NR 565 - ADVANCED PHARMACOLOGY
MIDTERM – CHAMBERLAIN EXAM
WITH CORRECT ANSWERS
1. During what trimester is a pregnant woman most at risk for
adverse drug reactions with potential long term
consequences? - ANSWER-1st trimester (fetus most at risk
d/t rapid growth)
2. What is BEERS criteria? - ANSWER-Recommendations of
medications inappropriate for elderly (65 and older),
prescriber ultimately decides
3. What is the CYP450 (cytochrome P450) - ANSWER-liver
enzyme system where medications are metabolized, can
either be inducers or inhibitors and create drug-drug
interactions
4. CYP450 inducers - ANSWER-Speed up metabolism of drugs
(drug is cleared faster), drug has lesser effect (decrease
blood levels of drug), elevate CYP450 enzymes
5. CYP450 inducers pneumonic - ANSWER-"Bullshit Crap GPS
INDUCES rage"
6. CYP450 inducer drug names - ANSWER-Barbituates, St John
wort, Carbamazepine, rifampin, alcohol, phenytoin,
griseofulvin, phenobarbital, sulfonylureas
7. CYP450 inhibitors - ANSWER-inhibit metabolism, increase
blood levels of medications
,8. CYP450 pneumonic - ANSWER-"VISA credit card debt
INHIBITS spending on designers like CK to look GQ"
9. CYP450 inhibitors drug names - ANSWER-Valproate,
isoniazid, sulfonamides, amiodarone, chloramphenicol,
ketoconazole, grapefruit juice, quinidine
10. Physiological changes during pregnancy that impact
pharmacodynamics and pharmacokinetic properties of
drugs? - ANSWER-increase glomerular filtration rate leads
to increase durg excretion
increase hepatic metabolism
decrease tone and motility of bowel
increase drug absorption
11. Examples of medications that can be teratogenic -
ANSWER-Antiepileptic drugs, antimicrobials such as
tetracyclines and fluoroquinolones, vitamin A in large
doses, some anticoagulants, and hormonal medications
such as diethylstilbestrol (DES).
12. How is absorption of intramuscular medications different
in neonates? - ANSWER-slow and erratic due to low blood
flow in muscles first few days of life
13. Why is absorption of medication in the stomach
increased in infancy? - ANSWER-delayed gastric emptying
14. Some medications that should be avoided in the
pediatric patient? - ANSWER-glucocorticoids, discoloration
of developing teeth with tetracyclines, and kernicterus with
sulfonamides, levofloxacin (antibiotics)
, 15. aspirin (Severe intoxication from acute overdose)
16. what should be included in medication administration
patient education? - ANSWER-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
17. What are some things that put the elderly patient at
higher risk for adverse drug reactions? - ANSWER-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
18. How can healthcare providers decrease likelihood of an
elderly patient experiencing an adverse drug reaction? -
ANSWER-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 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 patients?
- ANSWER-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
19. Why do nitrates need to be taken no later than 4 PM? -
ANSWER-Need nitrate free interval so tolerance doesn't
develop
20. Nine factors that impact outcome of medication? -
ANSWER-Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight
21. Do you need informed consent for genetic testing? -
ANSWER-yes
MIDTERM – CHAMBERLAIN EXAM
WITH CORRECT ANSWERS
1. During what trimester is a pregnant woman most at risk for
adverse drug reactions with potential long term
consequences? - ANSWER-1st trimester (fetus most at risk
d/t rapid growth)
2. What is BEERS criteria? - ANSWER-Recommendations of
medications inappropriate for elderly (65 and older),
prescriber ultimately decides
3. What is the CYP450 (cytochrome P450) - ANSWER-liver
enzyme system where medications are metabolized, can
either be inducers or inhibitors and create drug-drug
interactions
4. CYP450 inducers - ANSWER-Speed up metabolism of drugs
(drug is cleared faster), drug has lesser effect (decrease
blood levels of drug), elevate CYP450 enzymes
5. CYP450 inducers pneumonic - ANSWER-"Bullshit Crap GPS
INDUCES rage"
6. CYP450 inducer drug names - ANSWER-Barbituates, St John
wort, Carbamazepine, rifampin, alcohol, phenytoin,
griseofulvin, phenobarbital, sulfonylureas
7. CYP450 inhibitors - ANSWER-inhibit metabolism, increase
blood levels of medications
,8. CYP450 pneumonic - ANSWER-"VISA credit card debt
INHIBITS spending on designers like CK to look GQ"
9. CYP450 inhibitors drug names - ANSWER-Valproate,
isoniazid, sulfonamides, amiodarone, chloramphenicol,
ketoconazole, grapefruit juice, quinidine
10. Physiological changes during pregnancy that impact
pharmacodynamics and pharmacokinetic properties of
drugs? - ANSWER-increase glomerular filtration rate leads
to increase durg excretion
increase hepatic metabolism
decrease tone and motility of bowel
increase drug absorption
11. Examples of medications that can be teratogenic -
ANSWER-Antiepileptic drugs, antimicrobials such as
tetracyclines and fluoroquinolones, vitamin A in large
doses, some anticoagulants, and hormonal medications
such as diethylstilbestrol (DES).
12. How is absorption of intramuscular medications different
in neonates? - ANSWER-slow and erratic due to low blood
flow in muscles first few days of life
13. Why is absorption of medication in the stomach
increased in infancy? - ANSWER-delayed gastric emptying
14. Some medications that should be avoided in the
pediatric patient? - ANSWER-glucocorticoids, discoloration
of developing teeth with tetracyclines, and kernicterus with
sulfonamides, levofloxacin (antibiotics)
, 15. aspirin (Severe intoxication from acute overdose)
16. what should be included in medication administration
patient education? - ANSWER-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
17. What are some things that put the elderly patient at
higher risk for adverse drug reactions? - ANSWER-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
18. How can healthcare providers decrease likelihood of an
elderly patient experiencing an adverse drug reaction? -
ANSWER-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 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 patients?
- ANSWER-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
19. Why do nitrates need to be taken no later than 4 PM? -
ANSWER-Need nitrate free interval so tolerance doesn't
develop
20. Nine factors that impact outcome of medication? -
ANSWER-Gender and race
Genetics and pharmacogenomics
Variability in absorption
placebo effect
Tolerance
patho
age
bodyweight
21. Do you need informed consent for genetic testing? -
ANSWER-yes
