PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSE II II II II
PRESCRIBERS,QUESTIONS & ANSWERS FULLY ANALYSED EDITION EXAM 100%
II II II II II II II II
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II II II II II II
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II II II II II I II II II II
Chapter 1. II II
An Introduction to Pharmacogenetics
II II II
Multiple Choice II
Identify the choice that best completes the statement or answers the question.
II II II II II II II II II II II
II 1. Genetic polymorphisms account for differences in metabolism, including:
II II III II II II II II II II II
1. Poor metabolizers, who lack a working enzyme
II II II II II II
2. Intermediate metabolizers, who have one working, wild-type allele and one mutant II II II II II II II II II II
3. Extensive metabolizers, with two normally functioning alleles II II II II II II
4. All of the above
II II II
II 2. Up to 21% of Asians are ultra-rapid 2D6 metabolizers, leading to:
II II III II II II II II II II II II II II
1. A need to monitor drugs metabolized by 2D6 for toxicity
II II II II II II II II II
2. Increased dosages needed of drugs metabolized by 2D6, such as the II II II II II II II II II II
selective serotoreuptake inhibitors
II II I II
3. Decreased conversion of codeine to morphine by CYP 2D6 II II II II II II II II
4. The need for lowered dosages of drugs, such as beta blockers
II II II II II II II II II II
II 3. Rifampin is a nonspecific CYP450 inducer that may:
II II III II II II II II II II II
1. Lead to toxic levels of rifampin and must be monitored closely
II II II II II II II II II II
2. Cause toxic levels of drugs, such as oral contraceptives, when coadministered
II II II II II II II II II II
3. Induce the metabolism of drugs, such as oral contraceptives, leading to therapeutic
II II II II II II II II II II II
4. Cause nonspecific changes in drug metabolism
II II II II II
II 4. Inhibition of P-glycoprotein by a drug such as quinidine may lead to:
II II III II II II II II II II II II II II II
1. Decreased therapeutic levels of quinidine II II II II
2. Increased therapeutic levels of quinidine II II II II
3. Decreased levels of a coadministered drug, such as digoxin, that II II II II II II II II II
, PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSE II II II II
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II II II II II II II II
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II II II II II II
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II II II II II I II II II II
II requires P-glycoprabsorption and elimination
II I II II
4. Increased levels of a coadministered drug, such as digoxin, that
II II II II II II II II II
II requires P-glycoproabsorption and elimination
II I II II
II 5. Warfarin resistance may be seen in patients with VCORC1 mutation, leading to:
II II III II II II II II II II II II II II II
1. Toxic levels of warfarin building up
II II II II II
2. Decreased response to warfarin II II II
3. Increased risk for significant drug interactions with warfarin
II II II II II II II
4. Less risk of drug interactions with warfarin
II II II II II II
II 6. Genetic testing for VCORC1 mutation to assess potential warfarin
II II III II II II II II II II II II
II resistance is requiredprior to prescribing warfarin.
II II I II II II
1. True
2. False
II 7. Pharmacogenetic testing is required by the U.S. Food and Drug
II II III II II II II II II II II II II
Administration prior toprescribing:
II II II I
1. Erythromycin
2. Digoxin
3. Cetuximab
, PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSE II II II II
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II II II II II II II II
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II II II II II II
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II II II II II I II II II II
4. Rifampin
II 8. Carbamazepine has a Black Box Warning recommending testing for the
II II III II II II II II II II II II II
HLA-B*1502 allelein patients with Asian ancestry prior to starting
II II I II II II II II II II
II therapy due to: II II
1. Decreased effectiveness of carbamazepine in treating seizures in Asian patients wit
II II II II II II II II II II
HLA-B*1502 allele II
2. Increased risk for drug interactions in Asian patients with the HLA-B*1502 allele
II II II II II II II II II II II
3. Increased risk for Stevens-Johnson syndrome in Asian patients with HLA-B*1502 a
II II II II II II II II II II
4. Patients who have the HLA-B*1502 allele being more likely to have
II II II II II II II II II II
II a resistance tocarbamazepine
II II I
II 9. A genetic variation in how the metabolite of the cancer drug
II II III II II II II II II II II II II II
II irinotecan SN-38 isinactivated by the body may lead to:
II II I II II II II II II
1. Decreased effectiveness of irinotecan in the treatment of cancer
II II II II II II II II
2. Increased adverse drug reactions, such as neutropenia II II II II II II
3. Delayed metabolism of the prodrug irinotecan into the active metabolite SN-38
II II II II II II II II II II
4. Increased concerns for irinotecan being carcinogenic II II II II II
II 10. Patients who have a poor metabolism phenotype will have:
III II II II II II II II II II
1. Slowed metabolism of a prodrug into an active drug, leading to accumulation of pr
II II II II II II II II II II II II II
2. Accumulation of inactive metabolites of drugs II II II II II
3. A need for increased dosages of medications
II II II II II II
4. Increased elimination of an active drug II II II II II
II 11. Ultra-rapid metabolizers of drugs may have:
III II II II II II II
1. To have dosages of drugs adjusted downward to prevent drug accumulation
II II II II II II II II II II
2. Active drug rapidly metabolized into inactive metabolites, leading
II II II II II II II
II to potential therafailure
II II I
, PHARMACOTHERAPEUTICS FOR ADVANCED PRACTICE NURSE II II II II
PRESCRIBERS,QUESTIONS & ANSWERS FULLY ANALYSED EDITION EXAM 100%
II II II II II II II II
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II II II II II II
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II II II II II I II II II II
3. Increased elimination of active, nonmetabolized drug
II II II II II
4. Slowed metabolism of a prodrug into an active drug, leading to an accumulation of
II II II II II II II II II II II II II
II 12. A provider may consider testing for CYP2D6 variants prior to
III II II II II II II II II II II
II starting tamoxifen forbreast cancer to:
II II I II II
1. Ensure the patient will not have increased adverse drug reactions to the tamoxifen
II II II II II II II II II II II II
2. Identify potential drug-drug interactions that may occur with tamoxifen
II II II II II II II II
3. Reduce the likelihood of therapeutic failure with tamoxifen treatment
II II II II II II II II
4. Identify poor metabolizers of tamoxifen
II II II II
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