PHARMACOTHERAPEUTICS FOR ADVANCE PRACTICE NURSE QUESTIONS AND ANSWERS FULLY ANALYSED EXAM 100%NS AND ANSWERS

Chapter 1. An Introduction to Pharmacogenetics Multiple Choice Identify the choice that best completes the statement or answers the question. 1. Genetic polymorphisms account for differences in metabolism, including: • Poor metabolizers, who lack a working enzyme • Intermediate metabolizers, who have one working, wild-type allele and one mutant • Extensive metabolizers, with two normally functioning alleles • All of the above 2. Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to: • A need to monitor drugs metabolized by 2D6 for toxicity • Increased dosages needed of drugs metabolized by 2D6, such as the selective serotoreuptake inhibitors • Decreased conversion of codeine to morphine by CYP 2D6 • The need for lowered dosages of drugs, such as beta blockers 3. Rifampin is a nonspecific CYP450 inducer that may: • Lead to toxic levels of rifampin and must be monitored closely • Cause toxic levels of drugs, such as oral contraceptives, when coadministered • Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic • Cause nonspecific changes in drug metabolism 4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to: • Decreased therapeutic levels of quinidine • Increased therapeutic levels of quinidine • Decreased levels of a coadministered drug, such as digoxin, that requires P-glycopr absorption and elimination • Increased levels of a coadministered drug, such as digoxin, that requires P-glycopro absorption and elimination 5. Warfarin resistance may be seen in patients with VCORC1 mutation, leading to: • Toxic levels of war farin building up • Decreased response to warfarin • Increased risk for significant drug interactions with warfarin • Less risk of drug interactions with warfarin 6. Genetic testing for VCORC1 mutation to assess potential warfarin resistance is requiredprior to prescribing warfarin. • True • False 7. Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing: • Erythromycin • Digoxin • Cetuximab