Midterm Exam Week 1 -5: NRNP 6566/ NRNP6566
Advanced Care of Adults in Acute Settings I | Questions and
Verified Answers| Latest 2025/ 2026 Update- Walden
Describe cytochrome p450 system
Cytochrome p450 system is a series of enzymes used to metabolize medications
Inhibitors
block metabolic activity from one or more CYP450 enzymes
Inducers
increase CYP450 enzyme activity by increasing enzyme synthesis
Describe effect on low and high albumin levels on active drug levels especially for drugs that are
highly protein bound
Albumin is the plasma protein with the greatest capacity for binding drugs. Binding plasma
proteins affect drug distribution into tissues, because only drug that is not bound is available to
penetrate tissues, bind to receptors, and exert activity. As free drug leaves the blood stream, more
bound drug is released from binding sites.
Low albumin levels
malnutrition, chronic illness
Highly protein bound drugs can lead to
, Midterm Exam Week 1 -5: NRNP 6566/ NRNP6566
Advanced Care of Adults in Acute Settings I | Questions and
Verified Answers| Latest 2025/ 2026 Update- Walden
toxicity in patients with low albumin levels, example malnutrition or chronic illness. This is
because there are fewer than the normal sites for the drug to bind
Describe the ways the hepatic first pass effect- which is metabolism during first pass through the
liver
Alternative routes include:
suppository
intravenous
intramuscular
inhalational aerosol
transdermal
sublingual
These allow drugs to bypass the first-pass effect and be absorbed directly into systemic
circulation
Be able to calculate creatinine clearance using Cockgraft Gault equation:
Male = 140-age times weight in kilograms divided by serum creatinine times 72.
Women = CRCL (male) times 0.85
Describe what determines the frequency of drug administration
half life
plasma concentration
Advanced Care of Adults in Acute Settings I | Questions and
Verified Answers| Latest 2025/ 2026 Update- Walden
Describe cytochrome p450 system
Cytochrome p450 system is a series of enzymes used to metabolize medications
Inhibitors
block metabolic activity from one or more CYP450 enzymes
Inducers
increase CYP450 enzyme activity by increasing enzyme synthesis
Describe effect on low and high albumin levels on active drug levels especially for drugs that are
highly protein bound
Albumin is the plasma protein with the greatest capacity for binding drugs. Binding plasma
proteins affect drug distribution into tissues, because only drug that is not bound is available to
penetrate tissues, bind to receptors, and exert activity. As free drug leaves the blood stream, more
bound drug is released from binding sites.
Low albumin levels
malnutrition, chronic illness
Highly protein bound drugs can lead to
, Midterm Exam Week 1 -5: NRNP 6566/ NRNP6566
Advanced Care of Adults in Acute Settings I | Questions and
Verified Answers| Latest 2025/ 2026 Update- Walden
toxicity in patients with low albumin levels, example malnutrition or chronic illness. This is
because there are fewer than the normal sites for the drug to bind
Describe the ways the hepatic first pass effect- which is metabolism during first pass through the
liver
Alternative routes include:
suppository
intravenous
intramuscular
inhalational aerosol
transdermal
sublingual
These allow drugs to bypass the first-pass effect and be absorbed directly into systemic
circulation
Be able to calculate creatinine clearance using Cockgraft Gault equation:
Male = 140-age times weight in kilograms divided by serum creatinine times 72.
Women = CRCL (male) times 0.85
Describe what determines the frequency of drug administration
half life
plasma concentration
