1
NURS 5334 Advanced Pharmacology
Questions and Answers
1. noncompetitive antagonist - ANSWER Drug that reduces the effect of an
agonist, but does not compete at the receptor site.
- binds irreversibly to receptors
- reduce maximal response an agonist can elicit (fewer available
receptors)
- impact NOT permanent (cells constantly break down old receptors &
synthesize new ones)
2. competitive antagonist - ANSWER Drug that reduces the effect of an
agonist, competing at the receptor site.
- binds reversibly
3. equal affinity - ANSWER receptor occupied by whichever agent is present
in the highest concentration
4. partial agonist - ANSWER a drug that binds to a receptor and causes a
response that is less than that caused by a full agonist
- moderate intrinsic activity
- can act as antagonist as well as agonist
5. the number of receptors on the cell surface & the sensitivity to agonists can
change in response to... - ANSWER continuous activation and continuous
inhibition
6. continuous activation - ANSWER continuous exposure to an agonist = cell
becoming less responsive to agonist
7. desensitized or refractory, downregulation
8. continuous inhibition - ANSWER continuous exposure to antagonist = cell
becomes hypersensitive or supersensitive
, 2
9. drug responses that do NOT involve receptors - ANSWER simple physical
or chemical interactions with other small molecules
10.examples of receptorless drugs - ANSWER antacids, antiseptics, saline
laxatives, chelating agents
11.interpatient variability in drug responses - ANSWER dose required to
produce a therapeutic response can vary substantially among patients
12.the ED50 - ANSWER dose that produces a response in 50% of the
population
13.therapeutic index - ANSWER measure of drug's safety
ratio of drug's LD50 (average lethal dose to 50% of animals treated):ED50
What is prescriptive authority? - ANSWER Legal right to prescribe drugs
Varies for nonphysician providers
Limitations tied to oversight by MD or DO
14.Arguments for full prescriptive authority - ANSWER - APRNs are educated
to practice and prescribe independently without supervision
- National examinations validate ability to provide safe competent care
- Licensure ensures compliance with standards to promote public health
and safety - Limited prescriptive authority creates numerous barriers
to quality, affordable, & accessible patient care
15.Drug selection factors - ANSWER cost, guidelines, availability, interactions,
side effects, allergies, liver & renal function, need for monitoring, special
populations
16.Elements needed to complete a prescription - ANSWER - Prescriber name,
license number, and contact information
- Prescriber DEA number, if applicable
- Patient name and date of birth
- Patient allergies
- Name of medication
- Indication of medication
- Medication strength (e.g., 25 mg, 500 mg/mL)
- Dose of medication and frequency (e.g., 12.5 mg once daily)
- Number of tablets/capsules to dispense
- Number of refills
, 3
17.Pharmokinetics - ANSWER the study of drugs within the body, absorption ,
distribution, metabolism, excretion
18.3 ways drugs cross cell membrane - ANSWER 1. channels & pores
2. transport systems (p glycoprotein)
3. direct penetration of membrane ( most common -> drugs too large to pass
through pores & channels)
19.absorption - ANSWER the movement of a drug from its site of
administration into the blood
20.rate of absorption determines how soon effects will begin
21.amount of absorption determine intensity of effects
22.factors affecting absorption - ANSWER rate of dissolution, surface area,
blood flow, lipid solubility, pH partitioning
23.P-glycoprotein - ANSWER Transmembrane protein that transports a wide
variety of drugs out of cells
24.How does the liver aid in pharmacokinetics? - ANSWER transports drugs
into bile for elimination
25.How do the kidneys aid in pharmacokinetics? - ANSWER pumps drugs into
urine for excretion
26.How does the placenta aid in pharmacokinetics? - ANSWER transports
drugs back into the maternal blood
27.How does the brain aid in pharmacokinetics? - ANSWER pumps drugs into
blood to limit drugs' access to the brain
28.passive diffusion - ANSWER molecules move from one side of a barrier to
another without expending energy; moving from an area of higher
concentration to lower concentration
, 4
29."like dissolves like" rule - ANSWER Cell membranes are composed
primarily of lipids; therefore, to directly penetrate membranes, a drug must
be lipid soluble (lipophilic)
30.polar molecules - ANSWER Molecules that have an unequal distribution of
charges
No net charge
31.ions - ANSWER molecules that have a net electrical charge
32.quaternary ammonium compounds - ANSWER molecules that contain at
least 1 atom of nitrogen and carry a positive charge at all times
33.pH dependent ionization - ANSWER Acid is a proton donor - tends to ionize
in basic (alkaline) media
34.Base is a proton acceptor - tends to ionize in acidic media
35.ion trapping (pH partitioning) - ANSWER acidic drugs accumulate on the
alkaline side
36.basic drugs accumulate on the acidic side
37.blood flow to tissues - ANSWER Drugs are carried by the blood to tissues
and organs of the body
38.Blood flow determines the rate of delivery
39.abscesses and tumors ___ blood flow. - ANSWER decrease
40.How do drugs exit the vascular system? - ANSWER Typical capillary beds,
Drugs pass between capillary cells rather than through them.
41.blood-brain barrier - ANSWER Capillaries of CNS that have tight junctions
preventing free diffusion
42.Drugs must be able to pass through cells of capillary wall
43.Only lipid soluble drugs can cross BBB
NURS 5334 Advanced Pharmacology
Questions and Answers
1. noncompetitive antagonist - ANSWER Drug that reduces the effect of an
agonist, but does not compete at the receptor site.
- binds irreversibly to receptors
- reduce maximal response an agonist can elicit (fewer available
receptors)
- impact NOT permanent (cells constantly break down old receptors &
synthesize new ones)
2. competitive antagonist - ANSWER Drug that reduces the effect of an
agonist, competing at the receptor site.
- binds reversibly
3. equal affinity - ANSWER receptor occupied by whichever agent is present
in the highest concentration
4. partial agonist - ANSWER a drug that binds to a receptor and causes a
response that is less than that caused by a full agonist
- moderate intrinsic activity
- can act as antagonist as well as agonist
5. the number of receptors on the cell surface & the sensitivity to agonists can
change in response to... - ANSWER continuous activation and continuous
inhibition
6. continuous activation - ANSWER continuous exposure to an agonist = cell
becoming less responsive to agonist
7. desensitized or refractory, downregulation
8. continuous inhibition - ANSWER continuous exposure to antagonist = cell
becomes hypersensitive or supersensitive
, 2
9. drug responses that do NOT involve receptors - ANSWER simple physical
or chemical interactions with other small molecules
10.examples of receptorless drugs - ANSWER antacids, antiseptics, saline
laxatives, chelating agents
11.interpatient variability in drug responses - ANSWER dose required to
produce a therapeutic response can vary substantially among patients
12.the ED50 - ANSWER dose that produces a response in 50% of the
population
13.therapeutic index - ANSWER measure of drug's safety
ratio of drug's LD50 (average lethal dose to 50% of animals treated):ED50
What is prescriptive authority? - ANSWER Legal right to prescribe drugs
Varies for nonphysician providers
Limitations tied to oversight by MD or DO
14.Arguments for full prescriptive authority - ANSWER - APRNs are educated
to practice and prescribe independently without supervision
- National examinations validate ability to provide safe competent care
- Licensure ensures compliance with standards to promote public health
and safety - Limited prescriptive authority creates numerous barriers
to quality, affordable, & accessible patient care
15.Drug selection factors - ANSWER cost, guidelines, availability, interactions,
side effects, allergies, liver & renal function, need for monitoring, special
populations
16.Elements needed to complete a prescription - ANSWER - Prescriber name,
license number, and contact information
- Prescriber DEA number, if applicable
- Patient name and date of birth
- Patient allergies
- Name of medication
- Indication of medication
- Medication strength (e.g., 25 mg, 500 mg/mL)
- Dose of medication and frequency (e.g., 12.5 mg once daily)
- Number of tablets/capsules to dispense
- Number of refills
, 3
17.Pharmokinetics - ANSWER the study of drugs within the body, absorption ,
distribution, metabolism, excretion
18.3 ways drugs cross cell membrane - ANSWER 1. channels & pores
2. transport systems (p glycoprotein)
3. direct penetration of membrane ( most common -> drugs too large to pass
through pores & channels)
19.absorption - ANSWER the movement of a drug from its site of
administration into the blood
20.rate of absorption determines how soon effects will begin
21.amount of absorption determine intensity of effects
22.factors affecting absorption - ANSWER rate of dissolution, surface area,
blood flow, lipid solubility, pH partitioning
23.P-glycoprotein - ANSWER Transmembrane protein that transports a wide
variety of drugs out of cells
24.How does the liver aid in pharmacokinetics? - ANSWER transports drugs
into bile for elimination
25.How do the kidneys aid in pharmacokinetics? - ANSWER pumps drugs into
urine for excretion
26.How does the placenta aid in pharmacokinetics? - ANSWER transports
drugs back into the maternal blood
27.How does the brain aid in pharmacokinetics? - ANSWER pumps drugs into
blood to limit drugs' access to the brain
28.passive diffusion - ANSWER molecules move from one side of a barrier to
another without expending energy; moving from an area of higher
concentration to lower concentration
, 4
29."like dissolves like" rule - ANSWER Cell membranes are composed
primarily of lipids; therefore, to directly penetrate membranes, a drug must
be lipid soluble (lipophilic)
30.polar molecules - ANSWER Molecules that have an unequal distribution of
charges
No net charge
31.ions - ANSWER molecules that have a net electrical charge
32.quaternary ammonium compounds - ANSWER molecules that contain at
least 1 atom of nitrogen and carry a positive charge at all times
33.pH dependent ionization - ANSWER Acid is a proton donor - tends to ionize
in basic (alkaline) media
34.Base is a proton acceptor - tends to ionize in acidic media
35.ion trapping (pH partitioning) - ANSWER acidic drugs accumulate on the
alkaline side
36.basic drugs accumulate on the acidic side
37.blood flow to tissues - ANSWER Drugs are carried by the blood to tissues
and organs of the body
38.Blood flow determines the rate of delivery
39.abscesses and tumors ___ blood flow. - ANSWER decrease
40.How do drugs exit the vascular system? - ANSWER Typical capillary beds,
Drugs pass between capillary cells rather than through them.
41.blood-brain barrier - ANSWER Capillaries of CNS that have tight junctions
preventing free diffusion
42.Drugs must be able to pass through cells of capillary wall
43.Only lipid soluble drugs can cross BBB
