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AACN Pharmacology Exam Questions
and Answers 100% Solved | Latest
Update
GI flora changes from antibiotics - ✔✔1. Decreased GI flora which produce
Vit. K - warfarin pts prone to bleeding
2. Decreased production of estrogen metabolites by gut flora - estrogen
based contraceptives less effective
3. MACROLIDES decrease amount of gut flora which metabolize Digoxin,
therefore the active concentration increases
Chelation of oral drugs - ✔✔1. Cipro with antacids
2. Cholecystyramine (prevalite) with almost any other PO drug
,©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
3. Sucralfate with any other antacid - need AT LEAST 30 MIN between
administration
Major binding proteins - ✔✔Alpha1-acid glycoprotein
Albumin
*Both decreased in critical illness
Protein bound drugs - ✔✔E.g. Warfarin - has very low free fraction
The more protein bound a drug is, the higher chance of adverse reactions
and drug interactions—changes in diet or health and other drugs competing
for protein binding sites alter free fraction
Drug with higher protein affinity will bind and other drug will have increased
free fraction - e.g. aspirin displacing warfarin
Poorly protein bound drugs - ✔✔Gentamicin - free fraction relatively
independent of protein
Volume of distribution - ✔✔The extent to which a drug moves out of
intravascular space into body tissues
, ©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
(Lot of movement out = high volume of distribution)
Dependent upon lipid vs water solubility and protein binding
High Vd - ✔✔Poorly protein bound, lipid soluble
Sepsis - ✔✔qSOFA score >2
-->higher is worse
qSOFA (quick sequential organ failure assessment) - ✔✔respiratory rate
>22
SBP </=100
GCS <15
Septic shock - ✔✔MAP <65, Lactic >2 despite adequate (30ml/kg NS) fluid
boluses
3 hour surviving sepsis bundle - ✔✔-measure lactate, get BCs, hang ABX
w/in 1hr of arrival
-if lactate >4 or MAP <65, 30ml/kg fluid bolus
AACN Pharmacology Exam Questions
and Answers 100% Solved | Latest
Update
GI flora changes from antibiotics - ✔✔1. Decreased GI flora which produce
Vit. K - warfarin pts prone to bleeding
2. Decreased production of estrogen metabolites by gut flora - estrogen
based contraceptives less effective
3. MACROLIDES decrease amount of gut flora which metabolize Digoxin,
therefore the active concentration increases
Chelation of oral drugs - ✔✔1. Cipro with antacids
2. Cholecystyramine (prevalite) with almost any other PO drug
,©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
3. Sucralfate with any other antacid - need AT LEAST 30 MIN between
administration
Major binding proteins - ✔✔Alpha1-acid glycoprotein
Albumin
*Both decreased in critical illness
Protein bound drugs - ✔✔E.g. Warfarin - has very low free fraction
The more protein bound a drug is, the higher chance of adverse reactions
and drug interactions—changes in diet or health and other drugs competing
for protein binding sites alter free fraction
Drug with higher protein affinity will bind and other drug will have increased
free fraction - e.g. aspirin displacing warfarin
Poorly protein bound drugs - ✔✔Gentamicin - free fraction relatively
independent of protein
Volume of distribution - ✔✔The extent to which a drug moves out of
intravascular space into body tissues
, ©NINJANERD 2024/2025. YEAR PUBLISHED 2024.
(Lot of movement out = high volume of distribution)
Dependent upon lipid vs water solubility and protein binding
High Vd - ✔✔Poorly protein bound, lipid soluble
Sepsis - ✔✔qSOFA score >2
-->higher is worse
qSOFA (quick sequential organ failure assessment) - ✔✔respiratory rate
>22
SBP </=100
GCS <15
Septic shock - ✔✔MAP <65, Lactic >2 despite adequate (30ml/kg NS) fluid
boluses
3 hour surviving sepsis bundle - ✔✔-measure lactate, get BCs, hang ABX
w/in 1hr of arrival
-if lactate >4 or MAP <65, 30ml/kg fluid bolus
