Chamberlain NR 565 Final Exam 4 – Advanced Pharmacology Actual Questions
and Answers (PDF).
Pharmacokinetics & Pharmacodynamics (Questions 1–20)
1. A drug with a half‑life of 24 hours is given once daily. Approximately how many
days until steady state is reached?
A) 1 day
B) 3 days
C) 5 days
D) 7 days
Answer: C
Rationale: Steady state is reached after about 4–5 half‑lives. 5 × 24h = 120h = 5
days.
2. Which phase of drug metabolism most often produces inactive, conjugated
metabolites?
A) Phase I (oxidation)
B) Phase II (glucuronidation)
C) Absorption
,D) Distribution
Answer: B
Rationale: Phase II reactions (e.g., glucuronidation, sulfation) add polar groups,
increasing renal excretion, usually inactivating the drug.
3. A drug with high first‑pass effect is given orally. What change would most
increase its bioavailability?
A) Give with food
B) Change to intravenous route
C) Crush the tablet
D) Increase the dose
Answer: B
Rationale: IV route completely avoids first‑pass hepatic metabolism, dramatically
increasing bioavailability.
4. Which CYP enzyme is most commonly involved in clinically significant drug
interactions?
A) CYP1A2
,B) CYP2D6
C) CYP3A4
D) CYP2C9
Answer: C
Rationale: CYP3A4 metabolizes ~50% of all drugs; inhibition or induction causes
many interactions (e.g., statins, macrolides, azole antifungals).
5. A patient has a genetic variant causing poor CYP2D6 metabolism. Codeine will
likely be:
A) More effective
B) Less effective
C) Toxic
D) Unchanged
Answer: B
Rationale: Codeine is a prodrug requiring CYP2D6 to convert to morphine. Poor
metabolizers get little analgesia.
6. Which is an example of zero‑order kinetics?
, A) Phenytoin
B) Lisinopril
C) Metformin
D) Amoxicillin
Answer: A
Rationale: Phenytoin saturates hepatic enzymes at therapeutic doses; elimination
rate is constant, not proportional to concentration.
7. A drug with a narrow therapeutic index requires:
A) Less frequent monitoring
B) Therapeutic drug monitoring
C) Fixed dosing for all patients
D) Only oral administration
Answer: B
Rationale: Narrow therapeutic index (e.g., warfarin, digoxin, lithium) means small
changes in dose/concentration cause toxicity or failure; TDM is essential.
8. Volume of distribution (Vd) is high for a drug. This suggests:
and Answers (PDF).
Pharmacokinetics & Pharmacodynamics (Questions 1–20)
1. A drug with a half‑life of 24 hours is given once daily. Approximately how many
days until steady state is reached?
A) 1 day
B) 3 days
C) 5 days
D) 7 days
Answer: C
Rationale: Steady state is reached after about 4–5 half‑lives. 5 × 24h = 120h = 5
days.
2. Which phase of drug metabolism most often produces inactive, conjugated
metabolites?
A) Phase I (oxidation)
B) Phase II (glucuronidation)
C) Absorption
,D) Distribution
Answer: B
Rationale: Phase II reactions (e.g., glucuronidation, sulfation) add polar groups,
increasing renal excretion, usually inactivating the drug.
3. A drug with high first‑pass effect is given orally. What change would most
increase its bioavailability?
A) Give with food
B) Change to intravenous route
C) Crush the tablet
D) Increase the dose
Answer: B
Rationale: IV route completely avoids first‑pass hepatic metabolism, dramatically
increasing bioavailability.
4. Which CYP enzyme is most commonly involved in clinically significant drug
interactions?
A) CYP1A2
,B) CYP2D6
C) CYP3A4
D) CYP2C9
Answer: C
Rationale: CYP3A4 metabolizes ~50% of all drugs; inhibition or induction causes
many interactions (e.g., statins, macrolides, azole antifungals).
5. A patient has a genetic variant causing poor CYP2D6 metabolism. Codeine will
likely be:
A) More effective
B) Less effective
C) Toxic
D) Unchanged
Answer: B
Rationale: Codeine is a prodrug requiring CYP2D6 to convert to morphine. Poor
metabolizers get little analgesia.
6. Which is an example of zero‑order kinetics?
, A) Phenytoin
B) Lisinopril
C) Metformin
D) Amoxicillin
Answer: A
Rationale: Phenytoin saturates hepatic enzymes at therapeutic doses; elimination
rate is constant, not proportional to concentration.
7. A drug with a narrow therapeutic index requires:
A) Less frequent monitoring
B) Therapeutic drug monitoring
C) Fixed dosing for all patients
D) Only oral administration
Answer: B
Rationale: Narrow therapeutic index (e.g., warfarin, digoxin, lithium) means small
changes in dose/concentration cause toxicity or failure; TDM is essential.
8. Volume of distribution (Vd) is high for a drug. This suggests:
