NUR 354 PHARMACOLOGY FINAL PAPER
2026 QUESTIONS AND SOLUTIONS
EXAMPREP GRADED A+
▶ CYP450 Answer: · CYP: a set of isozymes primarily found in the liver
and GI tract
· Convert lipophilic drugs into more polar (and soluble) molecules
· Considerable genetic variability exists across race and gender
· Results in CYP450 polymorphisms which have a direct effect on drug
metabolism.
▶ Four isozymes are responsible for the majority of Phase I Metabolism
reactions Answer: 1. CYP3A4/5
2. CYP2D6
3. CYP2C8/9
4. CYP1A2
▶ If you have a patient experiencing a pharmacokinetic drug interaction,
consider...... Answer: CYP450.
▶ · Some drugs or exogenous substances can induce CYP isozymes (less
effect). Example.... Answer: St. John's wort (CYP3A4) and hormonal birth
control
▶ CYP450-related drug interactions can make predicting blood plasma
levels/steady state levels difficult.
Example.... Answer: If a drug inhibits enzymatic activity, a substrate drug
for that enzyme system will have a greater concentration in the blood.
▶ If a drug inhibits CYP isozymes, what is the effect of the substrate drug
Answer: The substrate drug will have greater effect
▶ Phase 2 Metabolism Answer: · Polar group is conjugated to the drug
· Results in increased polarity of the drug
,▶ Types of phase 2 metabolism reactions Answer: - Glycine conjugation
-Glucuronide conjugation
-Sulfate conjugation
▶ What is competitive antagonism? Answer: where one drug displaces
another on cell receptors.
▶ How is metabolism effected by different ethnic groups? Answer: Different
ethnic groups may have different hepatic metabolism rates
▶ Routes of elimination Answer: 1. Pulmonary = expired in the air (volatile
substances)
2. Bile = excreted in feces
3. Renal
-glomerular filtration
- tubular reabsorption
- tubular secretion
▶ Glomerular filtration rate (GFR) (Normal) Answer: 90-125L/min
▶ Most elimination involves..... Answer: renal function. (Renal blood flow,
creatinine clearance (CrCl) )
▶ Linear drug elimination Answer: Rate of elimination is proportional to
amount of drug present
▶ volatile drugs are excreted by the.... Answer: lungs
▶ Bioavailability Answer: A measure of the extent of drug absorption for a
given drug and route (from 0% to 100%).
▶ Which route of administration has the greatest bioavailability Answer:
intravenous, putting entire dose into a patients vein and bypassing
absorption.
▶ Which route of administration bypasses first-pass metabolism in the liver
Answer: intravenous
▶ Which method of administration has variable and erratic absorption
Answer: rectal
,▶ What is a half-life? Answer: the time required for serum plasma
concentrations to decrease by one-half, 50%
▶ When is a steady state reached? Answer: after 4-5 half lives
▶ What is zero-order (nonlinear) pharmacokinetics Answer: a drug is
metabolized at a constant rate per unit time
▶ Why is help life important Answer: -determines how frequently a drug
must be administered.
-predicts how long toxic effects can last (when the drug is over the
minimum toxic level)
▶ what is Michaelis-menten pharmacokinetics Answer: the rate of drug
elimination is directly proportional to the concentration of free drug
▶ Why is peak and trough measured Answer: to see if a drug is within its
therapeutic range
▶ What is narrow therapeutic index Answer: when the difference between
effective dose and a toxic blood level is small
▶ what is a wide therapeutic index? Answer: Greater distance between
effective dose and toxic dose, requires less intense monitoring
▶ what is drug potency Answer: the concentration needed to produce
measurable effect
▶ what is the onset of action Answer: the point in time when the drug's
blood concentration level elicits a response, the first indication that the drug
is having a therapeutic effect
▶ What is bioequivalence? Answer: Two drugs that demonstrate
comparable bioavailability and similar times to achieve peak blood
concentrations
▶ what is therapeutic equivalent Answer: Drug products are considered to
be therapeutic equivalents only if they are pharmaceutical equivalents and
, if they can be expected to have the same clinical effect and safety profile
when administered to patients.
example: ACE inhibitors (lisinopril, ramipril)
▶ what is therapeutic index Answer: Ratio of a drug's toxic level to the level
that provides therapeutic benefits
Calculation LD 50 / ED 50
▶ What is margin of safety Answer: The margin between the therapeutic
and lethal doses of a drug
▶ Why are loading doses given? Answer: reach a therapeutic effect
quicker
▶ Examples of medications with loading doses Answer: aminoglycosides
(gentamicin) or azithromycin, digoxin
▶ Do loading doses altered for patient metabolism or elimination Answer:
No. Loading doses are the same for every patient
▶ What initiates biochemical reactions Answer: Drugs bind to cellular
receptors. Pharmacological effect is due to the alteration of an intrinsic
physiological process and not the creation of a new process.
▶ Example of the actions that can occur when a drug binds to a receptor
Answer: -ion channel is opened or closed
-second messenger is activated (cAMP, cGMP, inositol phosphate, initiates
a series of reactions
-normal cellular function is inhibited
-cellular function is "turned on"
▶ What is affinity? Answer: refers to the strength of the attraction between
a drug and its receptor
*Number of occupied receptors is a function of a balance between bound
and free drug
▶ What is the dissociation constant (Kd) Answer: A measure of a drug's
affinity for a given receptor. It is the concentration of a drug required to
achieve 50% occupancy of its receptors
2026 QUESTIONS AND SOLUTIONS
EXAMPREP GRADED A+
▶ CYP450 Answer: · CYP: a set of isozymes primarily found in the liver
and GI tract
· Convert lipophilic drugs into more polar (and soluble) molecules
· Considerable genetic variability exists across race and gender
· Results in CYP450 polymorphisms which have a direct effect on drug
metabolism.
▶ Four isozymes are responsible for the majority of Phase I Metabolism
reactions Answer: 1. CYP3A4/5
2. CYP2D6
3. CYP2C8/9
4. CYP1A2
▶ If you have a patient experiencing a pharmacokinetic drug interaction,
consider...... Answer: CYP450.
▶ · Some drugs or exogenous substances can induce CYP isozymes (less
effect). Example.... Answer: St. John's wort (CYP3A4) and hormonal birth
control
▶ CYP450-related drug interactions can make predicting blood plasma
levels/steady state levels difficult.
Example.... Answer: If a drug inhibits enzymatic activity, a substrate drug
for that enzyme system will have a greater concentration in the blood.
▶ If a drug inhibits CYP isozymes, what is the effect of the substrate drug
Answer: The substrate drug will have greater effect
▶ Phase 2 Metabolism Answer: · Polar group is conjugated to the drug
· Results in increased polarity of the drug
,▶ Types of phase 2 metabolism reactions Answer: - Glycine conjugation
-Glucuronide conjugation
-Sulfate conjugation
▶ What is competitive antagonism? Answer: where one drug displaces
another on cell receptors.
▶ How is metabolism effected by different ethnic groups? Answer: Different
ethnic groups may have different hepatic metabolism rates
▶ Routes of elimination Answer: 1. Pulmonary = expired in the air (volatile
substances)
2. Bile = excreted in feces
3. Renal
-glomerular filtration
- tubular reabsorption
- tubular secretion
▶ Glomerular filtration rate (GFR) (Normal) Answer: 90-125L/min
▶ Most elimination involves..... Answer: renal function. (Renal blood flow,
creatinine clearance (CrCl) )
▶ Linear drug elimination Answer: Rate of elimination is proportional to
amount of drug present
▶ volatile drugs are excreted by the.... Answer: lungs
▶ Bioavailability Answer: A measure of the extent of drug absorption for a
given drug and route (from 0% to 100%).
▶ Which route of administration has the greatest bioavailability Answer:
intravenous, putting entire dose into a patients vein and bypassing
absorption.
▶ Which route of administration bypasses first-pass metabolism in the liver
Answer: intravenous
▶ Which method of administration has variable and erratic absorption
Answer: rectal
,▶ What is a half-life? Answer: the time required for serum plasma
concentrations to decrease by one-half, 50%
▶ When is a steady state reached? Answer: after 4-5 half lives
▶ What is zero-order (nonlinear) pharmacokinetics Answer: a drug is
metabolized at a constant rate per unit time
▶ Why is help life important Answer: -determines how frequently a drug
must be administered.
-predicts how long toxic effects can last (when the drug is over the
minimum toxic level)
▶ what is Michaelis-menten pharmacokinetics Answer: the rate of drug
elimination is directly proportional to the concentration of free drug
▶ Why is peak and trough measured Answer: to see if a drug is within its
therapeutic range
▶ What is narrow therapeutic index Answer: when the difference between
effective dose and a toxic blood level is small
▶ what is a wide therapeutic index? Answer: Greater distance between
effective dose and toxic dose, requires less intense monitoring
▶ what is drug potency Answer: the concentration needed to produce
measurable effect
▶ what is the onset of action Answer: the point in time when the drug's
blood concentration level elicits a response, the first indication that the drug
is having a therapeutic effect
▶ What is bioequivalence? Answer: Two drugs that demonstrate
comparable bioavailability and similar times to achieve peak blood
concentrations
▶ what is therapeutic equivalent Answer: Drug products are considered to
be therapeutic equivalents only if they are pharmaceutical equivalents and
, if they can be expected to have the same clinical effect and safety profile
when administered to patients.
example: ACE inhibitors (lisinopril, ramipril)
▶ what is therapeutic index Answer: Ratio of a drug's toxic level to the level
that provides therapeutic benefits
Calculation LD 50 / ED 50
▶ What is margin of safety Answer: The margin between the therapeutic
and lethal doses of a drug
▶ Why are loading doses given? Answer: reach a therapeutic effect
quicker
▶ Examples of medications with loading doses Answer: aminoglycosides
(gentamicin) or azithromycin, digoxin
▶ Do loading doses altered for patient metabolism or elimination Answer:
No. Loading doses are the same for every patient
▶ What initiates biochemical reactions Answer: Drugs bind to cellular
receptors. Pharmacological effect is due to the alteration of an intrinsic
physiological process and not the creation of a new process.
▶ Example of the actions that can occur when a drug binds to a receptor
Answer: -ion channel is opened or closed
-second messenger is activated (cAMP, cGMP, inositol phosphate, initiates
a series of reactions
-normal cellular function is inhibited
-cellular function is "turned on"
▶ What is affinity? Answer: refers to the strength of the attraction between
a drug and its receptor
*Number of occupied receptors is a function of a balance between bound
and free drug
▶ What is the dissociation constant (Kd) Answer: A measure of a drug's
affinity for a given receptor. It is the concentration of a drug required to
achieve 50% occupancy of its receptors
