NUR 635 ADVANCED PHARMACOLOGY
MIDTERM ACTUAL EXAM SCRIPT 2026
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
GRADED A+
⩥ Pharmacokinetics includes the following:
Answer: ADME (absorption, distribution, metabolism and elimination).
⩥ Pharmacokinetics is...
Answer: How the body effects the drug
⩥ Absorption
Answer: absorption from the administration site either directly or
indirectly into the blood/plasma.
⩥ Distribution
Answer: reversibly/irreversibly movement of drug from the bloodstream
into the interstitial and intracellular fluid.
⩥ Metabolism
,Answer: drug biotransformation via metabolic pathways, primarily the
liver, or by other tissues.
⩥ Elimination
Answer: how parent drug & its metabolites are eliminated from the body
⩥ Absorption factors
Answer: · Gastrointestinal pH changes
· Gastric emptying
· Gastric/intestinal enzymes
· Bile acids & biliary function
· Gastrointestinal flora (type and quantity of bacteria)
· Food & nutrient interactions (most common interaction influencing GI
drug absorption)
· Lipid solubility of the drug
⩥ Distribution factors
Answer: · Membrane permeability: Cross membranes to site of action
· Blood brain barrier reduces the speed of drug passage into and out of
brain tissue
· Plasma protein binding: drugs bound to plasma proteins do not cross
membranes (Note: Malnutrition = âalbumin = á free drug = greater
pharmacologic response)
,· Aging cause a reduction in production of plasma proteins
· Lipophilicity of drug: lipophilic drugs concentrate in adipose tissue;
remain in the body for a longer period of time
⩥ Volume of distribution
Answer: · Body Composition
- Increased Total body water and extracellular fluid
-Decreased Adipose tissue and skeletal muscle
· Protein Binding (changes with aging)
-Albumin, bilirubin, a1-acid glycoprotein
-Albumin affected by nutrition
-Low albumin (hypoalbuminemia) can cause less protein-bound drug
reaching the tissue site of action.
· Tissue Binding
- Compositional changes
⩥ Metabolism factors
Answer: o Drugs can undergo metabolism in the lungs, blood, liver,
intestines and kidney
o Volatile drugs are primarily excreted by the lungs
· The body changes drugs to more or less active forms (metabolites),
increases water solubility to increase elimination.
, ⩥ Phase 1 Metabolism
Answer: · Cytochrome P450 system
· Located within the endoplasmic reticulum of hepatocytes.
· Through electron transport chain, a drug bound to the CYP450 system
undergoes oxidation or reduction.
· Drug metabolism in the liver is also affected by:
-Enzyme induction
- Drug interactions
⩥ CYP450
Answer: · CYP: a set of isozymes primarily found in the liver and GI
tract
· Convert lipophilic drugs into more polar (and soluble) molecules
· Considerable genetic variability exists across race and gender
· Results in CYP450 polymorphisms which have a direct effect on drug
metabolism.
⩥ Four isozymes are responsible for the majority of Phase I Metabolism
reactions
Answer: 1. CYP3A4/5
2. CYP2D6
3. CYP2C8/9
4. CYP1A2
MIDTERM ACTUAL EXAM SCRIPT 2026
COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
GRADED A+
⩥ Pharmacokinetics includes the following:
Answer: ADME (absorption, distribution, metabolism and elimination).
⩥ Pharmacokinetics is...
Answer: How the body effects the drug
⩥ Absorption
Answer: absorption from the administration site either directly or
indirectly into the blood/plasma.
⩥ Distribution
Answer: reversibly/irreversibly movement of drug from the bloodstream
into the interstitial and intracellular fluid.
⩥ Metabolism
,Answer: drug biotransformation via metabolic pathways, primarily the
liver, or by other tissues.
⩥ Elimination
Answer: how parent drug & its metabolites are eliminated from the body
⩥ Absorption factors
Answer: · Gastrointestinal pH changes
· Gastric emptying
· Gastric/intestinal enzymes
· Bile acids & biliary function
· Gastrointestinal flora (type and quantity of bacteria)
· Food & nutrient interactions (most common interaction influencing GI
drug absorption)
· Lipid solubility of the drug
⩥ Distribution factors
Answer: · Membrane permeability: Cross membranes to site of action
· Blood brain barrier reduces the speed of drug passage into and out of
brain tissue
· Plasma protein binding: drugs bound to plasma proteins do not cross
membranes (Note: Malnutrition = âalbumin = á free drug = greater
pharmacologic response)
,· Aging cause a reduction in production of plasma proteins
· Lipophilicity of drug: lipophilic drugs concentrate in adipose tissue;
remain in the body for a longer period of time
⩥ Volume of distribution
Answer: · Body Composition
- Increased Total body water and extracellular fluid
-Decreased Adipose tissue and skeletal muscle
· Protein Binding (changes with aging)
-Albumin, bilirubin, a1-acid glycoprotein
-Albumin affected by nutrition
-Low albumin (hypoalbuminemia) can cause less protein-bound drug
reaching the tissue site of action.
· Tissue Binding
- Compositional changes
⩥ Metabolism factors
Answer: o Drugs can undergo metabolism in the lungs, blood, liver,
intestines and kidney
o Volatile drugs are primarily excreted by the lungs
· The body changes drugs to more or less active forms (metabolites),
increases water solubility to increase elimination.
, ⩥ Phase 1 Metabolism
Answer: · Cytochrome P450 system
· Located within the endoplasmic reticulum of hepatocytes.
· Through electron transport chain, a drug bound to the CYP450 system
undergoes oxidation or reduction.
· Drug metabolism in the liver is also affected by:
-Enzyme induction
- Drug interactions
⩥ CYP450
Answer: · CYP: a set of isozymes primarily found in the liver and GI
tract
· Convert lipophilic drugs into more polar (and soluble) molecules
· Considerable genetic variability exists across race and gender
· Results in CYP450 polymorphisms which have a direct effect on drug
metabolism.
⩥ Four isozymes are responsible for the majority of Phase I Metabolism
reactions
Answer: 1. CYP3A4/5
2. CYP2D6
3. CYP2C8/9
4. CYP1A2
