HNG 540 ACTUAL FINAL PAPER QUESTIONS AND
ANSWERS GRADED A+
✔✔Liver metabolism (biotransformation) - ✔✔metabolic reactions occurs mediated by
enzymes changing structure to be more water soluble allowing for ease of elimination
✔✔Phase I enzymes - ✔✔CYP450
✔✔What is phase I metabolism? - ✔✔oxidize, reduce and hydrolyze the drug; functional
groups intriduced making the drug more polar (water soluble) but not necessarily
inactive (otherwise drugs cannot be excreted and increased risk for toxicity)
✔✔Phase II metabolism - ✔✔drugs/phase I metabolites are conjugated with
endogenous compounds (like amino acids/sulfates) increasing water solubility and
facilitating elimination
✔✔what happens to drugs after first pass? - ✔✔drug is released into systemic
circulation then carried to various tissues and organs to exert effect
✔✔therapeutic action - ✔✔drug reaches target tissues and interacts with receptors to
produce desired effects
✔✔How are drugs eliminated? - ✔✔renal excretions (glomerulus via urine), biliary
excretion (biles into digestive tract), and other ways depending on the drug (skin, saliva
and breast milk)
✔✔What is the most common way for drugs to be eliminated? - ✔✔renal excretion
through the glomerulus via urine
✔✔considerations with slower metabolism - ✔✔the drug is processed slower and will
stay in the body for longer resulting in increased drug exposure and higher risk for
adverse effects; adjust dosing and intervals accordingly
✔✔higher metabolism you want to make the dose_________ slower metabolism you
want to make the dose________ - ✔✔higher, lower
✔✔sublingual administrations considerations - ✔✔allows drug to be absorbed directly
into the blood stream, causing drug to work much faster than oral medications;
bypasses the liver
✔✔Why would you avoid PO administration? - ✔✔reduced the amount of active drug
reaching the target site through first pass metabolism
, ✔✔volume distribution - ✔✔pharmacokinetic parameter that described the way in which
a drug is distributed through the body and influences the concentration in various
tissues; how readily the drug is able to diffuse throughout the body
✔✔What affects volume distribution? - ✔✔molecular size and weight, lipophilicity,
protein binding
✔✔How does molecular size and weight affect volume distribution? - ✔✔larger
molecules have smaller volume distribution because they are less likely to penetrate a
cell membrane and diffuse throughout the body; smaller molecules can distribute more
freely throughout the body so it has a larger volume distribution
✔✔how does Lipophilicity affect volume distribution of a drug? - ✔✔fat soluble drugs
have a larger volume distribution because they can distribute into fatty tissues and more
readily pass through cell membranes which are made of a lipid bilayer
✔✔how does protein binding affect volume distribution of a drug? - ✔✔drugs that
strongly bind to plasma protein (albumin) have a small volume distribution because they
are largely confined to the vascular space and cannot diffuse easily; drugs with weaker
protein binding have a larger volume distribution because they can move more easily in
the body (more free drug that is not bound roaming about the body)
✔✔What is a loading dose? - ✔✔initial higher dose of a drug that may be given at the
beginning of treatment to RAPIDLY achieve a therapeutic level
✔✔What is the goal of giving a loading dose? - ✔✔to cause a rapid onset of action, and
get to a therapeutic level faster
✔✔Why is a rapid onset of action important for a loading dose? - ✔✔in certain situations
a therapeutic effect is needed very quickly; administering this allows for rapid increase
in drug concentration leading to a faster onset of action
✔✔why is maintaining therapeutic levels important for a medication with a loading
dose? - ✔✔some drugs have long half-lves, reaching a steady state in the body takes
time, by administering this type of dose a prescriber can jumpstart the drug levels to a
therapeutic range more quickly and then switch to a lower maintenance dose to sustain
the drug level
✔✔When does drug toxicity and adverse effects occur? - ✔✔when the peak level of a
drug in the bloodstream exceeds the minimum toxic concentration
✔✔what adverse effects could abnormal drug concentration levels cause? - ✔✔nausea,
vomiting, diarrhea, dizziness, headache, confusion, blurry vision, tremors, seizures, and
other symptoms depending on the drug
ANSWERS GRADED A+
✔✔Liver metabolism (biotransformation) - ✔✔metabolic reactions occurs mediated by
enzymes changing structure to be more water soluble allowing for ease of elimination
✔✔Phase I enzymes - ✔✔CYP450
✔✔What is phase I metabolism? - ✔✔oxidize, reduce and hydrolyze the drug; functional
groups intriduced making the drug more polar (water soluble) but not necessarily
inactive (otherwise drugs cannot be excreted and increased risk for toxicity)
✔✔Phase II metabolism - ✔✔drugs/phase I metabolites are conjugated with
endogenous compounds (like amino acids/sulfates) increasing water solubility and
facilitating elimination
✔✔what happens to drugs after first pass? - ✔✔drug is released into systemic
circulation then carried to various tissues and organs to exert effect
✔✔therapeutic action - ✔✔drug reaches target tissues and interacts with receptors to
produce desired effects
✔✔How are drugs eliminated? - ✔✔renal excretions (glomerulus via urine), biliary
excretion (biles into digestive tract), and other ways depending on the drug (skin, saliva
and breast milk)
✔✔What is the most common way for drugs to be eliminated? - ✔✔renal excretion
through the glomerulus via urine
✔✔considerations with slower metabolism - ✔✔the drug is processed slower and will
stay in the body for longer resulting in increased drug exposure and higher risk for
adverse effects; adjust dosing and intervals accordingly
✔✔higher metabolism you want to make the dose_________ slower metabolism you
want to make the dose________ - ✔✔higher, lower
✔✔sublingual administrations considerations - ✔✔allows drug to be absorbed directly
into the blood stream, causing drug to work much faster than oral medications;
bypasses the liver
✔✔Why would you avoid PO administration? - ✔✔reduced the amount of active drug
reaching the target site through first pass metabolism
, ✔✔volume distribution - ✔✔pharmacokinetic parameter that described the way in which
a drug is distributed through the body and influences the concentration in various
tissues; how readily the drug is able to diffuse throughout the body
✔✔What affects volume distribution? - ✔✔molecular size and weight, lipophilicity,
protein binding
✔✔How does molecular size and weight affect volume distribution? - ✔✔larger
molecules have smaller volume distribution because they are less likely to penetrate a
cell membrane and diffuse throughout the body; smaller molecules can distribute more
freely throughout the body so it has a larger volume distribution
✔✔how does Lipophilicity affect volume distribution of a drug? - ✔✔fat soluble drugs
have a larger volume distribution because they can distribute into fatty tissues and more
readily pass through cell membranes which are made of a lipid bilayer
✔✔how does protein binding affect volume distribution of a drug? - ✔✔drugs that
strongly bind to plasma protein (albumin) have a small volume distribution because they
are largely confined to the vascular space and cannot diffuse easily; drugs with weaker
protein binding have a larger volume distribution because they can move more easily in
the body (more free drug that is not bound roaming about the body)
✔✔What is a loading dose? - ✔✔initial higher dose of a drug that may be given at the
beginning of treatment to RAPIDLY achieve a therapeutic level
✔✔What is the goal of giving a loading dose? - ✔✔to cause a rapid onset of action, and
get to a therapeutic level faster
✔✔Why is a rapid onset of action important for a loading dose? - ✔✔in certain situations
a therapeutic effect is needed very quickly; administering this allows for rapid increase
in drug concentration leading to a faster onset of action
✔✔why is maintaining therapeutic levels important for a medication with a loading
dose? - ✔✔some drugs have long half-lves, reaching a steady state in the body takes
time, by administering this type of dose a prescriber can jumpstart the drug levels to a
therapeutic range more quickly and then switch to a lower maintenance dose to sustain
the drug level
✔✔When does drug toxicity and adverse effects occur? - ✔✔when the peak level of a
drug in the bloodstream exceeds the minimum toxic concentration
✔✔what adverse effects could abnormal drug concentration levels cause? - ✔✔nausea,
vomiting, diarrhea, dizziness, headache, confusion, blurry vision, tremors, seizures, and
other symptoms depending on the drug
