APEA Predictor Exam Study
,APEA Predictor Exam Study
1. First-Pass Effect
1. What cytochrome metabolizes a medication drug during the FIRST-PASS Effect?
2. CYP450 enzyme is the most _____________.
3. It can either be induced or inhibited (T/F): 1. CYP450 metabolizes the drug in the liver
to release the drug to the body where it can be used.
2.Active
3.True
2. Pharmacokinetics
1. What are age-related changes?
(Distribution, Metabolism, Excretion)?: 1. Increase in fat-to-water ratio, decrease in liver
function, decrease in GFR
3. Pharmacology: Cardiac Glycosides
1. What order of line of treatment is Digoxin?
2. Signs of Digoxin Overdose
3. Laboratory tests
4. Treatment: 1. Second and Third
2.N/V, Hyperkalemia, Confusion, visual color changes
3.Digoxin level, CMP, EKG
4.Digoxin-specific antibodies
4. Pharmacology: Warfarin (Coumadin)
1. Category ____ for pregnancy.
2. Target INR for patients without mitral prosthetic valves? With prosthetic valves?
3. Referral to ________ for initiation and stabilization of warfarin dose.
4. How often do you check for consistently stable INR?
5. How often do you check for single out-of-range INR?
,APEA Predictor Exam Study
6. What do you educate the patient to do if the INR less than 5 with no significant
bleeding risk?
7. If one dose is missed, what do you do?
8. What kind of foods to avoid messing up the INR?: 1. X
2.2.0-3.0, 2.5-3.5
3.Cardiologist or anticoagulation clinic
4.Check every 2-4 weeks up to 12 weeks.
5.Continue warfarin dose, retest INR in 1-2 weeks.
6.Omit one dose, recheck INR.
7.Take the dose as soon as possible. Do not double dose.
8.Vitamin K foods
5. Pharmacology: Direct Oran Anticoagulants (DOAC)
1. Why are DOACs better than Warfarin?
2. Example of DOACs?
3. How long does it take for platelet function to return to normal after a patient
stops taking Plavix?: 1. Less monitoring and less side effects
2.Apixaban (Eliquis)
3.10 days
6. Pharmacology: Thiazide Diuretics
1. Examples
2. Contraindication
3. Adverse effects
4. Patients with osteoporosis receive an extra benefit from thiazide diuretics by reducing
__________ excretion (T/F): 1. HCTZ, Chlorthalidone
2.Sulfa allergy
3.Hykpokalemia, increases uric acid and increases LDL
4.Calcium, True
7. Pharmacology: Potassium-Sparing Diuretics
,APEA Predictor Exam Study
1. Examples
2. Contraindication
3. Adverse effects
4. Do not combine with which cardiac drugs to prevent hyperkalemia?:
1. Triamterene, Amiloride
2. Hyperkalemia
3.Elevates K+ levels
4.ACEIs and ARBs
8. Pharmacology: Loop Diuretics
1. Examples
2. Contraindication/Allergy
3. Adverse effects
4. Which toxicity with loop diuretics can occur?: 1. Furosemide
2.Sulfa Allergy
3.Hypokalemia, Hyponatremia, hypomagnesemia
4.Ototoxicity
9. Pharmacology: ACEIs and ARBs
1. Examples
2. Black Box Warning/Contraindications
3. Adverse Effects
4. ACEIs are first-line therapy for
5. ACEIs and ARBs protect the kidneys. But if severe CKD, should you continue
ACEIs and ARBs? Why?: 1. Lisinopril, Losartan
2.Pregnancy
3.Dry cough, Hyperkalemia, Angioedema
4.Heart Failure w/ left ventricular dysfinction (HFrEF)
5.No, because severe CKD and ACEIs and ARBs will lead to increased risk of hyperkalemia.
10. Pharmacology: CCBs
,APEA Predictor Exam Study
1. First-Pass Effect
1. What cytochrome metabolizes a medication drug during the FIRST-PASS Effect?
2. CYP450 enzyme is the most _____________.
3. It can either be induced or inhibited (T/F): 1. CYP450 metabolizes the drug in the liver
to release the drug to the body where it can be used.
2.Active
3.True
2. Pharmacokinetics
1. What are age-related changes?
(Distribution, Metabolism, Excretion)?: 1. Increase in fat-to-water ratio, decrease in liver
function, decrease in GFR
3. Pharmacology: Cardiac Glycosides
1. What order of line of treatment is Digoxin?
2. Signs of Digoxin Overdose
3. Laboratory tests
4. Treatment: 1. Second and Third
2.N/V, Hyperkalemia, Confusion, visual color changes
3.Digoxin level, CMP, EKG
4.Digoxin-specific antibodies
4. Pharmacology: Warfarin (Coumadin)
1. Category ____ for pregnancy.
2. Target INR for patients without mitral prosthetic valves? With prosthetic valves?
3. Referral to ________ for initiation and stabilization of warfarin dose.
4. How often do you check for consistently stable INR?
5. How often do you check for single out-of-range INR?
,APEA Predictor Exam Study
6. What do you educate the patient to do if the INR less than 5 with no significant
bleeding risk?
7. If one dose is missed, what do you do?
8. What kind of foods to avoid messing up the INR?: 1. X
2.2.0-3.0, 2.5-3.5
3.Cardiologist or anticoagulation clinic
4.Check every 2-4 weeks up to 12 weeks.
5.Continue warfarin dose, retest INR in 1-2 weeks.
6.Omit one dose, recheck INR.
7.Take the dose as soon as possible. Do not double dose.
8.Vitamin K foods
5. Pharmacology: Direct Oran Anticoagulants (DOAC)
1. Why are DOACs better than Warfarin?
2. Example of DOACs?
3. How long does it take for platelet function to return to normal after a patient
stops taking Plavix?: 1. Less monitoring and less side effects
2.Apixaban (Eliquis)
3.10 days
6. Pharmacology: Thiazide Diuretics
1. Examples
2. Contraindication
3. Adverse effects
4. Patients with osteoporosis receive an extra benefit from thiazide diuretics by reducing
__________ excretion (T/F): 1. HCTZ, Chlorthalidone
2.Sulfa allergy
3.Hykpokalemia, increases uric acid and increases LDL
4.Calcium, True
7. Pharmacology: Potassium-Sparing Diuretics
,APEA Predictor Exam Study
1. Examples
2. Contraindication
3. Adverse effects
4. Do not combine with which cardiac drugs to prevent hyperkalemia?:
1. Triamterene, Amiloride
2. Hyperkalemia
3.Elevates K+ levels
4.ACEIs and ARBs
8. Pharmacology: Loop Diuretics
1. Examples
2. Contraindication/Allergy
3. Adverse effects
4. Which toxicity with loop diuretics can occur?: 1. Furosemide
2.Sulfa Allergy
3.Hypokalemia, Hyponatremia, hypomagnesemia
4.Ototoxicity
9. Pharmacology: ACEIs and ARBs
1. Examples
2. Black Box Warning/Contraindications
3. Adverse Effects
4. ACEIs are first-line therapy for
5. ACEIs and ARBs protect the kidneys. But if severe CKD, should you continue
ACEIs and ARBs? Why?: 1. Lisinopril, Losartan
2.Pregnancy
3.Dry cough, Hyperkalemia, Angioedema
4.Heart Failure w/ left ventricular dysfinction (HFrEF)
5.No, because severe CKD and ACEIs and ARBs will lead to increased risk of hyperkalemia.
10. Pharmacology: CCBs
