NUR 521 ADVANCED PHARMACOLOGY| COMPLETE EXAM 2026/2027
| QUESTIONS AND 100% VERIFIED ANSWERS | PASS GUARANTEE
Q: What is bioavailability? ANSWER The fraction of an administered
dose of unchanged drug that reaches the systemic circulation.
Q: Define first-pass metabolism. ANSWER The initial metabolism of a
drug by the liver before it reaches systemic circulation, often reducing
bioavailability.
Q: What is the volume of distribution (Vd)? ANSWER A theoretical
volume that relates the amount of drug in the body to its concentration
in the blood/plasma.
Q: How does a drug with a high Vd distribute? ANSWER It distributes
widely into tissues (e.g., lipophilic drugs) rather than staying in the
plasma.
Q: What is the therapeutic index (TI)? ANSWER The ratio of the toxic
dose to the therapeutic dose; a higher TI indicates a safer drug.
Q: Define steady state. ANSWER The point at which the amount of drug
entering the body equals the amount being eliminated (achieved after
~4-5 half-lives).
Q: Which Cytochrome P450 enzymes metabolize the majority of drugs?
ANSWER CYP3A4, CYP2D6, and CYP2C19.
Q: What is a strong CYP3A4 inhibitor to remember? ANSWER Ritonavir,
grapefruit juice, and ketoconazole.
Q: What is a strong CYP3A4 inducer to remember? ANSWER Rifampin
and St. John’s Wort.
Q: What is pharmacogenomics? ANSWER The study of how genes affect
a person's response to drugs.
,Q: What does it mean if a patient is an "ultra-rapid metabolizer"?
ANSWER They metabolize drugs too quickly, potentially leading to
therapeutic failure at standard doses.
Q: What is phase I metabolism? ANSWER Modification of the drug
molecule via oxidation, reduction, or hydrolysis (usually by CYP450).
Q: What is phase II metabolism? ANSWER Conjugation of the drug (e.g.,
glucuronidation, acetylation) to make it more water-soluble for
excretion.
Q: How do highly protein-bound drugs interact? ANSWER They can
displace one another from binding sites, increasing the free (active)
fraction and risk of toxicity.
Q: What is the mechanism of action of a prodrug? ANSWER It is
administered in an inactive form and must be metabolized by the body
to become active.
Q: Give an example of a prodrug. ANSWER Codeine (metabolized to
morphine by CYP2D6) or clopidogrel.
Q: What is the primary route of excretion for lipophilic drugs? ANSWER
They must undergo hepatic metabolism to become hydrophilic before
renal excretion.
Q: How does kidney disease affect pharmacokinetics? ANSWER It
decreases the clearance of drugs excreted unchanged by the kidneys,
requiring dose adjustments.
Q: What is the FDA Pregnancy Category X? ANSWER Drugs that are
absolutely contraindicated in pregnancy due to proven fetal risk (e.g.,
isotretinoin, warfarin).
Q: What is the effect of decreased albumin on highly protein-bound
drugs? ANSWER Increased free drug levels, increasing the risk of
toxicity.
Autonomic Nervous System
Q: What is the primary neurotransmitter of the parasympathetic
nervous system? ANSWER Acetylcholine (ACh).
Q: What are the two main types of cholinergic receptors? ANSWER
Muscarinic and Nicotinic.
, Q: What are the effects of muscarinic receptor stimulation? ANSWER
"SLUDGE" - Salivation, Lacrimation, Urination, Defecation,
Gastrointestinal distress, Emesis. Also bronchoconstriction and
bradycardia.
Q: What is the drug of choice for organophosphate poisoning? ANSWER
Atropine (to counter muscarinic effects) plus Pralidoxime (to
regenerate acetylcholinesterase).
Q: What is the mechanism of action of beta-blockers? ANSWER
Antagonism of beta-adrenergic receptors, decreasing heart rate,
myocardial contractility, and renin release.
Q: Which beta-blockers are considered "cardioselective"? ANSWER
Metoprolol and atenolol (block beta-1 > beta-2).
Q: Why are non-selective beta-blockers contraindicated in asthma?
ANSWER Blocking beta-2 receptors in the lungs causes
bronchoconstriction.
Q: Which beta-blockers have alpha-1 blocking effects (vasodilation)?
ANSWER Labetalol and carvedilol.
Q: What is a major adverse effect of alpha-1 blockers (e.g., prazosin)?
ANSWER First-dose orthostatic hypotension.
Q: What is the mechanism of action of centrally acting alpha-2 agonists
(e.g., clonidine)? ANSWER Stimulate alpha-2 receptors in the brain,
decreasing sympathetic outflow from the CNS.
Q: What is the primary adverse effect of clonidine if stopped abruptly?
ANSWER Rebound hypertension.
Q: What class of drugs is used to treat urinary retention in BPH by
relaxing bladder neck smooth muscle? ANSWER Alpha-1 blockers (e.g.,
tamsulosin).
Q: What is the mechanism of action of cholinesterase inhibitors (e.g.,
donepezil)? ANSWER Prevent the breakdown of acetylcholine,
increasing its concentration in the synapse.
Q: What are the anticholinergic adverse effects to watch for in the
elderly? ANSWER Urinary retention, constipation, dry mouth, blurred
vision, and delirium.
| QUESTIONS AND 100% VERIFIED ANSWERS | PASS GUARANTEE
Q: What is bioavailability? ANSWER The fraction of an administered
dose of unchanged drug that reaches the systemic circulation.
Q: Define first-pass metabolism. ANSWER The initial metabolism of a
drug by the liver before it reaches systemic circulation, often reducing
bioavailability.
Q: What is the volume of distribution (Vd)? ANSWER A theoretical
volume that relates the amount of drug in the body to its concentration
in the blood/plasma.
Q: How does a drug with a high Vd distribute? ANSWER It distributes
widely into tissues (e.g., lipophilic drugs) rather than staying in the
plasma.
Q: What is the therapeutic index (TI)? ANSWER The ratio of the toxic
dose to the therapeutic dose; a higher TI indicates a safer drug.
Q: Define steady state. ANSWER The point at which the amount of drug
entering the body equals the amount being eliminated (achieved after
~4-5 half-lives).
Q: Which Cytochrome P450 enzymes metabolize the majority of drugs?
ANSWER CYP3A4, CYP2D6, and CYP2C19.
Q: What is a strong CYP3A4 inhibitor to remember? ANSWER Ritonavir,
grapefruit juice, and ketoconazole.
Q: What is a strong CYP3A4 inducer to remember? ANSWER Rifampin
and St. John’s Wort.
Q: What is pharmacogenomics? ANSWER The study of how genes affect
a person's response to drugs.
,Q: What does it mean if a patient is an "ultra-rapid metabolizer"?
ANSWER They metabolize drugs too quickly, potentially leading to
therapeutic failure at standard doses.
Q: What is phase I metabolism? ANSWER Modification of the drug
molecule via oxidation, reduction, or hydrolysis (usually by CYP450).
Q: What is phase II metabolism? ANSWER Conjugation of the drug (e.g.,
glucuronidation, acetylation) to make it more water-soluble for
excretion.
Q: How do highly protein-bound drugs interact? ANSWER They can
displace one another from binding sites, increasing the free (active)
fraction and risk of toxicity.
Q: What is the mechanism of action of a prodrug? ANSWER It is
administered in an inactive form and must be metabolized by the body
to become active.
Q: Give an example of a prodrug. ANSWER Codeine (metabolized to
morphine by CYP2D6) or clopidogrel.
Q: What is the primary route of excretion for lipophilic drugs? ANSWER
They must undergo hepatic metabolism to become hydrophilic before
renal excretion.
Q: How does kidney disease affect pharmacokinetics? ANSWER It
decreases the clearance of drugs excreted unchanged by the kidneys,
requiring dose adjustments.
Q: What is the FDA Pregnancy Category X? ANSWER Drugs that are
absolutely contraindicated in pregnancy due to proven fetal risk (e.g.,
isotretinoin, warfarin).
Q: What is the effect of decreased albumin on highly protein-bound
drugs? ANSWER Increased free drug levels, increasing the risk of
toxicity.
Autonomic Nervous System
Q: What is the primary neurotransmitter of the parasympathetic
nervous system? ANSWER Acetylcholine (ACh).
Q: What are the two main types of cholinergic receptors? ANSWER
Muscarinic and Nicotinic.
, Q: What are the effects of muscarinic receptor stimulation? ANSWER
"SLUDGE" - Salivation, Lacrimation, Urination, Defecation,
Gastrointestinal distress, Emesis. Also bronchoconstriction and
bradycardia.
Q: What is the drug of choice for organophosphate poisoning? ANSWER
Atropine (to counter muscarinic effects) plus Pralidoxime (to
regenerate acetylcholinesterase).
Q: What is the mechanism of action of beta-blockers? ANSWER
Antagonism of beta-adrenergic receptors, decreasing heart rate,
myocardial contractility, and renin release.
Q: Which beta-blockers are considered "cardioselective"? ANSWER
Metoprolol and atenolol (block beta-1 > beta-2).
Q: Why are non-selective beta-blockers contraindicated in asthma?
ANSWER Blocking beta-2 receptors in the lungs causes
bronchoconstriction.
Q: Which beta-blockers have alpha-1 blocking effects (vasodilation)?
ANSWER Labetalol and carvedilol.
Q: What is a major adverse effect of alpha-1 blockers (e.g., prazosin)?
ANSWER First-dose orthostatic hypotension.
Q: What is the mechanism of action of centrally acting alpha-2 agonists
(e.g., clonidine)? ANSWER Stimulate alpha-2 receptors in the brain,
decreasing sympathetic outflow from the CNS.
Q: What is the primary adverse effect of clonidine if stopped abruptly?
ANSWER Rebound hypertension.
Q: What class of drugs is used to treat urinary retention in BPH by
relaxing bladder neck smooth muscle? ANSWER Alpha-1 blockers (e.g.,
tamsulosin).
Q: What is the mechanism of action of cholinesterase inhibitors (e.g.,
donepezil)? ANSWER Prevent the breakdown of acetylcholine,
increasing its concentration in the synapse.
Q: What are the anticholinergic adverse effects to watch for in the
elderly? ANSWER Urinary retention, constipation, dry mouth, blurred
vision, and delirium.
