Midterm Exam: NR566/ NR 566 Advanced
Pharmacology Care of the Family Exam | Questions and Verified Answers (2025/ 2026 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 d/t 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 CYP450 inducers pneumonic - ANSWER "Bullshit Crap GPS INDUCES rage" CYP450 inducer drug names - ANSWER Barbituates, St John wort, Carbamazepine, rifampin, alcohol, phenytoin, griseofulvin, phenobarbital, sulfonylureas 1 / 4
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 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 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 2 / 4
Why is absorption of medication in the stomach increased in infancy? - ANSWER delayed gastric emptying Some medications that should be avoided in the pediatric patient? - ANSWER glucocorticoids, discoloration of developing teeth with tetracyclines, and 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 How can healthcare providers decrease likelihood of an elderly patient experiencing an adverse drug reaction? - ANSWER obtaining a thorough drug history that includes over-the-counter medications considering pharmacokinetic and pharmacodynamics changes due to age monitoring the patient's clinical response and plasma drug levels 3 / 4
using the simplest regimen possible monitoring for drug-drug interactions and iatrogenic illness periodically reviewing the need for continued drug therapy encouraging the patient to dispose of old medications taking steps to promote adherence and to avoid drugs on the Beers list How can we promote medication adherence with elderly patients? - ANSWER simplifying drug regimens providing clear and concise verbal and written instructions using an appropriate dosage form clearly labeling and dispensing easy-to-open containers developing daily reminders monitoring frequently affordability of drugs support systems Why do nitrates need to be taken no later than 4 PM? - ANSWER Need nitrate free interval so tolerance doesn't develop Nine factors that impact outcome of medication? - ANSWER Gender and race Genetics and pharmacogenomics Variability in absorption placebo effect Tolerance patho age bodyweight Do you need informed consent for genetic testing? - ANSWER yes
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