NR 565 ADVANCED PHARMACOLOGY 2026/2027
ACTUAL LATEST EXAMS QUESTIONS AND SOLUTIONS
RATED A+
✔✔Mechanism of Action (MOA) - ✔✔Specific biochemical interaction through which a
drug produces a pharmacological effect
✔✔Desensitization - ✔✔Reduction in response to an agonist while continuously present
at receptor
Progressive decrease in response to repeated exposure
✔✔Xenobiotics - ✔✔Substances that are foreign to the body
Synthetic chemical compounds
Medications
All can potentially adversely affect the body
*Occasionally can be transformed into toxic metabolite
✔✔Cytochrome P450 (CYP450) - ✔✔Xenobioitic-metabolizing enzymes
Necessary for the production of cholesterol and steroids
✔✔Role of CYP450 - ✔✔Detoxification of chemicals
Drug metabolism
✔✔CYP450: cyto - ✔✔Binds to cell membrane
✔✔CYP450: chrome + p - ✔✔Contains heme pigment
✔✔CYP450: 450 mm - ✔✔Absorbs light at 450 mm wavelength when exposed to
carbon monoxide (CO)
✔✔CYP450 system is thought to be ___ - ✔✔Major system of enzymes responsible for
phase 1 metabolism
✔✔3 possible outcomes of phase 1 metabolism - ✔✔Oxidized (most common)
Reduced
Hydrolyzed
✔✔Oxidation - ✔✔Drug becomes completely inactive
✔✔Reduction - ✔✔Drug becomes partially inactive; one or more metabolites remain
active
✔✔Hydrolization - ✔✔Original drug is not pharmacologically active; one metabolite
remains active
, ✔✔Alteration in CYP450 metabolism causes ___ - ✔✔Medication interactions
✔✔Substrate - ✔✔Xenobiotics that require the metabolic process of the body to activate
or de-activate the substance
✔✔Understanding substrates, inhibitors, and induces is crucial when prescribing ___ -
✔✔Medications for seizures, depression, and psychosis
✔✔Inhibitors - ✔✔Medications that inhibit metabolic activity of one or more CYP450
enzymes
Slows/blocks enzyme's metabolic activity that other medications are dependent on
✔✔Dangers of inhibitors - ✔✔Can cause increased levels of other meds, prolonged
pharmacological effect, and potential toxicity
✔✔Inhibitors: VISA CK GQ - ✔✔Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit
Quinidine
✔✔Inducers - ✔✔Xenobiotics (medications and environmental agents) that elevate
CYP450 enzyme activity by increasing enzyme synthesis
Additional sites for biotransformation = increased medication metabolism
✔✔Rifampin - ✔✔Inducer with short half-life
✔✔Phenobarbital - ✔✔Inducer with long half-life
✔✔Carbamazepine - ✔✔Potent inducer; metabolized by the same CYP450 enzyme it
induces
Start at low dose, increase weekly due to steady decrease in half-life over time
✔✔Inducers: CRAP GPS - ✔✔Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
ACTUAL LATEST EXAMS QUESTIONS AND SOLUTIONS
RATED A+
✔✔Mechanism of Action (MOA) - ✔✔Specific biochemical interaction through which a
drug produces a pharmacological effect
✔✔Desensitization - ✔✔Reduction in response to an agonist while continuously present
at receptor
Progressive decrease in response to repeated exposure
✔✔Xenobiotics - ✔✔Substances that are foreign to the body
Synthetic chemical compounds
Medications
All can potentially adversely affect the body
*Occasionally can be transformed into toxic metabolite
✔✔Cytochrome P450 (CYP450) - ✔✔Xenobioitic-metabolizing enzymes
Necessary for the production of cholesterol and steroids
✔✔Role of CYP450 - ✔✔Detoxification of chemicals
Drug metabolism
✔✔CYP450: cyto - ✔✔Binds to cell membrane
✔✔CYP450: chrome + p - ✔✔Contains heme pigment
✔✔CYP450: 450 mm - ✔✔Absorbs light at 450 mm wavelength when exposed to
carbon monoxide (CO)
✔✔CYP450 system is thought to be ___ - ✔✔Major system of enzymes responsible for
phase 1 metabolism
✔✔3 possible outcomes of phase 1 metabolism - ✔✔Oxidized (most common)
Reduced
Hydrolyzed
✔✔Oxidation - ✔✔Drug becomes completely inactive
✔✔Reduction - ✔✔Drug becomes partially inactive; one or more metabolites remain
active
✔✔Hydrolization - ✔✔Original drug is not pharmacologically active; one metabolite
remains active
, ✔✔Alteration in CYP450 metabolism causes ___ - ✔✔Medication interactions
✔✔Substrate - ✔✔Xenobiotics that require the metabolic process of the body to activate
or de-activate the substance
✔✔Understanding substrates, inhibitors, and induces is crucial when prescribing ___ -
✔✔Medications for seizures, depression, and psychosis
✔✔Inhibitors - ✔✔Medications that inhibit metabolic activity of one or more CYP450
enzymes
Slows/blocks enzyme's metabolic activity that other medications are dependent on
✔✔Dangers of inhibitors - ✔✔Can cause increased levels of other meds, prolonged
pharmacological effect, and potential toxicity
✔✔Inhibitors: VISA CK GQ - ✔✔Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit
Quinidine
✔✔Inducers - ✔✔Xenobiotics (medications and environmental agents) that elevate
CYP450 enzyme activity by increasing enzyme synthesis
Additional sites for biotransformation = increased medication metabolism
✔✔Rifampin - ✔✔Inducer with short half-life
✔✔Phenobarbital - ✔✔Inducer with long half-life
✔✔Carbamazepine - ✔✔Potent inducer; metabolized by the same CYP450 enzyme it
induces
Start at low dose, increase weekly due to steady decrease in half-life over time
✔✔Inducers: CRAP GPS - ✔✔Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
