NURS 5334 Advanced Pharmacology: Study Guide & Practice Quiz
(Quiz 1) Questions with Rationales & Answers (Graded A+)
University of Texas at Arlington (UTA)
NB answers at the end
Part 1: Core Pharmacological Principles & High-Yield Topics
Before tackling the practice questions, review these essential high-yield concepts commonly
tested in Advanced Pharmacology Quiz 1:
1. Pharmacokinetics & Pharmacodynamics
Pharmacokinetics (What the body does to the drug):
o Absorption: Bioavailability ($F$) represents the fraction of unchanged drug
reaching systemic circulation. First-pass metabolism in the liver significantly
lowers oral bioavailability.
o Distribution: Dependent on lipophilicity, protein binding (primarily albumin),
and blood flow. Highly plasma protein-bound drugs can be displaced by
competing drugs, increasing the free (active) fraction.
o Metabolism: Phase I reactions (CYP450 oxidation, reduction, hydrolysis) vs.
Phase II reactions (conjugation like glucuronidation to make molecules water-
soluble).
o Elimination: Clearance ($\text{CL}$) and Volume of Distribution ($V_d$)
determine elimination half-life ($\text{t}_{1/2}$). It takes 4 to 5 half-lives to
reach steady state or complete elimination. First-order kinetics (constant
percentage eliminated per unit time) vs. Zero-order kinetics (constant amount
eliminated per unit time, e.g., alcohol, aspirin at high doses).
, Pharmacodynamics (What the drug does to the body):
o Agonists: Full agonists produce $100\%$ maximal effect
($\text{E}_{\text{max}}$). Partial agonists produce a submaximal effect even
at full receptor occupancy and can act as antagonists in the presence of a full
agonist.
o Antagonists: Competitive antagonists shift the dose-response curve to the
right (potency decreases, $\text{E}_{\text{max}}$ unchanged; overcome by
increasing agonist dose). Non-competitive antagonists decrease
$\text{E}_{\text{max}}$ (cannot be overcome by higher agonist
concentration).
o Therapeutic Index (TI): $\text{TI} = \text{TD}_{50} / \text{ED}_{50}$. Drugs
with narrow therapeutic windows (e.g., Warfarin, Digoxin, Lithium,
Theophylline, Vancomycin, Phenytoin) require routine therapeutic drug
monitoring (TDM).
2. Autonomic Nervous System & Receptor Fundamentals
Sympathetic (Adrenergic):
o $\alpha_1$: Vasoconstriction, pupil dilation (mydriasis), bladder sphincter
contraction.
o $\alpha_2$: Presynaptic inhibition of norepinephrine release (decreases
sympathetic outflow centrally).
o $\beta_1$: Increases heart rate (chronotropy), contractility (inotropy), and
renin release from juxtaglomerular cells.
o $\beta_2$: Bronchodilation, vasodilation in skeletal muscle, uterine relaxation,
glycogenolysis.
Parasympathetic (Cholinergic):
, o Muscarinic Receptors ($M_1, M_2, M_3$): $M_2$ slows heart rate; $M_3$
increases glandular secretions, smooth muscle contraction
(bronchoconstriction, GI motility, bladder detrusor contraction), and pupillary
constriction (miosis).
3. Prescribing Safety & Pharmacogenomics
CYP Enzyme Dynamics:
o Inducers (e.g., Rifampin, Carbamazepine, St. John's Wort, Phenytoin,
Phenobarbital): Increase enzyme synthesis $\rightarrow$ lower substrate
drug levels $\rightarrow$ treatment failure.
o Inhibitors (e.g., Ketoconazole, Erythromycin/Clarithromycin, Grapefruit juice,
Amiodarone, Diltiazem/Verapamil): Block enzyme activity $\rightarrow$
increase substrate drug levels $\rightarrow$ drug toxicity.
Pregnancy Categories & Lactation: Transfer of drugs across placenta and into
breast milk is highest for small, highly lipophilic, uncharged, non-protein-bound
drugs.
Part 2: Practice Exam (Questions 1–100)
Questions 1–25: Pharmacokinetics & Pharmacodynamics
Q1
Which route of administration delivers a drug directly into systemic circulation with $100\%$
bioavailability ($F = 1.0$), bypassing first-pass hepatic metabolism?
A) Oral
B) Intravenous
C) Sublingual
, D) Transdermal
Q2
A drug has an elimination half-life ($\text{t}_{1/2}$) of 6 hours. If a constant dose is
administered every 6 hours, approximately how many hours will it take for the drug to reach
steady-state concentration?
A) 6 to 12 hours
B) 12 to 18 hours
C) 24 to 30 hours
D) 48 to 60 hours
Q3
What happens to the dose-response curve of a full agonist when a competitive antagonist is
added?
A) The curve shifts to the right, increasing $\text{EC}_{50}$ while
$\text{E}_{\text{max}}$ remains unchanged.
B) The curve shifts down, decreasing $\text{E}_{\text{max}}$ while $\text{EC}_{50}$
remains unchanged.
C) The curve shifts to the left, decreasing $\text{EC}_{50}$.
D) Both $\text{E}_{\text{max}}$ and $\text{EC}_{50}$ decrease proportionally.
Q4
Which parameter determines the dosing interval required to maintain a target steady-state
plasma concentration of a drug?
(Quiz 1) Questions with Rationales & Answers (Graded A+)
University of Texas at Arlington (UTA)
NB answers at the end
Part 1: Core Pharmacological Principles & High-Yield Topics
Before tackling the practice questions, review these essential high-yield concepts commonly
tested in Advanced Pharmacology Quiz 1:
1. Pharmacokinetics & Pharmacodynamics
Pharmacokinetics (What the body does to the drug):
o Absorption: Bioavailability ($F$) represents the fraction of unchanged drug
reaching systemic circulation. First-pass metabolism in the liver significantly
lowers oral bioavailability.
o Distribution: Dependent on lipophilicity, protein binding (primarily albumin),
and blood flow. Highly plasma protein-bound drugs can be displaced by
competing drugs, increasing the free (active) fraction.
o Metabolism: Phase I reactions (CYP450 oxidation, reduction, hydrolysis) vs.
Phase II reactions (conjugation like glucuronidation to make molecules water-
soluble).
o Elimination: Clearance ($\text{CL}$) and Volume of Distribution ($V_d$)
determine elimination half-life ($\text{t}_{1/2}$). It takes 4 to 5 half-lives to
reach steady state or complete elimination. First-order kinetics (constant
percentage eliminated per unit time) vs. Zero-order kinetics (constant amount
eliminated per unit time, e.g., alcohol, aspirin at high doses).
, Pharmacodynamics (What the drug does to the body):
o Agonists: Full agonists produce $100\%$ maximal effect
($\text{E}_{\text{max}}$). Partial agonists produce a submaximal effect even
at full receptor occupancy and can act as antagonists in the presence of a full
agonist.
o Antagonists: Competitive antagonists shift the dose-response curve to the
right (potency decreases, $\text{E}_{\text{max}}$ unchanged; overcome by
increasing agonist dose). Non-competitive antagonists decrease
$\text{E}_{\text{max}}$ (cannot be overcome by higher agonist
concentration).
o Therapeutic Index (TI): $\text{TI} = \text{TD}_{50} / \text{ED}_{50}$. Drugs
with narrow therapeutic windows (e.g., Warfarin, Digoxin, Lithium,
Theophylline, Vancomycin, Phenytoin) require routine therapeutic drug
monitoring (TDM).
2. Autonomic Nervous System & Receptor Fundamentals
Sympathetic (Adrenergic):
o $\alpha_1$: Vasoconstriction, pupil dilation (mydriasis), bladder sphincter
contraction.
o $\alpha_2$: Presynaptic inhibition of norepinephrine release (decreases
sympathetic outflow centrally).
o $\beta_1$: Increases heart rate (chronotropy), contractility (inotropy), and
renin release from juxtaglomerular cells.
o $\beta_2$: Bronchodilation, vasodilation in skeletal muscle, uterine relaxation,
glycogenolysis.
Parasympathetic (Cholinergic):
, o Muscarinic Receptors ($M_1, M_2, M_3$): $M_2$ slows heart rate; $M_3$
increases glandular secretions, smooth muscle contraction
(bronchoconstriction, GI motility, bladder detrusor contraction), and pupillary
constriction (miosis).
3. Prescribing Safety & Pharmacogenomics
CYP Enzyme Dynamics:
o Inducers (e.g., Rifampin, Carbamazepine, St. John's Wort, Phenytoin,
Phenobarbital): Increase enzyme synthesis $\rightarrow$ lower substrate
drug levels $\rightarrow$ treatment failure.
o Inhibitors (e.g., Ketoconazole, Erythromycin/Clarithromycin, Grapefruit juice,
Amiodarone, Diltiazem/Verapamil): Block enzyme activity $\rightarrow$
increase substrate drug levels $\rightarrow$ drug toxicity.
Pregnancy Categories & Lactation: Transfer of drugs across placenta and into
breast milk is highest for small, highly lipophilic, uncharged, non-protein-bound
drugs.
Part 2: Practice Exam (Questions 1–100)
Questions 1–25: Pharmacokinetics & Pharmacodynamics
Q1
Which route of administration delivers a drug directly into systemic circulation with $100\%$
bioavailability ($F = 1.0$), bypassing first-pass hepatic metabolism?
A) Oral
B) Intravenous
C) Sublingual
, D) Transdermal
Q2
A drug has an elimination half-life ($\text{t}_{1/2}$) of 6 hours. If a constant dose is
administered every 6 hours, approximately how many hours will it take for the drug to reach
steady-state concentration?
A) 6 to 12 hours
B) 12 to 18 hours
C) 24 to 30 hours
D) 48 to 60 hours
Q3
What happens to the dose-response curve of a full agonist when a competitive antagonist is
added?
A) The curve shifts to the right, increasing $\text{EC}_{50}$ while
$\text{E}_{\text{max}}$ remains unchanged.
B) The curve shifts down, decreasing $\text{E}_{\text{max}}$ while $\text{EC}_{50}$
remains unchanged.
C) The curve shifts to the left, decreasing $\text{EC}_{50}$.
D) Both $\text{E}_{\text{max}}$ and $\text{EC}_{50}$ decrease proportionally.
Q4
Which parameter determines the dosing interval required to maintain a target steady-state
plasma concentration of a drug?
