Frontier PC 707 Advanced Pharmacology Final Safety
Exam questions with correct answers
Understand and identify evidenced-based prescribing resources Correct
Answer-ACOG, American Ca Society, National lung and heart
instituete, EEP, Dynamed, Lexicomp, Sanford guide, lactamed **NO
PDR
Understand PLLR: Drugs in Pregnancy and Lactation: Improved
Benefit-Risk information. Correct Answer-June 2015; 3 sections
pregnancy-L&D, Lactation-nursing mothers; Fe/males of reproductive
age; labeling updated as new information arrives, more current
information to discuss risk vs benefit
Type 1-IgE Correct Answer-Immediate hypersensitivity ex)
angioedema, anaphylaxis
Type 2-antibody Dependent Correct Answer-minutes to days ex) heparin
induced thrombocytopenia
Type 3- Immune Complex hypersensitivity Correct Answer-ex) arthrus
reaction to tetanus
Type 4- non-IgE, Cell mediated delayed Correct Answer-48-72 hours
(delayed) ex) drug rash, Eosinophilia, poison Ivy,
,What are ADRs? What is the APRNs responsibility in ADRs? Correct
Answer-Adverse drug reactions 1) pharmacological (predictable) 2)
idiosyneratic (unpredicted/severe); APRN: document & record specific
reaction & drug; injury involved; FDA reporting
Concepts of pharmacokinetics and pharmacodynamics in safety. Correct
Answer-Pharmacokinetics- how body handles drug or how it moves
through the
Understand biotransformation, enzyme induction and inhibition and
Grapefruit and CYP 450. Correct Answer-enzyme Inhibitors: decrease
CYP450 enzymes, increasing pharmacological action of the drug (more
drug, more action); basically inhibit the metabolizing system. Enzyme
Induction: induces the CYP450 causing increased amount of CYP450
which results in the increased metabolism, which decreases
pharmacologic action of the drug.
Grapefruit juice Correct Answer-prevents certain drugs in GI system
from breaking down or metabolizing, therefore when combined with
certain drugs it equals increased action.
Common side effects Correct Answer-skin reactions-happen commonly;
also nausea, headache, dizziness
Serious side effects Correct Answer-those that result in death; life
threatening, hospitalization, dehibilitating, prolonged QT prolongation
,Absolute contraindication Correct Answer-DO NOT prescribe
Relative contraindication Correct Answer-risk of not using the med may
outweigh risk of using
Understand medication reconciliation and safety. Correct Answer-
Always ask about Allergies. Detail review of pt medication hx including
herbals, OTCs or PRN meds DO THIS AT EVERY VISIT. A-allergies
V-vitamins O-old drugs/OTC I-Interactions D-dependence M-mendel-
family hx-benefits or reactions; goal of therapy -related drug class -
MOA -features of specific drugs -how do they get into body (PO,
inject)-metabolized and excretion
Know The World Health Organization (WHO) Six Step Model of
Rational Prescribing Correct Answer-1-define pt problem 2-specify
therapeutic objective 3-choose tx 4-start tx 5-educate pt 6- monitor
effectiveness
Review physiologic changes in the elderly. Correct Answer-Increased
gastric PH; decreased peristalisis (increased length of time for
absorption to occur); decreased muscle mass; decreased total body water
(decreased distribution); decreased liver mass (effects metabolism); Also
polypharmacy >5 drugs
, Review physiologic changes in pregnancy. Correct Answer-Numerous
changes-most drugs don't need dosage change Increased volume=
decreased albumin=increased unbound drug=increased clearance
Increased blood flow to organs, increased GFR Increased renal excretion
Decreased gastric motility=longer transport times, increased
bioavailability Ex) SSRI-3rd trimester increased metabolism &
increased excretion = increased amounts, more frequent dosing because
of increased excretion, and longer transport/distribution
Review physiologic changes in peds. Correct Answer-Higher rate of
metabolism; drugs are less protein bound, higher water concentration=
increased distribution. Dosing based on kg; Infants= organ immaturity
which can increase toxicity (decreased metabolism & excretion);
underdeveloped blood brain barriar=drugs readily to CNS; PO drugs not
absorbed well due to variable peristalsis
What is Beers list and STOPP Tools and use implications? Correct
Answer-BEERS-1991 used to identify harmful drugs for elderly; >65
START-screening tool STOPP-screening tool >65 Tools-benefit
outweighs risk, use drug; Guidelines not protocols
Understand the impact of genomics and metabolism. Correct Answer-
Personalization of drug; each pt responds differently to drugs based on
individual genetic makeup; genetic data can guide selection of drugs &
avoid ADRs; cheek swab (inadequate efficacy & safety); especially
important for depression meds
What is a teratogen? Correct Answer-Causing malformation of embryo-
characterized by effect at gestation time
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