EXAM 1: NSG 531 - RUSH - ADVANCED
PHARMACOLOGY, 2025/2026 WITH
CORRECT/ACCURATE ANSWERS
hypoalbuminemia or drug displacement can produce increased
pharmacologic effect. What does the magnitude of this effect
depend on? -CORRECT ANSWERS a. presence of liver or renal
disease
b. drug's VD - if VD is high, less drug in the plasma is susceptible
to displacement
c. drug's therapeutic index - if ratio between therapeutic and toxic
doses is low, displacement may be important
t/f
Kd is positively associated with free drug in the plasma -CORRECT
ANSWERS true
what might decreased free drug in the plasma mean? -CORRECT
ANSWERS an increase in plasma albumin concentration
what might increased total drug concentration mean? -CORRECT
ANSWERS increased free drug in the plasma when the protein
binding sites are saturated
Biotransformation -CORRECT ANSWERS One or more
biochemical reactions involving a parent drug; occurs mainly in
,the liver and produces a metabolite that is either inactive or
active. Also known as metabolism.
what is the relationship between biotransformation reactions in
the body and the solubility of the drug? -CORRECT ANSWERS
makes the drug more water soluble so that we can get rid of it
because the body does something to the drug to change them
that is why we have to keep giving it because the body is always
trying to get rid of something that is not self
How come drugs don't initiate an immune reaction? -CORRECT
ANSWERS In order for something to stimulate an immune
response they have to be somewhat large and drugs by design
are somewhat small
What are the two major routes by which drugs are eliminated? -
CORRECT ANSWERS Liver - makes it water soluble
Kidneys - get rid of it
How does the liver prepare drugs for excretion? -CORRECT
ANSWERS by making them more water soluble and generally
by making them more polar
if they are more polar what happens when they are filtered into
the kidneys is that they bind to water and get excreted in the
urine and don't get filtered back into the systemic sirculation
phase I reactions -CORRECT ANSWERS mediated by enzymes in
the liver
at the end of this reaction the substance is more polar
the major reaction that occurs in a phase I reaction is oxidation
,What are the family of enzymes that mediate phase I reactions in
the liver? -CORRECT ANSWERS cytochrome p450 enzymes
their sole purpose is to get rid of something that we didn't mean
to consume
evolutionarily speaking this might be poisonous berries for
example
what is the major reaction that occurs in a phase I reaction? -
CORRECT ANSWERS oxidation
oxidation -CORRECT ANSWERS loss of electrons
when something gets oxidized it loses an. electron - oxidation is
the removal of an electron from a substance
we end up with a drug that is bound to the enzyme that is bound
to oxygen and that drug is now oxidized and has lost an electron
when a drug gets oxidized what happens to the oxygen? -
CORRECT ANSWERS it is reduced because it accepts an
electron
what are the three main phase I reactions -CORRECT ANSWERS
oxidation - take an electron
hydroxylation - add an OH group
hydrolysis - add water
phase II reaction -CORRECT ANSWERS conjugation
, most drugs cannot just go through phase I reactions to become
polar enough for excretion
usually glucuronidation (adding glucuronic acid)
CYP450 inhibitor -CORRECT ANSWERS Decreases the
metabolism of drug and therefore increases the amount of drug
circulating in the body
say we have Drug A and Drug B
Drug b is a CYP450 inhibitor
it is blocking the action of the enzyme that metabolizes drug A
therefore increase plasma concentrations of drug A
this may mean that drug B has a higher affinity for the
cytochrome p450 enzyme and therefore has a competitive
advantage over drug A for the binding sites
CYP450 inducer -CORRECT ANSWERS Increases the rate of
metabolism of the drug therefore decreasing the amount of drug
circulating in the body
Say we have Drug A and Drug B
Drug B is a CYP450 inducer
it is stimulating the production of the enzyme that metabolizes
drug A therefore decreasing plasma concentrations of drug A
what is the name of the enzyme that metabolizes ~50% of drugs -
CORRECT ANSWERS CYP3A
PHARMACOLOGY, 2025/2026 WITH
CORRECT/ACCURATE ANSWERS
hypoalbuminemia or drug displacement can produce increased
pharmacologic effect. What does the magnitude of this effect
depend on? -CORRECT ANSWERS a. presence of liver or renal
disease
b. drug's VD - if VD is high, less drug in the plasma is susceptible
to displacement
c. drug's therapeutic index - if ratio between therapeutic and toxic
doses is low, displacement may be important
t/f
Kd is positively associated with free drug in the plasma -CORRECT
ANSWERS true
what might decreased free drug in the plasma mean? -CORRECT
ANSWERS an increase in plasma albumin concentration
what might increased total drug concentration mean? -CORRECT
ANSWERS increased free drug in the plasma when the protein
binding sites are saturated
Biotransformation -CORRECT ANSWERS One or more
biochemical reactions involving a parent drug; occurs mainly in
,the liver and produces a metabolite that is either inactive or
active. Also known as metabolism.
what is the relationship between biotransformation reactions in
the body and the solubility of the drug? -CORRECT ANSWERS
makes the drug more water soluble so that we can get rid of it
because the body does something to the drug to change them
that is why we have to keep giving it because the body is always
trying to get rid of something that is not self
How come drugs don't initiate an immune reaction? -CORRECT
ANSWERS In order for something to stimulate an immune
response they have to be somewhat large and drugs by design
are somewhat small
What are the two major routes by which drugs are eliminated? -
CORRECT ANSWERS Liver - makes it water soluble
Kidneys - get rid of it
How does the liver prepare drugs for excretion? -CORRECT
ANSWERS by making them more water soluble and generally
by making them more polar
if they are more polar what happens when they are filtered into
the kidneys is that they bind to water and get excreted in the
urine and don't get filtered back into the systemic sirculation
phase I reactions -CORRECT ANSWERS mediated by enzymes in
the liver
at the end of this reaction the substance is more polar
the major reaction that occurs in a phase I reaction is oxidation
,What are the family of enzymes that mediate phase I reactions in
the liver? -CORRECT ANSWERS cytochrome p450 enzymes
their sole purpose is to get rid of something that we didn't mean
to consume
evolutionarily speaking this might be poisonous berries for
example
what is the major reaction that occurs in a phase I reaction? -
CORRECT ANSWERS oxidation
oxidation -CORRECT ANSWERS loss of electrons
when something gets oxidized it loses an. electron - oxidation is
the removal of an electron from a substance
we end up with a drug that is bound to the enzyme that is bound
to oxygen and that drug is now oxidized and has lost an electron
when a drug gets oxidized what happens to the oxygen? -
CORRECT ANSWERS it is reduced because it accepts an
electron
what are the three main phase I reactions -CORRECT ANSWERS
oxidation - take an electron
hydroxylation - add an OH group
hydrolysis - add water
phase II reaction -CORRECT ANSWERS conjugation
, most drugs cannot just go through phase I reactions to become
polar enough for excretion
usually glucuronidation (adding glucuronic acid)
CYP450 inhibitor -CORRECT ANSWERS Decreases the
metabolism of drug and therefore increases the amount of drug
circulating in the body
say we have Drug A and Drug B
Drug b is a CYP450 inhibitor
it is blocking the action of the enzyme that metabolizes drug A
therefore increase plasma concentrations of drug A
this may mean that drug B has a higher affinity for the
cytochrome p450 enzyme and therefore has a competitive
advantage over drug A for the binding sites
CYP450 inducer -CORRECT ANSWERS Increases the rate of
metabolism of the drug therefore decreasing the amount of drug
circulating in the body
Say we have Drug A and Drug B
Drug B is a CYP450 inducer
it is stimulating the production of the enzyme that metabolizes
drug A therefore decreasing plasma concentrations of drug A
what is the name of the enzyme that metabolizes ~50% of drugs -
CORRECT ANSWERS CYP3A
