Pharmacology for the Nurse Educator
Pharmacokinetics ------- ✔ CORRECT ANSWER ✓✓Involves ADME (absorption, distribution,
metabolism and elimination).
Absorption: absorption from the administration site either directly or indirectly into the
blood/plasma.
Distribution: reversibly or irreversibly move from the bloodstream into the interstitial and
intracellular fluid.
Metabolism: bio-transformed via hepatic metabolism or by other tissues.
Elimination: lastly, the drug & its metabolites are eliminated from the body
The route of administration with the highest bio-availability is ------- ✔ CORRECT ANSWER
✓✓Intravenous; putting entire dose into a patient's vein and bypassing absorption. Intravenous
route avoids first-pass metabolism in the liver.
rectal administration disadvantages ------- ✔ CORRECT ANSWER ✓✓variable and erratic
absorption
Steady state (SS) ------- ✔ CORRECT ANSWER ✓✓is usually reached within 4-5 half-lives of a
drug
,The half-life of a drug is defined as ------- ✔ CORRECT ANSWER ✓✓how long it takes for half the
drug to be excreted from the body
Half-life of a drug ------- ✔ CORRECT ANSWER ✓✓Determines how frequently the drug must be
administered
Predicts how long toxic effects can last
Half-life is constant with first-order pharmacokinetics of a drug
Zero-order (nonlinear) pharmacokinetics means a drug is metabolized at a constant rate per
unit time.
CYP3A4 substrate drugs ------- ✔ CORRECT ANSWER ✓✓May have enhanced activity if any
CYP3A4 inducer drugs are used along with it.
Drug development steps (according to the FDA) ------- ✔ CORRECT ANSWER ✓✓Discovery:
laboratory research to develop the new drug
Pre-clinical research with animal testing for safety (Phase I)
Clinical research on human subjects for medication safety (Phase II)
Clinical research in humans comparing the new drug to accepted medications or placebo
depending on the study (Phase III)
FDA review of the results to determine approval
, Post-marketing study to identify adverse effects not found in earlier clinical studies (Phase IV)
Medication safety organizations ------- ✔ CORRECT ANSWER ✓✓The Institute for Safe
Medication Practices (ISMP)
The Institute of Medicine (IOM)
The Joint Commission
The National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP)
Food and Drug Administration (FDA) Safe Use Initiative
Adverse Drug Reactions (ADRs) ------- ✔ CORRECT ANSWER ✓✓Two basic type of ADRs:
pharmacological and idiosyncratic.
85% to 90% of ADRs are pharmacological.
Adverse drug reactions are usually preventable, frequently occur in a hospital or nursing home
setting, and include medication errors, adverse drug effects, allergic and idiosyncratic type
reactions.
ADRs are not commonly reported; the FDA does not mandate that ADRs be reported.
Polypharmacy involves using multiple healthcare providers for care, using multiple medications,
and using several pharmacies for prescription filling.