NSG 6005 Pharm Weeks 1-3 Quiz (from
operation FNP Class 11)
Genetic polymorphisms account for differences in metabolism, including:
1. Poor metabolizers, who lack a working enzyme
2. Intermediate metabolizers, who have one working, wild-type allele and one mutant allele
3. Extensive metabolizers, with two normally functioning alleles
4. All of the above - correct answer 4. All of the above
Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
1. A need to monitor drugs metabolized by 2D6 for toxicity
2. Increased dosages needed of drugs metabolized by 2D6, such as the selective serotonin
reuptake inhibitors
3. Decreased conversion of codeine to morphine by CYP 2D6
4. The need for lowered dosages of drugs, such as beta blockers - correct answer 2. Increased
dosages needed of drugs metabolized by 2D6, such as the selective serotonin reuptake
inhibitors
Rifampin is a nonspecific CYP450 inducer that may:
1. Lead to toxic levels of rifampin and must be monitored closely
2. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
,NSG 6005 Pharm Weeks 1-3 Quiz (from
operation FNP Class 11)
3. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic failure
4. Cause nonspecific changes in drug metabolism - correct answer 3. Induce the metabolism of
drugs, such as oral contraceptives, leading to therapeutic failure
Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
1. Decreased therapeutic levels of quinidine
2. Increased therapeutic levels of quinidine
3. Decreased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
4. Increased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination - correct answer 4. Increased levels of a
coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
1. Toxic levels of warfarin building up
2. Decreased response to warfarin
3. Increased risk for significant drug interactions with warfarin
4. Less risk of drug interactions with warfarin - correct answer 2. Decreased response to
warfarin
,NSG 6005 Pharm Weeks 1-3 Quiz (from
operation FNP Class 11)
Genetic testing for VCORC1 mutation to assess potential warfarin resistance is required prior to
prescribing warfarin.
1. True
2. False - correct answer 2. False
Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to
prescribing:
1. Erythromycin
2. Digoxin
3. Cetuximab
4. Rifampin - correct answer 3. Cetuximab
Carbamazepine has a Black Box Warning recommending testing for the HLA-
B*1502 allele in patients with Asian ancestry prior to starting therapy due to:
1. Decreased effectiveness of carbamazepine in treating seizures in Asian patients with the HLA-
B*1502 allele
2. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
3. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 allele
, NSG 6005 Pharm Weeks 1-3 Quiz (from
operation FNP Class 11)
4. Patients who have the HLA-B*1502 allele being more likely to have a resistance to
carbamazepine - correct answer 3. Increased risk for Stevens-Johnson syndrome in Asian
patients with HLA-B*1502 allele
A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by
the body may lead to:
1. Decreased effectiveness of irinotecan in the treatment of cancer
2. Increased adverse drug reactions, such as neutropenia
3. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
4. Increased concerns for irinotecan being carcinogenic - correct answer 2. Increased adverse
drug reactions, such as neutropenia
Patients who have a poor metabolism phenotype will have:
1. Slowed metabolism of a prodrug into an active drug, leading to accumulation of prodrug
2. Accumulation of inactive metabolites of drugs
3. A need for increased dosages of medications
4. Increased elimination of an active drug - correct answer 1. Slowed metabolism of a prodrug
into an active drug, leading to accumulation of prodrug
Ultra-rapid metabolizers of drugs may have:
1. To have dosages of drugs adjusted downward to prevent drug accumulation
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