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Nr 565 Advanced Pharmacology Midterm Latest Updated 2024

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Nr 565 Advanced Pharmacology Midterm Latest Updated 2024 During what trimester is a pregnant woman most at risk for adverse drug reactions with potential long term consequences? - ANSWER-1st trimester (fetus most at risk d/t rapid growth) What is BEERS criteria? - ANSWER-Recommendations of...

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  • September 10, 2024
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  • 2024/2025
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Nr 565 Advanced Pharmacology Midterm Latest Updated 2024


During what trimester is a pregnant woman most at risk for adverse drug reactions with potential long
term consequences? - ANSWER-1st trimester (fetus most at risk d/t rapid growth)



What is BEERS criteria? - ANSWER-Recommendations of medications inappropriate for elderly (65 and
older), prescriber ultimately decides



What is the CYP450 (cytochrome P450) - ANSWER-liver enzyme system where medications are
metabolized, can either be inducers or inhibitors and create drug-drug interactions



CYP450 inducers - ANSWER-Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect
(decrease blood levels of drug), elevate CYP450 enzymes



CYP450 inducers pneumonic - ANSWER-"Bullshit Crap GPS INDUCES rage"



CYP450 inducer drug names - ANSWER-Barbituates, St John wort, Carbamazepine, rifampin, alcohol,
phenytoin, griseofulvin, phenobarbital, sulfonylureas



CYP450 inhibitors - ANSWER-inhibit metabolism, increase blood levels of medications



CYP450 pneumonic - ANSWER-"VISA credit card debt INHIBITS spending on designers like CK to look GQ"



CYP450 inhibitors drug names - ANSWER-Valproate, isoniazid, sulfonamides, amiodarone,
chloramphenicol, ketoconazole, grapefruit juice, quinidine



Physiological changes during pregnancy that impact pharmacodynamics and pharmacokinetic properties
of drugs? - ANSWER-increase glomerular filtration rate leads to increase durg excretion

,increase hepatic metabolism

decrease tone and motility of bowel

increase drug absorption



Examples of medications that can be teratogenic - ANSWER-Antiepileptic drugs, antimicrobials such as
tetracyclines and fluoroquinolones, vitamin A in large doses, some anticoagulants, and hormonal
medications such as diethylstilbestrol (DES).



How is absorption of intramuscular medications different in neonates? - ANSWER-slow and erratic due
to low blood flow in muscles first few days of life



Why is absorption of medication in the stomach increased in infancy? - ANSWER-delayed gastric
emptying



Some medications that should be avoided in the pediatric patient? - ANSWER-glucocorticoids,
discoloration of developing teeth with tetracyclines, and kernicterus with sulfonamides, levofloxacin
(antibiotics)

aspirin (Severe intoxication from acute overdose)



what should be included in medication administration patient education? - ANSWER-dosage size and
timing

route and technique of administration

duration of treatment

drug storage

nature and time course of desired responses

nature and time course of adverse responses

finish taking antibiotic

,What are some things that put the elderly patient at higher risk for adverse drug reactions? - ANSWER-
reduced renal function

polypharmacy (the use of five or more medications daily)

greater severity of illness

presence of comorbidities

use of drugs that have a low therapeutic index (e.g., digoxin)

increased individual variation secondary to altered pharmacokinetics

inadequate supervision of long-term therapy

poor patient adherence



How can healthcare providers decrease likelihood of an elderly patient experiencing an adverse drug
reaction? - ANSWER-obtaining a thorough drug history that includes over-the-counter medications

considering pharmacokinetic and pharmacodynamics changes due to age

monitoring the patient's clinical response and plasma drug levels

using the simplest regimen possible

monitoring for drug-drug interactions and iatrogenic illness

periodically reviewing the need for continued drug therapy

encouraging the patient to dispose of old medications

taking steps to promote adherence and to avoid drugs on the Beers list



How can we promote medication adherence with elderly patients? - ANSWER-simplifying drug regimens

providing clear and concise verbal and written instructions

using an appropriate dosage form

clearly labeling and dispensing easy-to-open containers

developing daily reminders

monitoring frequently

, affordability of drugs

support systems



Why do nitrates need to be taken no later than 4 PM? - ANSWER-Need nitrate free interval so tolerance
doesn't develop



Nine factors that impact outcome of medication? - ANSWER-Gender and race

Genetics and pharmacogenomics

Variability in absorption

placebo effect

Tolerance

patho

age

bodyweight



Do you need informed consent for genetic testing? - ANSWER-yes



What is the purpose of the Genetic Information Non-Discriminatory Act? - ANSWER-Protects patients
from discrimination by employers and insurance providers based on genetic information



Difference between practice authority and prescriptive authority? - ANSWER-Practice authority refers to
the nurse practitioner's ability to practice without physician oversight, whereas prescriptive authority
refers to the nurse practitioner's authority to prescribe medications independently and without
limitations.



Who regulates prescriptive authority? - ANSWER-the jurisdiction of a health professional board. This
may be the State Board of Nursing, the State Board of Medicine, or the State Board of Pharmacy, as
determined by each state.

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