NR 565 - advanced pharmacology midterm -
Chamberlain
1. What is BEERS criteria?: Recommendations of medications inappropriate for elderly
(65 and older), prescriber ultimately decides
2. What is the CYP450 (cytochrome P450): liver enzyme system where medications are
metabolized, can either be inducers or inhibitors and create drug-drug interactions
3. CYP450 inducers: Speed up metabolism of drugs (drug is cleared faster), drug has
lesser effect (decrease blood levels of drug), elevate CYP450 enzymes
4. CYP450 inducer drug names: Barbituates, St John wort, Carbamazepine, rifampin,
alcohol, pheny-
toin, griseofulvin, phenobarbital, sulfonylureas
5. CYP450 inhibitors: inhibit metabolism, increase blood levels of medications
6. CYP450 pneumonic: "VISA credit card debt INHIBITS spending on designers like CK to
look GQ"
7. CYP450 inhibitors drug names: Valproate, isoniazid, sulfonamides, amiodarone,
chloramphenicol, ketoconazole, grapefruit juice, quinidine
8. How is absorption of intramuscular medications different in neonates?: slow and
erratic due to low blood flow in muscles first few days of life
9. Why is absorption of medication in the stomach increased in infancy?: delayed gastric
emptying
10. Some medications that should be avoided in the pediatric patient?: glu-
cocorticoids, discoloration of developing teeth with tetracyclines, and kernicterus with
sulfonamides, levofloxacin
,NR 565 - advanced pharmacology midterm -
Chamberlain
(antibiotics)
aspirin (Severe intoxication from acute overdose)
11. what should be included in medication administration patient education?-
: dosage size and timing
route and technique of
administration duration of
treatment drug storage
nature and time course of desired
responses nature and time course of
adverse responses finish taking
antibiotic
12. What are some things that put the elderly patient at higher risk for adverse drug
reactions?: reduced renal function polypharmacy (the use of five or more medications
daily) greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g.,
digoxin) increased individual variation secondary to
altered pharmacokinetics inadequate supervision of
long-term therapy poor patient adherence
13. How can healthcare providers decrease likelihood of an elderly patient experiencing
an adverse drug reaction?: obtaining a thorough drug history that includes over-the-
counter medications
considering pharmacokinetic and pharmacodynamics
changes due to age monitoring the patient's clinical
response and plasma drug levels using the simplest
regimen possible
monitoring for drug-drug interactions and iatrogenic
illness periodically reviewing the need for continued
, NR 565 - advanced pharmacology midterm -
Chamberlain
drug therapy encouraging the patient to dispose of old
medications
taking steps to promote adherence and to avoid drugs on the Beers list
14. How can we promote medication adherence with elderly patients?: simplifying drug
regimens
providing clear and concise verbal and written
instructions using an appropriate dosage form
clearly labeling and dispensing easy-to-
open containers developing daily
reminders monitoring frequently
affordability of drugs support systems
15. Why do nitrates need to be taken no later than 4 PM?: Need nitrate free interval so
tolerance doesn't develop
16. Nine factors that impact outcome of medication?: Gender and race Genetics and
pharmacogenomics
Variability in
absorption
placebo effect
Tolerance patho
age
bodyweight
17. Do you need informed consent for genetic testing?: yes
18. What is the purpose of the Genetic Information Non-Discriminatory Act?: -
Protects patients from discrimination by employers and insurance providers based on
genetic information
Chamberlain
1. What is BEERS criteria?: Recommendations of medications inappropriate for elderly
(65 and older), prescriber ultimately decides
2. What is the CYP450 (cytochrome P450): liver enzyme system where medications are
metabolized, can either be inducers or inhibitors and create drug-drug interactions
3. CYP450 inducers: Speed up metabolism of drugs (drug is cleared faster), drug has
lesser effect (decrease blood levels of drug), elevate CYP450 enzymes
4. CYP450 inducer drug names: Barbituates, St John wort, Carbamazepine, rifampin,
alcohol, pheny-
toin, griseofulvin, phenobarbital, sulfonylureas
5. CYP450 inhibitors: inhibit metabolism, increase blood levels of medications
6. CYP450 pneumonic: "VISA credit card debt INHIBITS spending on designers like CK to
look GQ"
7. CYP450 inhibitors drug names: Valproate, isoniazid, sulfonamides, amiodarone,
chloramphenicol, ketoconazole, grapefruit juice, quinidine
8. How is absorption of intramuscular medications different in neonates?: slow and
erratic due to low blood flow in muscles first few days of life
9. Why is absorption of medication in the stomach increased in infancy?: delayed gastric
emptying
10. Some medications that should be avoided in the pediatric patient?: glu-
cocorticoids, discoloration of developing teeth with tetracyclines, and kernicterus with
sulfonamides, levofloxacin
,NR 565 - advanced pharmacology midterm -
Chamberlain
(antibiotics)
aspirin (Severe intoxication from acute overdose)
11. what should be included in medication administration patient education?-
: dosage size and timing
route and technique of
administration duration of
treatment drug storage
nature and time course of desired
responses nature and time course of
adverse responses finish taking
antibiotic
12. What are some things that put the elderly patient at higher risk for adverse drug
reactions?: reduced renal function polypharmacy (the use of five or more medications
daily) greater severity of illness
presence of comorbidities
use of drugs that have a low therapeutic index (e.g.,
digoxin) increased individual variation secondary to
altered pharmacokinetics inadequate supervision of
long-term therapy poor patient adherence
13. How can healthcare providers decrease likelihood of an elderly patient experiencing
an adverse drug reaction?: obtaining a thorough drug history that includes over-the-
counter medications
considering pharmacokinetic and pharmacodynamics
changes due to age monitoring the patient's clinical
response and plasma drug levels using the simplest
regimen possible
monitoring for drug-drug interactions and iatrogenic
illness periodically reviewing the need for continued
, NR 565 - advanced pharmacology midterm -
Chamberlain
drug therapy encouraging the patient to dispose of old
medications
taking steps to promote adherence and to avoid drugs on the Beers list
14. How can we promote medication adherence with elderly patients?: simplifying drug
regimens
providing clear and concise verbal and written
instructions using an appropriate dosage form
clearly labeling and dispensing easy-to-
open containers developing daily
reminders monitoring frequently
affordability of drugs support systems
15. Why do nitrates need to be taken no later than 4 PM?: Need nitrate free interval so
tolerance doesn't develop
16. Nine factors that impact outcome of medication?: Gender and race Genetics and
pharmacogenomics
Variability in
absorption
placebo effect
Tolerance patho
age
bodyweight
17. Do you need informed consent for genetic testing?: yes
18. What is the purpose of the Genetic Information Non-Discriminatory Act?: -
Protects patients from discrimination by employers and insurance providers based on
genetic information
