NR 565 MIDTERM EXAM 3 LATEST VERSIONS ACTUAL EXAM COMPLETE 50 QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
1. G-Protien coupled receptors and how they interact with drugs - (ANSWER)G-protein
coupled receptors (GPCR) interact with drugs through 7 regions of proteins that
span and innervate the cell membrane and trap the molecule into the receptor site
like an interwoven basket (Insel & Sriram, 2018). Drugs can then enter this space
and interact with the GRCP. A specific interaction and binding with a site on one or
more of the regions of proteins within the GPCR, and drugs bound with the GRCP !@#$%
can stimulate the release of G proteins that can interact with various effector ^&*()
proteins to create physiological responses within the body (Insel & Sriram, 2018).
This process occurs through secondary messengers (such as cAMP) which creates
the extracellular interactions produced by the drug binding to the GRCP.
2. What neurotransmitters are excitatory? - (ANSWER)amino acids such as glycine,
aspartate, and glutamate are excitatory (Woo & Robinson, p.16, 2016).
3. Which is the most common CYP enzyme in the body? What role does it play? -
(ANSWER)According to the textbook, the CYP3A4 is the most important enzyme in
the body. CYP3A4 is responsible for the metabolism of more than 50% of
medications and is considered a major drug metabolizing enzyme. CYP3A4 can be
found in the liver, as well as the lining of the GI tract. Due to this location, food can
also influence this CYP. One example of this is grapefruit juice, which can inhibit
CYP3A4. Medications that are metabolized by CYP3A4 include antimicrobials,
calcium channel blockers, antihistamines, anticonvulsants, azole antifungals, and
corticosteroids (Woo, & Robinson, 2016).
4. What is the clinical significance of being an ultra-rapid CYP2D6 metabolizer? -
(ANSWER)People who are ultra-rapid metabolizers have high activity of CYP2D6
enzymes that break down certain medicines rapidly and are likely to need different
doses or even a different medicine. Drug dose, response, and toxicity risk of beta-
blockers, antidepressants, antiarrhythmics, and opioid analgesics are dependent
on CYP2D6 pharmacogenetics (Ayazseven et al., 2020). Knowing the result of the
CYP2D6 test and which group the patient falls into such as poor metabolizers,
intermediate metabolizers, or ultra-rapid metabolizers, will help nurse practitioners
prescribe the right medication and dosage for the patient.
, NR 565 MIDTERM EXAM 3 LATEST VERSIONS ACTUAL EXAM COMPLETE 50 QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
5. What would be the concern if a drug is a CYP450indicer? How that might affect the
metabolism of another drug the patient is taking? - (ANSWER)Cytochrome P450
enzymes are in cells throughout the body, primarily found in liver cells (Girvan &
Munro, 2016). These enzymes are essential for the metabolism of many
medications. Cytochrome P450 enzymes can act as an inducer or inhibitor of
metabolism. When a medication induces the CYP450 enzyme that increases the !@#$%
rate of metabolism (Girvan & Munro, 2016). This can impact the effectiveness of ^&*()
other medications. For example, medication A induces CYP450 enzyme activity,
therefore medication B will be metabolized quicker and have a less therapeutic
effect.
6. Explain the significance of a drug being an inhibitor of P-glycoprotein? (see text) -
(ANSWER)P-glycoprotein (P-gp) is the main barrier of the body and it affects the
proper delivery of drugs and causes drug resistance in our body. P-gp is an efflux
membrane transporter, that can be found throughout the body and it controls the
cellular uptake and the distribution of synthetic substances, chemicals, and toxins.
Drugs are chemicals and P-gp hinders the absorption, permeability, and retention of
the drugs, extruding them out of the cells. This adversely affects drug therapies and
fails to yield good results, for example in therapies like using chemo agents in
cancer treatments. In this case, proper inhibition of P-gp is important to increase
cellular uptake, transport, and half-lives of drugs. The drug is an inhibitor of P-gp
that would help in the cost-effective treatment for disease conditions without
wasting an extra amount of medicines. It will help to shorten the treatment time and
speedy recovery of the patient (Abebe et al., 2019; Woo & Robinson, 2016).
7. Significance of a VCORC1 mutation for patients taking warfarin? - (ANSWER)In 2008,
the U.S Food and Drug Administration updated the dosing of warfarin to include the
application of pharmacogenomics. Variable metabolism by CYP2C9 was once
known as the major contributor to the variable response to warfarin. However, a
mutation in VCORC1 has been found to account for much more variability in
warfarin responses and can cause a rare syndrome of warfarin resistance. A
mutation in VCORC1 encodes a subunit of the vitamin K epoxide reductase complex
,the pharmacological target for warfarin, and increases the chances of uncontrolled
bleeding (Woo & Robinson, 2016). Therefore, if providers have information about the
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
1. G-Protien coupled receptors and how they interact with drugs - (ANSWER)G-protein
coupled receptors (GPCR) interact with drugs through 7 regions of proteins that
span and innervate the cell membrane and trap the molecule into the receptor site
like an interwoven basket (Insel & Sriram, 2018). Drugs can then enter this space
and interact with the GRCP. A specific interaction and binding with a site on one or
more of the regions of proteins within the GPCR, and drugs bound with the GRCP !@#$%
can stimulate the release of G proteins that can interact with various effector ^&*()
proteins to create physiological responses within the body (Insel & Sriram, 2018).
This process occurs through secondary messengers (such as cAMP) which creates
the extracellular interactions produced by the drug binding to the GRCP.
2. What neurotransmitters are excitatory? - (ANSWER)amino acids such as glycine,
aspartate, and glutamate are excitatory (Woo & Robinson, p.16, 2016).
3. Which is the most common CYP enzyme in the body? What role does it play? -
(ANSWER)According to the textbook, the CYP3A4 is the most important enzyme in
the body. CYP3A4 is responsible for the metabolism of more than 50% of
medications and is considered a major drug metabolizing enzyme. CYP3A4 can be
found in the liver, as well as the lining of the GI tract. Due to this location, food can
also influence this CYP. One example of this is grapefruit juice, which can inhibit
CYP3A4. Medications that are metabolized by CYP3A4 include antimicrobials,
calcium channel blockers, antihistamines, anticonvulsants, azole antifungals, and
corticosteroids (Woo, & Robinson, 2016).
4. What is the clinical significance of being an ultra-rapid CYP2D6 metabolizer? -
(ANSWER)People who are ultra-rapid metabolizers have high activity of CYP2D6
enzymes that break down certain medicines rapidly and are likely to need different
doses or even a different medicine. Drug dose, response, and toxicity risk of beta-
blockers, antidepressants, antiarrhythmics, and opioid analgesics are dependent
on CYP2D6 pharmacogenetics (Ayazseven et al., 2020). Knowing the result of the
CYP2D6 test and which group the patient falls into such as poor metabolizers,
intermediate metabolizers, or ultra-rapid metabolizers, will help nurse practitioners
prescribe the right medication and dosage for the patient.
, NR 565 MIDTERM EXAM 3 LATEST VERSIONS ACTUAL EXAM COMPLETE 50 QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED A+
5. What would be the concern if a drug is a CYP450indicer? How that might affect the
metabolism of another drug the patient is taking? - (ANSWER)Cytochrome P450
enzymes are in cells throughout the body, primarily found in liver cells (Girvan &
Munro, 2016). These enzymes are essential for the metabolism of many
medications. Cytochrome P450 enzymes can act as an inducer or inhibitor of
metabolism. When a medication induces the CYP450 enzyme that increases the !@#$%
rate of metabolism (Girvan & Munro, 2016). This can impact the effectiveness of ^&*()
other medications. For example, medication A induces CYP450 enzyme activity,
therefore medication B will be metabolized quicker and have a less therapeutic
effect.
6. Explain the significance of a drug being an inhibitor of P-glycoprotein? (see text) -
(ANSWER)P-glycoprotein (P-gp) is the main barrier of the body and it affects the
proper delivery of drugs and causes drug resistance in our body. P-gp is an efflux
membrane transporter, that can be found throughout the body and it controls the
cellular uptake and the distribution of synthetic substances, chemicals, and toxins.
Drugs are chemicals and P-gp hinders the absorption, permeability, and retention of
the drugs, extruding them out of the cells. This adversely affects drug therapies and
fails to yield good results, for example in therapies like using chemo agents in
cancer treatments. In this case, proper inhibition of P-gp is important to increase
cellular uptake, transport, and half-lives of drugs. The drug is an inhibitor of P-gp
that would help in the cost-effective treatment for disease conditions without
wasting an extra amount of medicines. It will help to shorten the treatment time and
speedy recovery of the patient (Abebe et al., 2019; Woo & Robinson, 2016).
7. Significance of a VCORC1 mutation for patients taking warfarin? - (ANSWER)In 2008,
the U.S Food and Drug Administration updated the dosing of warfarin to include the
application of pharmacogenomics. Variable metabolism by CYP2C9 was once
known as the major contributor to the variable response to warfarin. However, a
mutation in VCORC1 has been found to account for much more variability in
warfarin responses and can cause a rare syndrome of warfarin resistance. A
mutation in VCORC1 encodes a subunit of the vitamin K epoxide reductase complex
,the pharmacological target for warfarin, and increases the chances of uncontrolled
bleeding (Woo & Robinson, 2016). Therefore, if providers have information about the
