NRNP 6566 FINAL EXAM 4 2026 COMPLETE
STUDY GUIDE HIGH YIELD CONCEPTS A+
◉ Inhibitors. Answer: block metabolic activity from one or more
CYP450 enzymes
◉ Inducers. Answer: 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. Answer:
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. Answer: malnutrition, chronic illness
◉ Highly protein bound drugs can lead to. Answer: 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. Answer: 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:. Answer: 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.
Answer: half life
plasma concentration
◉ Be familiar with the beers criteria and how to use it. Answer:
Potentially Inappropriate Medication Use in Older Adults
STUDY GUIDE HIGH YIELD CONCEPTS A+
◉ Inhibitors. Answer: block metabolic activity from one or more
CYP450 enzymes
◉ Inducers. Answer: 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. Answer:
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. Answer: malnutrition, chronic illness
◉ Highly protein bound drugs can lead to. Answer: 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. Answer: 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:. Answer: 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.
Answer: half life
plasma concentration
◉ Be familiar with the beers criteria and how to use it. Answer:
Potentially Inappropriate Medication Use in Older Adults
