OPERATION FNP CLASS 11) BASED ON FINAL
EXAM!!
1. Genetic polymorphisms account for differences in metabolism, including:
☐ A. Poor metabolizers, who lack a working enzyme
☐ B. Intermediate metabolizers, who have one working, wild-type allele and one
mutant allele
☐ C. Extensive metabolizers, with two normally functioning alleles
☑ D. All of the above
2. Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
☐ A. A need to monitor drugs metabolized by 2D6 for toxicity
☑ B. Increased dosages needed of drugs metabolized by 2D6, such as the
selective serotonin reuptake inhibitors
☐ C. Decreased conversion of codeine to morphine by CYP 2D6
☐ D. The need for lowered dosages of drugs, such as beta blockers
3. Rifampin is a nonspecific CYP450 inducer that may:
☐ A. Lead to toxic levels of rifampin and must be monitored closely
☐ B. Cause toxic levels of drugs, such as oral contraceptives, when
coadministered
☑ C. Induce the metabolism of drugs, such as oral contraceptives, leading to
therapeutic failure
☐ D. Cause nonspecific changes in drug metabolism
,4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
☐ A. Decreased therapeutic levels of quinidine
☐ B. Increased therapeutic levels of quinidine
☐ C. Decreased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
☑ D. Increased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
5. Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
☐ A. Toxic levels of warfarin building up
☑ B. Decreased response to warfarin
☐ C. Increased risk for significant drug interactions with warfarin
☐ D. Less risk of drug interactions with warfarin
6. Genetic testing for VCORC1 mutation to assess potential warfarin resistance is
required prior to prescribing warfarin.
☐ A. True
☑ B. False
7. Pharmacogenetic testing is required by the U.S. Food and Drug Administration
prior to prescribing:
☐ A. Erythromycin
☐ B. Digoxin
,☑ C. Cetuximab
☐ D. Rifampin
8. Carbamazepine has a Black Box Warning recommending testing for the HLA-
B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
☐ A. Decreased effectiveness of carbamazepine in treating seizures
☐ B. Increased risk for drug interactions
☑ C. Increased risk for Stevens-Johnson syndrome
☐ D. Resistance to carbamazepine
9. A genetic variation in how the metabolite of the cancer drug irinotecan (SN-38)
is inactivated by the body may lead to:
☐ A. Decreased effectiveness of irinotecan
☑ B. Increased adverse drug reactions, such as neutropenia
☐ C. Delayed metabolism of irinotecan into SN-38
☐ D. Concerns of irinotecan being carcinogenic
10. Patients who have a poor metabolism phenotype will have:
☑ A. Slowed metabolism of a prodrug into an active drug, leading to
accumulation of prodrug
☐ B. Accumulation of inactive metabolites
☐ C. A need for increased dosages of medications
☐ D. Increased elimination of active drug
, 11. Ultra-rapid metabolizers of drugs may have:
☐ A. To have dosages adjusted downward to prevent drug accumulation
☑ B. Active drug rapidly metabolized into inactive metabolites, leading to
therapeutic failure
☐ C. Increased elimination of active, nonmetabolized drug
☐ D. Slowed metabolism of a prodrug, leading to accumulation
12. A provider may consider testing for CYP2D6 variants prior to starting
tamoxifen to:
☐ A. Ensure no increased adverse reactions to tamoxifen
☐ B. Identify potential drug-drug interactions
☑ C. Reduce the likelihood of therapeutic failure
☐ D. Identify poor metabolizers of tamoxifen
The most frequent type of drug-food interaction is food:
1. Causing increased therapeutic drug levels
2. Affecting the metabolism of the drug
3. Altering the volume of distribution of drugs
4. Affecting the gastrointestinal absorption of drugs