2026 COMPREHENSIVE STUDY GUIDE SOLVED
QUESTION SET
◉ The route of administration with the highest bio-availability is.
Answer: Intravenous; putting entire dose into a patient's vein and
bypassing absorption. Intravenous route avoids first-pass metabolism in
the liver.
◉ rectal administration disadvantages. Answer: variable and erratic
absorption
◉ Steady state (SS). Answer: is usually reached within 4-5 half-lives of
a drug
◉ The half-life of a drug is defined as. Answer: how long it takes for
half the drug to be excreted from the body
◉ Half-life of a drug. Answer: Determines how frequently the drug must
be administered
Predicts how long toxic effects can last
Half-life is constant with first-order pharmacokinetics of a drug
,Zero-order (nonlinear) pharmacokinetics means a drug is metabolized at
a constant rate per unit time.
◉ CYP3A4 substrate drugs. Answer: May have enhanced activity if any
CYP3A4 inducer drugs are used along with it.
◉ Drug development steps (according to the FDA). Answer: Discovery:
laboratory research to develop the new drug
Pre-clinical research with animal testing for safety (Phase I)
Clinical research on human subjects for medication safety (Phase II)
Clinical research in humans comparing the new drug to accepted
medications or placebo depending on the study (Phase III)
FDA review of the results to determine approval
Post-marketing study to identify adverse effects not found in earlier
clinical studies (Phase IV)
◉ Medication safety organizations. Answer: The Institute for Safe
Medication Practices (ISMP)
,The Institute of Medicine (IOM)
The Joint Commission
The National Coordinating Council for Medication Error Reporting and
Prevention (NCCMERP)
Food and Drug Administration (FDA) Safe Use Initiative
◉ Adverse Drug Reactions (ADRs). Answer: Two basic type of ADRs:
pharmacological and idiosyncratic.
85% to 90% of ADRs are pharmacological.
Adverse drug reactions are usually preventable, frequently occur in a
hospital or nursing home setting, and include medication errors, adverse
drug effects, allergic and idiosyncratic type reactions.
ADRs are not commonly reported; the FDA does not mandate that ADRs
be reported.
, Polypharmacy involves using multiple healthcare providers for care,
using multiple medications, and using several pharmacies for
prescription filling.
◉ Cardiovascular-Angiotensin converting enzyme inhibitors (ACEIs):.
Answer: Lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril;
*ACEIs reduce blood pressure by suppressing the release of angiotensin-
converting enzyme.
*Important side effects of ACE inhibitors include cough and
angioedema; discontinue the ACEI if angioedema occurs.
◉ Angiotensin II receptor blocking agents (ARBs):. Answer:
Candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro),
losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan).
ARBs reduce blood pressure by blocking angiotensin II receptors.
◉ Cardiovascular-Essential (primary) hypertension. Answer: Accounts
for 90% of cases; secondary hypertension may be caused by chronic
renal failure.
◉ Nitroglycerin. Answer: nitrate drug used in the treatment of angina; a
nitrate drug that can be administered IV, SL, a topical ointment and as a
transdermal patch
◉ PDE-5 inhibitors. Answer: -Pulmonary hypertension therapy