NR 565 ADVANCED PHARMACOLOGY ACTUAL EXAM
SCRIPT 2026/2027 QUESTIONS AND SOLUTIONS RATED
A+
✔✔Buprenorzhine and Naloxone benefit of combination - ✔✔Naloxone is added to
buprenorphine to decrease the likelihood of diversion and misuse of the combination
drug product
✔✔Treatment of chronic pain- Example: How should something like osteoarthritis be
treated? - ✔✔Non Opioid medications - NSAIDs, cox-2 inhibitors
Nonpharmacologic tx - heat/cold, yoga, physical therapy, exercise, healthy weight
✔✔When prescribing medication we must understand that liver function declines with
age due to what cause?
a. enlarged liver
b. decreased blood flow to liver
c. increased activity of the hepatic enzymes - ✔✔decreased blood flow to liver
a. decreased liver mass
c. decrease in enzyme activity
✔✔What is the most important cause of adverse drug reactions? (older age)
a. high drug dosages
b. lack of monitoring medications
c. decreased renal excretion
d. overprescribing/polypharmacy - ✔✔decreased renal excretion
✔✔Distribution of medication can be affected in the elderly in what ways? SATA
1. decreased hormones
2. increased body fat
3. decreased lean mass
4. decreased albumin - ✔✔2, 3, 4
changes in body composition associated with age due to an increase in body fat
percentage and decrease in lean muscle mass. There is also a decrease in total body
water. Distribution can also be impacted by decreased total body water and decreased
cardiac output. Absorption can be impacted by increase gastric pH, decreased
absorption surface area decreased G.I. motility and decrease gastric emptying.
Metabolism can be impacted by de Cristo paddock blood flow, paddock mask, and
activity of hepatic enzymes. Excretion can be impacted by decreased renal blood flow,
decrease GFR, decrees to both secretion, and decrease number of nephrons
✔✔An 82 year old male visits the clinic complaining that his pain medications "take
forever" to work after he takes his pill. What are possible reasons you can explain to
him?
1.Perhaps we need to increase your dosage.
, 2.Sometimes as you get older, absorption may be slower resulting in a delayed
response.
3.As we get older the gastric acid decreases and may slow absorption. - ✔✔2&3
✔✔Order of HTN medications typically prescribed - ✔✔Thiazide diuretics
Ace Inhibitors
ARBS
CCB
BB
✔✔Which is best HTN medication for someone with diabetes - ✔✔ACE inhibitor and
ARB
✔✔Which medication to avoid in a patient who is pregnant or breastfeeding? - ✔✔Avoid
ACE and ARBs in patients who are pregnant or may become pregnant. Especially
ARBs in the second and third trimester.
✔✔Medications best for HTN for patient who is pregnant? - ✔✔labetalol, methyldopa,
nifedipine
✔✔For general population which HTN class is appropriate? - ✔✔thiazide diuretics
✔✔For African Americans which class of HTN medications is appropriate? -
✔✔thiazide, CCB, BB
✔✔For a chronic kidney disease, what is the best HTN medication class? - ✔✔ACE
Inhibitors or ARBS
✔✔What class of medications to avoid in African Americans? - ✔✔ACE inhibitors and
ARBS
✔✔Thiazide diuretics MOA - ✔✔blockade of sodium and chloride reabsorption
increases renal excretion of sodium, chloride, potassium, and water (hyponatremia,
hypochloremia, hypokalemia)
✔✔ACE inhibitors MOA - ✔✔Angiotensin Converting Enzyme Inhibitors (ACE-I) prevent
the conversion of angiotensin I to angiotensin II, which disrupts the renin-angiotensin-
aldosterone system (RAAS).
1. reduce levels of angiotensin II (through inhibition of ACE)
2. increasing levels of bradykinin (through inhibition of kinase 11)
End in -pril
SCRIPT 2026/2027 QUESTIONS AND SOLUTIONS RATED
A+
✔✔Buprenorzhine and Naloxone benefit of combination - ✔✔Naloxone is added to
buprenorphine to decrease the likelihood of diversion and misuse of the combination
drug product
✔✔Treatment of chronic pain- Example: How should something like osteoarthritis be
treated? - ✔✔Non Opioid medications - NSAIDs, cox-2 inhibitors
Nonpharmacologic tx - heat/cold, yoga, physical therapy, exercise, healthy weight
✔✔When prescribing medication we must understand that liver function declines with
age due to what cause?
a. enlarged liver
b. decreased blood flow to liver
c. increased activity of the hepatic enzymes - ✔✔decreased blood flow to liver
a. decreased liver mass
c. decrease in enzyme activity
✔✔What is the most important cause of adverse drug reactions? (older age)
a. high drug dosages
b. lack of monitoring medications
c. decreased renal excretion
d. overprescribing/polypharmacy - ✔✔decreased renal excretion
✔✔Distribution of medication can be affected in the elderly in what ways? SATA
1. decreased hormones
2. increased body fat
3. decreased lean mass
4. decreased albumin - ✔✔2, 3, 4
changes in body composition associated with age due to an increase in body fat
percentage and decrease in lean muscle mass. There is also a decrease in total body
water. Distribution can also be impacted by decreased total body water and decreased
cardiac output. Absorption can be impacted by increase gastric pH, decreased
absorption surface area decreased G.I. motility and decrease gastric emptying.
Metabolism can be impacted by de Cristo paddock blood flow, paddock mask, and
activity of hepatic enzymes. Excretion can be impacted by decreased renal blood flow,
decrease GFR, decrees to both secretion, and decrease number of nephrons
✔✔An 82 year old male visits the clinic complaining that his pain medications "take
forever" to work after he takes his pill. What are possible reasons you can explain to
him?
1.Perhaps we need to increase your dosage.
, 2.Sometimes as you get older, absorption may be slower resulting in a delayed
response.
3.As we get older the gastric acid decreases and may slow absorption. - ✔✔2&3
✔✔Order of HTN medications typically prescribed - ✔✔Thiazide diuretics
Ace Inhibitors
ARBS
CCB
BB
✔✔Which is best HTN medication for someone with diabetes - ✔✔ACE inhibitor and
ARB
✔✔Which medication to avoid in a patient who is pregnant or breastfeeding? - ✔✔Avoid
ACE and ARBs in patients who are pregnant or may become pregnant. Especially
ARBs in the second and third trimester.
✔✔Medications best for HTN for patient who is pregnant? - ✔✔labetalol, methyldopa,
nifedipine
✔✔For general population which HTN class is appropriate? - ✔✔thiazide diuretics
✔✔For African Americans which class of HTN medications is appropriate? -
✔✔thiazide, CCB, BB
✔✔For a chronic kidney disease, what is the best HTN medication class? - ✔✔ACE
Inhibitors or ARBS
✔✔What class of medications to avoid in African Americans? - ✔✔ACE inhibitors and
ARBS
✔✔Thiazide diuretics MOA - ✔✔blockade of sodium and chloride reabsorption
increases renal excretion of sodium, chloride, potassium, and water (hyponatremia,
hypochloremia, hypokalemia)
✔✔ACE inhibitors MOA - ✔✔Angiotensin Converting Enzyme Inhibitors (ACE-I) prevent
the conversion of angiotensin I to angiotensin II, which disrupts the renin-angiotensin-
aldosterone system (RAAS).
1. reduce levels of angiotensin II (through inhibition of ACE)
2. increasing levels of bradykinin (through inhibition of kinase 11)
End in -pril
