodipine, vNifedipine
Nondihydropyridines: vVerapamil, vDiltiazem
2.Heart vblock vand vHeart vFailure
3. Vasodilation
11.Pharmacology: vBBs
1. Contraindications
2. Adverse vEffets: v1. vAsthma, vCOPD
2. vBronchospasm
12.Pharmacology: vTetracyclines
1. Examples:
2. Avoid vuse vduring vpregnancy vand vbreastfeeding vdue vto v of vteeth.
3. Sensitivity vto vwhat?: v1. vDoxycycline
2.Permanent vDiscoloration
3. Photosensitivity
13.Pharmacology: vMacrolides
1. Examples:
4 v/
v36
1.First-Pass vEffect
1. What vcytochrome vmetabolizes va vmedication vdrug vduring vthe vFIRST-
PASS vEffect?
2. CYP450 venzyme vis vthe vmost v .
3. It vcan veither vbe vinduced vor vinhibited v(T/F): v1. vCYP450 vmetabolizes vthe
vdrug vin vthe vliver vto vrelease vthe vdrug vto vthe vbody vwhere vit vcan vbe
vused.
2. Active
3. True
2. vPharmacokinetics
1. vWhat vare vage-related vchanges?
(Distribution, vMetabolism, vExcretion)?: v1. vIncrease vin vfat-to-water vratio,
vdecrease vin vliver vfunction, vdecrease vin vGFR
3. vPharmacology: vCardiac vGlycosides
1. What vorder vof vline vof vtreatment vis vDigoxin?
2. Signs vof vDigoxin vOverdose
3. Laboratory vtests
4. Treatment: v1. vSecond vand vThird
2.N/V, vHyperkalemia, vConfusion, vvisual vcolor vchanges
1 v/
v36
,3. Digoxin vlevel, vCMP, vEKG
4.Digoxin-specific vantibodies
4.Pharmacology: vWarfarin v(Coumadin)
1. Category v for vpregnancy.
2. Target vINR vfor vpatients vwithout vmitral vprosthetic vvalves? vWith
vprosthetic vvalves?
3. Referral vto v for vinitiation vand vstabilization vof vwarfarin vdose.
4. How voften vdo vyou vcheck vfor vconsistently vstable vINR?
5. How voften vdo vyou vcheck vfor vsingle vout-of-range vINR?
6. What vdo vyou veducate vthe vpatient vto vdo vif vthe vINR vless vthan v5
vwith vno vsignificant vbleeding vrisk?
7. If vone vdose vis vmissed, vwhat vdo vyou vdo?
8. What vkind vof vfoods vto vavoid vmessing vup vthe vINR?: v1. vX
2. v2.0-3.0, v2.5-3.5
3.Cardiologist vor vanticoagulation vclinic
4.Check vevery v2-4 vweeks vup vto v12 vweeks.
5.Continue vwarfarin vdose, vretest vINR vin v1-2 vweeks.
2 v/
v36
,6.Omit vone vdose, vrecheck vINR.
7.Take vthe vdose vas vsoon vas vpossible. vDo vnot vdouble vdose.
8.Vitamin vK vfoods
5.Pharmacology: vDirect vOran vAnticoagulants v(DOAC)
1. Why vare vDOACs vbetter vthan vWarfarin?
2. Example vof vDOACs?
3. How vlong vdoes vit vtake vfor vplatelet vfunction vto vreturn vto vnormal vafter va
vpatient vstops vtaking vPlavix?: v1. vLess vmonitoring vand vless vside veffects
2.Apixaban v(Eliquis)
3.10 vdays
6.Pharmacology: vThiazide vDiuretics
1. Examples
2. Contraindication
3. Adverse veffects
4. Patients vwith vosteoporosis vreceive van vextra vbenefit vfrom vthiazide
vdiuretics vby vreducing v excretion v(T/F): v1. vHCTZ, vChlorthalidone
2.Sulfa vallergy
3.Hykpokalemia, vincreases vuric vacid vand vincreases vLDL
4.Calcium, vTrue
7.Pharmacology: vPotassium-Sparing vDiuretics
1. Examples
2. Contraindication
3. Adverse veffects
4. Do vnot vcombine vwith vwhich vcardiac vdrugs vto vprevent
vhyperkalemia?: v1. vTriamterene, vAmiloride
2. Hyperkalemia
3.Elevates vK+ vlevels
4.ACEIs vand vARBs
8.Pharmacology: vLoop vDiuretics
1. Examples
2. Contraindication/Allergy
3. Adverse veffects
4. Which vtoxicity vwith vloop vdiuretics vcan voccur?: v1. vFurosemide
2.Sulfa vAllergy
3 v/
v36
, 3.Hypokalemia, vHyponatremia, vhypomagnesemia
4. Ototoxicity
9.Pharmacology: vACEIs vand vARBs
1. Examples
2. Black vBox vWarning/Contraindications
3. Adverse vEffects
4. ACEIs vare vfirst-line vtherapy vfor
5. ACEIs vand vARBs vprotect vthe vkidneys. vBut vif vsevere vCKD, vshould vyou
vcontinue vACEIs vand vARBs? vWhy?: v1. vLisinopril, vLosartan
2. Pregnancy
3.Dry vcough, vHyperkalemia, vAngioedema
4.Heart vFailure vw/ vleft vventricular vdysfinction v(HFrEF)
5.No, vbecause vsevere vCKD vand vACEIs vand vARBs vwill vlead vto
vincreased vrisk vof vhyperkalemia.
10.Pharmacology: vCCBs
1. Two vtypes vand vExamples vof vboth vtypes
2. Cardiac vcontraindications vfor vNondihydropyridines
3. Why vdoes vpedal vedema voccur vwith vdihydropyridines?: v1.
vDihydropyridines: vAmlodipine, vNifedipine
Nondihydropyridines: vVerapamil, vDiltiazem
2.Heart vblock vand vHeart vFailure
3. Vasodilation
11.Pharmacology: vBBs
1. Contraindications
2. Adverse vEffets: v1. vAsthma, vCOPD
2. vBronchospasm
12.Pharmacology: vTetracyclines
1. Examples:
2. Avoid vuse vduring vpregnancy vand vbreastfeeding vdue vto v of vteeth.
3. Sensitivity vto vwhat?: v1. vDoxycycline
2.Permanent vDiscoloration
3. Photosensitivity
13.Pharmacology: vMacrolides
1. Examples:
4 v/
v36
