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FNP Review: Pharmacology Exam Questions And Answers
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FNP Review: Pharmacology Exam Questions And Answers
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FNP Review: Pharmacology ExamQuestions And Answers
First-Pass Effect - correct answer ✅All oral drugs must go through "first-pass
metabolism" before they can be used by the body. When a drug is
swallowed, it is absorbed through the gastrointestinal (GI) tract where it
enters the portal circulation. After the drug enters the liver, it is metabolized
(biotransformation) and then released into the systemic circulation.
"First-pass metabolism" lowers the amount of active drug available to the
body. If a
drug has a high first-pass effect, most of it becomes "inactivated" and cannot
be used
by the body. Drugs that have extensive first-pass metabolism cannot be
given by the oral route. A good example is insulin, which, if given by the oral
route, is completely broken down in the GI tract (by enzymes). To bypass
first-pass metabolism, insulin must be given by
injection.
Drug Metabolism - correct answer ✅The most active organ is the liver
(cytochrome P450 enzyme system). The other organ systems are the
kidneys, the GI tract (breakdown by gut bacteria), and the lungs (CO2).
Drug Excretion - correct answer ✅Almost all drugs/chemicals are broken
down by the liver and excreted from the body in the bile, urine, feces,
respiratory gas (CO2), and as sweat (sweat glands). It is unusual to have a
drug that is totally (100%) broken down by only one organ (e.g., kidneys
only). Most drugs are excreted by both the liver and the kidneys. For
example, oral furosemide is excreted mainly through the kidneys (50%) and
some through feces.
,FNP Review: Pharmacology Exam
Questions And Answers
Half-life (t 1/2) - correct answer ✅The amount of time in which drug
concentration decreases by 50%.
Area under the curve (AUC) - correct answer ✅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.
Potent inhibitors of the cytochrome P450 (CYP450) system - correct answer
✅■ Macrolides (erythromycin, clarithromycin, pediazole)
■ Antifungals (ketoconazole, fluconazole)
■ Cimetidine (Tagament)
■ Citaprolam (Celexa)
The above drugs are some "problematic" drugs. These drugs are responsible
for a large number of drug-drug interactions. Drugs that act as inhibitors
slow down drug clearance (increase drug concentration). When this
happens, the patient is at high risk for a drug overdose and adverse effects.
Narrow therapeutic index drugs - correct answer ✅■ Warfarin sodium
(Coumadin): monitor INR.
■ Digoxin (Lanoxin): monitor digoxin level, EKG, electrolytes (potassium,
magnesium, calcium).
■ Theophylline: monitor blood levels.
■ Carbamezapine (Tegretol) and phenytoin (Dilantin): monitor blood levels.
■ Levothyroxine: monitor TSH.
■ Lithium: monitor blood levels, TSH (risk of hypothyroidism).
, FNP Review: Pharmacology Exam
Questions And Answers
Safety issues with some prescription drugs - correct answer
✅Thiazolidinediones (TZDs) Black Box Warning: cause or exacerbate CHF in
some patients. Do
not use if NYHA Class III or IV heart failure
Pioglitazone (Actos) Stop if: c/o dyspnea, weight gain, cough (heart failure)
Atypical antipsychotics
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quietipine (Seroquel)
High risk of weight gain, metabolic syndrome, and type 2 diabetes.
Monitor weight every 3 months. Black Box Warning: higher
mortality in elderly patients.
Monitor: TSH, lipids, weight/body mass index (BMI)
Bisphosphonates
Alendronate (Fosamax)
Risedronate (Actonel)
Jaw pain (jaw necrosis). Chest pain, diffi culty swallowing, burning
mid-back (perforation). Take alone upon awakening with 8 oz
glass water (NOT juice) before breakfast. Do not lie down
× 30 minutes afterward. Do not mix with other drugs). Take fi rst
thing in the morning before breakfast
Statins
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