ANCC AGPCNP STUDY SET EXAM
QUESTIONS WITH 100% CORRECT
ANSWERS | LATEST VERSION 2025/2026.
Pharmacology - ANS study of the interaction between the body and drugs
Pharmacokinetics - ANS the movement of drugs trough the body (absorption, bioavailability,
distribution, metabolism, and excretion)
Pharmacodynamics - ANS The study of the physiologic and biochemical effects of drugs
(what a drug does to the body)
Pharmacogenomics - ANS the study of how a person's genes affect response to medications.
Area under the curve (AUC) - ANS the average amount of a drug in the blood after a dose is
given. It is a measure of the availability (bioavailability) of a drug after it is administered.
maximum concentration (Cmax) - ANS The peak serum concentration of a drug
Minimum inhibitory concentration (MIC) - ANS the lowest concentration of an antibiotic that
will inhibit the growth of organisms (after overnight incubation).
Trough - ANS the lowest concentration of a drug after a dose
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,First-pass effect - ANS All oral drugs (except sublingual) must go through first-pass
metabolism before released and used by body.
In the liver the CYP450 system metabolizes the drug and then the active drug is released to the
body to be used.
What drug cannot be given orally because of extensive first-pass effect? - ANS insulin
Drug Excretion - ANS Renal filtration accounts for most of drug excretion. Kidney is the
principle organ for drug elimination.
Age related change to pharmacokinetics - ANS - Increase in fat-to-water ratio
- Decrease in albumin and plasma proteins
- Decrease in liver blood flow and size
- Decrease in some CYP450 enzyme pathways (decreased drug clearance)
- Decrease in glomerular filtration rate (GFR)
Specific Drugs affected by Kidney Disease - ANS - NSAIDS (reduction of renal blood flow will
damage kidneys)
- ACE inhibitors (higher risk of hyperkalemia)
- Warfarin (Higher risk of over coagulation (INR >4). Severe CKD and ESRD at risk of hemorrhagic
complications. Need more frequent monitoring
- Lithium (increase risk of kidney injury. Monitor renal fxn closely)
- Contrast dye (IV contrast can injure kidneys)
- Potassium sparing diuretics (increased risk of hyperkalemia)
- Oral sodium phosphate (used to cleanse bowel before colonoscopies) (May cause sudden loss
of kidney fxn (AKI) as well as blood mineral disturbances)
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, Potent CYP450 Inhibitors - ANS - THESE DRUGS SLOW DOWN CLEARANCE ((increase drug
concentration, high risk for drug overdose or ASEs)) --high likelihood of drug-drug interactions
- Macrolides (erythromycin, clarithromycin, telithromycin)
- Antifungals (ketoconazole, fluconazole, phenytoin)
- Cimetidine (Tagamet)
- Citalopram (Celexa)
- Protease inhibitors (saquinavir, indinavir, nelfinavir)
- Grapefruit Juice (affects CYP450 system)
What drugs does grapefruit interact with? - ANS - statins
-erythromycin
-calcium channel blocker ( nifedipine, nisoldipine)
-antivirals (indinavir, saquinavir)
-amiodarone
-benzodiazepines (diazepam, triazolam)
-cisapride
-carbamazepine
-buspirone
What to monitor with Digoxin - ANS - Digoxin levels
- EKG
-electrolytes (K+,Mg+,Ca2+)
What to monitor with Lithium? - ANS - blood levels
- TSH (risk for hypothyroidism)
Drugs to monitor drug levels - ANS - Digoxin
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
QUESTIONS WITH 100% CORRECT
ANSWERS | LATEST VERSION 2025/2026.
Pharmacology - ANS study of the interaction between the body and drugs
Pharmacokinetics - ANS the movement of drugs trough the body (absorption, bioavailability,
distribution, metabolism, and excretion)
Pharmacodynamics - ANS The study of the physiologic and biochemical effects of drugs
(what a drug does to the body)
Pharmacogenomics - ANS the study of how a person's genes affect response to medications.
Area under the curve (AUC) - ANS the average amount of a drug in the blood after a dose is
given. It is a measure of the availability (bioavailability) of a drug after it is administered.
maximum concentration (Cmax) - ANS The peak serum concentration of a drug
Minimum inhibitory concentration (MIC) - ANS the lowest concentration of an antibiotic that
will inhibit the growth of organisms (after overnight incubation).
Trough - ANS the lowest concentration of a drug after a dose
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
,First-pass effect - ANS All oral drugs (except sublingual) must go through first-pass
metabolism before released and used by body.
In the liver the CYP450 system metabolizes the drug and then the active drug is released to the
body to be used.
What drug cannot be given orally because of extensive first-pass effect? - ANS insulin
Drug Excretion - ANS Renal filtration accounts for most of drug excretion. Kidney is the
principle organ for drug elimination.
Age related change to pharmacokinetics - ANS - Increase in fat-to-water ratio
- Decrease in albumin and plasma proteins
- Decrease in liver blood flow and size
- Decrease in some CYP450 enzyme pathways (decreased drug clearance)
- Decrease in glomerular filtration rate (GFR)
Specific Drugs affected by Kidney Disease - ANS - NSAIDS (reduction of renal blood flow will
damage kidneys)
- ACE inhibitors (higher risk of hyperkalemia)
- Warfarin (Higher risk of over coagulation (INR >4). Severe CKD and ESRD at risk of hemorrhagic
complications. Need more frequent monitoring
- Lithium (increase risk of kidney injury. Monitor renal fxn closely)
- Contrast dye (IV contrast can injure kidneys)
- Potassium sparing diuretics (increased risk of hyperkalemia)
- Oral sodium phosphate (used to cleanse bowel before colonoscopies) (May cause sudden loss
of kidney fxn (AKI) as well as blood mineral disturbances)
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
, Potent CYP450 Inhibitors - ANS - THESE DRUGS SLOW DOWN CLEARANCE ((increase drug
concentration, high risk for drug overdose or ASEs)) --high likelihood of drug-drug interactions
- Macrolides (erythromycin, clarithromycin, telithromycin)
- Antifungals (ketoconazole, fluconazole, phenytoin)
- Cimetidine (Tagamet)
- Citalopram (Celexa)
- Protease inhibitors (saquinavir, indinavir, nelfinavir)
- Grapefruit Juice (affects CYP450 system)
What drugs does grapefruit interact with? - ANS - statins
-erythromycin
-calcium channel blocker ( nifedipine, nisoldipine)
-antivirals (indinavir, saquinavir)
-amiodarone
-benzodiazepines (diazepam, triazolam)
-cisapride
-carbamazepine
-buspirone
What to monitor with Digoxin - ANS - Digoxin levels
- EKG
-electrolytes (K+,Mg+,Ca2+)
What to monitor with Lithium? - ANS - blood levels
- TSH (risk for hypothyroidism)
Drugs to monitor drug levels - ANS - Digoxin
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED
