NR566/NR566 Advanced pharmacology for the care of the
family
Core NR566/NR566 Topics
• Pharmacokinetics & Pharmacodynamics
• Prescriptive Authority, Legal & Ethical Considerations
• Pharmacogenomics
• Central Nervous System Agents
• Cardiovascular Agents
• Endocrine Agents
• Respiratory Agents
• Renal & Fluid/Electrolyte Agents
• Gastrointestinal Agents
• Infectious Disease Agents
• Oncology & Immunology Agents
• Special Populations (Pediatrics, Geriatrics, Pregnancy & Lactation)
• Complementary & Alternative Medicine
Pharmacokinetics & Pharmacodynamics
1. Which process refers to how a drug moves from its site of administration into the
bloodstream?
A) Distribution
B) Metabolism
,C) Absorption
D) Excretion
Rationale: Absorption is the process of a drug entering the blood circulation from its
administration site (oral, IM, etc.). Distribution refers to the dispersion of drugs throughout body
tissues. Metabolism is the enzymatic breakdown of drugs, primarily in the liver. Excretion is the
elimination of drugs from the body, mainly via the kidneys.
2. True or False: The liver is the primary organ responsible for drug metabolism.
True
False
Rationale: The liver contains cytochrome P450 enzymes responsible for metabolizing most
drugs. Other organs (kidneys, intestines, lungs) can metabolize drugs, but their role is minor
compared to the liver.
3. The term "half-life" of a drug refers to:
A) The time it takes for half of the drug to be absorbed
B) The time it takes for half of the drug to be metabolized
C) The time it takes for plasma concentration of a drug to decrease by 50%
D) The time it takes for the drug to be eliminated completely
Rationale: Half-life is the time required for the plasma concentration of a drug to drop by 50%.
It is a critical determinant of dosing intervals. A drug is generally considered eliminated after
about 5 half-lives.
4. Which of the following processes is most influenced by protein binding in the blood?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Rationale: Protein binding affects drug distribution because only the unbound (free) drug can
cross cell membranes, bind receptors, and exert therapeutic effects. Highly protein-bound drugs
have less free drug available and may have longer half-lives. Absorption is largely unaffected by
protein binding, while metabolism and excretion act on free drug.
5. True or False: A drug with a narrow therapeutic index is considered safer than one with
a wide therapeutic index.
,True
False
Rationale: A narrow therapeutic index (e.g., digoxin, warfarin) means the toxic dose is close to
the therapeutic dose, so there’s little margin of safety. A wide therapeutic index provides a larger
buffer, making the drug safer.
6. The kidneys are primarily involved in which pharmacokinetic process?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Rationale: The kidneys filter drugs and their metabolites for elimination in urine. Absorption is
entry into the bloodstream, distribution is delivery to tissues, and metabolism is mainly liver-
based.
7. Which factor can decrease drug absorption in the gastrointestinal tract?
A) Taking the drug with water
B) Presence of food that alters pH or gastric emptying
C) Administering drug in liquid form
D) Increased blood flow to intestines
Rationale: Certain foods can alter gastric acidity, slow gastric emptying, or bind to drugs,
reducing absorption. Liquids and good blood flow usually enhance absorption.
8. True or False: Drug–receptor interactions are usually reversible.
True
False
Rationale: Most drug–receptor bindings are reversible, allowing the drug effect to wear off.
Some drugs (e.g., aspirin with platelets) form irreversible bonds, but these are exceptions.
9. The measure of a drug’s safety margin, calculated by comparing toxic dose to effective
dose, is called:
A) Bioavailability
B) Clearance
C) Therapeutic Index
, D) Potency
Rationale: The therapeutic index (TI) = TD50/ED50. A wide TI indicates safety, while a narrow
TI indicates high risk. Potency refers to drug strength, clearance is drug elimination rate, and
bioavailability is absorption extent.
10. Which pharmacokinetic process is most affected in patients with liver disease?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Rationale: The liver is the primary site of metabolism via CYP450 enzymes. Liver dysfunction
reduces metabolism, raising drug levels. Excretion is mainly renal, absorption is GI-based, and
distribution occurs after absorption.
11. Bioavailability refers to:
A) The fraction of drug that binds to plasma proteins
B) The proportion of an administered dose reaching systemic circulation
C) The rate of drug elimination
D) The volume of distribution of the drug
Rationale: Bioavailability (F) indicates the percentage of unchanged drug entering systemic
circulation. For IV drugs, F = 100%. Oral drugs often have reduced F due to first-pass
metabolism.
12. True or False: Lipid-soluble drugs cross cell membranes more easily than water-soluble
drugs.
True
False
Rationale: Lipophilic drugs can passively diffuse across lipid bilayers, while hydrophilic drugs
often need transporters or remain in extracellular fluid compartments.
13. Which of the following BEST describes drug clearance?
A) The volume of plasma completely cleared of drug per unit time
B) The half-life of a drug
C) The fraction of unchanged drug excreted in urine
family
Core NR566/NR566 Topics
• Pharmacokinetics & Pharmacodynamics
• Prescriptive Authority, Legal & Ethical Considerations
• Pharmacogenomics
• Central Nervous System Agents
• Cardiovascular Agents
• Endocrine Agents
• Respiratory Agents
• Renal & Fluid/Electrolyte Agents
• Gastrointestinal Agents
• Infectious Disease Agents
• Oncology & Immunology Agents
• Special Populations (Pediatrics, Geriatrics, Pregnancy & Lactation)
• Complementary & Alternative Medicine
Pharmacokinetics & Pharmacodynamics
1. Which process refers to how a drug moves from its site of administration into the
bloodstream?
A) Distribution
B) Metabolism
,C) Absorption
D) Excretion
Rationale: Absorption is the process of a drug entering the blood circulation from its
administration site (oral, IM, etc.). Distribution refers to the dispersion of drugs throughout body
tissues. Metabolism is the enzymatic breakdown of drugs, primarily in the liver. Excretion is the
elimination of drugs from the body, mainly via the kidneys.
2. True or False: The liver is the primary organ responsible for drug metabolism.
True
False
Rationale: The liver contains cytochrome P450 enzymes responsible for metabolizing most
drugs. Other organs (kidneys, intestines, lungs) can metabolize drugs, but their role is minor
compared to the liver.
3. The term "half-life" of a drug refers to:
A) The time it takes for half of the drug to be absorbed
B) The time it takes for half of the drug to be metabolized
C) The time it takes for plasma concentration of a drug to decrease by 50%
D) The time it takes for the drug to be eliminated completely
Rationale: Half-life is the time required for the plasma concentration of a drug to drop by 50%.
It is a critical determinant of dosing intervals. A drug is generally considered eliminated after
about 5 half-lives.
4. Which of the following processes is most influenced by protein binding in the blood?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Rationale: Protein binding affects drug distribution because only the unbound (free) drug can
cross cell membranes, bind receptors, and exert therapeutic effects. Highly protein-bound drugs
have less free drug available and may have longer half-lives. Absorption is largely unaffected by
protein binding, while metabolism and excretion act on free drug.
5. True or False: A drug with a narrow therapeutic index is considered safer than one with
a wide therapeutic index.
,True
False
Rationale: A narrow therapeutic index (e.g., digoxin, warfarin) means the toxic dose is close to
the therapeutic dose, so there’s little margin of safety. A wide therapeutic index provides a larger
buffer, making the drug safer.
6. The kidneys are primarily involved in which pharmacokinetic process?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Rationale: The kidneys filter drugs and their metabolites for elimination in urine. Absorption is
entry into the bloodstream, distribution is delivery to tissues, and metabolism is mainly liver-
based.
7. Which factor can decrease drug absorption in the gastrointestinal tract?
A) Taking the drug with water
B) Presence of food that alters pH or gastric emptying
C) Administering drug in liquid form
D) Increased blood flow to intestines
Rationale: Certain foods can alter gastric acidity, slow gastric emptying, or bind to drugs,
reducing absorption. Liquids and good blood flow usually enhance absorption.
8. True or False: Drug–receptor interactions are usually reversible.
True
False
Rationale: Most drug–receptor bindings are reversible, allowing the drug effect to wear off.
Some drugs (e.g., aspirin with platelets) form irreversible bonds, but these are exceptions.
9. The measure of a drug’s safety margin, calculated by comparing toxic dose to effective
dose, is called:
A) Bioavailability
B) Clearance
C) Therapeutic Index
, D) Potency
Rationale: The therapeutic index (TI) = TD50/ED50. A wide TI indicates safety, while a narrow
TI indicates high risk. Potency refers to drug strength, clearance is drug elimination rate, and
bioavailability is absorption extent.
10. Which pharmacokinetic process is most affected in patients with liver disease?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Rationale: The liver is the primary site of metabolism via CYP450 enzymes. Liver dysfunction
reduces metabolism, raising drug levels. Excretion is mainly renal, absorption is GI-based, and
distribution occurs after absorption.
11. Bioavailability refers to:
A) The fraction of drug that binds to plasma proteins
B) The proportion of an administered dose reaching systemic circulation
C) The rate of drug elimination
D) The volume of distribution of the drug
Rationale: Bioavailability (F) indicates the percentage of unchanged drug entering systemic
circulation. For IV drugs, F = 100%. Oral drugs often have reduced F due to first-pass
metabolism.
12. True or False: Lipid-soluble drugs cross cell membranes more easily than water-soluble
drugs.
True
False
Rationale: Lipophilic drugs can passively diffuse across lipid bilayers, while hydrophilic drugs
often need transporters or remain in extracellular fluid compartments.
13. Which of the following BEST describes drug clearance?
A) The volume of plasma completely cleared of drug per unit time
B) The half-life of a drug
C) The fraction of unchanged drug excreted in urine
