©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
NURS 549 Pharm Midterm Exam Study
Guide
Pharmacokinetics - Ans:✔✔-What the body does to the drug once administered
Pharmacodynamics - Ans:✔✔-The actions of a drug on the body
Absorption - Ans:✔✔-The transfer of the drug from the site of administration to the bloodstream
Distribution - Ans:✔✔-The process by which the drug leaves the blood stream and enters the interstitial
and then tissue cells
Metabolism - Ans:✔✔-The drug is broken down to metabolites in the tissues
Elimination - Ans:✔✔-Removal of drug from the body via bile, urine
Which drugs passively diffuse across membranes most easily: Un-ionized, lipid-soluble drugs OR ionized,
water-soluble drugs? - Ans:✔✔-Un-ionized, lipid soluble drugs
What drugs are easily eliminated via the kidney? - Ans:✔✔-Ionized, water soluble forms of drug
Page 1/53
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Where are weakly acidic drugs better absorbed? - Ans:✔✔-In the acidic media of the stomach drug will
remain protonated (un-ionized, lipid soluble)
Where will weakly basic drugs be better absorbed? - Ans:✔✔-In the basic media of the small intestine
the drug will remain protonated (un-ionized)
Where is drug absorption most efficient? Stomach, SI or LI? - Ans:✔✔-The small intestine, as it has the
largest surface area and blood flow
First pass effect - Ans:✔✔-The initial metabolism in the liver of a drug absorbed from the gastrointestinal
tract before the drug reaches systemic circulation through the bloodstream.
Oral bioavailability & relation to first pass effect - Ans:✔✔-The fraction of an administered drug that
reaches the systemic circulation after oral administration. High first pass effect, low oral bioavailability
Bioavailability = (AUC oral / AUC injected) x 100
SubQ versus IM absorption - Ans:✔✔-SubQ tissue has less vascularity than muscle tissue. IM absorption
is faster
Rectal administration - Ans:✔✔-Avoids liver biotransformation. 50% of drainage from rectal region
bypasses portal circulation
Page 2/53
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Drugs that are unstable in the acidic environment of the stomach and have 0% bioavailability - Ans:✔✔-
Insulin, Penicillin G
Bioequivalence - Ans:✔✔-Two drugs have comparable bioavailability (similar time to peak blood
concentration)
Pharmaceutical equivalence - Ans:✔✔-Drugs with the same active ingredient, same dosage form, same
route, identical in strength/concentration
Therapeutic equivalence - Ans:✔✔-Pharmaceutical equivalents with the same clinical effect and safety
profile
Drug distribution depends on... - Ans:✔✔-Cardiac output
Regional blood flow
Capillary permeability
Degree of drug binding to plasma and tissue proteins (drug that binds to albumin may not distribute.
rugs that bind tissue proteins may have prolonged effect)
Volume of distribution (Vd) - Ans:✔✔-Hypothetical volume of fluid into which the drug is disseminated -
numeric value based on liters, patient independent marker
Page 3/53
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Types of drugs with low Vd, higher Vd, and highest Vd - Ans:✔✔-Low Vd = hydrophilic, large molecular
weight, plasma protein-bound drugs that remain in plasma compartment
Higher Vd = hydrophilic, low molecular weight, non-plasma bound drug, distributes to plasma and
interstitium
Highest Vd = Lipophilic, low molecular weight, non-plasma bound drug, distributes to plasma,
interstitium, and intracellular fluid
First order kinetics - Ans:✔✔-Non-linear, exponential elimination of drugs. A constant fraction of drug is
metabolized per unit of time. Rate increases concentration increases. Applies to vast majority of drugs
Zero order kinetics - Ans:✔✔-A constant amount of drug is eliminated per unit time. Elimination is linear,
independent and non-proportional to drug concentration. All enzymes are saturated, at max capacity.
Must manufacture additional enzymes for future metabolism.
How must drugs be metabolized in order to be eliminated by the kidney? - Ans:✔✔-Lipophilic drugs
must be metabolized to more polar, hydrophilic substances in the liver
Phase 1 metabolism - Ans:✔✔-Oxidation reactions by CYP450 enzymes, reduction reactions, hydrolysis
reactions
Page 4/53
FIRST PUBLISH OCTOBER 2024
NURS 549 Pharm Midterm Exam Study
Guide
Pharmacokinetics - Ans:✔✔-What the body does to the drug once administered
Pharmacodynamics - Ans:✔✔-The actions of a drug on the body
Absorption - Ans:✔✔-The transfer of the drug from the site of administration to the bloodstream
Distribution - Ans:✔✔-The process by which the drug leaves the blood stream and enters the interstitial
and then tissue cells
Metabolism - Ans:✔✔-The drug is broken down to metabolites in the tissues
Elimination - Ans:✔✔-Removal of drug from the body via bile, urine
Which drugs passively diffuse across membranes most easily: Un-ionized, lipid-soluble drugs OR ionized,
water-soluble drugs? - Ans:✔✔-Un-ionized, lipid soluble drugs
What drugs are easily eliminated via the kidney? - Ans:✔✔-Ionized, water soluble forms of drug
Page 1/53
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Where are weakly acidic drugs better absorbed? - Ans:✔✔-In the acidic media of the stomach drug will
remain protonated (un-ionized, lipid soluble)
Where will weakly basic drugs be better absorbed? - Ans:✔✔-In the basic media of the small intestine
the drug will remain protonated (un-ionized)
Where is drug absorption most efficient? Stomach, SI or LI? - Ans:✔✔-The small intestine, as it has the
largest surface area and blood flow
First pass effect - Ans:✔✔-The initial metabolism in the liver of a drug absorbed from the gastrointestinal
tract before the drug reaches systemic circulation through the bloodstream.
Oral bioavailability & relation to first pass effect - Ans:✔✔-The fraction of an administered drug that
reaches the systemic circulation after oral administration. High first pass effect, low oral bioavailability
Bioavailability = (AUC oral / AUC injected) x 100
SubQ versus IM absorption - Ans:✔✔-SubQ tissue has less vascularity than muscle tissue. IM absorption
is faster
Rectal administration - Ans:✔✔-Avoids liver biotransformation. 50% of drainage from rectal region
bypasses portal circulation
Page 2/53
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Drugs that are unstable in the acidic environment of the stomach and have 0% bioavailability - Ans:✔✔-
Insulin, Penicillin G
Bioequivalence - Ans:✔✔-Two drugs have comparable bioavailability (similar time to peak blood
concentration)
Pharmaceutical equivalence - Ans:✔✔-Drugs with the same active ingredient, same dosage form, same
route, identical in strength/concentration
Therapeutic equivalence - Ans:✔✔-Pharmaceutical equivalents with the same clinical effect and safety
profile
Drug distribution depends on... - Ans:✔✔-Cardiac output
Regional blood flow
Capillary permeability
Degree of drug binding to plasma and tissue proteins (drug that binds to albumin may not distribute.
rugs that bind tissue proteins may have prolonged effect)
Volume of distribution (Vd) - Ans:✔✔-Hypothetical volume of fluid into which the drug is disseminated -
numeric value based on liters, patient independent marker
Page 3/53
, ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Types of drugs with low Vd, higher Vd, and highest Vd - Ans:✔✔-Low Vd = hydrophilic, large molecular
weight, plasma protein-bound drugs that remain in plasma compartment
Higher Vd = hydrophilic, low molecular weight, non-plasma bound drug, distributes to plasma and
interstitium
Highest Vd = Lipophilic, low molecular weight, non-plasma bound drug, distributes to plasma,
interstitium, and intracellular fluid
First order kinetics - Ans:✔✔-Non-linear, exponential elimination of drugs. A constant fraction of drug is
metabolized per unit of time. Rate increases concentration increases. Applies to vast majority of drugs
Zero order kinetics - Ans:✔✔-A constant amount of drug is eliminated per unit time. Elimination is linear,
independent and non-proportional to drug concentration. All enzymes are saturated, at max capacity.
Must manufacture additional enzymes for future metabolism.
How must drugs be metabolized in order to be eliminated by the kidney? - Ans:✔✔-Lipophilic drugs
must be metabolized to more polar, hydrophilic substances in the liver
Phase 1 metabolism - Ans:✔✔-Oxidation reactions by CYP450 enzymes, reduction reactions, hydrolysis
reactions
Page 4/53
