NURS 615 PHARM EXAM 1 MARYVILLE 2026/2027 | NURSING STUDY
GUIDE, PRACTICE QUESTIONS, ANSWERS & EXAM REVIEW
Low albumin = freer drug (bc the drug can't bind to albumin aka protein) = increased adverse effects -
ANS ✔✔How does hypoalbuminemia affect the process of prescribing?
is considered a contraindication to administer that drug. - ANS ✔✔What is a Black Box Warning:
Half-life specifically means the amount of time it takes for an administered drug to be halfway cleared
from the system. - ANS ✔✔What is the drugs half-life?
the time between drug administration and maximum concentration of drug in the blood stream. Best
therapeutic effect. - ANS ✔✔Peak of action:
the time between onset of action and metabolism of drug below the minimum needed for an effect. The
length of time you have the drug in your system. - ANS ✔✔Duration of action:
The first step is to define the patient's problem - ANS ✔✔According to the WHO what is the first step in
the prescribing process?
specify the therapeutic objective - ANS ✔✔The second step is to
choose which drug or treatment is needed. - ANS ✔✔The third step is to
Start the treatment - ANS ✔✔Step 4 of the WHO approach:
Educate the patient - ANS ✔✔Step 5 of the WHO approach:
Monitor the treatment - ANS ✔✔Step 6 of the WHO approach:
The drug is tested on healthy volunteers - ANS ✔✔Phase 1 of drug development:
trials with people who have the disease for which the drug is thought to be effective - ANS ✔✔Phase 2
of drug development:
Large numbers of patients in medical research centers receive the drug in phase 3. This larger sampling
provides information about infrequent or rare adverse effects. The FFA will approve a new drug
application if phase 3 studies are satisfactory. - ANS ✔✔Phase 3 of drug development:
This phase is voluntary and involves postmarket surveillance of the drug's therapeutic effects at the
completion of phase 3. The pharmaceutical company receives reports from doctors and other health
care professionals about the therapeutic results and adverse effects of the drug. Some medications, for
example, have been found to be toxic and have been removed from the market after their initial release.
- ANS ✔✔Phase 4 of drug development:
, much of the drug is lost in the absorption process. The liver metabolizes many drugs, thus reduces the
bioavailabilty of the drug. - ANS ✔✔Explain first pass metabolism
The fastest route of absorption is inhalation, and not as mistakenly considered the IV administration. -
ANS ✔✔What is the fasted route of absorption:
The GI tract is lined with epithelial cells; drugs must permeate through these cells in order to be
absorbed into the circulatory system. - ANS ✔✔Why does the GI tract take longer to absorb?
the cell membrane. Cell membranes are essentially lipid bilayers which form a semipermeable
membrane. Pure lipid bilayers are generally permeable only to small and uncharged solutes, hence
whether or not a molecule is ionized will affect its absorption, since ionic molecules are charged. - ANS
✔✔What is One particular cellular barrier that may prevent absorption of a given drug?
Solubility favors charged species, permeability favors neutral species. Some molecules have special
exchange proteins and channels to facilitate movement from the lumen into the circulation. - ANS
✔✔What is solubility?
Absorption occurs at a slower rate because the complex membrane systems of GI mucosal layers,
muscle, and skin delay drug passage. - ANS ✔✔Why does absorption occur at a slower rate for oral, IM,
SQ routes?
whether the drug is water or lipid (fat) soluble. Lipid-soluble drugs easily cross through cell membranes;
water-soluble drugs can't. Lipid-soluble drugs can also cross the blood-brain barrier and enter the brain. -
ANS ✔✔The ability of a drug to cross a cell membrane depends on:
proteins such as the plasma protein albumin. The drug can remain free or bind to the protein. The
portion of a drug that's bound to a protein is inactive and can't exert a therapeutic effect. Only the free,
or unbound, portion remains active. A drug is said to be highly protein-bound if more than 80% of the
drug is bound to protein. - ANS ✔✔As a drug travels through the body, it comes in contact with?
CYPs are the are the major enzymes involved in drug metabolism accounting for about 75% of the total
metabolism. - ANS ✔✔Identify drug metabolism and the role of isoenzymes in the p450 system
For example, bioactive compounds found in grapefruit juice and some other fruit juices including
dihydroxy forgotten and parasitin A have been found to inhibit CYP3a4 mediated metabolism of certain
medications leading to increased bioavailability and the strong possibility of overdosing. - ANS
✔✔Naturally occurring compounds may induce or inhibit CYP activity.
Grapefruit is an inhibitor and will decrease the metabolism of drugs by the cyp enzymes - ANS ✔✔What
does grapefruit have to do with CYP?
administered at separate times to prevent the metabolism of one drug resulting in toxic effects of the
other drug. (because it would have less protein to bind too, thus more free floating drug) - ANS
✔✔When 2 drugs are both metabolized by the p450 system the drug should be
Efficacy is the maximum response achievable from a drug. Effectiveness refers to the ability of the drug
to produce a beneficial effect. - ANS ✔✔What is the efficacy of a drug?
GUIDE, PRACTICE QUESTIONS, ANSWERS & EXAM REVIEW
Low albumin = freer drug (bc the drug can't bind to albumin aka protein) = increased adverse effects -
ANS ✔✔How does hypoalbuminemia affect the process of prescribing?
is considered a contraindication to administer that drug. - ANS ✔✔What is a Black Box Warning:
Half-life specifically means the amount of time it takes for an administered drug to be halfway cleared
from the system. - ANS ✔✔What is the drugs half-life?
the time between drug administration and maximum concentration of drug in the blood stream. Best
therapeutic effect. - ANS ✔✔Peak of action:
the time between onset of action and metabolism of drug below the minimum needed for an effect. The
length of time you have the drug in your system. - ANS ✔✔Duration of action:
The first step is to define the patient's problem - ANS ✔✔According to the WHO what is the first step in
the prescribing process?
specify the therapeutic objective - ANS ✔✔The second step is to
choose which drug or treatment is needed. - ANS ✔✔The third step is to
Start the treatment - ANS ✔✔Step 4 of the WHO approach:
Educate the patient - ANS ✔✔Step 5 of the WHO approach:
Monitor the treatment - ANS ✔✔Step 6 of the WHO approach:
The drug is tested on healthy volunteers - ANS ✔✔Phase 1 of drug development:
trials with people who have the disease for which the drug is thought to be effective - ANS ✔✔Phase 2
of drug development:
Large numbers of patients in medical research centers receive the drug in phase 3. This larger sampling
provides information about infrequent or rare adverse effects. The FFA will approve a new drug
application if phase 3 studies are satisfactory. - ANS ✔✔Phase 3 of drug development:
This phase is voluntary and involves postmarket surveillance of the drug's therapeutic effects at the
completion of phase 3. The pharmaceutical company receives reports from doctors and other health
care professionals about the therapeutic results and adverse effects of the drug. Some medications, for
example, have been found to be toxic and have been removed from the market after their initial release.
- ANS ✔✔Phase 4 of drug development:
, much of the drug is lost in the absorption process. The liver metabolizes many drugs, thus reduces the
bioavailabilty of the drug. - ANS ✔✔Explain first pass metabolism
The fastest route of absorption is inhalation, and not as mistakenly considered the IV administration. -
ANS ✔✔What is the fasted route of absorption:
The GI tract is lined with epithelial cells; drugs must permeate through these cells in order to be
absorbed into the circulatory system. - ANS ✔✔Why does the GI tract take longer to absorb?
the cell membrane. Cell membranes are essentially lipid bilayers which form a semipermeable
membrane. Pure lipid bilayers are generally permeable only to small and uncharged solutes, hence
whether or not a molecule is ionized will affect its absorption, since ionic molecules are charged. - ANS
✔✔What is One particular cellular barrier that may prevent absorption of a given drug?
Solubility favors charged species, permeability favors neutral species. Some molecules have special
exchange proteins and channels to facilitate movement from the lumen into the circulation. - ANS
✔✔What is solubility?
Absorption occurs at a slower rate because the complex membrane systems of GI mucosal layers,
muscle, and skin delay drug passage. - ANS ✔✔Why does absorption occur at a slower rate for oral, IM,
SQ routes?
whether the drug is water or lipid (fat) soluble. Lipid-soluble drugs easily cross through cell membranes;
water-soluble drugs can't. Lipid-soluble drugs can also cross the blood-brain barrier and enter the brain. -
ANS ✔✔The ability of a drug to cross a cell membrane depends on:
proteins such as the plasma protein albumin. The drug can remain free or bind to the protein. The
portion of a drug that's bound to a protein is inactive and can't exert a therapeutic effect. Only the free,
or unbound, portion remains active. A drug is said to be highly protein-bound if more than 80% of the
drug is bound to protein. - ANS ✔✔As a drug travels through the body, it comes in contact with?
CYPs are the are the major enzymes involved in drug metabolism accounting for about 75% of the total
metabolism. - ANS ✔✔Identify drug metabolism and the role of isoenzymes in the p450 system
For example, bioactive compounds found in grapefruit juice and some other fruit juices including
dihydroxy forgotten and parasitin A have been found to inhibit CYP3a4 mediated metabolism of certain
medications leading to increased bioavailability and the strong possibility of overdosing. - ANS
✔✔Naturally occurring compounds may induce or inhibit CYP activity.
Grapefruit is an inhibitor and will decrease the metabolism of drugs by the cyp enzymes - ANS ✔✔What
does grapefruit have to do with CYP?
administered at separate times to prevent the metabolism of one drug resulting in toxic effects of the
other drug. (because it would have less protein to bind too, thus more free floating drug) - ANS
✔✔When 2 drugs are both metabolized by the p450 system the drug should be
Efficacy is the maximum response achievable from a drug. Effectiveness refers to the ability of the drug
to produce a beneficial effect. - ANS ✔✔What is the efficacy of a drug?
