Exam 1 NURS 5354 2025/2026
Schedules III-V
In Texas, what schedules of
controlled substances can
APRNs prescribe with a
collaborative agreement?
serum lithium levels and sodium levels
what lab values should be
monitored when a patient is
prescribed lithium?
pharmacokinetics drug movement through the body
why should metronidazole not be it causes a disulfiram-like reaction, leading to nausea, vomiting,
used with alcohol? and flushing
Due to decreased renal/liver function, polypharmacy, cognitive
why are geriatric patients at decline, and issues with adherence or affordability
higher risk or drug-related
complications?
tyramine rich foods (aged and fermented cheeses,
which type of foods to avoid with cured/smoked/processed meats, fermented foods, avocados,
MAOIs? chocolate
Potassium and creatinine to watch for hyperkalemia and renal
Which labs should be monitored
for patients on ACE inhibitors? impairment
sodium affects lithium, and changes in sodium can cause lithium
why must sodium levels be toxicity or subtherapeautic levels
monitored in patients taking
lithium?
drugs are metabolized by the liver before reaching systemic
what is the significance of the circulation, reducing their bioavailability
first-pass effect in
pharmacokinetics?
CYP450 enzyme system, particularly CYP3A4
grapefruit juice can inhibit which
system, leading to increased
serum drug levels?
T/F: statins are hepatotoxic? true
absorption, distribution, metabolism, and elimination
What are the four fundamental
pharmacokinetic processes that
determined rug concentration in
the body?
indicates a small margin between effective and toxic doses,
what does a narrow therapeutic requiring close monitoring
index indicate about a drug's
safety profile?
they have comparable bioavailability and similar concentrations of
what does it mean when two the active ingredient in plasma over time
drugs are considered
bioequivalent?
what is an example of drug alcohol and benzodiazepines produce a greater sedative effect
together than either would alone
synergism
Page 1
, Exam 1 NURS 5354 2025/2026
inducers increase metabolism and decrease drug levels
how do CYP450 inducers affect
drug levels?
How do CYP450 inhibitors affect inhibitors decrease metabolism and increase drug levels
(grapefruit juice is an inhibitor)
drug levels?
statins, calcium channel blockers, anti anxiety meds
which drug classes are
commonly affected by grapefruit
juice and may have increased
toxicity?
statins, anti-seizure medications, and antimicrobials
three common drug classes
associated with hepatotoxicity?
tachyphylaxis
what is the term for a rapid
decrease in drug responsiveness
due to repeated dosing over a
short period?
Lipid soluble drugs
which type of drugs cross the
placenta more readily?
Which pregnancy category is X
considered the riskiest?
sertraline
which antidepressant is
considered the safest during
breastfeeding?
they have immature liver and kidney function, leading to decreased
why are neonates at higher risk
of drug toxicity? metabolism and extretion
to identify potentially inappropriate medications for older adults to
purpose of Beers criteria reduce adverse effects
diphenhydramine is an anticholinergic and is on the beers list due
a 78 year old patient is taking to its sedative properties and risk of confusion/falls in elderly
diphenhydramine nightly. why patients
might this be inappropriate?
the first trimester is the most critical period for organ development,
why is drug use during the first so teratogens pose the greatest risk of birth defects
trimester of pregnancy more
concerning?
disrupts function rather than gross anatomy; may disrupt brain
Teratogen disrupts what in the
2nd and 3rd trimesters? development
When is there significantly at birth and infancy
reduced renal excretion?
pediatric dosing is always based weight
on?
What do agonists do? activate receptors to produce a response
what do antagonists do? antagonists block receptors to prevent a response
Page 2
Schedules III-V
In Texas, what schedules of
controlled substances can
APRNs prescribe with a
collaborative agreement?
serum lithium levels and sodium levels
what lab values should be
monitored when a patient is
prescribed lithium?
pharmacokinetics drug movement through the body
why should metronidazole not be it causes a disulfiram-like reaction, leading to nausea, vomiting,
used with alcohol? and flushing
Due to decreased renal/liver function, polypharmacy, cognitive
why are geriatric patients at decline, and issues with adherence or affordability
higher risk or drug-related
complications?
tyramine rich foods (aged and fermented cheeses,
which type of foods to avoid with cured/smoked/processed meats, fermented foods, avocados,
MAOIs? chocolate
Potassium and creatinine to watch for hyperkalemia and renal
Which labs should be monitored
for patients on ACE inhibitors? impairment
sodium affects lithium, and changes in sodium can cause lithium
why must sodium levels be toxicity or subtherapeautic levels
monitored in patients taking
lithium?
drugs are metabolized by the liver before reaching systemic
what is the significance of the circulation, reducing their bioavailability
first-pass effect in
pharmacokinetics?
CYP450 enzyme system, particularly CYP3A4
grapefruit juice can inhibit which
system, leading to increased
serum drug levels?
T/F: statins are hepatotoxic? true
absorption, distribution, metabolism, and elimination
What are the four fundamental
pharmacokinetic processes that
determined rug concentration in
the body?
indicates a small margin between effective and toxic doses,
what does a narrow therapeutic requiring close monitoring
index indicate about a drug's
safety profile?
they have comparable bioavailability and similar concentrations of
what does it mean when two the active ingredient in plasma over time
drugs are considered
bioequivalent?
what is an example of drug alcohol and benzodiazepines produce a greater sedative effect
together than either would alone
synergism
Page 1
, Exam 1 NURS 5354 2025/2026
inducers increase metabolism and decrease drug levels
how do CYP450 inducers affect
drug levels?
How do CYP450 inhibitors affect inhibitors decrease metabolism and increase drug levels
(grapefruit juice is an inhibitor)
drug levels?
statins, calcium channel blockers, anti anxiety meds
which drug classes are
commonly affected by grapefruit
juice and may have increased
toxicity?
statins, anti-seizure medications, and antimicrobials
three common drug classes
associated with hepatotoxicity?
tachyphylaxis
what is the term for a rapid
decrease in drug responsiveness
due to repeated dosing over a
short period?
Lipid soluble drugs
which type of drugs cross the
placenta more readily?
Which pregnancy category is X
considered the riskiest?
sertraline
which antidepressant is
considered the safest during
breastfeeding?
they have immature liver and kidney function, leading to decreased
why are neonates at higher risk
of drug toxicity? metabolism and extretion
to identify potentially inappropriate medications for older adults to
purpose of Beers criteria reduce adverse effects
diphenhydramine is an anticholinergic and is on the beers list due
a 78 year old patient is taking to its sedative properties and risk of confusion/falls in elderly
diphenhydramine nightly. why patients
might this be inappropriate?
the first trimester is the most critical period for organ development,
why is drug use during the first so teratogens pose the greatest risk of birth defects
trimester of pregnancy more
concerning?
disrupts function rather than gross anatomy; may disrupt brain
Teratogen disrupts what in the
2nd and 3rd trimesters? development
When is there significantly at birth and infancy
reduced renal excretion?
pediatric dosing is always based weight
on?
What do agonists do? activate receptors to produce a response
what do antagonists do? antagonists block receptors to prevent a response
Page 2
