1|Page
NR565 OR NR 565 MIDTERM EXAM VERSION A & B
ADVANCED PHARMACOLOGY CARE OF THE
FUNDAMENTALS ACTUAL EXAM WITH 400
QUESTION AND ANSWERS||VERIFIED EXAM!!!
(VERIFIED ANSWERS) [ALREADY GRADED
A+]||NEWEST EXAM!!!
G-Protien coupled receptors and how they interact with
drugs - 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.
,2|Page
What neurotransmitters are excitatory? - 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? - 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? - 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
, 3|Page
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? - Answer-Cytochrome P450 enzymes
are in cells throughout the body, primarily found in liver
cells (Girvan & Munro, 2016). These enzymes are
essential for the metabolism of many medications.
Cytochrome P450 enzymes can act as an inducer or
inhibitor of metabolism. When a medication induces the
CYP450 enzyme that increases the rate of metabolism
(Girvan & Munro, 2016). This can impact the effectiveness
of other medications. For example, medication A induces
CYP450 enzyme activity, therefore medication B will be
metabolized quicker and have a less therapeutic effect.
Explain the significance of a drug being an inhibitor of P-
glycoprotein? (see text) - Answer-P-glycoprotein (P-gp) is
the main barrier of the body and it affects the proper
delivery of drugs and causes drug resistance in our body.
NR565 OR NR 565 MIDTERM EXAM VERSION A & B
ADVANCED PHARMACOLOGY CARE OF THE
FUNDAMENTALS ACTUAL EXAM WITH 400
QUESTION AND ANSWERS||VERIFIED EXAM!!!
(VERIFIED ANSWERS) [ALREADY GRADED
A+]||NEWEST EXAM!!!
G-Protien coupled receptors and how they interact with
drugs - 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.
,2|Page
What neurotransmitters are excitatory? - 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? - 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? - 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
, 3|Page
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? - Answer-Cytochrome P450 enzymes
are in cells throughout the body, primarily found in liver
cells (Girvan & Munro, 2016). These enzymes are
essential for the metabolism of many medications.
Cytochrome P450 enzymes can act as an inducer or
inhibitor of metabolism. When a medication induces the
CYP450 enzyme that increases the rate of metabolism
(Girvan & Munro, 2016). This can impact the effectiveness
of other medications. For example, medication A induces
CYP450 enzyme activity, therefore medication B will be
metabolized quicker and have a less therapeutic effect.
Explain the significance of a drug being an inhibitor of P-
glycoprotein? (see text) - Answer-P-glycoprotein (P-gp) is
the main barrier of the body and it affects the proper
delivery of drugs and causes drug resistance in our body.
