Advanced Pharmacology Week 11 Exam – 100 Questions with Rationales (Anticoagulation, Antiarrhythmics, Psychopharmacology, Antimicrobials, Pregnancy/Lactation, Pediatrics, Geriatrics)

Graduate-level advanced pharmacology test bank for Week 11 exam with 100 multiple-choice questions, correct answers, and detailed rationales. Section 1 – Anticoagulation & Antiplatelet Therapy (warfarin INR target 2.0-3.0 for atrial fibrillation, andexanet alfa reversal of apixaban, apixaban dosing in renal impairment CrCl 25 mL/min 2.5 mg BID, warfarin INR 4.8 without bleeding hold + low-dose oral vitamin K 2.5 mg, clopidogrel irreversible P2Y12 inhibitor, HIT enoxaparin contraindicated, rifampin warfarin interaction CYP2C9 induction ↓INR, dabigatran reversal idarucizumab, DOACs contraindicated in mechanical heart valves, clopidogrel stop 5-7 days pre-op, DAPT 12 months post-DES, heparin monitoring aPTT, argatroban HIT, apixaban no routine INR monitoring, apixaban safest in CKD stage 4, aspirin irreversible COX-1 inhibition ↓thromboxane A2, purple toe syndrome cholesterol embolization, CHA₂DS₂-VASc score 1 consider NOAC, rivaroxaban missed dose take same day). Section 2 – Antiarrhythmic Drugs (amiodarone baseline TSH, CXR, LFTs, dofetilide torsades de pointes QT monitoring, digoxin contraindicated in WPW + AF, lidocaine Class IB post-MI ventricular arrhythmias, flecainide increased mortality in CAD CAST trial, procainamide first-line stable monomorphic VT, dronedarone contraindicated in NYHA class IV HF, hypokalemia potentiates digoxin toxicity, amiodarone hypothyroidism manage with levothyroxine continue drug, sotalol beta-blocker + Class III, amiodarone corneal microdeposits annual eye exam, adenosine narrow-complex SVT transient asystole, verapamil Class IV L-type calcium channel blocker, propafenone Class IC no structural heart disease, amiodarone warfarin interaction inhibit CYP2C9 ↑INR). Section 3 – Psychopharmacology (sertraline onset 2-4 weeks, fluoxetine + linezolid serotonin syndrome, olanzapine highest metabolic syndrome risk, lithium toxicity coarse tremor confusion, amitriptyline TCAs fatal in overdose, clozapine ANC 500 stop REMS protocol, lamotrigine Stevens-Johnson syndrome rash, phenelzine MAOI tyramine restriction, buspirone onset 2-4 weeks, quetiapine alpha-1 blockade orthostatic hypotension, haloperidol tardive dyskinesia, valproate hepatotoxicity hyperammonemia monitor LFTs, venlafaxine withdrawal discontinuation syndrome brain zaps, buprenorphine partial mu agonist opioid use disorder, esketamine REMS 2-hour monitoring, paroxetine/fluoxetine strong CYP2D6 inhibitors, lithium + HCTZ ↓lithium clearance ↑toxicity, ziprasidone QTc prolongation baseline ECG, carbamazepine SIADH hyponatremia, disulfiram Antabuse aversive reaction). Section 4 – Antimicrobial Stewardship (vancomycin red man syndrome slow infusion, MRSA bacteremia vancomycin trough 15-20 mcg/mL, ciprofloxacin fluoroquinolone tendon rupture black box, ceftriaxone safe in penicillin anaphylaxis low cross-reactivity, gentamicin high trough ↑ototoxicity nephrotoxicity, C. diff oral vancomycin fidaxomicin, HIV CD4 80 PJP prophylaxis TMP-SMX, linezolid thrombocytopenia dose-related myelosuppression, oral ketoconazole hepatotoxicity black box, rifampin red-orange body fluids, gentamicin aminoglycoside TDM peak/trough, INH peripheral neuropathy pyridoxine B6, uncomplicated UTI TMP-SMX first-line, fulminant C. diff IV metronidazole + oral vancomycin, tenofovir TDF nephrotoxicity monitor creatinine). Sections 5-7 – Pregnancy/Lactation (lisinopril ACE inhibitor contraindicated pregnancy, valproate neural tube defects, sertraline preferred SSRI lactation, doxylamine/pyridoxine Diclegis FDA-approved hyperemesis, insulin preferred gestational diabetes, albuterol + prednisone safe asthma exacerbation pregnancy, levothyroxine dose increase 25-50% pregnancy, amoxicillin safe UTI pregnancy, dicloxacillin/cephalexin safe mastitis lactation, lamotrigine clearance ↑ in pregnancy ↑dose), Pediatrics (acetaminophen 15 mg/kg 14 kg = 210 mg, surfactant endotracheal tube RDS, methylphenidate insomnia appetite suppression, amoxicillin 90 mg/kg/day 20 kg BID = 900 mg, acetaminophen/ibuprofen for febrile seizure no aspirin, vitamin K IM at birth prevents VKDB, pancreatic enzymes applesauce every meal/snack, spacer improves inhaler delivery in children, ranitidine withdrawn NDMA contamination, phenytoin gingival hyperplasia switch levetiracetam), Geriatric Pharmacology (diphenhydramine Beers Criteria anticholinergic avoid, acetaminophen first-line OA elderly, donepezil bradycardia syncope fall risk, lisinopril ACE inhibitor ↑hyperkalemia risk, tamsulosin orthostatic hypotension falls, benzodiazepines avoid in elderly Beers Criteria, TMP-SMX warfarin major INR increase, oxybutynin anticholinergic cognitive impairment delirium, UTI common cause delirium in elderly with Parkinson’s, digoxin 0.125 mg/day Beers Criteria). Perfect for advanced pharmacology graduate courses, NP certification, and Week 11 final exam review