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Midterm Exam: NR565/ NR 565 Advanced
Pharmacology Care of the Fundamentals Exam | Questions and Verified ANSWERs (Update)- Chamberlain 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 due to rapid growth)
What is BEERS criteria?
ANSWER: Recommendations of medications inappropriate for
elderly (65 and older), prescriber ultimately decides
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
CYP450 inducers
ANSWER: Speed up metabolism of drugs (drug is cleared
faster), drug has lesser effect (decrease blood levels of drug), elevate CYP450 enzymes
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CYP450 inducers pneumonic
ANSWER: "Bullshit Crap GPS INDUCES rage"
CYP450 inducer drug names
ANSWER: Barbiturates, St John’s wort, Carbamazepine,
rifampin, alcohol, phenytoin, griseofulvin, phenobarbital, sulfonylureas
CYP450 inhibitors
ANSWER: Inhibit metabolism, increase blood levels of
medications
CYP450 pneumonic
ANSWER: "VISA credit card debt INHIBITS spending on
designers like CK to look GQ"
CYP450 inhibitors drug names
ANSWER: Valproate, isoniazid, sulfonamides, amiodarone,
chloramphenicol, ketoconazole, grapefruit juice, quinidine
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Physiological changes during pregnancy that impact pharmacodynamics and pharmacokinetic properties of drugs?
ANSWER: Increase glomerular filtration rate leads to increased
drug excretion, increase hepatic metabolism, decrease tone and motility of bowel, increase drug absorption
Examples of medications that can be teratogenic
ANSWER: Antiepileptic drugs, antimicrobials such as
tetracyclines and fluoroquinolones, vitamin A in large doses, some anticoagulants, and hormonal medications such as diethylstilbestrol (DES)
How is absorption of intramuscular medications different in neonates?
ANSWER: Slow and erratic due to low blood flow in muscles
first few days of life
Why is absorption of medication in the stomach increased in infancy?
ANSWER: Delayed gastric emptying
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Some medications that should be avoided in the pediatric patient?
ANSWER: Glucocorticoids, discoloration of developing teeth
with tetracyclines, kernicterus with sulfonamides, levofloxacin (antibiotics), aspirin (severe intoxication from acute overdose)
What should be included in medication administration patient education?
ANSWER: Dosage size and timing, route and technique of
administration, duration of treatment, drug storage, nature and time course of desired responses, nature and time course of adverse responses, finish taking antibiotic
What are some things that put the elderly patient at higher risk for adverse drug reactions?
ANSWER: Reduced renal function, polypharmacy (the use of
five or more medications daily), greater severity of illness, presence of comorbidities, use of drugs that have a low therapeutic index (e.g., digoxin), increased individual variation secondary to altered pharmacokinetics, inadequate supervision of long-term therapy, poor patient adherence