NR 565-advanced pharmacology midterm Exam Actual Questions
And Correct Verified Answers Chamberlain
During what trimester is a pregnant woman most at risk Ist trimester (fetus most at risk d/t rapid growth)
for adverse drug reactions with potential long term
consequences?
What is BEERS criteria? Recommendations of medications inappropriate for elderly (65 and older),
prescriber ultimately decides
What is the CYP450 (cytochrome P450) liver enzyme system where medications are metabolized, can either be inducers
or inhibitors and create drug-drug interactions
CYP450 inducers Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect
(decrease blood levels of drug), elevate CYP450 enzymes
CYP450 inducers pneumonic "Bullshit Crap GPS INDUCES rage"
,CYP450 inducer drug names Barbituates, St John
wort,Carbamazepine,rifampin,alcohol,phenytoin,griseofulvin,phenobarbital,sulfonylureas
CYP450 inhibitors inhibit metabolism, increase blood levels of medications
CYP450 pneumonic "VISA credit card debt INHIBITS spending on designers like CK to look GQ"
CYP450 inhibitors drug names Valproate,isoniazid,sulfonamides, amiodarone, chloramphenicol,ketoconazole,grapefruit
juice,quinidine
Physiological changes during pregnancy that impact increase glomerular filtration rate leads to increase durg excretion
pharmacodynamics and pharmacokinetic properties of increase hepatic metabolism
drugs? decrease tone and motility of bowel
increase drug absorption
Examples of medications that can be teratogenic
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 slow and erratic due to low blood flow in muscles first few days of life
different in neonates?
Why is absorption of medication in the stomach delayed gastric emptying
increased in infancy?
Some medications that should be avoidedin the glucocorticoids, discoloration of developing teeth with tetracyclines, and
pediatric patient? kernicterus with sulfonamides, levofloxacin (antibiotics)
aspirin (Severe intoxication from acute overdose)
what should be included in medication administration dosage size and timing
patient education? 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
, What are some things that put the elderly patient at higher risk reduced renal function
for adverse drug reactions? 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
How can healthcare providers decrease likelihood of an elderly obtaining a thorough drug history that includes over-the-counter medications considering
patient experiencing an adverse drug reaction? 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 drug therapy
encouraging the patient to dispose of old medications
taking steps to promote adherence and to avoid drugs on the Beers list
How can we promote medication adherence with elderly simplifying drug regimens
patients? 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
Why do nitrates need to be taken no later than 4 PM? Need nitrate free interval so tolerance doesn't develop
Nine factors that impact outcome of medication? Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight
Do you need informed consent for genetic testing? yes
What is the purpose of the Genetic Information Non- Protects patients from discrimination by employers and insurance providers
Discriminatory Act? based on genetic information
And Correct Verified Answers Chamberlain
During what trimester is a pregnant woman most at risk Ist trimester (fetus most at risk d/t rapid growth)
for adverse drug reactions with potential long term
consequences?
What is BEERS criteria? Recommendations of medications inappropriate for elderly (65 and older),
prescriber ultimately decides
What is the CYP450 (cytochrome P450) liver enzyme system where medications are metabolized, can either be inducers
or inhibitors and create drug-drug interactions
CYP450 inducers Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect
(decrease blood levels of drug), elevate CYP450 enzymes
CYP450 inducers pneumonic "Bullshit Crap GPS INDUCES rage"
,CYP450 inducer drug names Barbituates, St John
wort,Carbamazepine,rifampin,alcohol,phenytoin,griseofulvin,phenobarbital,sulfonylureas
CYP450 inhibitors inhibit metabolism, increase blood levels of medications
CYP450 pneumonic "VISA credit card debt INHIBITS spending on designers like CK to look GQ"
CYP450 inhibitors drug names Valproate,isoniazid,sulfonamides, amiodarone, chloramphenicol,ketoconazole,grapefruit
juice,quinidine
Physiological changes during pregnancy that impact increase glomerular filtration rate leads to increase durg excretion
pharmacodynamics and pharmacokinetic properties of increase hepatic metabolism
drugs? decrease tone and motility of bowel
increase drug absorption
Examples of medications that can be teratogenic
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 slow and erratic due to low blood flow in muscles first few days of life
different in neonates?
Why is absorption of medication in the stomach delayed gastric emptying
increased in infancy?
Some medications that should be avoidedin the glucocorticoids, discoloration of developing teeth with tetracyclines, and
pediatric patient? kernicterus with sulfonamides, levofloxacin (antibiotics)
aspirin (Severe intoxication from acute overdose)
what should be included in medication administration dosage size and timing
patient education? 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
, What are some things that put the elderly patient at higher risk reduced renal function
for adverse drug reactions? 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
How can healthcare providers decrease likelihood of an elderly obtaining a thorough drug history that includes over-the-counter medications considering
patient experiencing an adverse drug reaction? 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 drug therapy
encouraging the patient to dispose of old medications
taking steps to promote adherence and to avoid drugs on the Beers list
How can we promote medication adherence with elderly simplifying drug regimens
patients? 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
Why do nitrates need to be taken no later than 4 PM? Need nitrate free interval so tolerance doesn't develop
Nine factors that impact outcome of medication? Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight
Do you need informed consent for genetic testing? yes
What is the purpose of the Genetic Information Non- Protects patients from discrimination by employers and insurance providers
Discriminatory Act? based on genetic information
