APEA Predictor Exam
Study
1.First-Pass Effect
1. What cytochrome metabolizes a medication drug during the FIRST-
PASS Effect?
2. CYP450 enzyme is the most .
3. It can either be induced or inhibited (T/F): 1. CYP450 metabolizes the
drug in the liver to release the drug to the body where it can be used.
2. Active
3. True
2. Pharmacokinetics
1. What are age-related changes?
(Distribution, Metabolism, Excretion)?: 1. Increase in fat-to-water ratio,
decrease in liver function, decrease in GFR
3. Pharmacology: Cardiac Glycosides
1. What order of line of treatment is Digoxin?
2. Signs of Digoxin Overdose
3. Laboratory tests
4. Treatment: 1. Second and Third
2.N/V, Hyperkalemia, Confusion, visual color changes
3. Digoxin level, CMP, EKG
4.Digoxin-specific antibodies
4.Pharmacology: Warfarin (Coumadin)
1. Category for pregnancy.
2. Target INR for patients without mitral prosthetic valves? With
prosthetic valves?
3. Referral to for initiation and stabilization of warfarin dose.
4. How often do you check for consistently stable INR?
5. How often do you check for single out-of-range INR?
6. What do you educate the patient to do if the INR less than 5 with
no significant bleeding risk?
7. If one dose is missed, what do you do?
8. What kind of foods to avoid messing up the INR?: 1. X
2. 2.0-3.0, 2.5-3.5
3.Cardiologist or anticoagulation clinic
4.Check every 2-4 weeks up to 12 weeks.
5.Continue warfarin dose, retest INR in 1-2 weeks.
, APEA Predictor Exam
Study
6.Omit one dose, recheck INR.
7.Take the dose as soon as possible. Do not double dose.
8.Vitamin K foods
5.Pharmacology: Direct Oran Anticoagulants (DOAC)
1. Why are DOACs better than Warfarin?
2. Example of DOACs?
3. How long does it take for platelet function to return to normal after a
patient stops taking Plavix?: 1. Less monitoring and less side effects
2.Apixaban (Eliquis)
3.10 days
6.Pharmacology: Thiazide Diuretics
1. Examples
2. Contraindication
3. Adverse effects
4. Patients with osteoporosis receive an extra benefit from thiazide
diuretics by reducing excretion (T/F): 1. HCTZ, Chlorthalidone
2.Sulfa allergy
3.Hykpokalemia, increases uric acid and increases LDL
4.Calcium, True
7.Pharmacology: Potassium-Sparing Diuretics
1. Examples
2. Contraindication
3. Adverse effects
4. Do not combine with which cardiac drugs to prevent hyperkalemia?:
1. Triamterene, Amiloride
2. Hyperkalemia
3.Elevates K+ levels
4.ACEIs and ARBs
8.Pharmacology: Loop Diuretics
1. Examples
2. Contraindication/Allergy
3. Adverse effects
4. Which toxicity with loop diuretics can occur?: 1. Furosemide
2.Sulfa Allergy
, APEA Predictor Exam
Study
3.Hypokalemia, Hyponatremia, hypomagnesemia
4. Ototoxicity
9.Pharmacology: ACEIs and ARBs
1. Examples
2. Black Box Warning/Contraindications
3. Adverse Effects
4. ACEIs are first-line therapy for
5. ACEIs and ARBs protect the kidneys. But if severe CKD, should you
continue ACEIs and ARBs? Why?: 1. Lisinopril, Losartan
2. Pregnancy
3.Dry cough, Hyperkalemia, Angioedema
4.Heart Failure w/ left ventricular dysfinction (HFrEF)
5.No, because severe CKD and ACEIs and ARBs will lead to
increased risk of hyperkalemia.
10.Pharmacology: CCBs
1. Two types and Examples of both types
2. Cardiac contraindications for Nondihydropyridines
3. Why does pedal edema occur with dihydropyridines?: 1.
Dihydropyridines: Amlodipine, Nifedipine
Nondihydropyridines: Verapamil, Diltiazem
2.Heart block and Heart Failure
3. Vasodilation
11.Pharmacology: BBs
1. Contraindications
2. Adverse Effets: 1. Asthma, COPD
2. Bronchospasm
12.Pharmacology: Tetracyclines
1. Examples:
2. Avoid use during pregnancy and breastfeeding due to of teeth.
3. Sensitivity to what?: 1. Doxycycline
2.Permanent Discoloration
3. Photosensitivity
13.Pharmacology: Macrolides
1. Examples:
, APEA Predictor Exam
Study
2. Type of toxicity
3. Which is the most tolerated macrolide from GI side effects of Nausea
and vomiting?: 1. Azithromycin, Erythromycin
2. Hepatotoxicity
3. Azithromycin
14.Pharmacology: Cephalosporins
1. Examples of each of the First, Second and Third Generation
2. First line of treatment against gonorroheal infections?
3. Avoid ceftriaxone in hyperbilirubinemia infants because it can cause:
1. First: Cephalexin (Keflex), Second: Cefuroxime, Third: Cefdinir
2.Ceftriaxone (3rd Generation)
3. Kernicterus
15.Pharmacology: PCNs
1. Examples
2. Avoid using amoxicillin for patients with mononucleosis because it can
lead to a: 1. PCN, Amoxicillin, Augmentin
2. Rash
16.Pharmacology: Fluoroquinolones
1. Examples
2. Complications
3. Avoid in which population
4. Patients should avoid sun exposure due to with thix ABX
(T/F): 1. Ciprofloxacin, Levofloxacin
2.Achilles-Tendon Rupture, Torsades de Pointes, Abnormal bone
development
3.Pregnant women and growing children
4. Phototoxicity; True
17.FDA Controlled Substances Act
1. Schedule 1 Drugs are legal to prescribe (T/F)
2. Schedule II drugs require a new prescription written every month (T/F)
3. Testosterone is what scheduled drug number?: 1. False; Illegal
2. True
3. III
18.Screening Tests
Study
1.First-Pass Effect
1. What cytochrome metabolizes a medication drug during the FIRST-
PASS Effect?
2. CYP450 enzyme is the most .
3. It can either be induced or inhibited (T/F): 1. CYP450 metabolizes the
drug in the liver to release the drug to the body where it can be used.
2. Active
3. True
2. Pharmacokinetics
1. What are age-related changes?
(Distribution, Metabolism, Excretion)?: 1. Increase in fat-to-water ratio,
decrease in liver function, decrease in GFR
3. Pharmacology: Cardiac Glycosides
1. What order of line of treatment is Digoxin?
2. Signs of Digoxin Overdose
3. Laboratory tests
4. Treatment: 1. Second and Third
2.N/V, Hyperkalemia, Confusion, visual color changes
3. Digoxin level, CMP, EKG
4.Digoxin-specific antibodies
4.Pharmacology: Warfarin (Coumadin)
1. Category for pregnancy.
2. Target INR for patients without mitral prosthetic valves? With
prosthetic valves?
3. Referral to for initiation and stabilization of warfarin dose.
4. How often do you check for consistently stable INR?
5. How often do you check for single out-of-range INR?
6. What do you educate the patient to do if the INR less than 5 with
no significant bleeding risk?
7. If one dose is missed, what do you do?
8. What kind of foods to avoid messing up the INR?: 1. X
2. 2.0-3.0, 2.5-3.5
3.Cardiologist or anticoagulation clinic
4.Check every 2-4 weeks up to 12 weeks.
5.Continue warfarin dose, retest INR in 1-2 weeks.
, APEA Predictor Exam
Study
6.Omit one dose, recheck INR.
7.Take the dose as soon as possible. Do not double dose.
8.Vitamin K foods
5.Pharmacology: Direct Oran Anticoagulants (DOAC)
1. Why are DOACs better than Warfarin?
2. Example of DOACs?
3. How long does it take for platelet function to return to normal after a
patient stops taking Plavix?: 1. Less monitoring and less side effects
2.Apixaban (Eliquis)
3.10 days
6.Pharmacology: Thiazide Diuretics
1. Examples
2. Contraindication
3. Adverse effects
4. Patients with osteoporosis receive an extra benefit from thiazide
diuretics by reducing excretion (T/F): 1. HCTZ, Chlorthalidone
2.Sulfa allergy
3.Hykpokalemia, increases uric acid and increases LDL
4.Calcium, True
7.Pharmacology: Potassium-Sparing Diuretics
1. Examples
2. Contraindication
3. Adverse effects
4. Do not combine with which cardiac drugs to prevent hyperkalemia?:
1. Triamterene, Amiloride
2. Hyperkalemia
3.Elevates K+ levels
4.ACEIs and ARBs
8.Pharmacology: Loop Diuretics
1. Examples
2. Contraindication/Allergy
3. Adverse effects
4. Which toxicity with loop diuretics can occur?: 1. Furosemide
2.Sulfa Allergy
, APEA Predictor Exam
Study
3.Hypokalemia, Hyponatremia, hypomagnesemia
4. Ototoxicity
9.Pharmacology: ACEIs and ARBs
1. Examples
2. Black Box Warning/Contraindications
3. Adverse Effects
4. ACEIs are first-line therapy for
5. ACEIs and ARBs protect the kidneys. But if severe CKD, should you
continue ACEIs and ARBs? Why?: 1. Lisinopril, Losartan
2. Pregnancy
3.Dry cough, Hyperkalemia, Angioedema
4.Heart Failure w/ left ventricular dysfinction (HFrEF)
5.No, because severe CKD and ACEIs and ARBs will lead to
increased risk of hyperkalemia.
10.Pharmacology: CCBs
1. Two types and Examples of both types
2. Cardiac contraindications for Nondihydropyridines
3. Why does pedal edema occur with dihydropyridines?: 1.
Dihydropyridines: Amlodipine, Nifedipine
Nondihydropyridines: Verapamil, Diltiazem
2.Heart block and Heart Failure
3. Vasodilation
11.Pharmacology: BBs
1. Contraindications
2. Adverse Effets: 1. Asthma, COPD
2. Bronchospasm
12.Pharmacology: Tetracyclines
1. Examples:
2. Avoid use during pregnancy and breastfeeding due to of teeth.
3. Sensitivity to what?: 1. Doxycycline
2.Permanent Discoloration
3. Photosensitivity
13.Pharmacology: Macrolides
1. Examples:
, APEA Predictor Exam
Study
2. Type of toxicity
3. Which is the most tolerated macrolide from GI side effects of Nausea
and vomiting?: 1. Azithromycin, Erythromycin
2. Hepatotoxicity
3. Azithromycin
14.Pharmacology: Cephalosporins
1. Examples of each of the First, Second and Third Generation
2. First line of treatment against gonorroheal infections?
3. Avoid ceftriaxone in hyperbilirubinemia infants because it can cause:
1. First: Cephalexin (Keflex), Second: Cefuroxime, Third: Cefdinir
2.Ceftriaxone (3rd Generation)
3. Kernicterus
15.Pharmacology: PCNs
1. Examples
2. Avoid using amoxicillin for patients with mononucleosis because it can
lead to a: 1. PCN, Amoxicillin, Augmentin
2. Rash
16.Pharmacology: Fluoroquinolones
1. Examples
2. Complications
3. Avoid in which population
4. Patients should avoid sun exposure due to with thix ABX
(T/F): 1. Ciprofloxacin, Levofloxacin
2.Achilles-Tendon Rupture, Torsades de Pointes, Abnormal bone
development
3.Pregnant women and growing children
4. Phototoxicity; True
17.FDA Controlled Substances Act
1. Schedule 1 Drugs are legal to prescribe (T/F)
2. Schedule II drugs require a new prescription written every month (T/F)
3. Testosterone is what scheduled drug number?: 1. False; Illegal
2. True
3. III
18.Screening Tests
