NR668 2026 ACTUAL TEST PAPER
COMPLETE QUESTIONS AND VERIFIED
ANSWERS
◉Cytochrome P450 metabolizing enzymes. Answer: -Cytochrome
P450: Alters just how the body metabolizes many drugs
-Nomenclature: Example CYP2D6: CYP (cytochrome P450 enzyme)2
(Family) D (Subfamily) 6 (Individual enzyme)
-Pharmacogenetic testing
• determines CYP450 differences
• Predicts High vs. Low Substrates of 2D6, 2C19, 3A4
-Prodrug: Liver metabolism activates the drug. • Example: Codeine
• Converted to morphine via CYP2D6
◉CYP 1A2. Answer: -CYP 1A2 Substrates:
• Caffeine, Theophylline, some TCA's (Amitriptyline, clomipramine,
imipramine), Haloperidol, Olanzapine & others.
-CYP1A2 Inhibitors:
• Ciprofloxacin, Verapamil, Fluvoxamine
,-CYP1A2 Inducers:
• Omeprazole, Charbroiled foods, Phenobarbital, Tobacco smoking
• Tobacco smoking will induce the metabolism of Olanzapine
(Zyprexa) & Haloperidol (Haldol)
◉CYP 2D6. Answer: Greatly affected by polymorphism
-CYP 2D6 Substrates:
• Venlafaxine, Duloxetine, Fluoxetine, Paroxetine, Fluvoxamine,
several antipsychotics, Beta Blockers, Stimulants, Opioids
-CYP2D6 Inhibitors:
• Fluoxetine, Paroxetine, Bupropion & (Sertraline moderate
inhibitor)
-CYP2D6 Inducers:
• No strong inducers
◉CYP 3A4. Answer: -CYP 3A4 Substrates:
• Alprazolam, Buspirone, Statins, Chemo drugs, Calcium Channel
blockers, Macrolides, Celexa, Sertraline, Methadone, Sex hormones &
hormonal contraceptives.
,-CYP 3A4 Inhibitors:
• Fluvoxamine, Fluoxetine, Verapamil, Erythromycin, Protease
inhibitors & GRAPEFRUIT Juice.
-CYP 3A4 Inducers:
• Carbamazepine, St. John's wort
◉Key Neurotransmitters. Answer: -Serotonin
-Norepinephrine
-Dopamine
-Acetylcholine
-Glutamate
-GABA
◉Serotonin (5-HT). Answer: -Located in the raphe nuclei in the
brain stem
-Affects Mood & depression
-Regulating Obsessions
-Anxiety
-Gut motility (diarrhea/GI upset)
-Migraines
-Sexual function
, ◉Norepinephrine (NE). Answer: -Located in the locus ceruleus
(Brainstem)
-Attention/Concentration
-Fight/Flight
-Energy
-Mood
-Blood Pressure/Heart Rate
-Urinary retention
◉Dopamine (DA). Answer: -Movements
-Pleasurable
-behaviors/Reward/Motivation
-Psychosis
-Prolactin Secretion
-Attention
-Nausea
◉Acetylcholine (ACh). Answer: -Alertness
-Learning
-Memory (think opposite of Scopolamine)
COMPLETE QUESTIONS AND VERIFIED
ANSWERS
◉Cytochrome P450 metabolizing enzymes. Answer: -Cytochrome
P450: Alters just how the body metabolizes many drugs
-Nomenclature: Example CYP2D6: CYP (cytochrome P450 enzyme)2
(Family) D (Subfamily) 6 (Individual enzyme)
-Pharmacogenetic testing
• determines CYP450 differences
• Predicts High vs. Low Substrates of 2D6, 2C19, 3A4
-Prodrug: Liver metabolism activates the drug. • Example: Codeine
• Converted to morphine via CYP2D6
◉CYP 1A2. Answer: -CYP 1A2 Substrates:
• Caffeine, Theophylline, some TCA's (Amitriptyline, clomipramine,
imipramine), Haloperidol, Olanzapine & others.
-CYP1A2 Inhibitors:
• Ciprofloxacin, Verapamil, Fluvoxamine
,-CYP1A2 Inducers:
• Omeprazole, Charbroiled foods, Phenobarbital, Tobacco smoking
• Tobacco smoking will induce the metabolism of Olanzapine
(Zyprexa) & Haloperidol (Haldol)
◉CYP 2D6. Answer: Greatly affected by polymorphism
-CYP 2D6 Substrates:
• Venlafaxine, Duloxetine, Fluoxetine, Paroxetine, Fluvoxamine,
several antipsychotics, Beta Blockers, Stimulants, Opioids
-CYP2D6 Inhibitors:
• Fluoxetine, Paroxetine, Bupropion & (Sertraline moderate
inhibitor)
-CYP2D6 Inducers:
• No strong inducers
◉CYP 3A4. Answer: -CYP 3A4 Substrates:
• Alprazolam, Buspirone, Statins, Chemo drugs, Calcium Channel
blockers, Macrolides, Celexa, Sertraline, Methadone, Sex hormones &
hormonal contraceptives.
,-CYP 3A4 Inhibitors:
• Fluvoxamine, Fluoxetine, Verapamil, Erythromycin, Protease
inhibitors & GRAPEFRUIT Juice.
-CYP 3A4 Inducers:
• Carbamazepine, St. John's wort
◉Key Neurotransmitters. Answer: -Serotonin
-Norepinephrine
-Dopamine
-Acetylcholine
-Glutamate
-GABA
◉Serotonin (5-HT). Answer: -Located in the raphe nuclei in the
brain stem
-Affects Mood & depression
-Regulating Obsessions
-Anxiety
-Gut motility (diarrhea/GI upset)
-Migraines
-Sexual function
, ◉Norepinephrine (NE). Answer: -Located in the locus ceruleus
(Brainstem)
-Attention/Concentration
-Fight/Flight
-Energy
-Mood
-Blood Pressure/Heart Rate
-Urinary retention
◉Dopamine (DA). Answer: -Movements
-Pleasurable
-behaviors/Reward/Motivation
-Psychosis
-Prolactin Secretion
-Attention
-Nausea
◉Acetylcholine (ACh). Answer: -Alertness
-Learning
-Memory (think opposite of Scopolamine)
