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NUR 614E FINAL AND MID TERM EXAM (LATEST 2025/2026) | COMPLETE ACTUAL EXAM | QUESTIONS & 100% VERIFIED CORRECT ANSWERS | OBJECTIVE ASSESSMENT | PRE ASSESSMENT INCLUDED | GUARANTEED A+ | BRAND NEW UPDATE!

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NUR 614E FINAL AND MID TERM EXAM (LATEST 2025/2026) | COMPLETE ACTUAL EXAM | QUESTIONS & 100% VERIFIED CORRECT ANSWERS | OBJECTIVE ASSESSMENT | PRE ASSESSMENT INCLUDED | GUARANTEED A+ | BRAND NEW UPDATE! Pharmacokinetics - ANSWER elimination). Involves ADME (absorption, distribution, metabolism and 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 - 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 - ANSWER Steady state (SS) - ANSWER variable and erratic absorption is usually reached within 4-5 half-lives of a drug The half-life of a drug is defined as - ANSWER excreted from the body how long it takes for half the drug to be Half-life of a drug - 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 - ANSWER are used along with it. May have enhanced activity if any CYP3A4 inducer drugs Drug development steps (according to the FDA) - ANSWER to develop the new drug Pre-clinical research with animal testing for safety (Phase I) Discovery: laboratory research 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) The Institute for Safe Medication Practices Medication safety organizations - ANSWER (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) - ANSWER idiosyncratic. 85% to 90% of ADRs are pharmacological. Two basic type of ADRs: pharmacological and 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. Cardiovascular-Angiotensin converting enzyme inhibitors (ACEIs): - ANSWER captopril, enalapril, ramipril, benazepril, fosinopril; Lisinopril, *ACEIs reduce blood pressure by suppressing the release of angiotensin-converting enzyme. *Important side effects of ACE inhibitors include cough and angioedema; discontinue the ACEI if angioedema occurs. Angiotensin II receptor blocking agents (ARBs): - ANSWER Candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan). ARBs reduce blood pressure by blocking angiotensin II receptors. Cardiovascular-Essential (primary) hypertension - ANSWER secondary hypertension may be caused by chronic renal failure. Nitroglycerin - ANSWER Accounts for 90% of cases; nitrate drug used in the treatment of angina; a nitrate drug that can be administered IV, SL, a topical ointment and as a transdermal patch PDE-5 inhibitors - ANSWER -Pulmonary hypertension therapy -Include sildenafil. Inhibit cGMP PDE5 and prolong vasodilatory effect of nitric oxide. cGMP phosphodiesterase - ANSWER Amiodarone - ANSWER an enzyme in cells that converts cGMP into GMP is the antiarrhythmic of choice when there is coexisting heart failure; can cause thyroid and pulmonary toxicity. Alpha-1 adrenergic stimulation - ANSWER pressure. Alpha-1 adrenergic blockade - ANSWER results in vasoconstriction and increased blood results in vasodilation and reduced blood pressure

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Institution
NUR 641E
Course
NUR 641E

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NUR 614E FINAL AND MID TERM EXAM (LATEST 2025/2026) |
COMPLETE ACTUAL EXAM | QUESTIONS & 100% VERIFIED
CORRECT ANSWERS | OBJECTIVE ASSESSMENT | PRE ASSESSMENT
INCLUDED | GUARANTEED A+ | BRAND NEW UPDATE!


Pharmacokinetics - 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 - 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 - ANSWER variable and erratic absorption



Steady state (SS) - ANSWER is usually reached within 4-5 half-lives of a drug



The half-life of a drug is defined as - ANSWER how long it takes for half the drug to be
excreted from the body

, Half-life of a drug - 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 - ANSWER May have enhanced activity if any CYP3A4 inducer drugs
are used along with it.



Drug development steps (according to the FDA) - 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 - 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) - 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.



Cardiovascular-Angiotensin converting enzyme inhibitors (ACEIs): - ANSWER Lisinopril,
captopril, enalapril, ramipril, benazepril, fosinopril;

*ACEIs reduce blood pressure by suppressing the release of angiotensin-converting enzyme.

, *Important side effects of ACE inhibitors include cough and angioedema; discontinue the ACEI if
angioedema occurs.



Angiotensin II receptor blocking agents (ARBs): - ANSWER Candesartan (Atacand),
eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), telmisartan (Micardis) and
valsartan (Diovan).

ARBs reduce blood pressure by blocking angiotensin II receptors.



Cardiovascular-Essential (primary) hypertension - ANSWER Accounts for 90% of cases;
secondary hypertension may be caused by chronic renal failure.



Nitroglycerin - ANSWER nitrate drug used in the treatment of angina; a nitrate drug that
can be administered IV, SL, a topical ointment and as a transdermal patch



PDE-5 inhibitors - ANSWER -Pulmonary hypertension therapy

-Include sildenafil. Inhibit cGMP PDE5 and prolong vasodilatory effect of nitric oxide.



cGMP phosphodiesterase - ANSWER an enzyme in cells that converts cGMP into GMP



Amiodarone - ANSWER is the antiarrhythmic of choice when there is coexisting heart
failure; can cause thyroid and pulmonary toxicity.



Alpha-1 adrenergic stimulation - ANSWER results in vasoconstriction and increased blood
pressure.



Alpha-1 adrenergic blockade - ANSWER results in vasodilation and reduced blood pressure

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Course
NUR 641E

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