PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSE PRESCRIBERS, QUESTIONS & ANSWERS FULLY ANALYSED EDITION EXAM 100% CORRECTLY/VERIFIED ANSWERS WITH SATISFACTION GUARANTEED SUCCESS LATEST UPDATE 2023/2024 5TH EDITION WOO ROBINSON TEST BANK GRADED A+

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Chapter 1. v v



An Introduction to Pharmacogenetics
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Multiple Choice v


Identify the choice that best completes the statement or answers the question.
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v 1. Genetic polymorphisms account for differences in metabolism, including:
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1. Poor metabolizers, who lack a working enzyme
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2. Intermediate metabolizers, who have one working, wild-type allele and one mutantv v v v v v v v v v


3. Extensive metabolizers, with two normally functioning alleles
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4. All of the above v v v




v 2. Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
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1. A need to monitor drugs metabolized by 2D6 for toxicity
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2. Increased dosages needed of drugs metabolized by 2D6, such as the s
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elective serotoreuptake inhibitors v v v


3. Decreased conversion of codeine to morphine by CYP 2D6 v v v v v v v v


4. The need for lowered dosages of drugs, such as beta blockers
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v 3. Rifampin is a nonspecific CYP450 inducer that may:
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1. Lead to toxic levels of rifampin and must be monitored closely
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2. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
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3. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic
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4. Cause nonspecific changes in drug metabolism
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v 4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
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1. Decreased therapeutic levels of quinidine v v v v


2. Increased therapeutic levels of quinidine v v v v


3. Decreased levels of a coadministered drug, such as digoxin, that req
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uires P-glycoprabsorption and elimination
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4. Increased levels of a coadministered drug, such as digoxin, that requi
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res P-glycoproabsorption and elimination
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v 5. Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
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1. Toxic levels of warfarin building upv v v v v


2. Decreased response to warfarin v v v

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3. Increased risk for significant drug interactions with warfarin
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4. Less risk of drug interactions with warfarin
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v

6. Genetic testing for VCORC1 mutation to assess potential warfari
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n resistance is requiredprior to prescribing warfarin.
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1. True
2. False
v

7. Pharmacogenetic testing is required by the U.S. Food and Drug
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Administration prior toprescribing: v v v


1. Erythromycin
2. Digoxin
3. Cetuximab

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4. Rifampin
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8. Carbamazepine has a Black Box Warning recommending testing for
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the HLA-
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B*1502 allelein patients with Asian ancestry prior to starting therapy due
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to:
1. Decreased effectiveness of carbamazepine in treating seizures in Asian patients wit
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HLA-B*1502 allele v


2. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
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3. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 a
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4. Patients who have the HLA- v v v v


B*1502 allele being more likely to have a resistance tocarbamazepin
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e
v

9. A genetic variation in how the metabolite of the cancer dru
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g irinotecan SN-38 isinactivated by the body may lead to:
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1. Decreased effectiveness of irinotecan in the treatment of cancer
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2. Increased adverse drug reactions, such as neutropenia v v v v v v


3. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
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4. Increased concerns for irinotecan being carcinogenic v v v v v




v 10. Patients who have a poor metabolism phenotype will have:
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1. Slowed metabolism of a prodrug into an active drug, leading to accumulation of pr
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2. Accumulation of inactive metabolites of drugs v v v v v


3. A need for increased dosages of medications
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4. Increased elimination of an active drug v v v v v




v 11. Ultra-rapid metabolizers of drugs may have:
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1. To have dosages of drugs adjusted downward to prevent drug accumulation
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2. Active drug rapidly metabolized into inactive metabolites, leading to
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potential therafailure v v


3. Increased elimination of active, nonmetabolized drug v v v v v


4. Slowed metabolism of a prodrug into an active drug, leading to an accumulation of
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v

12. A provider may consider testing for CYP2D6 variants prior to
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starting tamoxifen forbreast cancer to:
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1. Ensure the patient will not have increased adverse drug reactions to the tamoxifen
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2. Identify potential drug-drug interactions that may occur with tamoxifen
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3. Reduce the likelihood of therapeutic failure with tamoxifen treatment
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4. Identify poor metabolizers of tamoxifen
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