NRP 571 ADVANCED PHARMACOLOGY
EXAM 1 - COMPREHENSIVE REVIEW
QUESTIONS AND ANSWERS | 2026/2027
UPDATE | 100% CORRECT
1. A drug has a half-life of 6 hours. If a patient is started on a continuous infusion at a
constant rate, how long will it approximately take for the drug to reach steady-state plasma
concentrations?
A. 6 to 12 hours
B. 12 to 18 hours
C. 24 to 30 hours
D. 48 to 60 hours
Answer: C
Conceptual Explanation: Steady state is generally reached after 4 to 5 half-lives. With a
half-life of 6 hours, 4 to 5 half-lives equals 24 to 30 hours.
2. Which mechanism best explains why ACE inhibitors are frequently associated with a
persistent dry cough?
A. Inhibition of Angiotensin II production in the lungs
B. Accumulation of bradykinin and substance P in the respiratory tract
,C. Direct irritation of the bronchial smooth muscle by the drug molecule
D. Increased production of aldosterone leading to pulmonary edema
Answer: B
Conceptual Explanation: ACE (Angiotensin-Converting Enzyme) is also responsible for
the breakdown of bradykinin. Inhibiting ACE leads to increased levels of bradykinin and
substance P, which sensitizes airway sensory nerves, causing a dry cough.
3. A 65-year-old patient with heart failure with reduced ejection fraction (HFrEF) is being
managed. Which of the following Calcium Channel Blockers is generally contraindicated in
this population?
A. Verapamil
B. Felodipine
C. Amlodipine
D. Nifedipine
Answer: A
Conceptual Explanation: Non-dihydropyridine CCBs like Verapamil and Diltiazem have
significant negative inotropic effects and can worsen heart failure symptoms in patients
with HFrEF.
4. Pharmacodynamics is best defined as:
A. What the body does to the drug
, B. What the drug does to the body
C. The movement of drugs through the bloodstream
D. The process of hepatic drug metabolism
Answer: B
Conceptual Explanation: Pharmacodynamics refers to the biochemical and physiological
effects of drugs and their mechanism of action (what the drug does to the body), whereas
pharmacokinetics refers to absorption, distribution, metabolism, and excretion (what the
body does to the drug).
5. A patient is prescribed Warfarin. Which of the following P450 enzymes is primarily
responsible for the metabolism of the more potent S-enantiomer of Warfarin?
A. CYP2C9
B. CYP2D6
C. CYP3A4
D. CYP1A2
Answer: A
Conceptual Explanation: CYP2C9 is the major enzyme responsible for the metabolism of
S-warfarin. Genetic polymorphisms in this enzyme can significantly affect dosing
requirements.
EXAM 1 - COMPREHENSIVE REVIEW
QUESTIONS AND ANSWERS | 2026/2027
UPDATE | 100% CORRECT
1. A drug has a half-life of 6 hours. If a patient is started on a continuous infusion at a
constant rate, how long will it approximately take for the drug to reach steady-state plasma
concentrations?
A. 6 to 12 hours
B. 12 to 18 hours
C. 24 to 30 hours
D. 48 to 60 hours
Answer: C
Conceptual Explanation: Steady state is generally reached after 4 to 5 half-lives. With a
half-life of 6 hours, 4 to 5 half-lives equals 24 to 30 hours.
2. Which mechanism best explains why ACE inhibitors are frequently associated with a
persistent dry cough?
A. Inhibition of Angiotensin II production in the lungs
B. Accumulation of bradykinin and substance P in the respiratory tract
,C. Direct irritation of the bronchial smooth muscle by the drug molecule
D. Increased production of aldosterone leading to pulmonary edema
Answer: B
Conceptual Explanation: ACE (Angiotensin-Converting Enzyme) is also responsible for
the breakdown of bradykinin. Inhibiting ACE leads to increased levels of bradykinin and
substance P, which sensitizes airway sensory nerves, causing a dry cough.
3. A 65-year-old patient with heart failure with reduced ejection fraction (HFrEF) is being
managed. Which of the following Calcium Channel Blockers is generally contraindicated in
this population?
A. Verapamil
B. Felodipine
C. Amlodipine
D. Nifedipine
Answer: A
Conceptual Explanation: Non-dihydropyridine CCBs like Verapamil and Diltiazem have
significant negative inotropic effects and can worsen heart failure symptoms in patients
with HFrEF.
4. Pharmacodynamics is best defined as:
A. What the body does to the drug
, B. What the drug does to the body
C. The movement of drugs through the bloodstream
D. The process of hepatic drug metabolism
Answer: B
Conceptual Explanation: Pharmacodynamics refers to the biochemical and physiological
effects of drugs and their mechanism of action (what the drug does to the body), whereas
pharmacokinetics refers to absorption, distribution, metabolism, and excretion (what the
body does to the drug).
5. A patient is prescribed Warfarin. Which of the following P450 enzymes is primarily
responsible for the metabolism of the more potent S-enantiomer of Warfarin?
A. CYP2C9
B. CYP2D6
C. CYP3A4
D. CYP1A2
Answer: A
Conceptual Explanation: CYP2C9 is the major enzyme responsible for the metabolism of
S-warfarin. Genetic polymorphisms in this enzyme can significantly affect dosing
requirements.
