NRNP 6566 Midterm year 2025 ,150+
questions and well written answers
(100%) upgraded upto2026 graded A+
Describe cytochrome p450 system - 100 correct
answer as-Cytochrome p450 system is a series of
enzymes used to metabolize medications
Inhibitors - 100 correct answer as-block metabolic
activity from one or more CYP450 enzymes
Inducers - 100 correct answer as-increase CYP450
enzyme activity by increasing enzyme synthesis
Describe effect on low and high albumin levels on active
drug levels especially for drugs that are highly protein
bound - 100 correct answer as-Albumin is the
plasma protein with the greatest capacity for binding
drugs. Binding plasma proteins affect drug distribution into
tissues, because only drug that is not bound is available to
penetrate tissues, bind to receptors, and exert activity. As
free drug leaves the blood stream, more bound drug is
released from binding sites.
Low albumin levels - 100 correct answer as-
malnutrition, chronic illness
,Highly protein bound drugs can lead to - 100 correct
answer as-toxicity in patients with low albumin levels,
example malnutrition or chronic illness. This is because
there are fewer than the normal sites for the drug to bind
Describe the ways the hepatic first pass effect- which is
metabolism during first pass through the liver - 100
correct answer as-Alternative routes include:
suppository
intravenous
intramuscular
inhalational aerosol
transdermal
sublingual
These allow drugs to bypass the first-pass effect and be
absorbed directly into systemic circulation
Be able to calculate creatinine clearance using Cockgraft
Gault equation: - 100 correct answer as-Male = 140-
age times weight in kilograms divided by serum creatinine
times 72.
Women = CRCL (male) times 0.85
Describe what determines the frequency of drug
administration - 100 correct answer as-half life
plasma concentration
, Be familiar with the beers criteria and how to use it - 100
correct answer as-Potentially Inappropriate
Medication Use in Older Adults
to call attention to medications that are most commonly
problematic and thus should be avoided in older adults
Describe factors that affect absorption - 100 correct
answer as-low blood state (shock or arrest), contact
time with GI tract too fast (diarrhea = cant absorb),
delayed stomach emptying (large meal = delayed
absorption)Drug- to drug or drug to food interactions
Describe the factors that affect distribution - 100 correct
answer as-low albumin levels, body composition,
cardiac decompensation (heart failure), age
Describe the factors that affect metabolism - 100
correct answer as-genetics, age, organ function
Describe factors that affect excretion - 100 correct
answer as-affected by abnormal kidney or liver function,
age, drug interactions
Define narrow therapeutic index. How would you monitor a
patient with a narrow therapeutic index? - 100 correct
answer as-Therapeutic index is the dose range of
effiency of med is optimized while side effects are
minimized
questions and well written answers
(100%) upgraded upto2026 graded A+
Describe cytochrome p450 system - 100 correct
answer as-Cytochrome p450 system is a series of
enzymes used to metabolize medications
Inhibitors - 100 correct answer as-block metabolic
activity from one or more CYP450 enzymes
Inducers - 100 correct answer as-increase CYP450
enzyme activity by increasing enzyme synthesis
Describe effect on low and high albumin levels on active
drug levels especially for drugs that are highly protein
bound - 100 correct answer as-Albumin is the
plasma protein with the greatest capacity for binding
drugs. Binding plasma proteins affect drug distribution into
tissues, because only drug that is not bound is available to
penetrate tissues, bind to receptors, and exert activity. As
free drug leaves the blood stream, more bound drug is
released from binding sites.
Low albumin levels - 100 correct answer as-
malnutrition, chronic illness
,Highly protein bound drugs can lead to - 100 correct
answer as-toxicity in patients with low albumin levels,
example malnutrition or chronic illness. This is because
there are fewer than the normal sites for the drug to bind
Describe the ways the hepatic first pass effect- which is
metabolism during first pass through the liver - 100
correct answer as-Alternative routes include:
suppository
intravenous
intramuscular
inhalational aerosol
transdermal
sublingual
These allow drugs to bypass the first-pass effect and be
absorbed directly into systemic circulation
Be able to calculate creatinine clearance using Cockgraft
Gault equation: - 100 correct answer as-Male = 140-
age times weight in kilograms divided by serum creatinine
times 72.
Women = CRCL (male) times 0.85
Describe what determines the frequency of drug
administration - 100 correct answer as-half life
plasma concentration
, Be familiar with the beers criteria and how to use it - 100
correct answer as-Potentially Inappropriate
Medication Use in Older Adults
to call attention to medications that are most commonly
problematic and thus should be avoided in older adults
Describe factors that affect absorption - 100 correct
answer as-low blood state (shock or arrest), contact
time with GI tract too fast (diarrhea = cant absorb),
delayed stomach emptying (large meal = delayed
absorption)Drug- to drug or drug to food interactions
Describe the factors that affect distribution - 100 correct
answer as-low albumin levels, body composition,
cardiac decompensation (heart failure), age
Describe the factors that affect metabolism - 100
correct answer as-genetics, age, organ function
Describe factors that affect excretion - 100 correct
answer as-affected by abnormal kidney or liver function,
age, drug interactions
Define narrow therapeutic index. How would you monitor a
patient with a narrow therapeutic index? - 100 correct
answer as-Therapeutic index is the dose range of
effiency of med is optimized while side effects are
minimized
