NURS 8024 PHARM MAIN EXAM TEST 2025/2026
QUESTIONS WITH SOLUTIONS GRADED A+
✔✔Lipophillic - ✔✔AKA hydrophobic
Preferred for drug to be mostly lipophillic to cross cell membranes (made of lipids)
Extremely hydrophobic/lipophillic drugs also poorly absorbed because insoluble in
aqueous body fluids
Some extremely lipophillic drugs are transported in aqueous solutions in the body via
carrier proteins like albumin
✔✔Lipophobic - ✔✔AKA hydrophillic
Unable to cross lipid rich cell membranes
Poorly absorbed
✔✔Lipid:aqueous partition coefficicent - ✔✔Determines how easily the molecule moves
between aqueous and lipid media
✔✔Partition coefficient - ✔✔Ratio of lipid solubility to aqueous solubility
If higher, substance is more membrane soluble
✔✔Factors influencing GI absorption - ✔✔Blood flow: intestinal blood flow > stomach
blood flow
pH: pH of stomach influences absorption (PPI/H2)
Surface area: intestinal surface microvilli
Contact time with absorptive surface: PSNS causes increased rate of gastric emptying
& less contact time; SNS causes decreased rate of gastric emptying & more contact
time; food affects this
✔✔Bioavailability - ✔✔Fraction of chemically unchanged drug that reaches systemic
circulation; affected by first-pass metabolism, solubility, chemical instability, nature of
the drug formation (chemistry, molecule size, entering coatings, etc.)
✔✔Ideal drug for absorption - ✔✔Largely hydrophobic/lipophillic, but with some
solubility in aqueous solution
✔✔Bioavailability: Enteral/Parenteral administration - ✔✔Bioavailability for IV drugs is
high right away; PO medication bioavailability is never quite as high d/t first-pass effect
✔✔Bioequivalence - ✔✔Similar drugs are bioequivalent if they have comparable
bioavailability and similar time to achieve peak plasma concentration
✔✔Therapeutic equivalence - ✔✔Similar drugs are deemed therapeutically equivalent if
comparable efficacy and safety
Clinical effectiveness is dependent on serum drug concentrations and the time it takes
to reach peak drug concentrations
, Two drugs that are bioequivalent may not be therapeutically equivalent
Used in substituting drugs for formularies
✔✔Drug distribution - ✔✔Process in which drug reversibly leaves bloodstream and
enters interstitium and/or cells
✔✔Drug delivery depends on... - ✔✔Blood flow
Capillary permeability
Plasma protein binding
Drug structure
Hydrophobicity
✔✔Drug distribution: Blood flow - ✔✔Wide variance d/t unequal distribution of cardiac
output; highest in organs (heart, brain, lungs, liver, kidney, guts), lower in skeletal
muscles, lowest in adipose tissue
✔✔Drug distribution: Capillary permeability - ✔✔Governed by capillary structure &
chemical nature of the drug
Large slit junctions between endothelial cells of spleen and liver allow passage of
plasma proteins & thus drug molecules
Slit junctions are absent in brain: "blood brain barrier"
Lipid soluble drugs penetrate the brain by going across membrane, but ionized or polar
drugs cannot enter brain d/t lack of slit junctions
✔✔Drug distribution: Drug Structure - ✔✔Chemical nature of the drug largely
determines it's ability to cross cell membranes
Hydrophobic/lipophillic drugs (no net charge, uniform electron distribution, easier to
pass through, able to dissolve in lipid cell membranes and permeate cell surface)
Hydrophillic/lipophobic drugs (positively or negatively charged, do not easily pass
through cell membranes, need slit junction for passage: liver, spleen)
✔✔Drug distribution: Plasma protein binding - ✔✔Plasma protein binding generally
reversible and non-selective; drugs bind where other compounds (such as bilirubin)
would normally attach
Plasma albumin: major drug binding protein
May act as "drug reservoir"- as free drug concentration decreases, protein bound drug
dissociates from protein to maintain a stable free-drug concentration in plasma
✔✔Volume of distribution - ✔✔Hypothetical volume of fluid into which a drug is
dispersed
Water compartments: plasma, intracellular, extracellular
Drug typically enters all compartments (including breast milk)
QUESTIONS WITH SOLUTIONS GRADED A+
✔✔Lipophillic - ✔✔AKA hydrophobic
Preferred for drug to be mostly lipophillic to cross cell membranes (made of lipids)
Extremely hydrophobic/lipophillic drugs also poorly absorbed because insoluble in
aqueous body fluids
Some extremely lipophillic drugs are transported in aqueous solutions in the body via
carrier proteins like albumin
✔✔Lipophobic - ✔✔AKA hydrophillic
Unable to cross lipid rich cell membranes
Poorly absorbed
✔✔Lipid:aqueous partition coefficicent - ✔✔Determines how easily the molecule moves
between aqueous and lipid media
✔✔Partition coefficient - ✔✔Ratio of lipid solubility to aqueous solubility
If higher, substance is more membrane soluble
✔✔Factors influencing GI absorption - ✔✔Blood flow: intestinal blood flow > stomach
blood flow
pH: pH of stomach influences absorption (PPI/H2)
Surface area: intestinal surface microvilli
Contact time with absorptive surface: PSNS causes increased rate of gastric emptying
& less contact time; SNS causes decreased rate of gastric emptying & more contact
time; food affects this
✔✔Bioavailability - ✔✔Fraction of chemically unchanged drug that reaches systemic
circulation; affected by first-pass metabolism, solubility, chemical instability, nature of
the drug formation (chemistry, molecule size, entering coatings, etc.)
✔✔Ideal drug for absorption - ✔✔Largely hydrophobic/lipophillic, but with some
solubility in aqueous solution
✔✔Bioavailability: Enteral/Parenteral administration - ✔✔Bioavailability for IV drugs is
high right away; PO medication bioavailability is never quite as high d/t first-pass effect
✔✔Bioequivalence - ✔✔Similar drugs are bioequivalent if they have comparable
bioavailability and similar time to achieve peak plasma concentration
✔✔Therapeutic equivalence - ✔✔Similar drugs are deemed therapeutically equivalent if
comparable efficacy and safety
Clinical effectiveness is dependent on serum drug concentrations and the time it takes
to reach peak drug concentrations
, Two drugs that are bioequivalent may not be therapeutically equivalent
Used in substituting drugs for formularies
✔✔Drug distribution - ✔✔Process in which drug reversibly leaves bloodstream and
enters interstitium and/or cells
✔✔Drug delivery depends on... - ✔✔Blood flow
Capillary permeability
Plasma protein binding
Drug structure
Hydrophobicity
✔✔Drug distribution: Blood flow - ✔✔Wide variance d/t unequal distribution of cardiac
output; highest in organs (heart, brain, lungs, liver, kidney, guts), lower in skeletal
muscles, lowest in adipose tissue
✔✔Drug distribution: Capillary permeability - ✔✔Governed by capillary structure &
chemical nature of the drug
Large slit junctions between endothelial cells of spleen and liver allow passage of
plasma proteins & thus drug molecules
Slit junctions are absent in brain: "blood brain barrier"
Lipid soluble drugs penetrate the brain by going across membrane, but ionized or polar
drugs cannot enter brain d/t lack of slit junctions
✔✔Drug distribution: Drug Structure - ✔✔Chemical nature of the drug largely
determines it's ability to cross cell membranes
Hydrophobic/lipophillic drugs (no net charge, uniform electron distribution, easier to
pass through, able to dissolve in lipid cell membranes and permeate cell surface)
Hydrophillic/lipophobic drugs (positively or negatively charged, do not easily pass
through cell membranes, need slit junction for passage: liver, spleen)
✔✔Drug distribution: Plasma protein binding - ✔✔Plasma protein binding generally
reversible and non-selective; drugs bind where other compounds (such as bilirubin)
would normally attach
Plasma albumin: major drug binding protein
May act as "drug reservoir"- as free drug concentration decreases, protein bound drug
dissociates from protein to maintain a stable free-drug concentration in plasma
✔✔Volume of distribution - ✔✔Hypothetical volume of fluid into which a drug is
dispersed
Water compartments: plasma, intracellular, extracellular
Drug typically enters all compartments (including breast milk)
