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APEA PREDICTOR STUDY GUIDE EXAM
2025/2026 |100% VERIFIED.
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
Pharmacokinetics
1. What are age-related changes?
(Distribution, Metabolism, Excretion)?
1. Increase in fat-to-water ratio, decrease in liver function, decrease in GFR
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
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?
, Page |2
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.
6. Omit one dose, recheck INR.
7. Take the dose as soon as possible. Do not double dose.
8. Vitamin K foods
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
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
Pharmacology: Potassium-Sparing Diuretics
1. Examples
, Page |3
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
Pharmacology: Loop Diuretics
1. Examples
2. Contraindication/Allergy
3. Adverse effects
4. Which toxicity with loop diuretics can occur?
1. Furosemide
2. Sulfa Allergy
3. Hypokalemia, Hyponatremia, hypomagnesemia
4. Ototoxicity
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.
Pharmacology: CCBs
1. Two types and Examples of both types
2. Cardiac contraindications for Nondihydropyridines
, Page |4
3. Why does pedal edema occur with dihydropyridines?
1. Dihydropyridines: Amlodipine, Nifedipine
Nondihydropyridines: Verapamil, Diltiazem
2. Heart block and Heart Failure
3. Vasodilation
Pharmacology: BBs
1. Contraindications
2. Adverse Effets
1. Asthma, COPD
2. Bronchospasm
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
Pharmacology: Macrolides
1. Examples:
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
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
APEA PREDICTOR STUDY GUIDE EXAM
2025/2026 |100% VERIFIED.
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
Pharmacokinetics
1. What are age-related changes?
(Distribution, Metabolism, Excretion)?
1. Increase in fat-to-water ratio, decrease in liver function, decrease in GFR
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
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?
, Page |2
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.
6. Omit one dose, recheck INR.
7. Take the dose as soon as possible. Do not double dose.
8. Vitamin K foods
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
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
Pharmacology: Potassium-Sparing Diuretics
1. Examples
, Page |3
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
Pharmacology: Loop Diuretics
1. Examples
2. Contraindication/Allergy
3. Adverse effects
4. Which toxicity with loop diuretics can occur?
1. Furosemide
2. Sulfa Allergy
3. Hypokalemia, Hyponatremia, hypomagnesemia
4. Ototoxicity
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.
Pharmacology: CCBs
1. Two types and Examples of both types
2. Cardiac contraindications for Nondihydropyridines
, Page |4
3. Why does pedal edema occur with dihydropyridines?
1. Dihydropyridines: Amlodipine, Nifedipine
Nondihydropyridines: Verapamil, Diltiazem
2. Heart block and Heart Failure
3. Vasodilation
Pharmacology: BBs
1. Contraindications
2. Adverse Effets
1. Asthma, COPD
2. Bronchospasm
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
Pharmacology: Macrolides
1. Examples:
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
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
