NR565 / NR 565 Advanced Pharmacology Fundamentals
Midterm Exam Study Guide
100% Guarantee Pass
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 medica- tions are metabolized, can either be
inducers or inhibitors and create drug-drug interactions
Jo
4. CYP450 inducers
sh
ua
,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
Jo
Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol,
sh
ua
,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, an- timicrobials 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
de- layed gastric emptying
Jo
sh
ua
,14. Some medications that should be avoided in the pediatric patient?
Answer
glu- cocorticoids, discoloration of developing teeth with tetracyclines, and
kernicterus with sulfonamides, levofloxacin (antibiotics)
aspirin (Severe intoxication from acute overdose)
15. 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
16. 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)
Jo
greater severity of illness
sh
ua
,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
17. 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
18. How can we promote medication adherence with elderly patients?
Answer
simpli- fying drug regimens
providing clear and concise verbal and written instructions
Jo
using an appropriate dosage form
sh
ua
,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
Jo
yes
sh
ua
,22. What is the purpose of the Genetic Information Non-Discriminatory Act?-
Answer
Protects patients from discrimination by employers and insurance providers based
on genetic information
23. Difference between practice authority and prescriptive authority?
Answer
Practice authority refers to the nurse practitioner's ability to practice without
physician over- sight, whereas prescriptive authority refers to the nurse
practitioner's authority to prescribe medications independently and without
limitations.
24. Who regulates prescriptive authority?
Answer
the jurisdiction of a health professional board. This may be the State Board of
Nursing, the State Board of Medicine, or the State Board of Pharmacy, as
determined by each state.
25. What is scope of practice determined by?
Answer
is determined by state practice and licensure laws.
Jo
sh
ua
, 26. What is full practice authority?
Answer
Nurse practitioners have the autonomy to evaluate patients, diagnose, order and
interpret tests, initiate and manage treat- ments and prescribe medications,
including controlled substances without physician oversight.
27. What is reduced practice authority?
Answer
Nurse practitioners are limited in at least one element of practice. The state
requires a formal collaborative agreement with an outside health discipline for the
nurse practitioner to provide patient care. ex/ physician involvement for 5 yrs than
independent
28. What is restricted practice authority?
Answer
Nurse practitioners are limited in at least one element of practice by requiring
supervision, delegation, or team man- agement by an outside health discipline for
the nurse practitioner to provide patient care.- typically doctor on site
29. What are components of Rx?
Answer
Prescriber Contact info Prescribers name
Jo
NPI
sh
ua
Midterm Exam Study Guide
100% Guarantee Pass
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 medica- tions are metabolized, can either be
inducers or inhibitors and create drug-drug interactions
Jo
4. CYP450 inducers
sh
ua
,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
Jo
Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol,
sh
ua
,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, an- timicrobials 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
de- layed gastric emptying
Jo
sh
ua
,14. Some medications that should be avoided in the pediatric patient?
Answer
glu- cocorticoids, discoloration of developing teeth with tetracyclines, and
kernicterus with sulfonamides, levofloxacin (antibiotics)
aspirin (Severe intoxication from acute overdose)
15. 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
16. 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)
Jo
greater severity of illness
sh
ua
,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
17. 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
18. How can we promote medication adherence with elderly patients?
Answer
simpli- fying drug regimens
providing clear and concise verbal and written instructions
Jo
using an appropriate dosage form
sh
ua
,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
Jo
yes
sh
ua
,22. What is the purpose of the Genetic Information Non-Discriminatory Act?-
Answer
Protects patients from discrimination by employers and insurance providers based
on genetic information
23. Difference between practice authority and prescriptive authority?
Answer
Practice authority refers to the nurse practitioner's ability to practice without
physician over- sight, whereas prescriptive authority refers to the nurse
practitioner's authority to prescribe medications independently and without
limitations.
24. Who regulates prescriptive authority?
Answer
the jurisdiction of a health professional board. This may be the State Board of
Nursing, the State Board of Medicine, or the State Board of Pharmacy, as
determined by each state.
25. What is scope of practice determined by?
Answer
is determined by state practice and licensure laws.
Jo
sh
ua
, 26. What is full practice authority?
Answer
Nurse practitioners have the autonomy to evaluate patients, diagnose, order and
interpret tests, initiate and manage treat- ments and prescribe medications,
including controlled substances without physician oversight.
27. What is reduced practice authority?
Answer
Nurse practitioners are limited in at least one element of practice. The state
requires a formal collaborative agreement with an outside health discipline for the
nurse practitioner to provide patient care. ex/ physician involvement for 5 yrs than
independent
28. What is restricted practice authority?
Answer
Nurse practitioners are limited in at least one element of practice by requiring
supervision, delegation, or team man- agement by an outside health discipline for
the nurse practitioner to provide patient care.- typically doctor on site
29. What are components of Rx?
Answer
Prescriber Contact info Prescribers name
Jo
NPI
sh
ua
