NUR 635 Advanced Pharmacology
Midterm Exam Updated 2025/2026
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Pharmacology - ANSWER ✓ the study of drugs and their structure, targets of
action, mechanisms of action (MOA), distribution (how the body disburses them
throughout the body), desired physiologic effects (efficacy) and undesirable side
effects (toxicity).
What is angina caused by - ANSWER ✓ an imbalance between myocardial oxygen
supply and demand (ischemia)
What is class 1 angina - ANSWER ✓ Proven coronary artery disease without
symptoms
what is class 2 angina - ANSWER ✓ Mild symptoms: angina and slight limitation
during ordinary activity
what is class 3 angina - ANSWER ✓ Marked limitations: angina during less-than-
routine physical activity (walking short distances)
what is class 4 angina - ANSWER ✓ Severe limitations: angina during minimal
activity or rest
how is angina reproduced - ANSWER ✓ Pain is reproducible with physical
exertion or emotional stress
,what is the goal of angina therapy - ANSWER ✓ control of anginal pain, maintain
blood pressure <130/85 mm Hg and pulse > 70 beats per minute, reduce the risks
of an MI and death, increase O2 delivery to myocardium, and reduce O2 demand
What class of medication can be used to treat angina - ANSWER ✓ Beta Blockers
Renin inhibitors (ACEIs)
ASA (all individuals with angina should be on at least 81mg ASA/day
Nitrates
CCBs
Healthy lifestyle
Exercise
Statins
what are Coronary Vasodilators - ANSWER ✓ Agents that increase myocardial
oxygen supply (NTG, isosorbide,
CCBs)
what needs to be remembered about heart failure patients - ANSWER ✓
Remember that many heart failure patients have more than just heart failure; look
for underlying hypertension, angina, etc.
what can increase risk for digoxin toxicity - ANSWER ✓ Low potassium levels
(hypokalemia)
How does heparin work - ANSWER ✓ produces rapid anticoagulation by binding
with antithrombin III, and inhibits factors IXa, Xa, XIIa, and XIII.
How is heparin monitored - ANSWER ✓ with aPTT (low dose SC heparin [5000
units BID] does not require aPTT monitoring).
how is heparin monitored when pregnant - ANSWER ✓ Monitor LMW heparin
by measuring Factor Xa levels in a pregnant patient.
how does warfarin work - ANSWER ✓ inhibits vitamin K-dependent blood
factors II, VII, IX and X; takes several days for its anticoagulant effect.
How is warfarin monitored? - ANSWER ✓ Monitor the International Normalized
Ratio (INR) when warfarin is used.
, what is dabigatran (Pradaxa) - ANSWER ✓ A Blood Factor IIa inhibitor (direct
thrombin inhibitor)
Clinical uses for warfarin - ANSWER ✓ Classic drug of choice for DVT and PE
· Start at 5 mg per day (7.5 mg/day if weight > 80 kg)
· Consider lower dose if > 75 years of age, multiple coexisting disorders, elevated
liver enzymes, changing thyroid status
-ASA
When on warfarin what should INR be - ANSWER ✓ between 2 and 3
What are the pharmacokinetics of warfarin - ANSWER ✓ 1. Well absorbed when
taken orally
1. Metabolized by CYP 1A2 & 2C9
2. Half-life of 3 to 4 days (must use a heparin while waiting for steady state
precautions and contraindications of warfarin - ANSWER ✓ 1. Pregnancy
category X
2. Use cautiously in patients with fall risk, dementia or uncontrolled hypertension
adverse reactions on warfarin - ANSWER ✓ -bleeding (antidote is vitamin K)
-allergic reaction (rare)
Drug interactions with warfarin - ANSWER ✓ 1. Many drug-drug interactions
2. Antiplatelet drugs
3. Thrombolytic drugs
What can decrease anticoagulant effect of warfarin - ANSWER ✓ oral
contraceptives, carbamazepine, vitamin K containing foods
What is the antidote for dabigatran (Pradaxa) - ANSWER ✓ idarucizumab.
Blood Factor Xa inhibitors: - ANSWER ✓ apixaban (Eliquis), edoxaban
(Savaysa), rivaroxaban (Xarelto), fondaparinux (Arixtra).
What is the antadote for apixaben and rivaroxaban - ANSWER ✓ Factor Xa
recombinant (Andexxa).
, what should patients using vitamin b12 monitor for - ANSWER ✓ should be
monitored for the development of hypokalemia which may be seen within the first
48 hours of therapy
Intravenous Anesthetics: - ANSWER ✓ ketamine, thiopental, fentanyl, propofol,
dexmedetomidine.
Propofol Pharmacokinetics - ANSWER ✓ a rapid onset, does not usually cause
nausea, and poor analgesia.
what should be monitored while on propofol - ANSWER ✓ Propofol can affect
triglycerides; monitor triglyceride levels
what is ICU delirium commonly treated with in the elderly - ANSWER ✓ treated
with haloperidol, although dexmedetomidine (Precedex) is the preferred drug for
sedation in the elderly
If respiratory depression is a concern what IV anesthetic should be used -
ANSWER ✓ dexmedetomidine (Precedex) is the preferred anesthetic; however, it
should not be used longer than 24 hours as per the FDA-approved product
information.
How do benzodiazepines work? - ANSWER ✓ bind to GABAA receptors,
allowing influx of chloride through the central ion channels, reducing
neurotransmission.
Hypnotic agents that bind to benzodiazepine receptors (subtype BZ): - ANSWER
✓ zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta).
what are benzodiazepines used for - ANSWER ✓ used to treat anxiety, as
sedative/hypnotics, for anterograde amnesia in procedures (midazolam [Versed]),
for epilepsy (clonazepam), and as muscle relaxants (mostly diazepam).
Benzodiazepines increase the risk of... - ANSWER ✓ increase falls in the elderly
and other people unsteady on their feet
Midterm Exam Updated 2025/2026
Exam Questions with Correct
Answers||Already Graded A+|| 100%
Guaranteed Pass||<<Newest
Version>>
Pharmacology - ANSWER ✓ the study of drugs and their structure, targets of
action, mechanisms of action (MOA), distribution (how the body disburses them
throughout the body), desired physiologic effects (efficacy) and undesirable side
effects (toxicity).
What is angina caused by - ANSWER ✓ an imbalance between myocardial oxygen
supply and demand (ischemia)
What is class 1 angina - ANSWER ✓ Proven coronary artery disease without
symptoms
what is class 2 angina - ANSWER ✓ Mild symptoms: angina and slight limitation
during ordinary activity
what is class 3 angina - ANSWER ✓ Marked limitations: angina during less-than-
routine physical activity (walking short distances)
what is class 4 angina - ANSWER ✓ Severe limitations: angina during minimal
activity or rest
how is angina reproduced - ANSWER ✓ Pain is reproducible with physical
exertion or emotional stress
,what is the goal of angina therapy - ANSWER ✓ control of anginal pain, maintain
blood pressure <130/85 mm Hg and pulse > 70 beats per minute, reduce the risks
of an MI and death, increase O2 delivery to myocardium, and reduce O2 demand
What class of medication can be used to treat angina - ANSWER ✓ Beta Blockers
Renin inhibitors (ACEIs)
ASA (all individuals with angina should be on at least 81mg ASA/day
Nitrates
CCBs
Healthy lifestyle
Exercise
Statins
what are Coronary Vasodilators - ANSWER ✓ Agents that increase myocardial
oxygen supply (NTG, isosorbide,
CCBs)
what needs to be remembered about heart failure patients - ANSWER ✓
Remember that many heart failure patients have more than just heart failure; look
for underlying hypertension, angina, etc.
what can increase risk for digoxin toxicity - ANSWER ✓ Low potassium levels
(hypokalemia)
How does heparin work - ANSWER ✓ produces rapid anticoagulation by binding
with antithrombin III, and inhibits factors IXa, Xa, XIIa, and XIII.
How is heparin monitored - ANSWER ✓ with aPTT (low dose SC heparin [5000
units BID] does not require aPTT monitoring).
how is heparin monitored when pregnant - ANSWER ✓ Monitor LMW heparin
by measuring Factor Xa levels in a pregnant patient.
how does warfarin work - ANSWER ✓ inhibits vitamin K-dependent blood
factors II, VII, IX and X; takes several days for its anticoagulant effect.
How is warfarin monitored? - ANSWER ✓ Monitor the International Normalized
Ratio (INR) when warfarin is used.
, what is dabigatran (Pradaxa) - ANSWER ✓ A Blood Factor IIa inhibitor (direct
thrombin inhibitor)
Clinical uses for warfarin - ANSWER ✓ Classic drug of choice for DVT and PE
· Start at 5 mg per day (7.5 mg/day if weight > 80 kg)
· Consider lower dose if > 75 years of age, multiple coexisting disorders, elevated
liver enzymes, changing thyroid status
-ASA
When on warfarin what should INR be - ANSWER ✓ between 2 and 3
What are the pharmacokinetics of warfarin - ANSWER ✓ 1. Well absorbed when
taken orally
1. Metabolized by CYP 1A2 & 2C9
2. Half-life of 3 to 4 days (must use a heparin while waiting for steady state
precautions and contraindications of warfarin - ANSWER ✓ 1. Pregnancy
category X
2. Use cautiously in patients with fall risk, dementia or uncontrolled hypertension
adverse reactions on warfarin - ANSWER ✓ -bleeding (antidote is vitamin K)
-allergic reaction (rare)
Drug interactions with warfarin - ANSWER ✓ 1. Many drug-drug interactions
2. Antiplatelet drugs
3. Thrombolytic drugs
What can decrease anticoagulant effect of warfarin - ANSWER ✓ oral
contraceptives, carbamazepine, vitamin K containing foods
What is the antidote for dabigatran (Pradaxa) - ANSWER ✓ idarucizumab.
Blood Factor Xa inhibitors: - ANSWER ✓ apixaban (Eliquis), edoxaban
(Savaysa), rivaroxaban (Xarelto), fondaparinux (Arixtra).
What is the antadote for apixaben and rivaroxaban - ANSWER ✓ Factor Xa
recombinant (Andexxa).
, what should patients using vitamin b12 monitor for - ANSWER ✓ should be
monitored for the development of hypokalemia which may be seen within the first
48 hours of therapy
Intravenous Anesthetics: - ANSWER ✓ ketamine, thiopental, fentanyl, propofol,
dexmedetomidine.
Propofol Pharmacokinetics - ANSWER ✓ a rapid onset, does not usually cause
nausea, and poor analgesia.
what should be monitored while on propofol - ANSWER ✓ Propofol can affect
triglycerides; monitor triglyceride levels
what is ICU delirium commonly treated with in the elderly - ANSWER ✓ treated
with haloperidol, although dexmedetomidine (Precedex) is the preferred drug for
sedation in the elderly
If respiratory depression is a concern what IV anesthetic should be used -
ANSWER ✓ dexmedetomidine (Precedex) is the preferred anesthetic; however, it
should not be used longer than 24 hours as per the FDA-approved product
information.
How do benzodiazepines work? - ANSWER ✓ bind to GABAA receptors,
allowing influx of chloride through the central ion channels, reducing
neurotransmission.
Hypnotic agents that bind to benzodiazepine receptors (subtype BZ): - ANSWER
✓ zolpidem (Ambien), zaleplon (Sonata), eszopiclone (Lunesta).
what are benzodiazepines used for - ANSWER ✓ used to treat anxiety, as
sedative/hypnotics, for anterograde amnesia in procedures (midazolam [Versed]),
for epilepsy (clonazepam), and as muscle relaxants (mostly diazepam).
Benzodiazepines increase the risk of... - ANSWER ✓ increase falls in the elderly
and other people unsteady on their feet
