7/28/25, 11:57 PM NURS 682: Pharmacology Midterm Review
NURS 682 PHARMACOLOGY MIDTERM REVIEW EXAM
2025-2026 LATEST VERSION WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
\VERIFIED 100% ALREADY GRADED A+
-Healthy adults 20-30 vs. 60- Volume of distribution: age related changes
80
-Older adults get more
dehydrated
-Medications that are
lipophilic will stay longer in
the older adult and older
adults get
-Liver shrinks with age and
albumin is synthesized in
the liver. There is freer drug
available in highly protein
bound drugs—-
>Decrease in serum albumin
-Most drugs are
biotransformed in the liver,
with older adults there is
slower transformation and
longer half lives
Aging Factors that influence volume of distribution
-less free water, more body
fat
-lower average
serum albumin
Hydration Status
Compartment and volume
1/113
,7/28/25, 11:57 PM NURS 682: Pharmacology Midterm Review
Biostranformation and/or First Pass Effect (pre-systemic elimination)
excretion of oral drug by
hepatic mechanisms
-occurs prior to
entering GI tract
Drugs absorbed from
the GI tract
Extensive hepatic
metabolism.extraciton
Ex. IV vs oral dosages
Works primarily by Agonists
stimulating the activity of a
receptor site
binds to a receptor, causes
an effect similar to
endogenous compound
Clinical action= occupying a Antagonist
receptor site and inhibiting
its endogenous activity
2/113
,7/28/25, 11:57 PM NURS 682: Pharmacology Midterm Review
small differences in drug Narrow therapeutic Index
dose or blood
concentration can be fatal
Any pharmaceutical which
has <2-fold difference
between the minimum toxic
concentration and minimum
effective concentration in
blood
Greater distance between Wide therapeutic index
effective dose and toxic
dose
Ex. Fluoxetine does NOT
need drug monitoring
Drug absorption, distribution, Pharmacogenetics: PK genetic influences
metabolism, excretion
Influence dose requirements
and/or adverse effects
Drug targets: Receptors, Pharmacogenetics: PD genetic influences
transporters, intracellular
signaling pathways, enzymes
and metabolic pathways
Influence drug efficacy
Ventricular repolarization Drugs with QT prolongation
prolongation
Ectopic beats with long
pause follow by baseline
rhythm beat with marked
prolonged QT interval
Underlying risk factors +
Adding medications with QT
3/113
, 7/28/25, 11:57 PM NURS 682: Pharmacology Midterm Review
prolonging effects
Known: Amiodarone, Haldol
OLDER AGE Known risk of QT prolongaiton
Older adults have.... Summary of Age-Related Changes
-less % body weight as water
-less lean muscle mass
-higher % weight as fat
-LOWER SERIUM ALBUMIN**
-lower relative kidney weight
-less relative hepatic blood
flow
Unconditionally Beer's Criteria
inappropriate meds &
Generally best avoided
regardless of
circumstances
Usually alternative available
Conditioned upon disease
state & dose Likely only to
be inappropriate in specific
context
4/113
NURS 682 PHARMACOLOGY MIDTERM REVIEW EXAM
2025-2026 LATEST VERSION WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
\VERIFIED 100% ALREADY GRADED A+
-Healthy adults 20-30 vs. 60- Volume of distribution: age related changes
80
-Older adults get more
dehydrated
-Medications that are
lipophilic will stay longer in
the older adult and older
adults get
-Liver shrinks with age and
albumin is synthesized in
the liver. There is freer drug
available in highly protein
bound drugs—-
>Decrease in serum albumin
-Most drugs are
biotransformed in the liver,
with older adults there is
slower transformation and
longer half lives
Aging Factors that influence volume of distribution
-less free water, more body
fat
-lower average
serum albumin
Hydration Status
Compartment and volume
1/113
,7/28/25, 11:57 PM NURS 682: Pharmacology Midterm Review
Biostranformation and/or First Pass Effect (pre-systemic elimination)
excretion of oral drug by
hepatic mechanisms
-occurs prior to
entering GI tract
Drugs absorbed from
the GI tract
Extensive hepatic
metabolism.extraciton
Ex. IV vs oral dosages
Works primarily by Agonists
stimulating the activity of a
receptor site
binds to a receptor, causes
an effect similar to
endogenous compound
Clinical action= occupying a Antagonist
receptor site and inhibiting
its endogenous activity
2/113
,7/28/25, 11:57 PM NURS 682: Pharmacology Midterm Review
small differences in drug Narrow therapeutic Index
dose or blood
concentration can be fatal
Any pharmaceutical which
has <2-fold difference
between the minimum toxic
concentration and minimum
effective concentration in
blood
Greater distance between Wide therapeutic index
effective dose and toxic
dose
Ex. Fluoxetine does NOT
need drug monitoring
Drug absorption, distribution, Pharmacogenetics: PK genetic influences
metabolism, excretion
Influence dose requirements
and/or adverse effects
Drug targets: Receptors, Pharmacogenetics: PD genetic influences
transporters, intracellular
signaling pathways, enzymes
and metabolic pathways
Influence drug efficacy
Ventricular repolarization Drugs with QT prolongation
prolongation
Ectopic beats with long
pause follow by baseline
rhythm beat with marked
prolonged QT interval
Underlying risk factors +
Adding medications with QT
3/113
, 7/28/25, 11:57 PM NURS 682: Pharmacology Midterm Review
prolonging effects
Known: Amiodarone, Haldol
OLDER AGE Known risk of QT prolongaiton
Older adults have.... Summary of Age-Related Changes
-less % body weight as water
-less lean muscle mass
-higher % weight as fat
-LOWER SERIUM ALBUMIN**
-lower relative kidney weight
-less relative hepatic blood
flow
Unconditionally Beer's Criteria
inappropriate meds &
Generally best avoided
regardless of
circumstances
Usually alternative available
Conditioned upon disease
state & dose Likely only to
be inappropriate in specific
context
4/113
