Advanced Pharmacology - Modules 1-5 Final
Exam Review Questions and Answers_ Well
Updated 100% A+ Graded
Once you graduate from an NP program, in order to prescribe you'll need: - CORRECT
ANSWER--Advanced nurse prescriber license
-DEA #
What is the purpose of a DEA #? - CORRECT ANSWER-Needed to prescribed scheduled drugs
Rules for prescribing Schedule II drugs: - CORRECT ANSWER--Written script needed
-1 month supply only
-No refills
What is the PDMP? - CORRECT ANSWER-Prescription Drug Monitoring Program
Used to effectively track patient's controlled substance uses across different health facilities (in
the same state)
What are clinical practice guidelines? - CORRECT ANSWER-Recommendations that are
intended to optimize patient care that are informed by a systematic review of the evidence and an
assessment of the benefits/harms of alternative care practices
Ex: sepsis, CAP
Common causes of medication errors: - CORRECT ANSWER--Illegible writing
-Drug names that sound alike
-Medications that look alike
-Administering a drug with the wrong route
What is pharmacokinetics? What are its 4 categories? - CORRECT ANSWER-What the body
does to the drug
1. Absorption
2. Metabolism
3. Distribution
4. Excretion
,Quickest route of absorption? Slowest? - CORRECT ANSWER-IV = quickest
IM = slowest
What is the most common way drugs pass through cell membranes? - CORRECT ANSWER-
Passive diffusion
What characteristics of a drug allow it to pass most quickly through cell membranes (usually
through passive diffusion)? - CORRECT ANSWER-Small, uncharged (unionized), lipid soluble-
-pass through membrane without any energy
What does it mean when a drug is ionized? - CORRECT ANSWER-It means that the drug is
stuck in the compartment it was ionized in and has to be moved to the next compartment (cannot
be absorbed into the bloodstream)
Where do weak acids absorb? - CORRECT ANSWER-Stomach
Where do weak bases absorb? - CORRECT ANSWER-Small intestine
pH of stomach: - CORRECT ANSWER-2-4
pH of small intestine: - CORRECT ANSWER-6-7
pH of large intestine: - CORRECT ANSWER-6-7
pH of bloodstream: - CORRECT ANSWER-7.35-7.45
pH of bladder: - CORRECT ANSWER-5-8
pH of breastmilk: - CORRECT ANSWER-7.1
Where will a drug absorb if it is a weak base that ionizes at a pH of 4 and lower? - CORRECT
ANSWER-In the small intestine (since the stomach has a pH of 2-4, so the drug will become
ionized and move to the small intestine where it will be able to absorb into the bloodstream)
How can we manipulate the urine pH in cases of overdose? - CORRECT ANSWER-Drugs that
are weak acids (aspirin) can be trapped and excreted through the urine.
We raise pH of the urine (with sodium bicarb) to force the drug to ionize and allow it to be
excreted, not reabsorbed through the bloodstream.
,What is distribution? - CORRECT ANSWER-How a drug will be transported to the tissues it
needs to go to in order for it to exert its effects
Drug factors related to distribution: - CORRECT ANSWER--Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
-Therapeutic effects
-Toxic effects
(lipid soluble, small, and non-ionized drugs will distribute more quickly)
Body factors related to distribution: - CORRECT ANSWER--Vascularity (poor perfusion,
disruption of blood flow due to trauma--difficulty distributing)
-Blood barriers (blood-brain-barrier can be problematic if we need to get drugs to the brain--will
need very high dosing since only a small amount of the drug will get through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
-Drug interactions
What is the key plasma protein involved with protein binding for medications? - CORRECT
ANSWER-Albumin
Why do we monitor albumin? - CORRECT ANSWER-Indicative of nutritional status and how
well protein-bound drugs will be transported to their target locations
What happens to the therapeutic effect of a drug when the patient is elderly and has very low
levels of albumin? - CORRECT ANSWER-The drug does not bind to the protein (albumin) as
much as expected, so there is a lot of free drug floating in the plasma; high risk for drug toxicity
Protein bound means: - CORRECT ANSWER-Inactive form of the drug; does not have any
therapeutic effect when bound to a protein
Free drug means: - CORRECT ANSWER-Active form of the drug (available for therapeutic
effect)
, What happens when a patient is on two drugs that are competing for the same protein binding
site on the albumin? - CORRECT ANSWER-Some drug interactions can occur. Drugs fight for
binding position, but both drugs do not get enough as the usually would. Leads to higher free
drug levels, decreased overall albumin binding, and potential toxicity for both drugs.
**Unpredictable**
What is the 1st pass effect? - CORRECT ANSWER-PO drug goes through GI tract and absorbs
in the stomach or intestines into local circulation that reaches the liver. The liver inactivates
portions of the drug before it goes into systemic circulation. Some drugs with a very high 1st
pass effect may have to be given IV (goes directly into systemic circulation) or in higher PO
doses (watch for side effects)
What does a substrate for an enzyme mean? - CORRECT ANSWER-It needs it to undergo
metabolism
What is an enzyme inducer? - CORRECT ANSWER-It increases clearance of the drug
(decreased blood levels of drug--may need dose increase)
What is an enzyme inhibitor? - CORRECT ANSWER-It reduces clearance (increased blood
levels of drug--may need dose decrease)
Who is at risk for drug toxicity? - CORRECT ANSWER-Elderly, those with decreased renal
function
-Cannot properly excrete the drug
What are the key pharmacokinetic changes that occur during pregnancy? - CORRECT
ANSWER--Decreased absorption
-Increased hepatic metabolism
-Increased renal excretion
**Dose adjustments are common during pregnancy
What is the safest drug category for pregnant women? - CORRECT ANSWER-Category A
What is the contraindicated drug category for pregnant women? - CORRECT ANSWER-
Category X
What is pharmacodynamics? - CORRECT ANSWER-What the drug does to the body
Exam Review Questions and Answers_ Well
Updated 100% A+ Graded
Once you graduate from an NP program, in order to prescribe you'll need: - CORRECT
ANSWER--Advanced nurse prescriber license
-DEA #
What is the purpose of a DEA #? - CORRECT ANSWER-Needed to prescribed scheduled drugs
Rules for prescribing Schedule II drugs: - CORRECT ANSWER--Written script needed
-1 month supply only
-No refills
What is the PDMP? - CORRECT ANSWER-Prescription Drug Monitoring Program
Used to effectively track patient's controlled substance uses across different health facilities (in
the same state)
What are clinical practice guidelines? - CORRECT ANSWER-Recommendations that are
intended to optimize patient care that are informed by a systematic review of the evidence and an
assessment of the benefits/harms of alternative care practices
Ex: sepsis, CAP
Common causes of medication errors: - CORRECT ANSWER--Illegible writing
-Drug names that sound alike
-Medications that look alike
-Administering a drug with the wrong route
What is pharmacokinetics? What are its 4 categories? - CORRECT ANSWER-What the body
does to the drug
1. Absorption
2. Metabolism
3. Distribution
4. Excretion
,Quickest route of absorption? Slowest? - CORRECT ANSWER-IV = quickest
IM = slowest
What is the most common way drugs pass through cell membranes? - CORRECT ANSWER-
Passive diffusion
What characteristics of a drug allow it to pass most quickly through cell membranes (usually
through passive diffusion)? - CORRECT ANSWER-Small, uncharged (unionized), lipid soluble-
-pass through membrane without any energy
What does it mean when a drug is ionized? - CORRECT ANSWER-It means that the drug is
stuck in the compartment it was ionized in and has to be moved to the next compartment (cannot
be absorbed into the bloodstream)
Where do weak acids absorb? - CORRECT ANSWER-Stomach
Where do weak bases absorb? - CORRECT ANSWER-Small intestine
pH of stomach: - CORRECT ANSWER-2-4
pH of small intestine: - CORRECT ANSWER-6-7
pH of large intestine: - CORRECT ANSWER-6-7
pH of bloodstream: - CORRECT ANSWER-7.35-7.45
pH of bladder: - CORRECT ANSWER-5-8
pH of breastmilk: - CORRECT ANSWER-7.1
Where will a drug absorb if it is a weak base that ionizes at a pH of 4 and lower? - CORRECT
ANSWER-In the small intestine (since the stomach has a pH of 2-4, so the drug will become
ionized and move to the small intestine where it will be able to absorb into the bloodstream)
How can we manipulate the urine pH in cases of overdose? - CORRECT ANSWER-Drugs that
are weak acids (aspirin) can be trapped and excreted through the urine.
We raise pH of the urine (with sodium bicarb) to force the drug to ionize and allow it to be
excreted, not reabsorbed through the bloodstream.
,What is distribution? - CORRECT ANSWER-How a drug will be transported to the tissues it
needs to go to in order for it to exert its effects
Drug factors related to distribution: - CORRECT ANSWER--Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
-Therapeutic effects
-Toxic effects
(lipid soluble, small, and non-ionized drugs will distribute more quickly)
Body factors related to distribution: - CORRECT ANSWER--Vascularity (poor perfusion,
disruption of blood flow due to trauma--difficulty distributing)
-Blood barriers (blood-brain-barrier can be problematic if we need to get drugs to the brain--will
need very high dosing since only a small amount of the drug will get through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
-Drug interactions
What is the key plasma protein involved with protein binding for medications? - CORRECT
ANSWER-Albumin
Why do we monitor albumin? - CORRECT ANSWER-Indicative of nutritional status and how
well protein-bound drugs will be transported to their target locations
What happens to the therapeutic effect of a drug when the patient is elderly and has very low
levels of albumin? - CORRECT ANSWER-The drug does not bind to the protein (albumin) as
much as expected, so there is a lot of free drug floating in the plasma; high risk for drug toxicity
Protein bound means: - CORRECT ANSWER-Inactive form of the drug; does not have any
therapeutic effect when bound to a protein
Free drug means: - CORRECT ANSWER-Active form of the drug (available for therapeutic
effect)
, What happens when a patient is on two drugs that are competing for the same protein binding
site on the albumin? - CORRECT ANSWER-Some drug interactions can occur. Drugs fight for
binding position, but both drugs do not get enough as the usually would. Leads to higher free
drug levels, decreased overall albumin binding, and potential toxicity for both drugs.
**Unpredictable**
What is the 1st pass effect? - CORRECT ANSWER-PO drug goes through GI tract and absorbs
in the stomach or intestines into local circulation that reaches the liver. The liver inactivates
portions of the drug before it goes into systemic circulation. Some drugs with a very high 1st
pass effect may have to be given IV (goes directly into systemic circulation) or in higher PO
doses (watch for side effects)
What does a substrate for an enzyme mean? - CORRECT ANSWER-It needs it to undergo
metabolism
What is an enzyme inducer? - CORRECT ANSWER-It increases clearance of the drug
(decreased blood levels of drug--may need dose increase)
What is an enzyme inhibitor? - CORRECT ANSWER-It reduces clearance (increased blood
levels of drug--may need dose decrease)
Who is at risk for drug toxicity? - CORRECT ANSWER-Elderly, those with decreased renal
function
-Cannot properly excrete the drug
What are the key pharmacokinetic changes that occur during pregnancy? - CORRECT
ANSWER--Decreased absorption
-Increased hepatic metabolism
-Increased renal excretion
**Dose adjustments are common during pregnancy
What is the safest drug category for pregnant women? - CORRECT ANSWER-Category A
What is the contraindicated drug category for pregnant women? - CORRECT ANSWER-
Category X
What is pharmacodynamics? - CORRECT ANSWER-What the drug does to the body
