NR565 – Advanced Pharmacology Midterm Exam Study Guide |
Actual study Questions and correct Answers | 2026/27
Updates | 100% correct | Passed on First Attempt
Week 1: Chapters 1–10 – Foundations in Pharmacology
• Prescriptive authority
Definition: Prescriptive authority refers to the legal ability of licensed healthcare
providers (physicians, nurse practitioners, physician assistants) to prescribe
medications.
Key Considerations: Prescriptive authority is governed by state and federal laws,
and the scope may vary by provider type and jurisdiction. Prescribers must follow
drug approval guidelines, consider patient conditions, and prescribe within their
area of expertise.
• Prescription writing
Patient information (name, date, age)
Medication name (generic and/or brand)
Dosage form (tablet, injection, cream)
Dosage strength
Dosage instructions (how, when, and for how long to take the drug
Quantity to dispense
Refills (if applicable)
Prescriber’s signature and license number
Legal Considerations: Prescriptions should be clear, legible, and in accordance with
regulatory standards (e.g., controlled substances require specific documentation).
• Prescribing considerations
Patient Factors: Age, weight, gender, health status, kidney/liver function, allergies,
and other drugs being taken.
Therapeutic Effect: Consider the drug’s therapeutic benefits and the potential risks.
Cost: Affordable options should be considered to improve patient adherence.
,Drug Formulation: Availability of the drug in suitable formulations (oral, topical,
injectable) for the patient’s condition
,• Medication education
Patient Education: Include information on how to take the medication correctly,
potential side effects, what to do in case of missed doses, and the importance of
follow-up visits.
Safety Information: Educate patients on potential drug interactions, warnings, and
signs of adverse reactions.
• Drug absorption
The process by which a drug moves from its site of administration (oral,
intravenous, topical) into the bloodstream.
Route: Oral vs. IM vs. SubQ
Blood flow
GI motility and pH
Drug formulation (extended-release vs. immediate-release)
Process by which a drug enters the bloodstream.
Affected by: route (oral, IV, IM, transdermal), gastric pH, motility, blood flow,
and first-pass metabolism.
Pediatric patients: gastric acidity low, delayed gastric emptying, affecting
absorption.
Older adults: slowed absorption due to delayed gastric emptying and reduced
splanchnic blood flow.
• Drug distribution
The process by which the drug moves from the bloodstream into various tissues
and organs.
Influenced by: plasma protein binding (albumin), tissue perfusion, body
composition, and blood-brain barrier permeability.
Pediatrics: low albumin → higher free drug levels → increased sensitivity.
Geriatrics: increased body fat → prolonged half-life for lipophilic drugs; decreased
water → higher concentrations for hydrophilic drugs
• Drug metabolism
Mostly occurs in the liver via cytochrome P450 enzymes.
Converts drugs to more water-soluble metabolites for renal excretion.
Pediatrics: immature hepatic enzymes → slower metabolism in neonates, faster
than adults in toddlers.
, Geriatrics: decreased hepatic blood flow, mass, and enzyme activity → prolonged
half-life.
Genetic variation in metabolizing enzymes.
Age, liver function, other drugs, and diet.
• Renal drug excretion
The removal of drugs and metabolites from the body via the kidneys (urine).
Processes Involved:
Glomerular filtration
Tubular secretion (active transport of drugs into the urine)
Reabsorption (drugs may be reabsorbed into the bloodstream, affecting drug
elimination).
Factors Affecting Renal Excretion:
Renal function (creatinine clearance, glomerular filtration rate)
Urine pH
Kidney disease (can reduce drug elimination).
Pediatrics: immature renal function → reduced excretion → increased risk of
toxicity.
Older adults: decreased renal blood flow, GFR, tubular function → monitor
creatinine clearance, not serum creatinine alone.
• Agonists and antagonists
Agonists: Drugs that bind to a receptor and activate it to produce a physiological
response.
Example: morphine is an agonist at opioid receptors.
Antagonists: Drugs that bind to a receptor but do not activate it, blocking the
effect of agonists.
Example: naloxone (Narcan) is an antagonist at opioid receptors and can
reverse opioid toxicity
Clinical relevance: understanding receptor interactions helps predict drug
efficacy and potential side effects.
• Drug interactions
Can alter absorption, distribution, metabolism, or excretion.
Can lead to enhanced or reduced drug effects, or adverse reactions.
Actual study Questions and correct Answers | 2026/27
Updates | 100% correct | Passed on First Attempt
Week 1: Chapters 1–10 – Foundations in Pharmacology
• Prescriptive authority
Definition: Prescriptive authority refers to the legal ability of licensed healthcare
providers (physicians, nurse practitioners, physician assistants) to prescribe
medications.
Key Considerations: Prescriptive authority is governed by state and federal laws,
and the scope may vary by provider type and jurisdiction. Prescribers must follow
drug approval guidelines, consider patient conditions, and prescribe within their
area of expertise.
• Prescription writing
Patient information (name, date, age)
Medication name (generic and/or brand)
Dosage form (tablet, injection, cream)
Dosage strength
Dosage instructions (how, when, and for how long to take the drug
Quantity to dispense
Refills (if applicable)
Prescriber’s signature and license number
Legal Considerations: Prescriptions should be clear, legible, and in accordance with
regulatory standards (e.g., controlled substances require specific documentation).
• Prescribing considerations
Patient Factors: Age, weight, gender, health status, kidney/liver function, allergies,
and other drugs being taken.
Therapeutic Effect: Consider the drug’s therapeutic benefits and the potential risks.
Cost: Affordable options should be considered to improve patient adherence.
,Drug Formulation: Availability of the drug in suitable formulations (oral, topical,
injectable) for the patient’s condition
,• Medication education
Patient Education: Include information on how to take the medication correctly,
potential side effects, what to do in case of missed doses, and the importance of
follow-up visits.
Safety Information: Educate patients on potential drug interactions, warnings, and
signs of adverse reactions.
• Drug absorption
The process by which a drug moves from its site of administration (oral,
intravenous, topical) into the bloodstream.
Route: Oral vs. IM vs. SubQ
Blood flow
GI motility and pH
Drug formulation (extended-release vs. immediate-release)
Process by which a drug enters the bloodstream.
Affected by: route (oral, IV, IM, transdermal), gastric pH, motility, blood flow,
and first-pass metabolism.
Pediatric patients: gastric acidity low, delayed gastric emptying, affecting
absorption.
Older adults: slowed absorption due to delayed gastric emptying and reduced
splanchnic blood flow.
• Drug distribution
The process by which the drug moves from the bloodstream into various tissues
and organs.
Influenced by: plasma protein binding (albumin), tissue perfusion, body
composition, and blood-brain barrier permeability.
Pediatrics: low albumin → higher free drug levels → increased sensitivity.
Geriatrics: increased body fat → prolonged half-life for lipophilic drugs; decreased
water → higher concentrations for hydrophilic drugs
• Drug metabolism
Mostly occurs in the liver via cytochrome P450 enzymes.
Converts drugs to more water-soluble metabolites for renal excretion.
Pediatrics: immature hepatic enzymes → slower metabolism in neonates, faster
than adults in toddlers.
, Geriatrics: decreased hepatic blood flow, mass, and enzyme activity → prolonged
half-life.
Genetic variation in metabolizing enzymes.
Age, liver function, other drugs, and diet.
• Renal drug excretion
The removal of drugs and metabolites from the body via the kidneys (urine).
Processes Involved:
Glomerular filtration
Tubular secretion (active transport of drugs into the urine)
Reabsorption (drugs may be reabsorbed into the bloodstream, affecting drug
elimination).
Factors Affecting Renal Excretion:
Renal function (creatinine clearance, glomerular filtration rate)
Urine pH
Kidney disease (can reduce drug elimination).
Pediatrics: immature renal function → reduced excretion → increased risk of
toxicity.
Older adults: decreased renal blood flow, GFR, tubular function → monitor
creatinine clearance, not serum creatinine alone.
• Agonists and antagonists
Agonists: Drugs that bind to a receptor and activate it to produce a physiological
response.
Example: morphine is an agonist at opioid receptors.
Antagonists: Drugs that bind to a receptor but do not activate it, blocking the
effect of agonists.
Example: naloxone (Narcan) is an antagonist at opioid receptors and can
reverse opioid toxicity
Clinical relevance: understanding receptor interactions helps predict drug
efficacy and potential side effects.
• Drug interactions
Can alter absorption, distribution, metabolism, or excretion.
Can lead to enhanced or reduced drug effects, or adverse reactions.
