NRNP 6566 WK1-5 Midterm Questions with
100% Correct Answers | Verified | Latest
Update 2025 RATED A+
Describe cytochrome p450 system - CORRECT ANSWERS Cytochrome p450 system is a series of
enzymes used to metabolize medications
Inhibitors - CORRECT ANSWERS block metabolic activity from one or more CYP450 enzymes
Inducers - CORRECT ANSWERS increase CYP450 enzyme activity by increasing enzyme synthesis
Describe effect on low and high albumin levels on active drug levels especially for drugs that are highly
protein bound - CORRECT ANSWERS Albumin is the plasma protein with the greatest capacity for
binding drugs. Binding plasma proteins affect drug distribution into tissues, because only drug that is not
bound is available to penetrate tissues, bind to receptors, and exert activity. As free drug leaves the
blood stream, more bound drug is released from binding sites.
Low albumin levels - CORRECT ANSWERS malnutrition, chronic illness
Highly protein bound drugs can lead to - CORRECT ANSWERS toxicity in patients with low
albumin levels, example malnutrition or chronic illness. This is because there are fewer than the normal
sites for the drug to bind
Describe the ways the hepatic first pass effect- which is metabolism during first pass through the liver -
CORRECT ANSWERS Alternative routes include:
suppository
intravenous
intramuscular
, inhalational aerosol
transdermal
sublingual
These allow drugs to bypass the first-pass effect and be absorbed directly into systemic circulation
Be able to calculate creatinine clearance using Cockgraft Gault equation: - CORRECT ANSWERS
Male = 140-age times weight in kilograms divided by serum creatinine times 72.
Women = CRCL (male) times 0.85
Describe what determines the frequency of drug administration - CORRECT ANSWERS half life
plasma concentration
Be familiar with the beers criteria and how to use it - CORRECT ANSWERS Potentially
Inappropriate Medication Use in Older Adults
to call attention to medications that are most commonly problematic and thus should be avoided in
older adults
Describe factors that affect absorption - CORRECT ANSWERS low blood state (shock or arrest),
contact time with GI tract too fast (diarrhea = cant absorb), delayed stomach emptying (large meal =
delayed absorption)Drug- to drug or drug to food interactions
Describe the factors that affect distribution - CORRECT ANSWERS low albumin levels, body
composition, cardiac decompensation (heart failure), age
Describe the factors that affect metabolism - CORRECT ANSWERS genetics, age, organ function
100% Correct Answers | Verified | Latest
Update 2025 RATED A+
Describe cytochrome p450 system - CORRECT ANSWERS Cytochrome p450 system is a series of
enzymes used to metabolize medications
Inhibitors - CORRECT ANSWERS block metabolic activity from one or more CYP450 enzymes
Inducers - CORRECT ANSWERS increase CYP450 enzyme activity by increasing enzyme synthesis
Describe effect on low and high albumin levels on active drug levels especially for drugs that are highly
protein bound - CORRECT ANSWERS Albumin is the plasma protein with the greatest capacity for
binding drugs. Binding plasma proteins affect drug distribution into tissues, because only drug that is not
bound is available to penetrate tissues, bind to receptors, and exert activity. As free drug leaves the
blood stream, more bound drug is released from binding sites.
Low albumin levels - CORRECT ANSWERS malnutrition, chronic illness
Highly protein bound drugs can lead to - CORRECT ANSWERS toxicity in patients with low
albumin levels, example malnutrition or chronic illness. This is because there are fewer than the normal
sites for the drug to bind
Describe the ways the hepatic first pass effect- which is metabolism during first pass through the liver -
CORRECT ANSWERS Alternative routes include:
suppository
intravenous
intramuscular
, inhalational aerosol
transdermal
sublingual
These allow drugs to bypass the first-pass effect and be absorbed directly into systemic circulation
Be able to calculate creatinine clearance using Cockgraft Gault equation: - CORRECT ANSWERS
Male = 140-age times weight in kilograms divided by serum creatinine times 72.
Women = CRCL (male) times 0.85
Describe what determines the frequency of drug administration - CORRECT ANSWERS half life
plasma concentration
Be familiar with the beers criteria and how to use it - CORRECT ANSWERS Potentially
Inappropriate Medication Use in Older Adults
to call attention to medications that are most commonly problematic and thus should be avoided in
older adults
Describe factors that affect absorption - CORRECT ANSWERS low blood state (shock or arrest),
contact time with GI tract too fast (diarrhea = cant absorb), delayed stomach emptying (large meal =
delayed absorption)Drug- to drug or drug to food interactions
Describe the factors that affect distribution - CORRECT ANSWERS low albumin levels, body
composition, cardiac decompensation (heart failure), age
Describe the factors that affect metabolism - CORRECT ANSWERS genetics, age, organ function
