Pharmacology Foundations for the AANP FNP exam
Pharmacology is woven through 30 to 40 percent of the exam. This chapter covers the foundational rules: pregnancy safety, Beers Criteria, and key drug interactions. This chapter has 26 topics, a video lecture, an audio lesson, clinical scenarios, exam pearls and a quiz.
What you will learn
- Memorize medications safe vs avoid in pregnancy
- Master the high-yield Beers Criteria entries
- Recognize common drug-drug interactions tested by AANP
- Understand renal and hepatic dose-adjustment principles
Topics in this chapter
- Pregnancy and lactationDrugs to avoid, drugs that are safe, the PLLR replacement of letter categories, lactation considerations.
- Beers Criteria (drugs to avoid in elderly)High-yield Beers Criteria entries: drugs to avoid in adults 65+, with the alternative for each.
- Major drug-drug interactionsMajor drug-drug interactions that get tested: warfarin, statins, MAOI, serotonin syndrome.
- Renal and hepatic dosingeGFR thresholds for common drugs, hepatic dose adjustments, Child-Pugh basics.
- Antibiotics by classAntibiotic classes by mechanism, when to use which, AANP-favorite spectrum questions.
- Pain management & opioid safetyWHO pain ladder, opioid prescribing safety, MMEs, naloxone, PMP checks, NSAID rules.
- Anticoagulant reversalHow to reverse warfarin, DOACs, heparin, and antiplatelets in bleeding emergencies.
- CYP450 inducers & inhibitorsCYP450 inducers and inhibitors that the exam tests, with practical impact on common drugs.
- High-yield adverse drug reactionsHigh-yield adverse drug reactions to recognize on the exam: classic patterns and culprit drugs.
- Controlled substances & prescribing rulesDEA schedules, refill rules, e-prescribing, opioid-use-disorder treatment, prescribing across state lines.
- Toxicology and antidotesHigh-yield poisoning patterns and their specific antidotes. Acetaminophen, opioid, benzo, anticholinergic, beta-blocker, etc.
- Therapeutic drug monitoringTherapeutic drug monitoring: targets, timing, and toxicity for vancomycin, digoxin, lithium, theophylline, AED levels.
- Drug-food interactionsDrug-food interactions tested on every exam: warfarin/vit K, MAOI/tyramine, grapefruit, dairy/tetracycline, statin/grapefruit.
- Pediatric drug dosingWeight-based pediatric dosing, age-related PK differences, formulations, drugs to avoid in children.
- Drug allergies & desensitizationIgE vs non-IgE drug allergies, true PCN allergy, cross-reactivity, SCAR recognition, anaphylaxis treatment.
- Vaccinations across the lifespanAdult immunization schedule, contraindications, live vs inactivated, post-exposure prophylaxis, vaccines in pregnancy.
- Polypharmacy & deprescribingPolypharmacy in elderly, deprescribing approach, anticholinergic burden, transitions of care.
- The Rights of Medication AdministrationThe classic Five Rights plus the additional rights, what each one actually checks at the point of care, and why the exam frames errors around them.
- Drugs That Require Eye MonitoringMedications that demand baseline and periodic eye exams, the specific toxicity each one causes, and the monitoring interval the exam expects you to recognize.
- OTC Cold, Cough, and Sinus MedicinesWhat is actually in OTC cold and cough combinations, the trap of topical nasal decongestants, and the firm pediatric cautions the exam expects.
- Core Drug Classes You Should Reason About by ClassClass-level teaching for antihistamines, beta-blockers, calcium channel blockers, diuretics, glucocorticoids, and clindamycin, so you reason by class instead of memorizing drugs one at a time.
- ARNI, First-Pass Effect, and Drug ExcretionNeprilysin inhibition in ARNI therapy, what the first-pass effect means for dosing, and how drugs leave the body, all of which the exam tests as pharmacokinetic reasoning.
- Immunosuppressants, Biologics, and Herbal SupplementsA practical overview of immunosuppressants and biologics including their universal infection risk, plus the herbal supplements that cause real drug interactions.
- Salicylate (Aspirin) Toxicity and Aspirin's Antiplatelet RoleHow salicylate poisoning presents as the classic mixed acid-base picture, why tinnitus is the early clue, the Reye syndrome caution in children, and how aspirin's irreversible platelet effect drives both its cardioprotective use and its bleeding risk.
- Tetracyclines as a Drug Class (Doxycycline, Minocycline)Tetracyclines as a class, with the counseling points the exam reliably tests: photosensitivity, chelation by dairy and metal cations, the firm contraindication in pregnancy and in children under 8, and pill-induced esophagitis.
- Direct Renin Inhibitors (Aliskiren) Within the RAAS DrugsWhere aliskiren, the only direct renin inhibitor, sits within the RAAS drug family, what it shares with ACE inhibitors and ARBs, and the firm rule against combining RAAS agents.
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Last updated November 4, 2026. Verify exam details against the official AANPCB Candidate Handbook before exam day.