NR 565 MIDTERM EXAM | QUESTIONS &
ANSWERS (VERIFIED) | LATEST UPDATE |
GRADED A+
,G-Protien coupled receptors and how they interact with drugs
Correct Answer: G-protein coupled receptors (GPCR) interact with drugs through 7
regions of proteins that span and innervate the cell membrane and trap the molecule
into the receptor site like an interwoven basket (Insel & Sriram, 2018). Drugs can then
enter this space and interact with the GRCP. A specific interaction and binding with a
site on one or more of the regions of proteins within the GPCR, and drugs bound with
the GRCP can stimulate the release of G proteins that can interact with various effector
proteins to create physiological responses within the body (Insel & Sriram, 2018). This
process occurs through secondary messengers (such as cAMP) which creates the
extracellular interactions produced by the drug binding to the GRCP.
What neurotransmitters are excitatory?
Correct Answer: amino acids such as glycine, aspartate, and glutamate are excitatory
(Woo & Robinson, p.16, 2016).
Which is the most common CYP enzyme in the body? What role does it play?
1
,Correct Answer: According to the textbook, the CYP3A4 is the most important enzyme
in the body. CYP3A4 is responsible for the metabolism of more than 50% of
medications and is considered a major drug metabolizing enzyme. CYP3A4 can be
found in the liver, as well as the lining of the GI tract. Due to this location, food can also
influence this CYP. One example of this is grapefruit juice, which can inhibit CYP3A4.
Medications that are metabolized by CYP3A4 include antimicrobials, calcium channel
blockers, antihistamines, anticonvulsants, azole antifungals, and corticosteroids (Woo,
& Robinson, 2016).
What is the clinical significance of being an ultra-rapid CYP2D6 metabolizer?
Correct Answer: People who are ultra-rapid metabolizers have high activity of CYP2D6
enzymes that break down certain medicines rapidly and are likely to need different
doses or even a different medicine. Drug dose, response, and toxicity risk of beta-
blockers, antidepressants, antiarrhythmics, and opioid analgesics are dependent on
CYP2D6 pharmacogenetics (Ayazseven et al., 2020). Knowing the result of the
CYP2D6 test and which group the patient falls into such as poor metabolizers,
intermediate metabolizers, or ultra-rapid metabolizers, will help nurse practitioners
prescribe the right medication and dosage for the patient.
What would be the concern if a drug is a CYP450indicer? How that might affect the
metabolism of another drug the patient is taking?
Correct Answer: Cytochrome P450 enzymes are in cells throughout the body, primarily
, found in liver cells (Girvan & Munro, 2016). These enzymes are essential for the
2
ANSWERS (VERIFIED) | LATEST UPDATE |
GRADED A+
,G-Protien coupled receptors and how they interact with drugs
Correct Answer: G-protein coupled receptors (GPCR) interact with drugs through 7
regions of proteins that span and innervate the cell membrane and trap the molecule
into the receptor site like an interwoven basket (Insel & Sriram, 2018). Drugs can then
enter this space and interact with the GRCP. A specific interaction and binding with a
site on one or more of the regions of proteins within the GPCR, and drugs bound with
the GRCP can stimulate the release of G proteins that can interact with various effector
proteins to create physiological responses within the body (Insel & Sriram, 2018). This
process occurs through secondary messengers (such as cAMP) which creates the
extracellular interactions produced by the drug binding to the GRCP.
What neurotransmitters are excitatory?
Correct Answer: amino acids such as glycine, aspartate, and glutamate are excitatory
(Woo & Robinson, p.16, 2016).
Which is the most common CYP enzyme in the body? What role does it play?
1
,Correct Answer: According to the textbook, the CYP3A4 is the most important enzyme
in the body. CYP3A4 is responsible for the metabolism of more than 50% of
medications and is considered a major drug metabolizing enzyme. CYP3A4 can be
found in the liver, as well as the lining of the GI tract. Due to this location, food can also
influence this CYP. One example of this is grapefruit juice, which can inhibit CYP3A4.
Medications that are metabolized by CYP3A4 include antimicrobials, calcium channel
blockers, antihistamines, anticonvulsants, azole antifungals, and corticosteroids (Woo,
& Robinson, 2016).
What is the clinical significance of being an ultra-rapid CYP2D6 metabolizer?
Correct Answer: People who are ultra-rapid metabolizers have high activity of CYP2D6
enzymes that break down certain medicines rapidly and are likely to need different
doses or even a different medicine. Drug dose, response, and toxicity risk of beta-
blockers, antidepressants, antiarrhythmics, and opioid analgesics are dependent on
CYP2D6 pharmacogenetics (Ayazseven et al., 2020). Knowing the result of the
CYP2D6 test and which group the patient falls into such as poor metabolizers,
intermediate metabolizers, or ultra-rapid metabolizers, will help nurse practitioners
prescribe the right medication and dosage for the patient.
What would be the concern if a drug is a CYP450indicer? How that might affect the
metabolism of another drug the patient is taking?
Correct Answer: Cytochrome P450 enzymes are in cells throughout the body, primarily
, found in liver cells (Girvan & Munro, 2016). These enzymes are essential for the
2
