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NR 566 / NR566 Final Exam (2026 Update) |
Verified Questions & Correct Answers with
Rationales – Advanced Pharmacology
Subject: Advanced Pharmacology
Source: NR 566 Final Exam
Format: Key Drug Facts, Contraindications, Indications, Management
Principles with Rationales
1. Sumatriptan contraindications
Answer: Contraindicated in patients with history of ischemic heart disease,
MI, uncontrolled hypertension, or other heart disease. Avoid in pregnancy.
Rationale: Sumatriptan is a triptan that causes vasoconstriction,
which can worsen coronary artery disease and lead to serious
cardiovascular events. Its safety in pregnancy has not been established.
2. Ergot Alkaloids and dihydroergotamine
Answer: Second-line therapy for migraines after first-line treatment fails.
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Rationale: Ergot alkaloids have a higher risk of severe
vasoconstriction and adverse effects compared to triptans, so they are
reserved for cases where first-line agents are ineffective or contraindicated.
3. Pramipexole can cause
Answer: Sleep attacks (overwhelming and irresistible sleepiness).
Rationale: Pramipexole, a dopamine agonist, can cause sudden-onset
somnolence, which poses a risk for falls, accidents, and injury, especially
during activities like driving.
4. Screening before pramipexole prescribing
Answer: Screen for compulsive behaviors.
Rationale: Dopamine agonists like pramipexole can trigger impulse
control disorders (e.g., gambling, shopping, binge eating), so assessing risk
before initiation is essential.
5. Parkinson’s disease underlying cause
Answer: Loss of dopaminergic neurons in the substantia nigra.
Rationale: Degeneration of dopamine-producing neurons in the
substantia nigra leads to dopamine deficiency, causing the motor symptoms
of Parkinson’s disease.
NR 566 / NR566 Final Exam (2026 Update) |
Verified Questions & Correct Answers with
Rationales – Advanced Pharmacology
Subject: Advanced Pharmacology
Source: NR 566 Final Exam
Format: Key Drug Facts, Contraindications, Indications, Management
Principles with Rationales
1. Sumatriptan contraindications
Answer: Contraindicated in patients with history of ischemic heart disease,
MI, uncontrolled hypertension, or other heart disease. Avoid in pregnancy.
Rationale: Sumatriptan is a triptan that causes vasoconstriction,
which can worsen coronary artery disease and lead to serious
cardiovascular events. Its safety in pregnancy has not been established.
2. Ergot Alkaloids and dihydroergotamine
Answer: Second-line therapy for migraines after first-line treatment fails.
, 2|Page
Rationale: Ergot alkaloids have a higher risk of severe
vasoconstriction and adverse effects compared to triptans, so they are
reserved for cases where first-line agents are ineffective or contraindicated.
3. Pramipexole can cause
Answer: Sleep attacks (overwhelming and irresistible sleepiness).
Rationale: Pramipexole, a dopamine agonist, can cause sudden-onset
somnolence, which poses a risk for falls, accidents, and injury, especially
during activities like driving.
4. Screening before pramipexole prescribing
Answer: Screen for compulsive behaviors.
Rationale: Dopamine agonists like pramipexole can trigger impulse
control disorders (e.g., gambling, shopping, binge eating), so assessing risk
before initiation is essential.
5. Parkinson’s disease underlying cause
Answer: Loss of dopaminergic neurons in the substantia nigra.
Rationale: Degeneration of dopamine-producing neurons in the
substantia nigra leads to dopamine deficiency, causing the motor symptoms
of Parkinson’s disease.
