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2024 NR565 MIDTERM WEEK 4 EXAM WITH CORRECT ANSWERS
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2024 NR565 MIDTERM WEEK 4 EXAM WITH CORRECT ANSWERS
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2024 NR565 MIDTERM WEEK 4EXAM WITH CORRECT ANSWERS
Name the 4 medications that REQUIRE pharmacogenetic testing - CORRECT
ANSWERS-Cetuximab, trastuzumab, maraviroc, dasatinib
2 medications prescribed together that are highly protein bound, what is
clinical outcome? - CORRECT ANSWERS-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 ANSWERS-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 ANSWERS-Limited to no
research in racial considerations
ACEIs - CORRECT ANSWERS-monitor CMP or BMP for potassium retention and
kidney function
Pregnancy category C in first trimester, D in following
4 phases of clinical trials - CORRECT ANSWERS-I. small number of healthy
volunteers (dosage range), II. small group of patients (efficacy), III. large
number of patients (rare complications), various sites, IV. Post marketing
surveillance
controlled substances schedule I - CORRECT ANSWERS-highest potential for
abuse like heroin, LSD, marijuana, Peyote
Schedule II controlled substances - CORRECT ANSWERS-high potential for
abuse
legal, but no refills may be prescribed (but you can do multiple rx for up to
90 days supply)
dilaudid, methadone, percocet
Schedule III - CORRECT ANSWERS-potential for abuse is there, ketamine,
suboxone, tylenol with codeine
, Schedule IV Controlled Substances - CORRECT ANSWERS-lower abuse
potential, xanax, klonopin, valium, ativan
schedule V substances - CORRECT ANSWERS-no more than 200 mg of
codeine per 100 ml, robitussin
common otc meds used to make meth - CORRECT ANSWERS-ephedrine,
bronchodilators, nasal decongestants
anticonvulsants rx to women of childbearing age - CORRECT ANSWERS-
lamotrigine has lowest risk
First line tx for MDD - CORRECT ANSWERS-sertraline, escitalopram, due to
efficacy and lowest amount of side effects
prophy treatment for migraines - CORRECT ANSWERS-antiepileptics,
betablockers, tricyclic antidepressants
what makes clopidogrel unique among other P2Y12 inhibitors? - CORRECT
ANSWERS-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 ANSWERS-Brilinta (ticagrelor) or
Effient (Prasugrel) because they are not dependent on CYP2C19 genotype
Purpose of genetic testing with Tamoxifen? - CORRECT ANSWERS-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 ANSWERS-
Creatinine, BUN, GFR, AST, ALT, Bilirubin
Dose of propranolol in migraine reduction - CORRECT ANSWERS-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
ANSWERS-Cardio selectivity
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