NSG 6005 PHARM WEEKS 1-3 QUIZ (FROM
OPERATION FNP CLASS 11)
Genetic polymorphisms account for differences in metabolism, including:
1. Poor metabolizers, who lack a working enzyme
2. Intermediate metabolizers, who have one working, wild-type allele and one mutant
allele
3. Extensive metabolizers, with two normally functioning alleles
4. All of the above - Answer -4. All of the above
Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
1. A need to monitor drugs metabolized by 2D6 for toxicity
2. Increased dosages needed of drugs metabolized by 2D6, such as the selective
serotonin reuptake inhibitors
3. Decreased conversion of codeine to morphine by CYP 2D6
4. The need for lowered dosages of drugs, such as beta blockers - Answer -2.
Increased dosages needed of drugs metabolized by 2D6, such as the selective
serotonin reuptake inhibitors
Rifampin is a nonspecific CYP450 inducer that may:
1. Lead to toxic levels of rifampin and must be monitored closely
2. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
3. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic
failure
4. Cause nonspecific changes in drug metabolism - Answer -3. Induce the metabolism
of drugs, such as oral contraceptives, leading to therapeutic failure
Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
1. Decreased therapeutic levels of quinidine
2. Increased therapeutic levels of quinidine
,3. Decreased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
4. Increased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination - Answer -4. Increased levels of a
coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
1. Toxic levels of warfarin building up
2. Decreased response to warfarin
3. Increased risk for significant drug interactions with warfarin
4. Less risk of drug interactions with warfarin - Answer -2. Decreased response to
warfarin
Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required
prior to prescribing warfarin.
1. True
2. False - Answer -2. False
Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to
prescribing:
1. Erythromycin
2. Digoxin
3. Cetuximab
4. Rifampin - Answer -3. Cetuximab
Carbamazepine has a Black Box Warning recommending testing for the HLA-
B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
1. Decreased effectiveness of carbamazepine in treating seizures in Asian patients with
the HLA-B*1502 allele
2. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
,3. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502
allele
4. Patients who have the HLA-B*1502 allele being more likely to have a resistance to
carbamazepine - Answer -3. Increased risk for Stevens-Johnson syndrome in Asian
patients with HLA-B*1502 allele
A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is
inactivated by the body may lead to:
1. Decreased effectiveness of irinotecan in the treatment of cancer
2. Increased adverse drug reactions, such as neutropenia
3. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
4. Increased concerns for irinotecan being carcinogenic - Answer -2. Increased adverse
drug reactions, such as neutropenia
Patients who have a poor metabolism phenotype will have:
1. Slowed metabolism of a prodrug into an active drug, leading to accumulation of
prodrug
2. Accumulation of inactive metabolites of drugs
3. A need for increased dosages of medications
4. Increased elimination of an active drug - Answer -1. Slowed metabolism of a prodrug
into an active drug, leading to accumulation of prodrug
Ultra-rapid metabolizers of drugs may have:
1. To have dosages of drugs adjusted downward to prevent drug accumulation
2. Active drug rapidly metabolized into inactive metabolites, leading to potential
therapeutic failure
3. Increased elimination of active, nonmetabolized drug
4. Slowed metabolism of a prodrug into an active drug, leading to an accumulation of
prodrug - Answer -2. Active drug rapidly metabolized into inactive metabolites, leading
to potential therapeutic failure
A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for
breast cancer to:
, 1. Ensure the patient will not have increased adverse drug reactions to the tamoxifen
2. Identify potential drug-drug interactions that may occur with tamoxifen
3. Reduce the likelihood of therapeutic failure with tamoxifen treatment
4. Identify poor metabolizers of tamoxifen - Answer -3. Reduce the likelihood of
therapeutic failure with tamoxifen treatment
The most frequent type of drug-food interaction is food:
1. Causing increased therapeutic drug levels
2. Affecting the metabolism of the drug
3. Altering the volume of distribution of drugs
4. Affecting the gastrointestinal absorption of drugs - Answer -4. Affecting the
gastrointestinal absorption of drugs
Food in the gastrointestinal tract affects drug absorption by:
1. Altering the pH of the colon, which decreases absorption
2. Competing with the drug for plasma proteins
3. Altering gastric emptying time
4. Altering the pH of urine - Answer -3. Altering gastric emptying time
Food can alter the pH of the stomach, leading to:
1. Enhanced drug metabolism
2. Altered vitamin K absorption
3. Increased vitamin D absorption
4. Altered drug bioavailability - Answer -4. Altered drug bioavailability
Fasting for an extended period can:
1. Increase drug absorption due to lack of competition between food and the drug
2. Alter the pH of the gastrointestinal tract, affecting absorption
OPERATION FNP CLASS 11)
Genetic polymorphisms account for differences in metabolism, including:
1. Poor metabolizers, who lack a working enzyme
2. Intermediate metabolizers, who have one working, wild-type allele and one mutant
allele
3. Extensive metabolizers, with two normally functioning alleles
4. All of the above - Answer -4. All of the above
Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
1. A need to monitor drugs metabolized by 2D6 for toxicity
2. Increased dosages needed of drugs metabolized by 2D6, such as the selective
serotonin reuptake inhibitors
3. Decreased conversion of codeine to morphine by CYP 2D6
4. The need for lowered dosages of drugs, such as beta blockers - Answer -2.
Increased dosages needed of drugs metabolized by 2D6, such as the selective
serotonin reuptake inhibitors
Rifampin is a nonspecific CYP450 inducer that may:
1. Lead to toxic levels of rifampin and must be monitored closely
2. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
3. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic
failure
4. Cause nonspecific changes in drug metabolism - Answer -3. Induce the metabolism
of drugs, such as oral contraceptives, leading to therapeutic failure
Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
1. Decreased therapeutic levels of quinidine
2. Increased therapeutic levels of quinidine
,3. Decreased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
4. Increased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination - Answer -4. Increased levels of a
coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
1. Toxic levels of warfarin building up
2. Decreased response to warfarin
3. Increased risk for significant drug interactions with warfarin
4. Less risk of drug interactions with warfarin - Answer -2. Decreased response to
warfarin
Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required
prior to prescribing warfarin.
1. True
2. False - Answer -2. False
Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to
prescribing:
1. Erythromycin
2. Digoxin
3. Cetuximab
4. Rifampin - Answer -3. Cetuximab
Carbamazepine has a Black Box Warning recommending testing for the HLA-
B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
1. Decreased effectiveness of carbamazepine in treating seizures in Asian patients with
the HLA-B*1502 allele
2. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
,3. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502
allele
4. Patients who have the HLA-B*1502 allele being more likely to have a resistance to
carbamazepine - Answer -3. Increased risk for Stevens-Johnson syndrome in Asian
patients with HLA-B*1502 allele
A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is
inactivated by the body may lead to:
1. Decreased effectiveness of irinotecan in the treatment of cancer
2. Increased adverse drug reactions, such as neutropenia
3. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
4. Increased concerns for irinotecan being carcinogenic - Answer -2. Increased adverse
drug reactions, such as neutropenia
Patients who have a poor metabolism phenotype will have:
1. Slowed metabolism of a prodrug into an active drug, leading to accumulation of
prodrug
2. Accumulation of inactive metabolites of drugs
3. A need for increased dosages of medications
4. Increased elimination of an active drug - Answer -1. Slowed metabolism of a prodrug
into an active drug, leading to accumulation of prodrug
Ultra-rapid metabolizers of drugs may have:
1. To have dosages of drugs adjusted downward to prevent drug accumulation
2. Active drug rapidly metabolized into inactive metabolites, leading to potential
therapeutic failure
3. Increased elimination of active, nonmetabolized drug
4. Slowed metabolism of a prodrug into an active drug, leading to an accumulation of
prodrug - Answer -2. Active drug rapidly metabolized into inactive metabolites, leading
to potential therapeutic failure
A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for
breast cancer to:
, 1. Ensure the patient will not have increased adverse drug reactions to the tamoxifen
2. Identify potential drug-drug interactions that may occur with tamoxifen
3. Reduce the likelihood of therapeutic failure with tamoxifen treatment
4. Identify poor metabolizers of tamoxifen - Answer -3. Reduce the likelihood of
therapeutic failure with tamoxifen treatment
The most frequent type of drug-food interaction is food:
1. Causing increased therapeutic drug levels
2. Affecting the metabolism of the drug
3. Altering the volume of distribution of drugs
4. Affecting the gastrointestinal absorption of drugs - Answer -4. Affecting the
gastrointestinal absorption of drugs
Food in the gastrointestinal tract affects drug absorption by:
1. Altering the pH of the colon, which decreases absorption
2. Competing with the drug for plasma proteins
3. Altering gastric emptying time
4. Altering the pH of urine - Answer -3. Altering gastric emptying time
Food can alter the pH of the stomach, leading to:
1. Enhanced drug metabolism
2. Altered vitamin K absorption
3. Increased vitamin D absorption
4. Altered drug bioavailability - Answer -4. Altered drug bioavailability
Fasting for an extended period can:
1. Increase drug absorption due to lack of competition between food and the drug
2. Alter the pH of the gastrointestinal tract, affecting absorption
