principles of safe prescribing ?

Question 1

A drug’s mechanism of action is part of its:

Answer 1

Pharmacodynamics.

Question 2

The process of absorption, distribution, metabolism and elimination of a drug is known as:

Answer 2

Pharmacokinetics.

Question 3

Which of the following would best describe a pharmacodynamic study?

Answer 3

Determining the effect of a specific medication dose in treating a disease

Question 4

Cmax is best described as:

Answer 4

Maximum or peak concentration of a drug observed after its administration.

Question 5

When counseling a 56-year-old woman with type 2 diabetes mellitus, the NP mentions which of the following regarding the use of semaglutide?

Answer 5

The oral dose of the medication needed is quite high compared to the injectable for due to issues with GI absorption.

Question 6

Tmax is best defined as:

Answer 6

Time to maximum drug level is observed.

Question 7

In the development, testing, and approval of a new medication, which of the following best describes the question that is being asked in phase 3 testing?

Answer 7

Does the medication appear to have a clinical effect when subjected to a double-blind clinical trial?

Question 8

Age-related changes in the elder include all of the following except:

Answer 8

Increase in serum albumin.

Question 9

When considering the movement of drugs throughout the body, it is important to consider that the most common form of drug absorption is via:

Answer 9

Passive diffusion.

Question 10

The safety and pharmacokinetics of a new drug are best determined in which phase of clinical trials?

Answer 10

Phase 1

Question 11

Bioavailability is defined as the:

Answer 11

Fraction of the administered drug that reaches systemic circulation.

Question 12

A nursing mother is taking a medication with a 2-hour half-life and is concerned about her infant ingesting some of the drug through breastmilk. The NP knows that <10% of the original drug dose will remain in the body after how many hours following her dose?

Answer 12

8

Question 13

Drugs that are antagonists exhibit clinical action primarily by:

Answer 13

Occupying a receptor site and inhibiting its endogenous activity.

Question 14

In advising a 40-year-old woman who is taking ciprofloxacin with a calcium-containing antacid, which of the following statement is correct?

Answer 14

The clinical effect of the antimicrobial will be reduced via chelation if the two medications are taken together.

Question 15

Which of the following is not a requirement for a medication to be delivered transdermally?

Answer 15

pH <4 in aqueous medium

Question 16

A 37-year-old woman with a history of migraines requests a migraine treatment. She describes that her migraines tend to develop slowly and will last several hours. The NP recommends which of the following triptans?

Answer 16

Frovatriptan

Question 17

Agonist drugs work primarily by:

Answer 17

Stimulating the activity of a receptor site.

Question 18

Of the following drug characteristics, which contributes significantly to the difference in the HMG-CoA reductase inhibitors (the statins) potencies?

Answer 18

Bioavailability and half-life

Question 19

The biotransformation and/or excretion of an oral drug by hepatic mechanisms prior to entering the GI tract is known as:

Answer 19

First pass effect.

Question 20

When counseling a 58-year-old woman on the use of levothyroxine, the NP advises that the medication:

Answer 20

Should be taken on an empty stomach.

Question 21

When counseling a 58-year-old woman on the use of levothyroxine, the NP advises that the medication:

Answer 21

Should be taken on an empty stomach.

Question 22

The most commonly utilized CYP 450 isoenzyme for drug metabolism or biotransformation is:

Answer 22

3A4.

Question 23

Which of the following medications is considered to have a wide therapeutic index and would not require therapeutic drug monitoring?

Answer 23

Fluoxetine

Question 24

Which of the following statins would be preferred for a 67-year-old man with hypercholesterolemia and who likes to have a glass of grapefruit juice every morning?

Answer 24

Pravastatin

Question 25

When developing a plan of care to minimize drug-drug interaction risk in 64-year-old man with atrial fibrillation and taking warfarin, the NP pays particular attention to avoiding medications that inhibit CYP450:

Answer 25

2C9.

Question 26

All of the following are potential signs of Torsades de Pointe except:

Answer 26

Vertigo

Question 27

A 57-year-old woman with a history of intracerebral hemorrhage and who is taking warfarin requires treatment with metronidazole. Aside from close clinical monitoring and periodic checking of INR, the NP considers which of the following adjustments to therapy?

Answer 27

Decrease the warfarin dose by 25% for the duration of antimicrobial therapy

Question 28

A 42-year-old man is taking indinavir for HIV infection. He mentions that he wishes to start taking St. John’s wort to help with some depression he has been feeling lately. The NP advises:

Answer 28

St. John’s wort will decrease the effectiveness of the antiviral.

Question 29

A 63-year-old man with a history of ventricular arrhythmia is diagnosed with community-acquired pneumonia. Which of the following oral medications should be avoided due to the risk of QT prolongation?

Answer 29

Moxifloxacin

Question 30

Which of the following statements is most accurate regarding the use of azithromycin and cardiovascular death?

Answer 30

An increased risk of cardiovascular death with azithromycin is likely limited to high-risk patient populations.

Question 31

Which of the following medications is considered to have a wide therapeutic index and would not require therapeutic drug monitoring?

Answer 31

Fluoxetine

Question 31

Which of the following statements is most accurate regarding the use of azithromycin and cardiovascular death?

Answer 31

An increased risk of cardiovascular death with azithromycin is likely limited to high-risk patient populations.

Question 31

Which of the following is a known risk factor for Torsades de Pointe with the use of a QT-prolonging medication?

Answer 31

Older age

Question 31

Which of the following statins would be preferred for a 67-year-old man with hypercholesterolemia and who likes to have a glass of grapefruit juice every morning?

Answer 31

Pravastatin

Question 32

In the development, testing, and approval of a new medication, which of the following best describes the question that is being asked in phase 3 testing?

Answer 32

Does the medication appear to have a clinical effect when subjected to a double-blind clinical trial?

Question 32

When developing a plan of care to minimize drug-drug interaction risk in 64-year-old man with atrial fibrillation and taking warfarin, the NP pays particular attention to avoiding medications that inhibit CYP450:

Answer 32

2C9.

Question 32

A 42-year-old man is taking indinavir for HIV infection. He mentions that he wishes to start taking St. John’s wort to help with some depression he has been feeling lately. The NP advises:

Answer 32

St. John’s wort will decrease the effectiveness of the antiviral.

Question 32

A 57-year-old woman with a history of intracerebral hemorrhage and who is taking warfarin requires treatment with metronidazole. Aside from close clinical monitoring and periodic checking of INR, the NP considers which of the following adjustments to therapy?

Answer 32

Decrease the warfarin dose by 25% for the duration of antimicrobial therapy

Question 32

When considering the movement of drugs throughout the body, it is important to consider that the most common form of drug absorption is via:

Answer 32

Passive diffusion.

Question 32

All of the following are potential signs of Torsades de Pointe except:

Answer 32

Vertigo

Question 32

Age-related changes in the elder include all of the following except:

Answer 32

Increase in serum albumin.