Nursing exam quiz [DOCUMENT SUBTITLE]
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MID-TERM SUMMARY & STUDY GUIDE
NURS-6521
• 100-question Exam which will assess your knowledge on the Learning Resources from Weeks 1-6.
• Time limit of 2 hours.
• Multiple choice or multiple selection.
PHARMACODYNAMICS: HOW THE DRUG EFFECTS THE BODY
Pharmacokinetics: how the body effects the drug
❒ UNDERSTAND THE IMPLICATIONS OF CHANGING RENAL FUNCTION ON CREATININE & DRUG DOSING.
Kidney/Renal functions :
• Filters blood = Remove Waste, Toxins, and Extra Fluid from the body
• Returns needed substances to the blood – & the remainder becomes urine
• Removes acid produced by cells of the body to maintain balanced water, salts; minerals
• Makes hormones that control BP, make RBCs; keeps bones strong
Creatinine: Measures kidney function - byproduct of muscle metabolism (creatinine phosphate)
Normal Serum Creatinine levels: 0.6-1.3 mg/dL - healthy kidney (Easily filters & excretes creatinine)
More Reliable than BUN. Creatinine is Not Absorbed by the kidneys.
Rises indicate renal damage or failure = Kidney is unable to properly filter & excrete waste (creatinine) = Lab
Value rises in the serum.
W Creatinine = u Kidney Function = Requires a decreased dose of medication or different dosing schedule
= Renal Dosing
❒ WHAT IS THE IMPACT OF THE FOLLOWING ON DRUG LEVELS AND DOSING:
➢ Cirrhosis: a disease in which normal liver cells are replaced by scar tissue.
As liver cells die, the organ makes less of the proteins that regulate fluid retention & blood clotting and
the liver loses its ability to metabolize the pigment bilirubin.
Liver/Hepatic functions :
• Produces proteins that help clot blood
, 2
• Removes / neutralizes poisons, drugs and alcohol
• Manufactures bile that helps the body absorb fats & cholesterol
• Helps maintain normal blood sugar levels
• Regulates hormones
With Cirrhosis - the liver fails to detoxify the blood & it becomes less able to metabolize medications, which
magnifies their effects. Eventually toxins build up in the brain & can produce:
• Increased sensitivity to drugs
• Levels of medication will be higher d/t decreased metabolism
• Requires decreased dose of medication
U LIVER/HEPATIC FUNCTION = U ABILITY TO METABOLIZE MEDICATION = REQUIRES A DECREASED DOSE
OF MEDICATION OR DIFFERENT DOSING SCHEDULE = HEPATIC DOSING
, 3
➢ Protein binding: Drugs can form reversible bonds with various proteins in the body.
Plasma albumin is the most important - large molecule - too large to leave the
bloodstream! Binding is reversive & Drugs can be bound or unbound.
% of drug molecules that are bound is determined by the attraction between it and albumin.
Ex. Albumin & Warfarin – Strong Attraction =
99% of warfarin molecules in plasma are bound. 1% Free.
Albumin & Antibiotic Gentamicin – Weak Attraction =
< 10% of gentamicin molecules in plasma are bound. > 90% Free.
• Restricted drug distribution = Albumin is too large to leave; bound molecules cannot leave either!
o Bound molecules cannot reach their site of action or undergo metabolism/excretion until drug-protein bond
is broken so the is free to leave the circulation.
• Drug Interactions = Each Albumin molecule has only a few sites where drug molecules can bind.
o Drugs will complete with 1 another for the limited binding sites = 1 drug displaces another from albumin = Free
concentration of the displaced drug Rises = Increasing intensity of drug responses!
o If plasma drug levels rise = Toxicity!
o If the drug is highly protein bound = Need higher dose of drug to attach to/saturate all areas of the
drug binding proteins & the Receptors TO GET RESULTS!
o If you have Drug A in place at all drug binding protein sites, and you add Drug B (which is more protein
bound), it will displace (Kick off) Drug A & take their place at the drug binding protein sites = Causing
more Drug A to be free floating
o Ex: Coumadin & Dilantin Both Highly Plasma Protein Bound Drugs!
o 3 days prior to surgery, Coumadin in stopped – leaving more protein binding sites for Dilantin. The
Dilantin binds and leaves less available to prevent Seizure
o Starting or stopping drugs that bind to plasma protein changes the free drug levels of other
protein bound drugs *Check Levels & Drug Effects more frequently!
➢ Drug interactions: When two drugs interact, there are three possible outcomes:
(1) one drug may intensify the effects of the other
(2) one drug may reduce the effects of the other
(3) the combination may produce a new response not seen with either drug alone.
• Medications must be prescribed at doses that will allot for the appropriate level of outcome
required specifically for that patient.
• Frequent monitoring of effects & levels are required
[Draw your reader in with an engaging abstract. It is typically a short
summary of the document. When you’re ready to add your content, just
click here and start typing.]
, 1
MID-TERM SUMMARY & STUDY GUIDE
NURS-6521
• 100-question Exam which will assess your knowledge on the Learning Resources from Weeks 1-6.
• Time limit of 2 hours.
• Multiple choice or multiple selection.
PHARMACODYNAMICS: HOW THE DRUG EFFECTS THE BODY
Pharmacokinetics: how the body effects the drug
❒ UNDERSTAND THE IMPLICATIONS OF CHANGING RENAL FUNCTION ON CREATININE & DRUG DOSING.
Kidney/Renal functions :
• Filters blood = Remove Waste, Toxins, and Extra Fluid from the body
• Returns needed substances to the blood – & the remainder becomes urine
• Removes acid produced by cells of the body to maintain balanced water, salts; minerals
• Makes hormones that control BP, make RBCs; keeps bones strong
Creatinine: Measures kidney function - byproduct of muscle metabolism (creatinine phosphate)
Normal Serum Creatinine levels: 0.6-1.3 mg/dL - healthy kidney (Easily filters & excretes creatinine)
More Reliable than BUN. Creatinine is Not Absorbed by the kidneys.
Rises indicate renal damage or failure = Kidney is unable to properly filter & excrete waste (creatinine) = Lab
Value rises in the serum.
W Creatinine = u Kidney Function = Requires a decreased dose of medication or different dosing schedule
= Renal Dosing
❒ WHAT IS THE IMPACT OF THE FOLLOWING ON DRUG LEVELS AND DOSING:
➢ Cirrhosis: a disease in which normal liver cells are replaced by scar tissue.
As liver cells die, the organ makes less of the proteins that regulate fluid retention & blood clotting and
the liver loses its ability to metabolize the pigment bilirubin.
Liver/Hepatic functions :
• Produces proteins that help clot blood
, 2
• Removes / neutralizes poisons, drugs and alcohol
• Manufactures bile that helps the body absorb fats & cholesterol
• Helps maintain normal blood sugar levels
• Regulates hormones
With Cirrhosis - the liver fails to detoxify the blood & it becomes less able to metabolize medications, which
magnifies their effects. Eventually toxins build up in the brain & can produce:
• Increased sensitivity to drugs
• Levels of medication will be higher d/t decreased metabolism
• Requires decreased dose of medication
U LIVER/HEPATIC FUNCTION = U ABILITY TO METABOLIZE MEDICATION = REQUIRES A DECREASED DOSE
OF MEDICATION OR DIFFERENT DOSING SCHEDULE = HEPATIC DOSING
, 3
➢ Protein binding: Drugs can form reversible bonds with various proteins in the body.
Plasma albumin is the most important - large molecule - too large to leave the
bloodstream! Binding is reversive & Drugs can be bound or unbound.
% of drug molecules that are bound is determined by the attraction between it and albumin.
Ex. Albumin & Warfarin – Strong Attraction =
99% of warfarin molecules in plasma are bound. 1% Free.
Albumin & Antibiotic Gentamicin – Weak Attraction =
< 10% of gentamicin molecules in plasma are bound. > 90% Free.
• Restricted drug distribution = Albumin is too large to leave; bound molecules cannot leave either!
o Bound molecules cannot reach their site of action or undergo metabolism/excretion until drug-protein bond
is broken so the is free to leave the circulation.
• Drug Interactions = Each Albumin molecule has only a few sites where drug molecules can bind.
o Drugs will complete with 1 another for the limited binding sites = 1 drug displaces another from albumin = Free
concentration of the displaced drug Rises = Increasing intensity of drug responses!
o If plasma drug levels rise = Toxicity!
o If the drug is highly protein bound = Need higher dose of drug to attach to/saturate all areas of the
drug binding proteins & the Receptors TO GET RESULTS!
o If you have Drug A in place at all drug binding protein sites, and you add Drug B (which is more protein
bound), it will displace (Kick off) Drug A & take their place at the drug binding protein sites = Causing
more Drug A to be free floating
o Ex: Coumadin & Dilantin Both Highly Plasma Protein Bound Drugs!
o 3 days prior to surgery, Coumadin in stopped – leaving more protein binding sites for Dilantin. The
Dilantin binds and leaves less available to prevent Seizure
o Starting or stopping drugs that bind to plasma protein changes the free drug levels of other
protein bound drugs *Check Levels & Drug Effects more frequently!
➢ Drug interactions: When two drugs interact, there are three possible outcomes:
(1) one drug may intensify the effects of the other
(2) one drug may reduce the effects of the other
(3) the combination may produce a new response not seen with either drug alone.
• Medications must be prescribed at doses that will allot for the appropriate level of outcome
required specifically for that patient.
• Frequent monitoring of effects & levels are required
