MIDTERM EXAM: NR565/ NR 565 ADVANCED
PHARMACOLOGY CARE OF THE FUNDAMENTALS EXAM |
QUESTIONS AND VERIFIED ANSWERS -CHAMBERLAIN
Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score
What is it?
Correct Answer: ASCVD risk assessment is directed at determining the patient's absolute risk of
developing clinical coronary disease over the next 10 years. Defines high risk as 7.5% or greater.
A calculation of your 10-year risk of having a cardiovascular problem, such as a heart attack or
stroke.
When is it used - ASCVD Risk Score
Correct Answer: In children a screening should be done between ages 9 and 11 and then again
at ages 19 and 21. For adults every 5 years after the age of 20. Some people are at greater risk
like those with diabetes and a risk score greater than 7.5% and should be screened more often
Ezetimibe- when can it be used?
• Pregnancy/breastfeeding
• Can be use in monotherapy or as adjunct therapy with a statin or a fibrate
,What is ezetimibe?
Correct Answer: Cholesterol Absorption Inhibitor- lowers cholesterol levels by decreasing the
amount of cholesterol that is absorbed from the small intestine, so that there is less intestinal
cholesterol delivered to the liver. Does not affect triglycerides
Lifestyle changes for high cholesterol
Correct Answer: Lifestyle changes are non drug measures used to lower LDL. Four main issues
are diet, exercise, weight control, and smoking cessation
If a patient wanted to minimize side effects, which drug classification is a good choice?
Correct Answer: Non-statins- fibrates, Ezetimibe, Bile acid sequestrants. Statins are generally
well tolerated and side effects are uncommon. Some patients develop headache, flatulence,
constipation, or GI disturbances, but these effects are usually mild and transient
Therapeutic action of organic nitrates (nitroglycerin)
Direct relaxant effect on vascular smooth muscles, and the dilation of coronary vessels improves
oxygen supply to the myocardium. The dilation of peripheral veins, and in higher doses
peripheral arteries, reduces preload and afterload, and thereby lowers myocardial oxygen
consumption.
Correct Answer: Promote vasodilation
What is the CYP450 (cytochrome P450)
Correct Answer: liver enzyme system where medications are metabolized, can either be
inducers or inhibitors and create drug-drug interactions
CYP450 inducers
,Correct Answer: Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect
(decrease blood levels of drug), elevate CYP450 enzymes
CYP450 inducers pneumonic
Correct Answer: "Bullshit Crap GPS INDUCES rage"
CYP450 inducer drug names
Correct Answer: Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin,
griseofulvin, phenobarbital, sulfonylureas
CYP450 inhibitors
Correct Answer: Inhibit metabolism, increase blood levels of medications
CYP450 pneumonic
Correct Answer: "VISA credit card debt INHIBITS spending on designers like CK to look GQ"
CYP450 inhibitors drug names
Correct Answer: Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol,
ketoconazole, grapefruit juice, quinidine
During what trimester is a pregnant woman most at risk for adverse drug reactions with
potential long term consequences?
Correct Answer: 1st trimester (fetus most at risk d/t rapid growth)
, What is BEERS criteria?
Correct Answer: Recommendations of medications inappropriate for elderly (65 and older),
prescriber ultimately decides
Physiological changes during pregnancy that impact pharmacodynamics and pharmacokinetic
properties of drugs?
• Increase glomerular filtration rate leads to increase durg excretion
• Increase hepatic metabolism
• Decrease tone and motility of bowel
• Increase drug absorption
Examples of medications that can be teratogenic
Correct Answer: Antiepileptic drugs, antimicrobials such as tetracyclines and fluoroquinolones,
vitamin A in large doses, some anticoagulants, and hormonal medications such as
diethylstilbestrol (DES).
How is absorption of intramuscular medications different in neonates?
Correct Answer: Slow and erratic due to low blood flow in muscles first few days of life
Why is absorption of medication in the stomach increased in infancy?
Correct Answer: Delayed gastric emptying
Some medications that should be avoided in the pediatric patient?
Correct Answer: Glucocorticoids, discoloration of developing teeth with tetracyclines, and
kernicterus with sulfonamides, levofloxacin (antibiotics)
PHARMACOLOGY CARE OF THE FUNDAMENTALS EXAM |
QUESTIONS AND VERIFIED ANSWERS -CHAMBERLAIN
Atherosclerotic Cardiovascular Disease (ASCVD) Risk Score
What is it?
Correct Answer: ASCVD risk assessment is directed at determining the patient's absolute risk of
developing clinical coronary disease over the next 10 years. Defines high risk as 7.5% or greater.
A calculation of your 10-year risk of having a cardiovascular problem, such as a heart attack or
stroke.
When is it used - ASCVD Risk Score
Correct Answer: In children a screening should be done between ages 9 and 11 and then again
at ages 19 and 21. For adults every 5 years after the age of 20. Some people are at greater risk
like those with diabetes and a risk score greater than 7.5% and should be screened more often
Ezetimibe- when can it be used?
• Pregnancy/breastfeeding
• Can be use in monotherapy or as adjunct therapy with a statin or a fibrate
,What is ezetimibe?
Correct Answer: Cholesterol Absorption Inhibitor- lowers cholesterol levels by decreasing the
amount of cholesterol that is absorbed from the small intestine, so that there is less intestinal
cholesterol delivered to the liver. Does not affect triglycerides
Lifestyle changes for high cholesterol
Correct Answer: Lifestyle changes are non drug measures used to lower LDL. Four main issues
are diet, exercise, weight control, and smoking cessation
If a patient wanted to minimize side effects, which drug classification is a good choice?
Correct Answer: Non-statins- fibrates, Ezetimibe, Bile acid sequestrants. Statins are generally
well tolerated and side effects are uncommon. Some patients develop headache, flatulence,
constipation, or GI disturbances, but these effects are usually mild and transient
Therapeutic action of organic nitrates (nitroglycerin)
Direct relaxant effect on vascular smooth muscles, and the dilation of coronary vessels improves
oxygen supply to the myocardium. The dilation of peripheral veins, and in higher doses
peripheral arteries, reduces preload and afterload, and thereby lowers myocardial oxygen
consumption.
Correct Answer: Promote vasodilation
What is the CYP450 (cytochrome P450)
Correct Answer: liver enzyme system where medications are metabolized, can either be
inducers or inhibitors and create drug-drug interactions
CYP450 inducers
,Correct Answer: Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect
(decrease blood levels of drug), elevate CYP450 enzymes
CYP450 inducers pneumonic
Correct Answer: "Bullshit Crap GPS INDUCES rage"
CYP450 inducer drug names
Correct Answer: Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin,
griseofulvin, phenobarbital, sulfonylureas
CYP450 inhibitors
Correct Answer: Inhibit metabolism, increase blood levels of medications
CYP450 pneumonic
Correct Answer: "VISA credit card debt INHIBITS spending on designers like CK to look GQ"
CYP450 inhibitors drug names
Correct Answer: Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol,
ketoconazole, grapefruit juice, quinidine
During what trimester is a pregnant woman most at risk for adverse drug reactions with
potential long term consequences?
Correct Answer: 1st trimester (fetus most at risk d/t rapid growth)
, What is BEERS criteria?
Correct Answer: Recommendations of medications inappropriate for elderly (65 and older),
prescriber ultimately decides
Physiological changes during pregnancy that impact pharmacodynamics and pharmacokinetic
properties of drugs?
• Increase glomerular filtration rate leads to increase durg excretion
• Increase hepatic metabolism
• Decrease tone and motility of bowel
• Increase drug absorption
Examples of medications that can be teratogenic
Correct Answer: Antiepileptic drugs, antimicrobials such as tetracyclines and fluoroquinolones,
vitamin A in large doses, some anticoagulants, and hormonal medications such as
diethylstilbestrol (DES).
How is absorption of intramuscular medications different in neonates?
Correct Answer: Slow and erratic due to low blood flow in muscles first few days of life
Why is absorption of medication in the stomach increased in infancy?
Correct Answer: Delayed gastric emptying
Some medications that should be avoided in the pediatric patient?
Correct Answer: Glucocorticoids, discoloration of developing teeth with tetracyclines, and
kernicterus with sulfonamides, levofloxacin (antibiotics)
