2025 NR565 MIDTERM WEEK 4
EXAM WITH CORRECT ANSWERS UPDATED
STUDY SOLUTIONS
Name the 4 medications that REQUIRE pharmacogenetic testing - CORRECT
ANSWERS-Cetuximab, trastuzumab, maraviroc, dasatinib
2 medications prescribed together that are highly protein bound, what is clinical outcome? -
CORRECT ANSWERS-The two drugs compete for availability of plasma proteins and one or the
other becomes increasingly effective, think extra medication is floating around as it cannot bind
to plasma proteins. Warfarin is highly protein bound.
What areas of healthcare most heavily integrate pharmacogenetics into clinical practice? -
CORRECT ANSWERS-Oncology & cystic fibrosis population
Think HER2 with breast cancer and CF have 2 defective CFTR genes
Barrier in understanding racial differences in drug pharmacokinetics with
American Indian or Alaskan Natives? - CORRECT ANSWERS-Limited to no
research in racial considerations
ACEIs - CORRECT ANSWERS-monitor CMP or BMP for potassium retention and
kidney function
Pregnancy category C in first trimester, D in following
4 phases of clinical trials - CORRECT ANSWERS-I. small number of healthy volunteers (dosage
range), II. small group of patients (efficacy), III. large number of patients (rare complications),
various sites, IV. Post marketing surveillance
controlled substances schedule I - CORRECT ANSWERS-highest potential for
abuse like heroin, LSD, marijuana, Peyote
Schedule II controlled substances - CORRECT ANSWERS-high potential for
abuse
legal, but no refills may be prescribed (but you can do multiple rx for up to
90 days supply)
dilaudid, methadone, percocet
Schedule III - CORRECT ANSWERS-potential for abuse is there, ketamine,
suboxone, tylenol with codeine
Schedule IV Controlled Substances - CORRECT ANSWERS-lower abuse
potential, xanax, klonopin, valium, ativan
schedule V substances - CORRECT ANSWERS-no more than 200 mg of
This study source was downloaded by 100000882397936 from nursinghero.com on 09-02-2025 06:58:15 GMT -05:00
https://www.nursinghero.com//study-files/24039519
, codeine per 100 ml, robitussin
common otc meds used to make meth - CORRECT ANSWERS-ephedrine,
bronchodilators, nasal decongestants
anticonvulsants rx to women of childbearing age - CORRECT ANSWERS-
lamotrigine has lowest risk
First line tx for MDD - CORRECT ANSWERS-sertraline, escitalopram, due to
efficacy and lowest amount of side effects
prophy treatment for migraines - CORRECT ANSWERS-antiepileptics, betablockers, tricyclic
antidepressants
what makes clopidogrel unique among other P2Y12 inhibitors? - CORRECT ANSWERS-relies on
cytochrome P450 enzyme to convert into active metabolite (CYP2C19) thus requiring this gene
to be present to be an effective drug in clot formation
Alternatives to clopidogrel - CORRECT ANSWERS-Brilinta (ticagrelor) or
Effient (Prasugrel) because they are not dependent on CYP2C19 genotype
Purpose of genetic testing with Tamoxifen? - CORRECT ANSWERS-Reduce the risk of therapeutic
failure as variation of CYP2D6 will not allow for activation and conversion to endoxifen which is
necessary for treating estrogen sensitive cancers.
Liver and Kidney functions labs for monitoring? - CORRECT ANSWERS-
Creatinine, BUN, GFR, AST, ALT, Bilirubin
Dose of propranolol in migraine reduction - CORRECT ANSWERS-20-80mg 3-
4X daily
increases levels of serotonin, prevents beta receptor vasodilation
allow 4-6 weeks to trial treatment
First consideration in selecting most appropriate beta blocker? - CORRECT
ANSWERS-Cardio selectivity
Pregnancy Categories B vs D with beta blockers - CORRECT ANSWERS-
Atenolol - D
betaxolol, acebutolol, metoprolol, nadolol, nebivolol, tiolol, propranolol - C
Where are beta 2 receptors located and what do they do? - CORRECT ANSWERS-smooth muscle
of eye, arterioles, venules, bronchioles, liver, pancreas, GI, GU
Stimulate adneylyl cyclase, increase cAMP, activate cardiac G1
Drug of choice for HTN with concomitant BPH - CORRECT ANSWERS-Alpha 1
adrenergic antagonist
Beta blockers that require dosage adjustment in patients with renal
impairment - CORRECT ANSWERS-acebutolol, atenolol, nadolol, and nebivolol
Dosing schedule of donepizil - CORRECT ANSWERS-5mg nightly at bedtime,
This study source was downloaded by 100000882397936 from nursinghero.com on 09-02-2025 06:58:15 GMT -05:00
https://www.nursinghero.com//study-files/24039519
EXAM WITH CORRECT ANSWERS UPDATED
STUDY SOLUTIONS
Name the 4 medications that REQUIRE pharmacogenetic testing - CORRECT
ANSWERS-Cetuximab, trastuzumab, maraviroc, dasatinib
2 medications prescribed together that are highly protein bound, what is clinical outcome? -
CORRECT ANSWERS-The two drugs compete for availability of plasma proteins and one or the
other becomes increasingly effective, think extra medication is floating around as it cannot bind
to plasma proteins. Warfarin is highly protein bound.
What areas of healthcare most heavily integrate pharmacogenetics into clinical practice? -
CORRECT ANSWERS-Oncology & cystic fibrosis population
Think HER2 with breast cancer and CF have 2 defective CFTR genes
Barrier in understanding racial differences in drug pharmacokinetics with
American Indian or Alaskan Natives? - CORRECT ANSWERS-Limited to no
research in racial considerations
ACEIs - CORRECT ANSWERS-monitor CMP or BMP for potassium retention and
kidney function
Pregnancy category C in first trimester, D in following
4 phases of clinical trials - CORRECT ANSWERS-I. small number of healthy volunteers (dosage
range), II. small group of patients (efficacy), III. large number of patients (rare complications),
various sites, IV. Post marketing surveillance
controlled substances schedule I - CORRECT ANSWERS-highest potential for
abuse like heroin, LSD, marijuana, Peyote
Schedule II controlled substances - CORRECT ANSWERS-high potential for
abuse
legal, but no refills may be prescribed (but you can do multiple rx for up to
90 days supply)
dilaudid, methadone, percocet
Schedule III - CORRECT ANSWERS-potential for abuse is there, ketamine,
suboxone, tylenol with codeine
Schedule IV Controlled Substances - CORRECT ANSWERS-lower abuse
potential, xanax, klonopin, valium, ativan
schedule V substances - CORRECT ANSWERS-no more than 200 mg of
This study source was downloaded by 100000882397936 from nursinghero.com on 09-02-2025 06:58:15 GMT -05:00
https://www.nursinghero.com//study-files/24039519
, codeine per 100 ml, robitussin
common otc meds used to make meth - CORRECT ANSWERS-ephedrine,
bronchodilators, nasal decongestants
anticonvulsants rx to women of childbearing age - CORRECT ANSWERS-
lamotrigine has lowest risk
First line tx for MDD - CORRECT ANSWERS-sertraline, escitalopram, due to
efficacy and lowest amount of side effects
prophy treatment for migraines - CORRECT ANSWERS-antiepileptics, betablockers, tricyclic
antidepressants
what makes clopidogrel unique among other P2Y12 inhibitors? - CORRECT ANSWERS-relies on
cytochrome P450 enzyme to convert into active metabolite (CYP2C19) thus requiring this gene
to be present to be an effective drug in clot formation
Alternatives to clopidogrel - CORRECT ANSWERS-Brilinta (ticagrelor) or
Effient (Prasugrel) because they are not dependent on CYP2C19 genotype
Purpose of genetic testing with Tamoxifen? - CORRECT ANSWERS-Reduce the risk of therapeutic
failure as variation of CYP2D6 will not allow for activation and conversion to endoxifen which is
necessary for treating estrogen sensitive cancers.
Liver and Kidney functions labs for monitoring? - CORRECT ANSWERS-
Creatinine, BUN, GFR, AST, ALT, Bilirubin
Dose of propranolol in migraine reduction - CORRECT ANSWERS-20-80mg 3-
4X daily
increases levels of serotonin, prevents beta receptor vasodilation
allow 4-6 weeks to trial treatment
First consideration in selecting most appropriate beta blocker? - CORRECT
ANSWERS-Cardio selectivity
Pregnancy Categories B vs D with beta blockers - CORRECT ANSWERS-
Atenolol - D
betaxolol, acebutolol, metoprolol, nadolol, nebivolol, tiolol, propranolol - C
Where are beta 2 receptors located and what do they do? - CORRECT ANSWERS-smooth muscle
of eye, arterioles, venules, bronchioles, liver, pancreas, GI, GU
Stimulate adneylyl cyclase, increase cAMP, activate cardiac G1
Drug of choice for HTN with concomitant BPH - CORRECT ANSWERS-Alpha 1
adrenergic antagonist
Beta blockers that require dosage adjustment in patients with renal
impairment - CORRECT ANSWERS-acebutolol, atenolol, nadolol, and nebivolol
Dosing schedule of donepizil - CORRECT ANSWERS-5mg nightly at bedtime,
This study source was downloaded by 100000882397936 from nursinghero.com on 09-02-2025 06:58:15 GMT -05:00
https://www.nursinghero.com//study-files/24039519
