NURS 5334 ADVANCED PHARMACOLOGY
TEST 1 EXAM SCRIPT 2026 FULL SOLUTION
GUIDE AND ANSWERS GRADED A+
⩥ older adults: altered pharmacokinetics.
Answer: more sensitive to drugs than younger adults & w/ greater
variation in pharmacokinetics
multiple & severity of illness, multiple pathologies
multiple-drug therapy (excessive prescribing)
poor adherence
⩥ older adults: absorption.
Answer: - rate of absorption slows w/ age
- delayed gastric emptying & reduced splanchnic blood flow
⩥ older adults: distribution.
Answer: - increased body fat % (storage depot for lipid-soluble drugs)
- decreased lean body mass %
,- decreased total body water (distributed in smaller volume,
concentration increased & effects more intense)
- reduced concentration of serum albumin -> decreased protein binding
of drugs & increased levels of free drugs
⩥ older adults: metabolism.
Answer: - hepatic metabolism declines
- reduced hepatic blood flow & liver mass
- decreased activity of hepatic enzymes
- half-life of some drugs may increase
- prolonged & enhanced drug responses
⩥ older adults: excretion.
Answer: - decline in renal function, blood flow, GFR, active tubular
secretion, # of nephrons
- drug accumulation d/t reduced renal excretion**
⩥ pharmacodynamic changes in older adult patients.
Answer: - drugs w/ more intense effects
- beta blockers less effective, even in same concentrations
⩥ adverse drug reactions in older adults.
Answer: 7x more likely than adults
,majority are dose related, not idiosyncratic
symptoms are often nonspecific
⩥ predisposing adverse reaction factors in older adults.
Answer: - Drug accumulation secondary to reduced renal function
- Polypharmacy
- Greater severity of illness
- Multiple pathologies
- Greater use of drugs that have a low therapeutic index (e.g.,digoxin)
- Increased individual variations secondary to altered pharmacokinetics
- Inadequate supervision of long-term therapy
- Poor patient adherence
⩥ antimicrobials.
Answer: used to treat infectious dx
significantly reduced morbidity and mortality from infection
⩥ classification of antibiotics.
Answer: Drugs work on:
Cell wall synthesis
, Cell membrane permeability
Protein synthesis (lethal)
Nonlethal inhibitors of protein synthesis
Synthesis of nucleic acids
Antimetabolites
Viral enzyme inhibitors
⩥ bactericidal.
Answer: directly lethal to bacteria at achievable concentrations
⩥ bacteriostatic.
Answer: slows bacterial growth but doesn't cause cell death
⩥ penicillin and cephalosporin MOA.
Answer: inhibit cell wall synthesis-> bacterial lysis and death
⩥ ___ MOA.
Answer: increase cell membrane permeability -> leaking of ICF
⩥ aminoglycosides MOA.
Answer: lethal inhibition of bacterial protein synthesis -> cell death
TEST 1 EXAM SCRIPT 2026 FULL SOLUTION
GUIDE AND ANSWERS GRADED A+
⩥ older adults: altered pharmacokinetics.
Answer: more sensitive to drugs than younger adults & w/ greater
variation in pharmacokinetics
multiple & severity of illness, multiple pathologies
multiple-drug therapy (excessive prescribing)
poor adherence
⩥ older adults: absorption.
Answer: - rate of absorption slows w/ age
- delayed gastric emptying & reduced splanchnic blood flow
⩥ older adults: distribution.
Answer: - increased body fat % (storage depot for lipid-soluble drugs)
- decreased lean body mass %
,- decreased total body water (distributed in smaller volume,
concentration increased & effects more intense)
- reduced concentration of serum albumin -> decreased protein binding
of drugs & increased levels of free drugs
⩥ older adults: metabolism.
Answer: - hepatic metabolism declines
- reduced hepatic blood flow & liver mass
- decreased activity of hepatic enzymes
- half-life of some drugs may increase
- prolonged & enhanced drug responses
⩥ older adults: excretion.
Answer: - decline in renal function, blood flow, GFR, active tubular
secretion, # of nephrons
- drug accumulation d/t reduced renal excretion**
⩥ pharmacodynamic changes in older adult patients.
Answer: - drugs w/ more intense effects
- beta blockers less effective, even in same concentrations
⩥ adverse drug reactions in older adults.
Answer: 7x more likely than adults
,majority are dose related, not idiosyncratic
symptoms are often nonspecific
⩥ predisposing adverse reaction factors in older adults.
Answer: - Drug accumulation secondary to reduced renal function
- Polypharmacy
- Greater severity of illness
- Multiple pathologies
- Greater use of drugs that have a low therapeutic index (e.g.,digoxin)
- Increased individual variations secondary to altered pharmacokinetics
- Inadequate supervision of long-term therapy
- Poor patient adherence
⩥ antimicrobials.
Answer: used to treat infectious dx
significantly reduced morbidity and mortality from infection
⩥ classification of antibiotics.
Answer: Drugs work on:
Cell wall synthesis
, Cell membrane permeability
Protein synthesis (lethal)
Nonlethal inhibitors of protein synthesis
Synthesis of nucleic acids
Antimetabolites
Viral enzyme inhibitors
⩥ bactericidal.
Answer: directly lethal to bacteria at achievable concentrations
⩥ bacteriostatic.
Answer: slows bacterial growth but doesn't cause cell death
⩥ penicillin and cephalosporin MOA.
Answer: inhibit cell wall synthesis-> bacterial lysis and death
⩥ ___ MOA.
Answer: increase cell membrane permeability -> leaking of ICF
⩥ aminoglycosides MOA.
Answer: lethal inhibition of bacterial protein synthesis -> cell death
