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NURS 5334 ADVANCED PHARMACOLOGY
EXAM 1 PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY
A GRADD WITH EXPERT FEEDBACK |NEW
AND REVISED
What is distribution? - ANSWER- How a drug will be transported to the
tissues it needs to go to in order for it to exert its effects
Drug factors related to distribution: - ANSWER- -Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
-Therapeutic effects
-Toxic effects
(lipid soluble, small, and non-ionized drugs will distribute more quickly)
Body factors related to distribution: - ANSWER- -Vascularity (poor
perfusion, disruption of blood flow due to trauma--difficulty
distributing)
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-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? - ANSWER- Albumin
Why do we monitor albumin? - ANSWER- 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? - ANSWER- 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: - ANSWER- Inactive form of the drug; does not
have any therapeutic effect when bound to a protein
Free drug means: - ANSWER- Active form of the drug (available for
therapeutic effect)
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What happens when a patient is on two drugs that are competing for the
same protein binding site on the albumin? - ANSWER- 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? - ANSWER- 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? - ANSWER- It needs it to
undergo metabolism
What is an enzyme inducer? - ANSWER- It increases clearance of the
drug (decreased blood levels of drug--may need dose increase)
What is an enzyme inhibitor? - ANSWER- It reduces clearance
(increased blood levels of drug--may need dose decrease)
Who is at risk for drug toxicity? - ANSWER- Elderly, those with
decreased renal function
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-Cannot properly excrete the drug
What are the key pharmacokinetic changes that occur during pregnancy?
- ANSWER- -Decreased absorption
-Increased hepatic metabolism
-Increased renal excretion
**Dose adjustments are common during pregnancy
What is the safest drug category for pregnant women? - ANSWER-
Category A
What is the contraindicated drug category for pregnant women? -
ANSWER- Category X
What is pharmacodynamics? - ANSWER- What the drug does to the
body
What is a drug's half-life? - ANSWER- The time it takes for the
concentration of a drug in the body to be reduced by 50%
How many half-lives does it take to remove most of the drug from the
body? - ANSWER- Appx 4
NURS 5334 ADVANCED PHARMACOLOGY
EXAM 1 PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY
A GRADD WITH EXPERT FEEDBACK |NEW
AND REVISED
What is distribution? - ANSWER- How a drug will be transported to the
tissues it needs to go to in order for it to exert its effects
Drug factors related to distribution: - ANSWER- -Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
-Therapeutic effects
-Toxic effects
(lipid soluble, small, and non-ionized drugs will distribute more quickly)
Body factors related to distribution: - ANSWER- -Vascularity (poor
perfusion, disruption of blood flow due to trauma--difficulty
distributing)
,2|Page
-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? - ANSWER- Albumin
Why do we monitor albumin? - ANSWER- 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? - ANSWER- 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: - ANSWER- Inactive form of the drug; does not
have any therapeutic effect when bound to a protein
Free drug means: - ANSWER- 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? - ANSWER- 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? - ANSWER- 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? - ANSWER- It needs it to
undergo metabolism
What is an enzyme inducer? - ANSWER- It increases clearance of the
drug (decreased blood levels of drug--may need dose increase)
What is an enzyme inhibitor? - ANSWER- It reduces clearance
(increased blood levels of drug--may need dose decrease)
Who is at risk for drug toxicity? - ANSWER- Elderly, those with
decreased renal function
, 4|Page
-Cannot properly excrete the drug
What are the key pharmacokinetic changes that occur during pregnancy?
- ANSWER- -Decreased absorption
-Increased hepatic metabolism
-Increased renal excretion
**Dose adjustments are common during pregnancy
What is the safest drug category for pregnant women? - ANSWER-
Category A
What is the contraindicated drug category for pregnant women? -
ANSWER- Category X
What is pharmacodynamics? - ANSWER- What the drug does to the
body
What is a drug's half-life? - ANSWER- The time it takes for the
concentration of a drug in the body to be reduced by 50%
How many half-lives does it take to remove most of the drug from the
body? - ANSWER- Appx 4
