ANCC AGPCNP Study Set UPDATED
ACTUAL Exam Questions and CORECT
Answers
Pharmacology - CORRECT ANSWER study of the interaction between the body and drugs
Pharmacokinetics - CORRECT ANSWER the movement of drugs trough the body
(absorption, bioavailability, distribution, metabolism, and excretion)
Pharmacodynamics - CORRECT ANSWER The study of the physiologic and biochemical
effects of drugs (what a drug does to the body)
Pharmacogenomics - CORRECT ANSWER the study of how a person's genes affect response
to medications.
Area under the curve (AUC) - CORRECT ANSWER the average amount of a drug in the
blood after a dose is given. It is a measure of the availability (bioavailability) of a drug after it is
administered.
maximum concentration (Cmax) - CORRECT ANSWER The peak serum concentration of a
drug
Minimum inhibitory concentration (MIC) - CORRECT ANSWER the lowest concentration of
an antibiotic that will inhibit the growth of organisms (after overnight incubation).
Trough - CORRECT ANSWER the lowest concentration of a drug after a dose
First-pass effect - CORRECT ANSWER All oral drugs (except sublingual) must go through
first-pass metabolism before released and used by body.
,In the liver the CYP450 system metabolizes the drug and then the active drug is released to the
body to be used.
What drug cannot be given orally because of extensive first-pass effect? - CORRECT
ANSWER insulin
Drug Excretion - CORRECT ANSWER Renal filtration accounts for most of drug excretion.
Kidney is the principle organ for drug elimination.
Age related change to pharmacokinetics - CORRECT ANSWER - Increase in fat-to-water
ratio
- Decrease in albumin and plasma proteins
- Decrease in liver blood flow and size
- Decrease in some CYP450 enzyme pathways (decreased drug clearance)
- Decrease in glomerular filtration rate (GFR)
Specific Drugs affected by Kidney Disease - CORRECT ANSWER - NSAIDS (reduction of
renal blood flow will damage kidneys)
- ACE inhibitors (higher risk of hyperkalemia)
- Warfarin (Higher risk of over coagulation (INR >4). Severe CKD and ESRD at risk of
hemorrhagic complications. Need more frequent monitoring
- Lithium (increase risk of kidney injury. Monitor renal fxn closely)
- Contrast dye (IV contrast can injure kidneys)
- Potassium sparing diuretics (increased risk of hyperkalemia)
- Oral sodium phosphate (used to cleanse bowel before colonoscopies) (May cause sudden loss
of kidney fxn (AKI) as well as blood mineral disturbances)
Potent CYP450 Inhibitors - CORRECT ANSWER - THESE DRUGS SLOW DOWN
CLEARANCE ((increase drug concentration, high risk for drug overdose or ASEs)) --high
likelihood of drug-drug interactions
- Macrolides (erythromycin, clarithromycin, telithromycin)
, - Antifungals (ketoconazole, fluconazole, phenytoin)
- Cimetidine (Tagamet)
- Citalopram (Celexa)
- Protease inhibitors (saquinavir, indinavir, nelfinavir)
- Grapefruit Juice (affects CYP450 system)
What drugs does grapefruit interact with? - CORRECT ANSWER - statins
-erythromycin
-calcium channel blocker ( nifedipine, nisoldipine)
-antivirals (indinavir, saquinavir)
-amiodarone
-benzodiazepines (diazepam, triazolam)
-cisapride
-carbamazepine
-buspirone
What to monitor with Digoxin - CORRECT ANSWER - Digoxin levels
- EKG
-electrolytes (K+,Mg+,Ca2+)
What to monitor with Lithium? - CORRECT ANSWER - blood levels
- TSH (risk for hypothyroidism)
Drugs to monitor drug levels - CORRECT ANSWER - Digoxin
-Theophylline
-Carbamazepine
-Phenytoin (Dilantin)
-Lithium
ACTUAL Exam Questions and CORECT
Answers
Pharmacology - CORRECT ANSWER study of the interaction between the body and drugs
Pharmacokinetics - CORRECT ANSWER the movement of drugs trough the body
(absorption, bioavailability, distribution, metabolism, and excretion)
Pharmacodynamics - CORRECT ANSWER The study of the physiologic and biochemical
effects of drugs (what a drug does to the body)
Pharmacogenomics - CORRECT ANSWER the study of how a person's genes affect response
to medications.
Area under the curve (AUC) - CORRECT ANSWER the average amount of a drug in the
blood after a dose is given. It is a measure of the availability (bioavailability) of a drug after it is
administered.
maximum concentration (Cmax) - CORRECT ANSWER The peak serum concentration of a
drug
Minimum inhibitory concentration (MIC) - CORRECT ANSWER the lowest concentration of
an antibiotic that will inhibit the growth of organisms (after overnight incubation).
Trough - CORRECT ANSWER the lowest concentration of a drug after a dose
First-pass effect - CORRECT ANSWER All oral drugs (except sublingual) must go through
first-pass metabolism before released and used by body.
,In the liver the CYP450 system metabolizes the drug and then the active drug is released to the
body to be used.
What drug cannot be given orally because of extensive first-pass effect? - CORRECT
ANSWER insulin
Drug Excretion - CORRECT ANSWER Renal filtration accounts for most of drug excretion.
Kidney is the principle organ for drug elimination.
Age related change to pharmacokinetics - CORRECT ANSWER - Increase in fat-to-water
ratio
- Decrease in albumin and plasma proteins
- Decrease in liver blood flow and size
- Decrease in some CYP450 enzyme pathways (decreased drug clearance)
- Decrease in glomerular filtration rate (GFR)
Specific Drugs affected by Kidney Disease - CORRECT ANSWER - NSAIDS (reduction of
renal blood flow will damage kidneys)
- ACE inhibitors (higher risk of hyperkalemia)
- Warfarin (Higher risk of over coagulation (INR >4). Severe CKD and ESRD at risk of
hemorrhagic complications. Need more frequent monitoring
- Lithium (increase risk of kidney injury. Monitor renal fxn closely)
- Contrast dye (IV contrast can injure kidneys)
- Potassium sparing diuretics (increased risk of hyperkalemia)
- Oral sodium phosphate (used to cleanse bowel before colonoscopies) (May cause sudden loss
of kidney fxn (AKI) as well as blood mineral disturbances)
Potent CYP450 Inhibitors - CORRECT ANSWER - THESE DRUGS SLOW DOWN
CLEARANCE ((increase drug concentration, high risk for drug overdose or ASEs)) --high
likelihood of drug-drug interactions
- Macrolides (erythromycin, clarithromycin, telithromycin)
, - Antifungals (ketoconazole, fluconazole, phenytoin)
- Cimetidine (Tagamet)
- Citalopram (Celexa)
- Protease inhibitors (saquinavir, indinavir, nelfinavir)
- Grapefruit Juice (affects CYP450 system)
What drugs does grapefruit interact with? - CORRECT ANSWER - statins
-erythromycin
-calcium channel blocker ( nifedipine, nisoldipine)
-antivirals (indinavir, saquinavir)
-amiodarone
-benzodiazepines (diazepam, triazolam)
-cisapride
-carbamazepine
-buspirone
What to monitor with Digoxin - CORRECT ANSWER - Digoxin levels
- EKG
-electrolytes (K+,Mg+,Ca2+)
What to monitor with Lithium? - CORRECT ANSWER - blood levels
- TSH (risk for hypothyroidism)
Drugs to monitor drug levels - CORRECT ANSWER - Digoxin
-Theophylline
-Carbamazepine
-Phenytoin (Dilantin)
-Lithium
