NRNP 6566 WK1-5 Midterm questions and
answers 2025\2026 A+ Grade
Describe cytochrome p450 system
- correct answer Cytochrome p450 system is a series of enzymes used to metabolize medications
Inhibitors
- correct answer block metabolic activity from one or more CYP450 enzymes
Inducers
- correct answer 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 answer 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 answer malnutrition, chronic illness
Highly protein bound drugs can lead to
- correct answer 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 answer 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 answer 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 answer half life
plasma concentration
Be familiar with the beers criteria and how to use it
- correct answer 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 answer 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 answer low albumin levels, body composition, cardiac decompensation (heart failure), age
Describe the factors that affect metabolism
- correct answer genetics, age, organ function
answers 2025\2026 A+ Grade
Describe cytochrome p450 system
- correct answer Cytochrome p450 system is a series of enzymes used to metabolize medications
Inhibitors
- correct answer block metabolic activity from one or more CYP450 enzymes
Inducers
- correct answer 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 answer 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 answer malnutrition, chronic illness
Highly protein bound drugs can lead to
- correct answer 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 answer 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 answer 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 answer half life
plasma concentration
Be familiar with the beers criteria and how to use it
- correct answer 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 answer 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 answer low albumin levels, body composition, cardiac decompensation (heart failure), age
Describe the factors that affect metabolism
- correct answer genetics, age, organ function
