NR 565 (Advanced Pharmacology) MIDTERM EXAM STUDY GUIDE 2026/2027 ACCURATE QUESTIONS WITH CORRECT DETAILED SOLUTIONS || 100% GUARANTEED PASS NEWEST VERSION CHAMBERLAIN

NR 565 (Advanced Pharmacology) MIDTERM EXAM STUDY GUIDE 2026/2027 ACCURATE QUESTIONS WITH CORRECT DETAILED SOLUTIONS || 100% GUARANTEED PASS NEWEST VERSION CHAMBERLAIN 1. During what trimester is a pregnant woman most at risk for adverse drug reactions with potential long term consequences? - ANSWER 1st trimester (fetus most at risk d/t rapid growth) 2. What is BEERS criteria? - ANSWER Recommendations of medications inappropriate for elderly (65 and older), prescriber ultimately decides 3. What is the CYP450 (cytochrome P450) - ANSWER liver enzyme system where medications are metabolized, can either be inducers or inhibitors and create drug-drug interactions 4. CYP450 inducers - ANSWER Speed up metabolism of drugs (drug is cleared faster), drug has lesser effect (decrease blood levels of drug), elevate CYP450 enzymes 5. CYP450 inducers pneumonic - ANSWER "Bullshit Crap GPS INDUCES rage" 6. CYP450 inducer drug names - ANSWER Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin, phenobarbital, sulfonylureas 7. CYP450 inhibitors - ANSWER inhibit metabolism, increase blood levels of medications 8. CYP450 pneumonic - ANSWER "VISA credit card debt INHIBITS spending on designers like CK to look GQ" 9. CYP450 inhibitors drug names - ANSWER Valproate, isoniazid, sulfonamides, amiodarone, chloramphenicol, ketoconazole, grapefruit juice, quinidine 10. Physiological changes during pregnancy that impact pharmacodynamics and pharmacokinetic properties of drugs? - ANSWER increase glomerular filtration rate leads to increase durg excretion increase hepatic metabolism decrease tone and motility of bowel increase drug absorption 11. What medications should be used cautiously with statins bc they can raise plasma levels? - ANSWER inhibitors of CYP3A4 (ex/ erythromycin, amiodarone, grapefruit) 12. What are bile salts such as colesevlam used for? - ANSWER decrease LDL 13. What is gemfibrozil used to treat - ANSWER decreases total glyiceride and raises HDL 14. What is a major drug interaction with gemfibrozil (fibrate) - ANSWER warfarin (increases anti-coagulant effects) 15. fibrates are contraindicated in what patients - ANSWER liver and gallbladder disease 16. adverse effects of nitro - ANSWER headache, hypotension, and tachycardia (secondary to vasodilation) 17. what medication is contraindicated when a patient is prescribed nitro? - ANSWER inhibitors of PDE-5 18. How can we prevent nitro tolerance? - ANSWER use lowest effective dosage and long term acting formulations (patches, sustained release) used on intermittent schedule allowing at least 8 drug free hours every day (usually at night) 19. Warfarin MOA - ANSWER suppresses coagulation by decreasing production of four clotting factors, inhibits enzyme vit K from converting to active form 20. INR target range for warfarin - ANSWER 2.5 to 3.5 21. patient education on warfarin - ANSWER bleeding - soft toothbrush, electric razor, avoid green leafy vegetables 22. Beta-blockers use with nitroglycerin - ANSWER Beta Blockers suppress nitroglycerin induced tachycardia. They do so by preventing sympathetic activation of beta 1 adrenergic receptors on the heart. Nitroglycerin lowers BP by reducing venous return and dilating arterioles. the lowered BP activates the baroreceptor reflex causing reflex tachycardia. Which will increase cardiac demand and negate the therapeutic effects of nitroglycerin. Txt with beta blocker can suppress the heart and slow the rate. no digoxin - increase contractility of heart 23. examples of beta blockers - ANSWER end in -lol/-olol Atenolol, bisoprolol, metoprolol, metoprolol succinate, Carvedilol, labetalol, nadolol, propranolol, and Sotalol (Betapace®) 24. An 82 year old male visits the clinic complaining that his pain medications "take forever" to work after he takes his pill. What are possible reasons you can explain to him? 1.Perhaps we need to increase your dosage. 2.Sometimes as you get older, absorption may be slower resulting in a delayed response. 3.As we get older the gastric acid decreases and may slow absorption. - ANSWER 2&3 25. Order of HTN medications typically prescribed - ANSWER Thiazide diuretics Ace Inhibitors ARBS CCB BB 26. Which is best HTN medication for someone with diabetes - ANSWER ACE inhibitor and ARB 27. Which medication to avoid in a patient who is pregnant or breastfeeding? - ANSWER Avoid ACE and ARBs in patients who are pregnant or may become pregnant. Especially ARBs in the second and third trimester. 28. Medications best for HTN for patient who is pregnant? - ANSWER labetalol, methyldopa, nifedipine 29. For general population which HTN class is appropriate? - ANSWER thiazide diuretics 30. For African Americans which class of HTN medications is appropriate? - ANSWER thiazide, CCB, BB 31. For a chronic kidney disease, what is the best HTN medication class? - ANSWER ACE Inhibitors or ARBS 32. What class of medications to avoid in African Americans? - ANSWER ACE inhibitors and ARBS 33. Thiazide diuretics MOA - ANSWER blockade of sodium and chloride reabsorption increases renal excretion of sodium, chloride, potassium, and water (hyponatremia, hypochloremia, hypokalemia) 34. ACE inhibitors MOA - ANSWER Angiotensin Converting Enzyme Inhibitors (ACE-I) prevent the conversion of angiotensin I to angiotensin II, which disrupts the renin-angiotensin-aldosterone system (RAAS). 1. reduce levels of angiotensin II (through inhibition of ACE)