NR 565 Advanced Pharmacology Fundamentals Final
Exam Prep Material Newest 2025/2026 Complete 300
Questions And Correct Detailed Answers (Verified
Answers)|Brand New Version!
Treatment of chronic pain- Example: How should something like osteoarthritis be
treated? -: answers :-Non Opioid medications - NSAIDs, cox-2 inhibitors
Nonpharmacologic tx - heat/cold, yoga, physical therapy, exercise, healthy weight
When prescribing medication we must understand that liver function declines with age
due to what cause?
a. enlarged liver
b. decreased blood flow to liver
c. increased activity of the hepatic enzymes -: answers :-decreased blood flow to liver
a. decreased liver mass
c. decrease in enzyme activity
What is the most important cause of adverse drug reactions? (older age)
a. high drug dosages
b. lack of monitoring medications
c. decreased renal excretion
d. overprescribing/polypharmacy -: answers :-decreased renal excretion
Distribution of medication can be affected in the elderly in what ways? SATA
1. decreased hormones
2. increased body fat
3. decreased lean mass
4. decreased albumin -: answers :-2, 3, 4
changes in body composition associated with age due to an increase in body fat
percentage and decrease in lean muscle mass. There is also a decrease in total body
water. Distribution can also be impacted by decreased total body water and decreased
cardiac output. Absorption can be impacted by increase gastric pH, decreased
absorption surface area decreased G.I. motility and decrease gastric emptying.
Metabolism can be impacted by de Cristo paddock blood flow, paddock mask, and
activity of hepatic enzymes. Excretion can be impacted by decreased renal blood flow,
decrease GFR, decrees to both secretion, and decrease number of nephrons
,An 82 year old male visits the clinic complaining that his pain medications "take forever"
to work after he takes his pill. What are possible reasons you can explain to him?
1.Perhaps we need to increase your dosage.
2.Sometimes as you get older, absorption may be slower resulting in a delayed
response.
3.As we get older the gastric acid decreases and may slow absorption. -: answers :-
2&3
Order of HTN medications typically prescribed -: answers :-Thiazide diuretics
Ace Inhibitors
ARBS
CCB
BB
Which is best HTN medication for someone with diabetes -: answers :-ACE inhibitor
and ARB
Which medication to avoid in a patient who is pregnant or breastfeeding? -: answers :-
Avoid ACE and ARBs in patients who are pregnant or may become pregnant. Especially
ARBs in the second and third trimester.
Medications best for HTN for patient who is pregnant? -: answers :-labetalol,
methyldopa, nifedipine
For general population which HTN class is appropriate? -: answers :-thiazide diuretics
For African Americans which class of HTN medications is appropriate? -: answers :-
thiazide, CCB, BB
For a chronic kidney disease, what is the best HTN medication class? -: answers :-
ACE Inhibitors or ARBS
What class of medications to avoid in African Americans? -: answers :-ACE inhibitors
and ARBS
Thiazide diuretics MOA -: answers :-blockade of sodium and chloride reabsorption
increases renal excretion of sodium, chloride, potassium, and water (hyponatremia,
hypochloremia, hypokalemia)
ACE inhibitors MOA -: answers :-Angiotensin Converting Enzyme Inhibitors (ACE-I)
prevent the conversion of angiotensin I to angiotensin II, which disrupts the renin-
angiotensin-aldosterone system (RAAS).
1. reduce levels of angiotensin II (through inhibition of ACE)
2. increasing levels of bradykinin (through inhibition of kinase 11)
End in -pril
, ARBS MOA -: answers :-Block angiotensin II receptors on blood vessels in heart and
adrenals. Increases renal excretion of sodium and water. Cause dilation of arterioles
and veins.
End in -sartan
CCB MOA -: answers :-They work by preventing calcium from entering the cells of the
heart and arteries. Calcium causes the heart and arteries to squeeze (contract) more
strongly. By blocking calcium, calcium channel blockers allow blood vessels to relax and
open.
blockade of peripheral arterioles cause dilation and reduces arterial pressure, arterioles
of the heart increases coronary perfusion, blockade of the SA node reduces heart rate,
decreases AV node conduction, myocardium decreases force of contraction
Prescribing considerations when carbamazepine is prescribed with warfarin -: answers
:-Carbamazepine lowers the effectiveness of Warfarin. This is because of the induction
of drug-metabolizing enzymes. There needs to be close monitoring for the Warfarin
dose by checking the prothrombin and INR. The dose may need to be adjusted to
counterbalance the effect of adding or removing the inducing agent
A patient with HF develops fibrotic changes, what should the provider do next? -:
answers :-ensure that a patient is on an ARB (valsartan) as this inhibits fibrosis
(aldosterone antagonist)
Adverse effects of lasix (flurosemide) -: answers :-ototoxicity
What medication causes ototoxicity as well and should not be prescribed with lasix? -:
answers :-aminoglycoside antibiotics, end in -cin
What medication might we consider prescribing with a loop diuretic to prevent an
electrolyte imbalance? -: answers :-potassium sparing diuretic (spironolactone)
black box warning for spironolactone -: answers :-endocrine effects - gynecomastia,
menstrual irregularities, hirsutism, deepening of voice
HYPERKALEMIA
What is the action of aldosterone? -: answers :-acts on distal tubules of the kidney to
cause retention of sodium and excretion of potassium and hydrogen. Retention of Na
causes water to be retained as well. Aldosterone increases blood volume which
increases blood pressure
How to migrate adverse effects of aldosterone? -: answers :-Aldosterone antagonist
(ex/ spironolactone, eplerenone)
Exam Prep Material Newest 2025/2026 Complete 300
Questions And Correct Detailed Answers (Verified
Answers)|Brand New Version!
Treatment of chronic pain- Example: How should something like osteoarthritis be
treated? -: answers :-Non Opioid medications - NSAIDs, cox-2 inhibitors
Nonpharmacologic tx - heat/cold, yoga, physical therapy, exercise, healthy weight
When prescribing medication we must understand that liver function declines with age
due to what cause?
a. enlarged liver
b. decreased blood flow to liver
c. increased activity of the hepatic enzymes -: answers :-decreased blood flow to liver
a. decreased liver mass
c. decrease in enzyme activity
What is the most important cause of adverse drug reactions? (older age)
a. high drug dosages
b. lack of monitoring medications
c. decreased renal excretion
d. overprescribing/polypharmacy -: answers :-decreased renal excretion
Distribution of medication can be affected in the elderly in what ways? SATA
1. decreased hormones
2. increased body fat
3. decreased lean mass
4. decreased albumin -: answers :-2, 3, 4
changes in body composition associated with age due to an increase in body fat
percentage and decrease in lean muscle mass. There is also a decrease in total body
water. Distribution can also be impacted by decreased total body water and decreased
cardiac output. Absorption can be impacted by increase gastric pH, decreased
absorption surface area decreased G.I. motility and decrease gastric emptying.
Metabolism can be impacted by de Cristo paddock blood flow, paddock mask, and
activity of hepatic enzymes. Excretion can be impacted by decreased renal blood flow,
decrease GFR, decrees to both secretion, and decrease number of nephrons
,An 82 year old male visits the clinic complaining that his pain medications "take forever"
to work after he takes his pill. What are possible reasons you can explain to him?
1.Perhaps we need to increase your dosage.
2.Sometimes as you get older, absorption may be slower resulting in a delayed
response.
3.As we get older the gastric acid decreases and may slow absorption. -: answers :-
2&3
Order of HTN medications typically prescribed -: answers :-Thiazide diuretics
Ace Inhibitors
ARBS
CCB
BB
Which is best HTN medication for someone with diabetes -: answers :-ACE inhibitor
and ARB
Which medication to avoid in a patient who is pregnant or breastfeeding? -: answers :-
Avoid ACE and ARBs in patients who are pregnant or may become pregnant. Especially
ARBs in the second and third trimester.
Medications best for HTN for patient who is pregnant? -: answers :-labetalol,
methyldopa, nifedipine
For general population which HTN class is appropriate? -: answers :-thiazide diuretics
For African Americans which class of HTN medications is appropriate? -: answers :-
thiazide, CCB, BB
For a chronic kidney disease, what is the best HTN medication class? -: answers :-
ACE Inhibitors or ARBS
What class of medications to avoid in African Americans? -: answers :-ACE inhibitors
and ARBS
Thiazide diuretics MOA -: answers :-blockade of sodium and chloride reabsorption
increases renal excretion of sodium, chloride, potassium, and water (hyponatremia,
hypochloremia, hypokalemia)
ACE inhibitors MOA -: answers :-Angiotensin Converting Enzyme Inhibitors (ACE-I)
prevent the conversion of angiotensin I to angiotensin II, which disrupts the renin-
angiotensin-aldosterone system (RAAS).
1. reduce levels of angiotensin II (through inhibition of ACE)
2. increasing levels of bradykinin (through inhibition of kinase 11)
End in -pril
, ARBS MOA -: answers :-Block angiotensin II receptors on blood vessels in heart and
adrenals. Increases renal excretion of sodium and water. Cause dilation of arterioles
and veins.
End in -sartan
CCB MOA -: answers :-They work by preventing calcium from entering the cells of the
heart and arteries. Calcium causes the heart and arteries to squeeze (contract) more
strongly. By blocking calcium, calcium channel blockers allow blood vessels to relax and
open.
blockade of peripheral arterioles cause dilation and reduces arterial pressure, arterioles
of the heart increases coronary perfusion, blockade of the SA node reduces heart rate,
decreases AV node conduction, myocardium decreases force of contraction
Prescribing considerations when carbamazepine is prescribed with warfarin -: answers
:-Carbamazepine lowers the effectiveness of Warfarin. This is because of the induction
of drug-metabolizing enzymes. There needs to be close monitoring for the Warfarin
dose by checking the prothrombin and INR. The dose may need to be adjusted to
counterbalance the effect of adding or removing the inducing agent
A patient with HF develops fibrotic changes, what should the provider do next? -:
answers :-ensure that a patient is on an ARB (valsartan) as this inhibits fibrosis
(aldosterone antagonist)
Adverse effects of lasix (flurosemide) -: answers :-ototoxicity
What medication causes ototoxicity as well and should not be prescribed with lasix? -:
answers :-aminoglycoside antibiotics, end in -cin
What medication might we consider prescribing with a loop diuretic to prevent an
electrolyte imbalance? -: answers :-potassium sparing diuretic (spironolactone)
black box warning for spironolactone -: answers :-endocrine effects - gynecomastia,
menstrual irregularities, hirsutism, deepening of voice
HYPERKALEMIA
What is the action of aldosterone? -: answers :-acts on distal tubules of the kidney to
cause retention of sodium and excretion of potassium and hydrogen. Retention of Na
causes water to be retained as well. Aldosterone increases blood volume which
increases blood pressure
How to migrate adverse effects of aldosterone? -: answers :-Aldosterone antagonist
(ex/ spironolactone, eplerenone)
