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PHARMACOLOGY- AANP EXAM QUESTIONS AND ANSWERS
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PHARMACOLOGY- AANP EXAMQUESTIONS AND ANSWERS
MOST COMMON DRUG INTERACTION IN PRIMARY CARE - - correct
answer ✅Between warfarin sodium (Coumadin) and
trimethoprim-sulfamethoxazole (Bactrim). Sulfa drugs will interact
with Warfarin (increases blood level), which results in an elevation
of the INR and the risk of bleeding
FIRST PASS HEPATIC METABOLISM/FIRST-PASS EFFECT - - correct
answer ✅absorbed through small intestine, enter portal
circulation inside the liver, the cytochrome P450 (CYP450) system
responsible for bio-transformation, drugs that have extensive first
pass metabolism must be given my injection, ex: insulin
DRUG EXCRETION - - correct answer ✅Most drugs are excreted by
both the hepatobiliary system and the kidneys.
HALF LIFE - - correct answer ✅The amount of time in which drug
concentration decreased 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.
,PHARMACOLOGY- AANP EXAM
QUESTIONS AND ANSWERS
MINIMUM INHIBITORY CONCENTRATION (MIC) - - correct answer
✅The lowest concentration of an antibiotic that will inhibit the
growth of the organisms (after overnight incubation)
MAXIMUM CONCENTRATION - - correct answer ✅The lowest
concentration of a drug after a dose
TROUGH (MINIMUM CONCENTRATION) - - correct answer ✅The
lowest concentration of a drug after a dose.
POTENT INHIBITORS: CYP450 SYSTEM PROBLEMATIC DRUGS - -
correct answer ✅Responsible for a large number of drug-drug
interactions. 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. Questions asking about
drug interaction, think of these drugs:
Macrolides (erythromycin, clarithromycin)
Antifungals (ketoconazole, fluconazole)
Cisapride (Tagament)
Citalopram (Celexa)
Grapefruit juice affects CYP450 system
, PHARMACOLOGY- AANP EXAM
QUESTIONS AND ANSWERS
DRUGS AFFECTED BY GRAPEFRUIT JUICE - - correct answer
✅statins, erythromycin, calcium channel blockers,( nifedipine,
nisoldipine), antivirals (indinavir, saquinavir), amiodarone,
benzodiazepines (diazepam, triazolam), cisapride, carbamazepine,
buspirone, others
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
Carbamazepine (Tegretol): and phenytoin (Dilantin): Monitor blood
levels
Levothyroxine: Monitor TSH
Lithium: Monitor blood levels, TSH (risk of hypothyroidism_
PROTON-PUMP INHIBITOR (PPIs)- Safety Issues - - correct answer
✅Increased risk of fractures (postmenopausal women),
pneumonia, Clostridium difficile infection, hypomagnesemia, B12
and iron malabsorption, atrophic gastritis and kidney disease
OMEPRAZOLE (Prilosec)- SAFETY ISSUES - - correct answer
✅Interacts with warfarin (Coumadin), diazepam (Valium),
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