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NU 518 MODULE 2 EXAM 2026/2027 |
ADVANCED PHARMACOLOGY | 40 VERIFIED
Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION 1: PHARMACOGENOMICS AND DRUG METABOLISM - Questions 1-10
Q1: Phase II Metabolism
The student is reviewing drug metabolism. Which of the following is an example of a Phase II
metabolic reaction?
A. Oxidation
B. Reduction
C. Hydrolysis
D. Glucuronidation
Correct Answer: D
Rationale: Phase II reactions involve conjugation of a drug or its metabolite with an endogenous
substance (e.g., glucuronic acid, sulfate, glycine) to increase water solubility and facilitate excretion.
Glucuronidation is the most common Phase II reaction. Oxidation, reduction, and hydrolysis are
Phase I reactions. [100% CORRECT]
Q2: CYP3A4 Inhibition
The student is reviewing cytochrome P450 interactions. Which drug is a strong inhibitor of CYP3A4?
A. Rifampin
B. Carbamazepine
C. Ketoconazole
D. Phenytoin
Correct Answer: C
Rationale: Ketoconazole is a potent inhibitor of CYP3A4, increasing the levels of drugs metabolized
by this enzyme (e.g., statins, benzodiazepines, immunosuppressants). Rifampin, carbamazepine, and
phenytoin are inducers of CYP3A4. [100% CORRECT]
Q3: Warfarin Pharmacogenomics
The student is reviewing pharmacogenomics. Which genetic polymorphism increases sensitivity to
warfarin?
, 2
A. CYP2C9 poor metabolizer
B. VKORC1 -1639G>A
C. CYP2D6 ultra-rapid metabolizer
D. HLA-B*5701
Correct Answer: B
Rationale: The VKORC1 -1639G>A polymorphism reduces the expression of vitamin K epoxide
reductase, the target of warfarin, leading to increased sensitivity and a lower dose requirement.
CYP2C9 poor metabolizer status also increases warfarin sensitivity by reducing its metabolism, but
VKORC1 is a direct pharmacodynamic variant. [100% CORRECT]
Q4: Prodrug Activation by CYP2D6
The student is reviewing prodrugs. Which analgesic requires CYP2D6 for conversion to its active
metabolite?
A. Morphine
B. Tramadol
C. Oxycodone
D. Fentanyl
Correct Answer: B
Rationale: Tramadol is a prodrug that is metabolized by CYP2D6 to O-desmethyltramadol, which has
greater analgesic potency. Poor metabolizers may experience reduced analgesia. Morphine,
oxycodone, and fentanyl are active parent drugs. [100% CORRECT]
Q5: Phase I Reactions
The student is reviewing drug metabolism. Which cytochrome P450 enzyme is responsible for the
metabolism of approximately 50% of drugs?
A. CYP2D6
B. CYP2C9
C. CYP3A4
D. CYP1A2
Correct Answer: C
Rationale: CYP3A4 is the most abundant CYP enzyme in the liver and intestine and metabolizes
approximately 50% of all drugs. CYP2D6, CYP2C9, and CYP1A2 also play significant roles but are less
dominant. [100% CORRECT]
Q6: Acetylation Polymorphism
The student is reviewing pharmacogenomics. Slow acetylators are at increased risk of toxicity from
which drug?
NU 518 MODULE 2 EXAM 2026/2027 |
ADVANCED PHARMACOLOGY | 40 VERIFIED
Q&A | DETAILED RATIONALES | NGN-
ALIGNED | PASS GUARANTEED – A+ GRADED
SECTION 1: PHARMACOGENOMICS AND DRUG METABOLISM - Questions 1-10
Q1: Phase II Metabolism
The student is reviewing drug metabolism. Which of the following is an example of a Phase II
metabolic reaction?
A. Oxidation
B. Reduction
C. Hydrolysis
D. Glucuronidation
Correct Answer: D
Rationale: Phase II reactions involve conjugation of a drug or its metabolite with an endogenous
substance (e.g., glucuronic acid, sulfate, glycine) to increase water solubility and facilitate excretion.
Glucuronidation is the most common Phase II reaction. Oxidation, reduction, and hydrolysis are
Phase I reactions. [100% CORRECT]
Q2: CYP3A4 Inhibition
The student is reviewing cytochrome P450 interactions. Which drug is a strong inhibitor of CYP3A4?
A. Rifampin
B. Carbamazepine
C. Ketoconazole
D. Phenytoin
Correct Answer: C
Rationale: Ketoconazole is a potent inhibitor of CYP3A4, increasing the levels of drugs metabolized
by this enzyme (e.g., statins, benzodiazepines, immunosuppressants). Rifampin, carbamazepine, and
phenytoin are inducers of CYP3A4. [100% CORRECT]
Q3: Warfarin Pharmacogenomics
The student is reviewing pharmacogenomics. Which genetic polymorphism increases sensitivity to
warfarin?
, 2
A. CYP2C9 poor metabolizer
B. VKORC1 -1639G>A
C. CYP2D6 ultra-rapid metabolizer
D. HLA-B*5701
Correct Answer: B
Rationale: The VKORC1 -1639G>A polymorphism reduces the expression of vitamin K epoxide
reductase, the target of warfarin, leading to increased sensitivity and a lower dose requirement.
CYP2C9 poor metabolizer status also increases warfarin sensitivity by reducing its metabolism, but
VKORC1 is a direct pharmacodynamic variant. [100% CORRECT]
Q4: Prodrug Activation by CYP2D6
The student is reviewing prodrugs. Which analgesic requires CYP2D6 for conversion to its active
metabolite?
A. Morphine
B. Tramadol
C. Oxycodone
D. Fentanyl
Correct Answer: B
Rationale: Tramadol is a prodrug that is metabolized by CYP2D6 to O-desmethyltramadol, which has
greater analgesic potency. Poor metabolizers may experience reduced analgesia. Morphine,
oxycodone, and fentanyl are active parent drugs. [100% CORRECT]
Q5: Phase I Reactions
The student is reviewing drug metabolism. Which cytochrome P450 enzyme is responsible for the
metabolism of approximately 50% of drugs?
A. CYP2D6
B. CYP2C9
C. CYP3A4
D. CYP1A2
Correct Answer: C
Rationale: CYP3A4 is the most abundant CYP enzyme in the liver and intestine and metabolizes
approximately 50% of all drugs. CYP2D6, CYP2C9, and CYP1A2 also play significant roles but are less
dominant. [100% CORRECT]
Q6: Acetylation Polymorphism
The student is reviewing pharmacogenomics. Slow acetylators are at increased risk of toxicity from
which drug?
