NURS 6013 EXAM:An Introduction to Pharmacogenomics
QUESTIONS WITH ANSWERS 2023
Chapter 6.
1. Genetic polymorphisms account for differences in metabolism, including:
1.
Poor metabolizers, who lack a working enzyme
2.
Intermediate metabolizers, who have one working, wild-type allele and one mutant
allele
3.
Extensive metabolizers, with two normally functioning alleles
4. All of the above
2. Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
1.
A need to monitor drugs metabolized by 2D6 for toxicity
2. Increased dosages needed of drugs metabolized by 2D6, such as the
selective serotonin reuptake inhibitors
3.
Decreased conversion of codeine to morphine by CYP2D6
4.
The need for lowered dosages of drugs, such as beta blockers
3. Rifampin is a nonspecific CYP450 inducer that may:
1.
Lead to toxic levels of rifampin and so must be monitored closely
2.
Cause toxic levels of drugs, such as oral contraceptives, when coadministered
3. Induce the metabolism of drugs, such as oral contraceptives, leading
to therapeutic failure
4.
Cause nonspecific changes in drug metabolism
4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
1.
Decreased therapeutic levels of quinidine
2.
Increased therapeutic levels of quinidine
3. Decreased levels of a coadministered drug, such as digoxin, that requires
P- glycoprotein for absorption and elimination
4.
Increased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
5. Warfarin resistance may be seen in patients with a VKORC1 mutation, leading to:
1.
Toxic levels of warfarin building up
2. Decreased response to warfarin
3.
Increased risk for significant drug interactions with warfarin
4.
Less risk of drug interactions with warfarin
6. Genetic testing for a VKORC1 mutation to assess potential warfarin resistance is required prior to
prescribing warfarin.
1.
True
2. False
7. Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing:
1.
Erythromycin
,NURS 6013 EXAM:An Introduction to Pharmacogenomics
QUESTIONS WITH ANSWERS 2023
2.
Digoxin
3. Cetuximab
4.
Rifampin
8. Carbamazepine has a black box warning recommending testing for the HLA-B*1502 allele in
patients with Asian ancestry prior to starting therapy due to:
1.
Decreased effectiveness of carbamazepine in treating seizures in Asian patients
with the HLA-B*1502 allele
2.
Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
3. Increased risk for Stevens-Johnson syndrome in Asian patients with the
HLA- B*1502 allele
4.
Patients who have the HLA-B*1502 allele being more likely to have a resistance to
carbamazepine
9. A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the
body may lead to:
1.
Decreased effectiveness of irinotecan in the treatment of cancer
2. Increased adverse drug reactions, such as neutropenia
3.
Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
4.
Increased concerns for irinotecan being carcinogenic
10. Patients who have a poor metabolism phenotype will have:
1. Slowed metabolism of a prodrug into an active drug, leading to
accumulation of prodrug
2.
Accumulation of inactive metabolites of drugs
3.
A need for increased dosages of medications
4.
Increased elimination of an active drug
11. Ultra-rapid metabolizers of drugs may have:
1.
To have dosages of drugs adjusted downward to prevent drug accumulation
2. Active drug rapidly metabolized into inactive metabolites, leading to
potential therapeutic failure
3.
Increased elimination of active, nonmetabolized drug
4.
Slowed metabolism of a prodrug into an active drug, leading to an accumulation of
prodrug
12. A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer
to:
1.
Ensure the patient will not have increased adverse drug reactions to the tamoxifen
2.
Identify potential drug–drug interactions that may occur with tamoxifen
3. Reduce the likelihood of therapeutic failure with tamoxifen treatment
4.
Identify poor metabolizers of tamoxifen
, NURS 6013 EXAM:An Introduction to Pharmacogenomics
QUESTIONS WITH ANSWERS 2023
Chapter 7. Nutrition and Nutraceuticals
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The most frequent type of drug–food interaction is food:
1.
Causing increased therapeutic drug levels
2.
Affecting the metabolism of the drug
3.
Altering the volume of distribution of drugs
4. Affecting the gastrointestinal absorption of drugs
2. Food in the gastrointestinal tract affects drug absorption by:
1.
Altering the pH of the colon, which decreases absorption
2.
Competing with the drug for plasma proteins
3. Altering gastric emptying time
4.
Altering the pH of urine
3. Food can alter the pH of the stomach, leading to:
1.
Enhanced drug metabolism
2.
Altered vitamin K absorption
3.
Increased vitamin D absorption
4. Altered drug bioavailability
4. Fasting for an extended period can:
1.
Increase drug absorption due to lack of competition between food and the drug
2.
Alter the pH of the gastrointestinal tract, affecting absorption
3. Cause vasoconstriction, leading to decreased drug absorption
4.
Shrink the stomach, causing decreased surface area for drug absorption
5. Tetracycline needs to be given on an empty stomach because it chelates with:
1.
Calcium
2.
Magnesium
3.
Iron
4. All of the above
6. A low-carbohydrate, high-protein diet may:
1. Increase drug-metabolizing enzymes
2.
Decrease drug absorption from the gastrointestinal (GI) tract
3.
Alter drug binding to plasma proteins
4.
Enhance drug elimination
7. Grapefruit juice contains furanocoumarins that have been found to:
1.
Alter absorption of drugs through competition for binding sites
2. Inhibit CYP3A4, leading to decreased first-pass metabolism of drugs
3.
Alter vitamin K metabolism, leading to prolonged bleeding
4.
Enhance absorption of calcium and vitamin D
QUESTIONS WITH ANSWERS 2023
Chapter 6.
1. Genetic polymorphisms account for differences in metabolism, including:
1.
Poor metabolizers, who lack a working enzyme
2.
Intermediate metabolizers, who have one working, wild-type allele and one mutant
allele
3.
Extensive metabolizers, with two normally functioning alleles
4. All of the above
2. Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
1.
A need to monitor drugs metabolized by 2D6 for toxicity
2. Increased dosages needed of drugs metabolized by 2D6, such as the
selective serotonin reuptake inhibitors
3.
Decreased conversion of codeine to morphine by CYP2D6
4.
The need for lowered dosages of drugs, such as beta blockers
3. Rifampin is a nonspecific CYP450 inducer that may:
1.
Lead to toxic levels of rifampin and so must be monitored closely
2.
Cause toxic levels of drugs, such as oral contraceptives, when coadministered
3. Induce the metabolism of drugs, such as oral contraceptives, leading
to therapeutic failure
4.
Cause nonspecific changes in drug metabolism
4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
1.
Decreased therapeutic levels of quinidine
2.
Increased therapeutic levels of quinidine
3. Decreased levels of a coadministered drug, such as digoxin, that requires
P- glycoprotein for absorption and elimination
4.
Increased levels of a coadministered drug, such as digoxin, that requires P-
glycoprotein for absorption and elimination
5. Warfarin resistance may be seen in patients with a VKORC1 mutation, leading to:
1.
Toxic levels of warfarin building up
2. Decreased response to warfarin
3.
Increased risk for significant drug interactions with warfarin
4.
Less risk of drug interactions with warfarin
6. Genetic testing for a VKORC1 mutation to assess potential warfarin resistance is required prior to
prescribing warfarin.
1.
True
2. False
7. Pharmacogenetic testing is required by the U.S. Food and Drug Administration prior to prescribing:
1.
Erythromycin
,NURS 6013 EXAM:An Introduction to Pharmacogenomics
QUESTIONS WITH ANSWERS 2023
2.
Digoxin
3. Cetuximab
4.
Rifampin
8. Carbamazepine has a black box warning recommending testing for the HLA-B*1502 allele in
patients with Asian ancestry prior to starting therapy due to:
1.
Decreased effectiveness of carbamazepine in treating seizures in Asian patients
with the HLA-B*1502 allele
2.
Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
3. Increased risk for Stevens-Johnson syndrome in Asian patients with the
HLA- B*1502 allele
4.
Patients who have the HLA-B*1502 allele being more likely to have a resistance to
carbamazepine
9. A genetic variation in how the metabolite of the cancer drug irinotecan SN-38 is inactivated by the
body may lead to:
1.
Decreased effectiveness of irinotecan in the treatment of cancer
2. Increased adverse drug reactions, such as neutropenia
3.
Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
4.
Increased concerns for irinotecan being carcinogenic
10. Patients who have a poor metabolism phenotype will have:
1. Slowed metabolism of a prodrug into an active drug, leading to
accumulation of prodrug
2.
Accumulation of inactive metabolites of drugs
3.
A need for increased dosages of medications
4.
Increased elimination of an active drug
11. Ultra-rapid metabolizers of drugs may have:
1.
To have dosages of drugs adjusted downward to prevent drug accumulation
2. Active drug rapidly metabolized into inactive metabolites, leading to
potential therapeutic failure
3.
Increased elimination of active, nonmetabolized drug
4.
Slowed metabolism of a prodrug into an active drug, leading to an accumulation of
prodrug
12. A provider may consider testing for CYP2D6 variants prior to starting tamoxifen for breast cancer
to:
1.
Ensure the patient will not have increased adverse drug reactions to the tamoxifen
2.
Identify potential drug–drug interactions that may occur with tamoxifen
3. Reduce the likelihood of therapeutic failure with tamoxifen treatment
4.
Identify poor metabolizers of tamoxifen
, NURS 6013 EXAM:An Introduction to Pharmacogenomics
QUESTIONS WITH ANSWERS 2023
Chapter 7. Nutrition and Nutraceuticals
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The most frequent type of drug–food interaction is food:
1.
Causing increased therapeutic drug levels
2.
Affecting the metabolism of the drug
3.
Altering the volume of distribution of drugs
4. Affecting the gastrointestinal absorption of drugs
2. Food in the gastrointestinal tract affects drug absorption by:
1.
Altering the pH of the colon, which decreases absorption
2.
Competing with the drug for plasma proteins
3. Altering gastric emptying time
4.
Altering the pH of urine
3. Food can alter the pH of the stomach, leading to:
1.
Enhanced drug metabolism
2.
Altered vitamin K absorption
3.
Increased vitamin D absorption
4. Altered drug bioavailability
4. Fasting for an extended period can:
1.
Increase drug absorption due to lack of competition between food and the drug
2.
Alter the pH of the gastrointestinal tract, affecting absorption
3. Cause vasoconstriction, leading to decreased drug absorption
4.
Shrink the stomach, causing decreased surface area for drug absorption
5. Tetracycline needs to be given on an empty stomach because it chelates with:
1.
Calcium
2.
Magnesium
3.
Iron
4. All of the above
6. A low-carbohydrate, high-protein diet may:
1. Increase drug-metabolizing enzymes
2.
Decrease drug absorption from the gastrointestinal (GI) tract
3.
Alter drug binding to plasma proteins
4.
Enhance drug elimination
7. Grapefruit juice contains furanocoumarins that have been found to:
1.
Alter absorption of drugs through competition for binding sites
2. Inhibit CYP3A4, leading to decreased first-pass metabolism of drugs
3.
Alter vitamin K metabolism, leading to prolonged bleeding
4.
Enhance absorption of calcium and vitamin D
