1|Page
NGR5172 ADVANCED
PHARMACOLOGY FINAL NEWEST
ACTUAL EXAM PREPARATION
WITH COMPLETE QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALES | ALREADY GRADED
A+||BRAND NEW VERSION!!
Body factors related to distribution:
----Solution-----
Vascularity (poor perfusion, disruption of blood flow due to trauma--
difficulty distributing)
-Blood barriers (blood-brain-barrier can be problematic if we need to get
drugs to the brain--will need very high dosing since only a small amount
of the drug will get through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
-Drug interactions
What is the key plasma protein involved with protein binding for
medications?
,2|Page
----Solution----
Albumin
Why do we monitor albumin?
----Solution----
Indicative of nutritional status and how well protein-bound drugs will be
transported to their target locations
What happens to the therapeutic effect of a drug when the patient is
elderly and has very low levels of albumin?
----Solution----
The drug does not bind to the protein (albumin) as much as expected, so
there is a lot of free drug floating in the plasma; high risk for drug
toxicity
Protein bound means:
----Solution----
Inactive form of the drug; does not have any therapeutic effect when
bound to a protein
Free drug means:
----Solution----
Active form of the drug (available for therapeutic effect)
,3|Page
What happens when a patient is on two drugs that are competing for the
same protein binding site on the albumin?
----Solution----
Some drug interactions can occur. Drugs fight for binding position, but
both drugs do not get enough as the usually would. Leads to higher free
drug levels, decreased overall albumin binding, and potential toxicity for
both drugs.
**Unpredictable**
What is the 1st pass effect?
----Solution----
PO drug goes through GI tract and absorbs in the stomach or intestines
into local circulation that reaches the liver. The liver inactivates portions
of the drug before it goes into systemic circulation. Some drugs with a
very high 1st pass effect may have to be given IV (goes directly into
systemic circulation) or in higher PO doses (watch for side effects)
What does a substrate for an enzyme mean?
----Solution----
It needs it to undergo metabolism
What is an enzyme inducer?
----Solution----
It increases clearance of the drug (decreased blood levels of drug--may
need dose increase)
, 4|Page
What is an enzyme inhibitor?
----Solution----
It reduces clearance (increased blood levels of drug--may need dose
decrease)
Who is at risk for drug toxicity?
----Solution----
Elderly, those with decreased renal function
-Cannot properly excrete the drug
What are the key pharmacokinetic changes that occur during pregnancy?
----Solution----
-Decreased absorption
-Increased hepatic metabolism
-Increased renal excretion
**Dose adjustments are common during pregnancy
What is the safest drug category for pregnant women?
----Solution----
Category A
What is the contraindicated drug category for pregnant women?
NGR5172 ADVANCED
PHARMACOLOGY FINAL NEWEST
ACTUAL EXAM PREPARATION
WITH COMPLETE QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALES | ALREADY GRADED
A+||BRAND NEW VERSION!!
Body factors related to distribution:
----Solution-----
Vascularity (poor perfusion, disruption of blood flow due to trauma--
difficulty distributing)
-Blood barriers (blood-brain-barrier can be problematic if we need to get
drugs to the brain--will need very high dosing since only a small amount
of the drug will get through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
-Drug interactions
What is the key plasma protein involved with protein binding for
medications?
,2|Page
----Solution----
Albumin
Why do we monitor albumin?
----Solution----
Indicative of nutritional status and how well protein-bound drugs will be
transported to their target locations
What happens to the therapeutic effect of a drug when the patient is
elderly and has very low levels of albumin?
----Solution----
The drug does not bind to the protein (albumin) as much as expected, so
there is a lot of free drug floating in the plasma; high risk for drug
toxicity
Protein bound means:
----Solution----
Inactive form of the drug; does not have any therapeutic effect when
bound to a protein
Free drug means:
----Solution----
Active form of the drug (available for therapeutic effect)
,3|Page
What happens when a patient is on two drugs that are competing for the
same protein binding site on the albumin?
----Solution----
Some drug interactions can occur. Drugs fight for binding position, but
both drugs do not get enough as the usually would. Leads to higher free
drug levels, decreased overall albumin binding, and potential toxicity for
both drugs.
**Unpredictable**
What is the 1st pass effect?
----Solution----
PO drug goes through GI tract and absorbs in the stomach or intestines
into local circulation that reaches the liver. The liver inactivates portions
of the drug before it goes into systemic circulation. Some drugs with a
very high 1st pass effect may have to be given IV (goes directly into
systemic circulation) or in higher PO doses (watch for side effects)
What does a substrate for an enzyme mean?
----Solution----
It needs it to undergo metabolism
What is an enzyme inducer?
----Solution----
It increases clearance of the drug (decreased blood levels of drug--may
need dose increase)
, 4|Page
What is an enzyme inhibitor?
----Solution----
It reduces clearance (increased blood levels of drug--may need dose
decrease)
Who is at risk for drug toxicity?
----Solution----
Elderly, those with decreased renal function
-Cannot properly excrete the drug
What are the key pharmacokinetic changes that occur during pregnancy?
----Solution----
-Decreased absorption
-Increased hepatic metabolism
-Increased renal excretion
**Dose adjustments are common during pregnancy
What is the safest drug category for pregnant women?
----Solution----
Category A
What is the contraindicated drug category for pregnant women?
