NR565 midterm, week 4exam Questions
and Answers NR-565 Advanced
Pharmacology Fundamentals | 100% Pass
what makes clopidogrel unique among other P2Y12 inhibitors? - CORRECT ANSWER-relies on
cytochrome P450 enzyme to convert into active metabolite (CYP2C19) thus requiring this gene
to be present to be an effective drug in clot formation
Alternatives to clopidogrel - CORRECT ANSWER-Brilinta (ticagrelor) or Effient (Prasugrel)
because they are not dependent on CYP2C19 genotype
Name the 4 medications that REQUIRE pharmacogenetic testing - CORRECT ANSWER-
Cetuximab, trastuzumab, maraviroc, dasatinib
2 medications prescribed together that are highly protein bound, what is clinical outcome? -
CORRECT ANSWER-The two drugs compete for availability of plasma proteins and one or the
other becomes increasingly effective, think extra medication is floating around as it cannot bind
to plasma proteins. Warfarin is highly protein bound.
What areas of healthcare most heavily integrate pharmacogenetics into clinical practice? -
CORRECT ANSWER-Oncology & cystic fibrosis population
Think HER2 with breast cancer and CF have 2 defective CFTR genes
Barrier in understanding racial differences in drug pharmacokinetics with American Indian or
Alaskan Natives? - CORRECT ANSWER-Limited to no research in racial considerations
, Purpose of genetic testing with Tamoxifen? - CORRECT ANSWER-Reduce the risk of therapeutic
failure as variation of CYP2D6 will not allow for activation and conversion to endoxifen which is
necessary for treating estrogen sensitive cancers.
Liver and Kidney functions labs for monitoring? - CORRECT ANSWER-Creatinine, BUN, GFR, AST,
ALT, Bilirubin
Dose of propranolol in migraine reduction - CORRECT ANSWER-20-80mg 3-4X daily
increases levels of serotonin, prevents beta receptor vasodilation
allow 4-6 weeks to trial treatment
First consideration in selecting most appropriate beta blocker? - CORRECT ANSWER-Cardio
selectivity
Pregnancy Categories B vs D with beta blockers - CORRECT ANSWER-Atenolol - D
betaxolol, acebutolol, metoprolol, nadolol, nebivolol, tiolol, propranolol - C
Where are beta 2 receptors located and what do they do? - CORRECT ANSWER-smooth muscle
of eye, arterioles, venules, bronchioles, liver, pancreas, GI, GU
Stimulate adneylyl cyclase, increase cAMP, activate cardiac G1
Drug of choice for HTN with concomitant BPH - CORRECT ANSWER-Alpha 1 adrenergic
antagonist
Beta blockers that require dosage adjustment in patients with renal impairment - CORRECT
ANSWER-acebutolol, atenolol, nadolol, and nebivolol
and Answers NR-565 Advanced
Pharmacology Fundamentals | 100% Pass
what makes clopidogrel unique among other P2Y12 inhibitors? - CORRECT ANSWER-relies on
cytochrome P450 enzyme to convert into active metabolite (CYP2C19) thus requiring this gene
to be present to be an effective drug in clot formation
Alternatives to clopidogrel - CORRECT ANSWER-Brilinta (ticagrelor) or Effient (Prasugrel)
because they are not dependent on CYP2C19 genotype
Name the 4 medications that REQUIRE pharmacogenetic testing - CORRECT ANSWER-
Cetuximab, trastuzumab, maraviroc, dasatinib
2 medications prescribed together that are highly protein bound, what is clinical outcome? -
CORRECT ANSWER-The two drugs compete for availability of plasma proteins and one or the
other becomes increasingly effective, think extra medication is floating around as it cannot bind
to plasma proteins. Warfarin is highly protein bound.
What areas of healthcare most heavily integrate pharmacogenetics into clinical practice? -
CORRECT ANSWER-Oncology & cystic fibrosis population
Think HER2 with breast cancer and CF have 2 defective CFTR genes
Barrier in understanding racial differences in drug pharmacokinetics with American Indian or
Alaskan Natives? - CORRECT ANSWER-Limited to no research in racial considerations
, Purpose of genetic testing with Tamoxifen? - CORRECT ANSWER-Reduce the risk of therapeutic
failure as variation of CYP2D6 will not allow for activation and conversion to endoxifen which is
necessary for treating estrogen sensitive cancers.
Liver and Kidney functions labs for monitoring? - CORRECT ANSWER-Creatinine, BUN, GFR, AST,
ALT, Bilirubin
Dose of propranolol in migraine reduction - CORRECT ANSWER-20-80mg 3-4X daily
increases levels of serotonin, prevents beta receptor vasodilation
allow 4-6 weeks to trial treatment
First consideration in selecting most appropriate beta blocker? - CORRECT ANSWER-Cardio
selectivity
Pregnancy Categories B vs D with beta blockers - CORRECT ANSWER-Atenolol - D
betaxolol, acebutolol, metoprolol, nadolol, nebivolol, tiolol, propranolol - C
Where are beta 2 receptors located and what do they do? - CORRECT ANSWER-smooth muscle
of eye, arterioles, venules, bronchioles, liver, pancreas, GI, GU
Stimulate adneylyl cyclase, increase cAMP, activate cardiac G1
Drug of choice for HTN with concomitant BPH - CORRECT ANSWER-Alpha 1 adrenergic
antagonist
Beta blockers that require dosage adjustment in patients with renal impairment - CORRECT
ANSWER-acebutolol, atenolol, nadolol, and nebivolol
