NU 578 Exam 1 Prep combination | Questions with 100%
Verified Answers | Latest Update 2026/2027
Question: p-glycoprotein
Answer: a transport protein that transports many drugs out of cells. It is also called multidrug
transporter protein . In capillaries of the CNS, it pumps drugs back into blood and
thereby limits their access to the brain (BBB)
Question: CYP450
Answer: group of 12 closely related enzyme families. Three of the families (1-3) metabolize
drugs,
while the other nine families metabolize endogenous compounds such as steroids and
fatty acids.
Types 1-3 have isoforms which describe which drugs they metabolize
Question: hepatic microsomal enzyme system
Answer: Called the P-450 system, they inactivate drugs and accelerate their excretion.
Question: 2 represents family, D represents subfamily, and 6 represents
isoenzyme.
Answer: In P450 CYP-2D6, which parts represent family, subfamily, and isoenzyme?
Question: p-glycoprotein effects on excretion
Answer: When induced, this may cause decreased absorption, decreased fetal drug exposure,
decreased brain/CNS drug exposure, and increased drug elimination. When cell is
resistance
Question: pediatric consideration with pharmacokinetics
Answer: absorption may not moralize until about two years, plasma proteins are lower for first
year so distribution is affected, BBB not fully developed so CNS sensitive, metabolic
enzymes do not fully develop until one year, renal function approaches adult levels after
one year
Question: geriatric considerations regarding pharmacokinetics
Answer: Monitor for organ failure; absorption is decreased slightly; distribution if affected by
increased body fat and less lean body mass, decreased TBW, and decreased serum
albumin (poor nutrition); slight decrease in hepatic metabolism; progressive decline in
renal function and resulting drug accumulation is the MOST common cause of adverse
drug reactions - Monitor for CrCl
Question: blood brain barrier effects on pharmacokinetics
Answer: a barrier to distribution. It has no intercellular pores due to tight junctions which limits
movement of ionized or highly polar substances. This means that drugs must be lipid
soluble to diffuse across cell membranes or be actively transporter by a carrier to pass it.
,Question: blood brain barrier
Answer: unique anatomy of capillaries in CNS. Tight junctions compose walls which prevent
drug
passage. Passing through require lipid solubility or a transport system. It also as PGP (a
transporter that pumps drugs out of cells). In the CNS, PGP pumps drugs back into the
blood and thereby limits access to brain. Not fully developed at birth, so newborns have
heightened sensitivity to medicine that act on brain. Neonates vulnerable to CNS toxicity.
Question: renal function and excretion
Answer: one of the primary ways drugs get out of body. Function decreases by 10% with each
decade after the 40s. Adjust dosing accordingly. May be altered due to drug-induced
decreased cardiac output. If failure occurs, then drug duration and intensity of response
may increase
Question: urinary excretion
Answer: This function is the net result of glomerular filtration, passive tubular reabsorption,
and
active tubular secretion
Question: glomerular filtration
Answer: beginning of renal excretion of drugs. Blood flows through glomerular capillaries,
forcing
fluids and small molecules (like drugs) through capillary wall pores. Moves drugs from
blood into tubular urine. Blood cells and large molecules like proteins are too large to
undergo this process. Because large molecules are left behind, drugs bound to albumin
may also be left behind
Question: passive tubular reabsorption
Answer: lipid soluble drugs move back into blood. polar and ionized drugs remain in urine.
drug
concentrations are lower in blood than in tubule at the point which vessels return to
proximity with renal tubule at a point distal to glomerulus. The concentration gradient
drives the drugs from lumen of tubule to blood. Lipid soluble drugs readily cross
membranes that compose tubular and vascular walls, so therefore drugs that are lipid
soluble readily undergo this process from tubule back into blood.
Question: active tubular secretion
Answer: active transport systems in kidney tubules that pump drugs from blood to tubular
urine.
Pumps have high capacity and play important role. Tubule pumps for organic acids and
bases move drugs from blood to urine
Question: pH dependent ionization
Answer: this phenomenon can be used to accelerate renal excretion of drugs. Because ions are
not lipid soluble, drugs that are ionized at pH of tubular urine will remain in tubule and be
excreted. Therefore, manipulating urinary pH to promote ionization of a drug can
decrease passive reabsorption back into blood and hasten drug's elimination
,Question: competition for active tubular transport
Answer: this leads to delayed renal excretion and prolonged drug effects. Active transport
systems are like revolving doors which carry drugs from plasma into renal tubules. They
can only carry so many molecules at a time, so if there are too many molecules then
some have to wait their turn. If two drugs which use the same system are administered
together, they will prolong each others effects due to this
Question: age and renal excretion
Answer: Newborns have immature organs which cause drugs to build up. A few months after
birth,
drugs may accumulate for this reason. With aging, function declines because organs
shrink and functional units decrease. This leads to lower blood filtration. Vessel changes
like atherosclerosis also contribute to worsened blood flow. Excretion is decreased for
this reason.
Question: perfusion/blood flow to tissues
Answer: heart, liver, kidney, brain, and lung are exposed to drug in first few minutes following
absorption (initial phase of this). Muscle and skin are less rapidly exposed due to this
factor. Bone and fat are only exposed in final phase of distribution (over a period of
hours) due to this.
Question: abscesses and tumor
Answer: Two pathologic conditions that can affect regional blood flow and therefore drug
therapy. One has no internal blood vessels, so antibiotics cannot reach it easily. It often
requires surgical draining. The other has a limited blood supply. Outer regions may be
vascularized, but this becomes progressively less the more inward we look. Therefore,
penetrating deeply into it can be difficult when providing drug therapy (resistance to
therapy)
Question: capillary beds
Answer: Most of these do not offer resistance to departure of drugs because drugs can leave
by
passing through pores rather (between) rather than passing through cells themselves.
Movement into interstitial space is not impeded.
Question: drug bindings to plasma protein
Answer: affects drug distribution. Reverisble (noncovalent bonding). Free drug and protein -->
drug-protein complex. Albumin for acidic drugs, alpha-1 acid glycoprotein for basic
drugs, and lipoproteins.
Question: free drug
Answer: Drug in this form can diffuse to site of action. Therefore, concentration in plasma
determines pharmacologic activity for highly bound drugs. If hypoalbuminemia is
present, excess drug in this form may be present, but this is only important for highly
bound drugs (may require dose adjustment)
, Question: placental barrier
Answer: drugs pass this by diffusion; lipid-soluble, nonionized drugs penetrate most rapidly.
Transfer is slow, about 15 minutes for most drugs and almost and hour for others. Virtually
every drug does cross this, so no real barrier exists - it is a time factor.
Question: drug safety in pregnancy
Answer: A B C D X classification. X is harm. A is safe. C is unknown.
Question: pharmacokinetic factors affecting distribution
Answer: Competition for protein binding sites is occasionally significant for this factor.
Alteration in extracellular pH may be useful in overdose or poisoning. Urine can be
alkalinized to excrete acidic drugs.
Question: blood flow
Answer: In distribution of drugs regarding very ill patients, this is an important determinant.
Consider distribution disturbances in patients with cardiovascular disease, vessel disease,
and perfusion disorders. Also remember barriers.
Question: placental barrier consideration
Answer: Not an absolute barrier. Lipid-soluble, nonionized compounds pass from systemic
circulation into blood of fetus. Ionized, highly polar, or protein bound compounds are
largely excluded, as are drugs that are substrates for PGP transporter that can pump a
variety of drugs out of placental cells into systemic circulation. Most drugs cross via
simple diffusion
Question: determinant of bound drug molecules
Answer: determined by the strength of attraction between albumin and the drug. example:
anticoagulant warfarin is strong, so there is little free warfarin in blood. On the other
hand, abx gentamicin and albumin have weak bond so less than 10% are bound leaving
most of it free.
Question: albumin interaction
Answer: This molecule is only able to bind to so many drug molecules. Therefore, when drugs
need to share this molecule, some drugs may kick other drugs off. This causes one drug
to amplify the effects of another drug --> toxicity
Question: liberation phase
Answer: extends from time of drug administration to point where drug is dissolved in body
fluids
and ready for absorption
Question: absorption
Answer: process of drug movement from site across one or more cell membrane barriers into
circulation. Most common mechanism for drug is passive diffusion.
Verified Answers | Latest Update 2026/2027
Question: p-glycoprotein
Answer: a transport protein that transports many drugs out of cells. It is also called multidrug
transporter protein . In capillaries of the CNS, it pumps drugs back into blood and
thereby limits their access to the brain (BBB)
Question: CYP450
Answer: group of 12 closely related enzyme families. Three of the families (1-3) metabolize
drugs,
while the other nine families metabolize endogenous compounds such as steroids and
fatty acids.
Types 1-3 have isoforms which describe which drugs they metabolize
Question: hepatic microsomal enzyme system
Answer: Called the P-450 system, they inactivate drugs and accelerate their excretion.
Question: 2 represents family, D represents subfamily, and 6 represents
isoenzyme.
Answer: In P450 CYP-2D6, which parts represent family, subfamily, and isoenzyme?
Question: p-glycoprotein effects on excretion
Answer: When induced, this may cause decreased absorption, decreased fetal drug exposure,
decreased brain/CNS drug exposure, and increased drug elimination. When cell is
resistance
Question: pediatric consideration with pharmacokinetics
Answer: absorption may not moralize until about two years, plasma proteins are lower for first
year so distribution is affected, BBB not fully developed so CNS sensitive, metabolic
enzymes do not fully develop until one year, renal function approaches adult levels after
one year
Question: geriatric considerations regarding pharmacokinetics
Answer: Monitor for organ failure; absorption is decreased slightly; distribution if affected by
increased body fat and less lean body mass, decreased TBW, and decreased serum
albumin (poor nutrition); slight decrease in hepatic metabolism; progressive decline in
renal function and resulting drug accumulation is the MOST common cause of adverse
drug reactions - Monitor for CrCl
Question: blood brain barrier effects on pharmacokinetics
Answer: a barrier to distribution. It has no intercellular pores due to tight junctions which limits
movement of ionized or highly polar substances. This means that drugs must be lipid
soluble to diffuse across cell membranes or be actively transporter by a carrier to pass it.
,Question: blood brain barrier
Answer: unique anatomy of capillaries in CNS. Tight junctions compose walls which prevent
drug
passage. Passing through require lipid solubility or a transport system. It also as PGP (a
transporter that pumps drugs out of cells). In the CNS, PGP pumps drugs back into the
blood and thereby limits access to brain. Not fully developed at birth, so newborns have
heightened sensitivity to medicine that act on brain. Neonates vulnerable to CNS toxicity.
Question: renal function and excretion
Answer: one of the primary ways drugs get out of body. Function decreases by 10% with each
decade after the 40s. Adjust dosing accordingly. May be altered due to drug-induced
decreased cardiac output. If failure occurs, then drug duration and intensity of response
may increase
Question: urinary excretion
Answer: This function is the net result of glomerular filtration, passive tubular reabsorption,
and
active tubular secretion
Question: glomerular filtration
Answer: beginning of renal excretion of drugs. Blood flows through glomerular capillaries,
forcing
fluids and small molecules (like drugs) through capillary wall pores. Moves drugs from
blood into tubular urine. Blood cells and large molecules like proteins are too large to
undergo this process. Because large molecules are left behind, drugs bound to albumin
may also be left behind
Question: passive tubular reabsorption
Answer: lipid soluble drugs move back into blood. polar and ionized drugs remain in urine.
drug
concentrations are lower in blood than in tubule at the point which vessels return to
proximity with renal tubule at a point distal to glomerulus. The concentration gradient
drives the drugs from lumen of tubule to blood. Lipid soluble drugs readily cross
membranes that compose tubular and vascular walls, so therefore drugs that are lipid
soluble readily undergo this process from tubule back into blood.
Question: active tubular secretion
Answer: active transport systems in kidney tubules that pump drugs from blood to tubular
urine.
Pumps have high capacity and play important role. Tubule pumps for organic acids and
bases move drugs from blood to urine
Question: pH dependent ionization
Answer: this phenomenon can be used to accelerate renal excretion of drugs. Because ions are
not lipid soluble, drugs that are ionized at pH of tubular urine will remain in tubule and be
excreted. Therefore, manipulating urinary pH to promote ionization of a drug can
decrease passive reabsorption back into blood and hasten drug's elimination
,Question: competition for active tubular transport
Answer: this leads to delayed renal excretion and prolonged drug effects. Active transport
systems are like revolving doors which carry drugs from plasma into renal tubules. They
can only carry so many molecules at a time, so if there are too many molecules then
some have to wait their turn. If two drugs which use the same system are administered
together, they will prolong each others effects due to this
Question: age and renal excretion
Answer: Newborns have immature organs which cause drugs to build up. A few months after
birth,
drugs may accumulate for this reason. With aging, function declines because organs
shrink and functional units decrease. This leads to lower blood filtration. Vessel changes
like atherosclerosis also contribute to worsened blood flow. Excretion is decreased for
this reason.
Question: perfusion/blood flow to tissues
Answer: heart, liver, kidney, brain, and lung are exposed to drug in first few minutes following
absorption (initial phase of this). Muscle and skin are less rapidly exposed due to this
factor. Bone and fat are only exposed in final phase of distribution (over a period of
hours) due to this.
Question: abscesses and tumor
Answer: Two pathologic conditions that can affect regional blood flow and therefore drug
therapy. One has no internal blood vessels, so antibiotics cannot reach it easily. It often
requires surgical draining. The other has a limited blood supply. Outer regions may be
vascularized, but this becomes progressively less the more inward we look. Therefore,
penetrating deeply into it can be difficult when providing drug therapy (resistance to
therapy)
Question: capillary beds
Answer: Most of these do not offer resistance to departure of drugs because drugs can leave
by
passing through pores rather (between) rather than passing through cells themselves.
Movement into interstitial space is not impeded.
Question: drug bindings to plasma protein
Answer: affects drug distribution. Reverisble (noncovalent bonding). Free drug and protein -->
drug-protein complex. Albumin for acidic drugs, alpha-1 acid glycoprotein for basic
drugs, and lipoproteins.
Question: free drug
Answer: Drug in this form can diffuse to site of action. Therefore, concentration in plasma
determines pharmacologic activity for highly bound drugs. If hypoalbuminemia is
present, excess drug in this form may be present, but this is only important for highly
bound drugs (may require dose adjustment)
, Question: placental barrier
Answer: drugs pass this by diffusion; lipid-soluble, nonionized drugs penetrate most rapidly.
Transfer is slow, about 15 minutes for most drugs and almost and hour for others. Virtually
every drug does cross this, so no real barrier exists - it is a time factor.
Question: drug safety in pregnancy
Answer: A B C D X classification. X is harm. A is safe. C is unknown.
Question: pharmacokinetic factors affecting distribution
Answer: Competition for protein binding sites is occasionally significant for this factor.
Alteration in extracellular pH may be useful in overdose or poisoning. Urine can be
alkalinized to excrete acidic drugs.
Question: blood flow
Answer: In distribution of drugs regarding very ill patients, this is an important determinant.
Consider distribution disturbances in patients with cardiovascular disease, vessel disease,
and perfusion disorders. Also remember barriers.
Question: placental barrier consideration
Answer: Not an absolute barrier. Lipid-soluble, nonionized compounds pass from systemic
circulation into blood of fetus. Ionized, highly polar, or protein bound compounds are
largely excluded, as are drugs that are substrates for PGP transporter that can pump a
variety of drugs out of placental cells into systemic circulation. Most drugs cross via
simple diffusion
Question: determinant of bound drug molecules
Answer: determined by the strength of attraction between albumin and the drug. example:
anticoagulant warfarin is strong, so there is little free warfarin in blood. On the other
hand, abx gentamicin and albumin have weak bond so less than 10% are bound leaving
most of it free.
Question: albumin interaction
Answer: This molecule is only able to bind to so many drug molecules. Therefore, when drugs
need to share this molecule, some drugs may kick other drugs off. This causes one drug
to amplify the effects of another drug --> toxicity
Question: liberation phase
Answer: extends from time of drug administration to point where drug is dissolved in body
fluids
and ready for absorption
Question: absorption
Answer: process of drug movement from site across one or more cell membrane barriers into
circulation. Most common mechanism for drug is passive diffusion.
