Nur 641 E Final Exam Study Guide Grand Canyon University with
Answers Graded A+
absorption, distribution, metabolism, excretion Pharmacokinetics involves
absorption from the administration site either directly or
Pharmacokinetic absorption
indirectly in the blood plasma
reversibly or irreversibly move from the bloodstream into
Parmacokinetic distribution
the interstitial and intracellular fluid
biotransformed via hepatic metabolism or by other tissue Pharmacokinetics metabolism
1. highest bioavailability
2. places entire does into venin thus bypassing absorp-
Intravenous medications
tion
3. avoids hepatic first pass metabolism in the liver
usually reached within 4-5 half lives of the drug steady state medication
1. the time required for the elimination process to reduce
2. the concentration of the drug to one half what it was at
initial administration
drug half life
3. determines drug frequency
4. predicts length of toxic ettects
5. constant first order pharmacokinetics of a drug
drug is metabolized at a constant rate per unit zero order (nonlinear)
metabolizes 50% drugs
inhibit: grapefruit juice
CYP3A4
- increase drug -> adverse ettects
may have enhanced activity with any other CYP3A4
1. discovery or laboratory for development
2. Phase 1 begins with animal testing
3. phase 2 human subjects
4. compare drug to placebo or other drug that is ettective Six steps in drug development process
5. FDA then reviews result and determines approval
6. Post market study to determine other side ettects that
were not seen while lab testing
,Nur 641 E Final Exam Study Guide Grand Canyon University with
Answers Graded A+
1. Institute of Safe mediation Practice
2. Institute of Medicine
3. Joint commission
organizations for medication safety
4. National Coordinating Council form mediation error re-
porting and prevention
5. Food and Drug Administration (safe use initiative)
1. Also known as a side ettect, an undesirable reaction that
accompanies the principal response for which the drug
was taken include allergic reactions and adverse drug
ettects
2. Either pharmacological or idiosyncratic
3. 85-90% of ADRs are pharmacological
Adverse Drug Reaction (ADR)
4. Reporting is not mandated by FDA thus are not com-
monly reported
5. usually preventable occur in hospital and nursing
homes due to med errors
6. Polypharmacy, multiple doctors and multiple pharma-
cies increase risk
1. end in pril: lisinopril, captopril, enalapril, ramipril, be-
nazepril and fosinopril
2. suppress release of angiotensin converting enzyme Angiotensin-converting enzyme (ACE) inhibitors
3. side ettects include cough and angioedema, with an-
gioedema the medication should be discontinued
1. -sartan: candesartan, eprosartan, ibesartan, Isosartan,
telmisartan, valsartan Angiotensin II Receptor Blockers (ARBs)
2. block angiotensin 11 receptors
Essential HTN accounts for 90% of cases and is also called
Essential vs Secondary HTN
primary, secondary may be caused by CKD
use: angina pectoris
action: dilate veins and arteries and thereby reducing
, ischemia and relieving pain by decreasing myocardial O2
consumption
Side ettects: throbbing HA, flushing, hypotension tachy-
Nitroglycerin (Nitrate)
cardia
available: IV, SL, topical ointment and transdermal patch
contraindicated with PDE-5 (sildanfil and vardenafil)
1. antiarrhythmic of choice when there is coexisting heart
failure Amiodarone
2. can cause thyroid and pulmonary toxicity
vasoconstriction and increased blood pressure Alpha 1 adrenergic stimulation results
Decrease sympathetic stimulation causing vasodilation
alpha 1 blockade
and decreased blood pressure
stimulation by beta agonists (isoproterenol) result in in-
creased heart rate, blood pressure and cardiac output
beta 1 adrenergic
2. blockade results in decreased heart rate, bp, and car-
diac output
The heart does not adequately circulate blood to systemic
system. Due to pressure overload or volume overload left heart failure
causing a reduction of oxygenated blood to body tissue
1. Associated with pulmonary disease and increased pul-
monary vascular resistance
2. The heart does not adequately circulate blood to the
pulmonic system. Can be due to volume overload or re- Right heart failure
gurgitation in Tricuspid Valve or Pulmonic Valve.
Can lead to systemic edema, back up of blood in liver and
lower extremities
1. Inhibit water transport across Loop of Henle work on
Loop diuretics MOA
receptors in ascending renal loop
Answers Graded A+
absorption, distribution, metabolism, excretion Pharmacokinetics involves
absorption from the administration site either directly or
Pharmacokinetic absorption
indirectly in the blood plasma
reversibly or irreversibly move from the bloodstream into
Parmacokinetic distribution
the interstitial and intracellular fluid
biotransformed via hepatic metabolism or by other tissue Pharmacokinetics metabolism
1. highest bioavailability
2. places entire does into venin thus bypassing absorp-
Intravenous medications
tion
3. avoids hepatic first pass metabolism in the liver
usually reached within 4-5 half lives of the drug steady state medication
1. the time required for the elimination process to reduce
2. the concentration of the drug to one half what it was at
initial administration
drug half life
3. determines drug frequency
4. predicts length of toxic ettects
5. constant first order pharmacokinetics of a drug
drug is metabolized at a constant rate per unit zero order (nonlinear)
metabolizes 50% drugs
inhibit: grapefruit juice
CYP3A4
- increase drug -> adverse ettects
may have enhanced activity with any other CYP3A4
1. discovery or laboratory for development
2. Phase 1 begins with animal testing
3. phase 2 human subjects
4. compare drug to placebo or other drug that is ettective Six steps in drug development process
5. FDA then reviews result and determines approval
6. Post market study to determine other side ettects that
were not seen while lab testing
,Nur 641 E Final Exam Study Guide Grand Canyon University with
Answers Graded A+
1. Institute of Safe mediation Practice
2. Institute of Medicine
3. Joint commission
organizations for medication safety
4. National Coordinating Council form mediation error re-
porting and prevention
5. Food and Drug Administration (safe use initiative)
1. Also known as a side ettect, an undesirable reaction that
accompanies the principal response for which the drug
was taken include allergic reactions and adverse drug
ettects
2. Either pharmacological or idiosyncratic
3. 85-90% of ADRs are pharmacological
Adverse Drug Reaction (ADR)
4. Reporting is not mandated by FDA thus are not com-
monly reported
5. usually preventable occur in hospital and nursing
homes due to med errors
6. Polypharmacy, multiple doctors and multiple pharma-
cies increase risk
1. end in pril: lisinopril, captopril, enalapril, ramipril, be-
nazepril and fosinopril
2. suppress release of angiotensin converting enzyme Angiotensin-converting enzyme (ACE) inhibitors
3. side ettects include cough and angioedema, with an-
gioedema the medication should be discontinued
1. -sartan: candesartan, eprosartan, ibesartan, Isosartan,
telmisartan, valsartan Angiotensin II Receptor Blockers (ARBs)
2. block angiotensin 11 receptors
Essential HTN accounts for 90% of cases and is also called
Essential vs Secondary HTN
primary, secondary may be caused by CKD
use: angina pectoris
action: dilate veins and arteries and thereby reducing
, ischemia and relieving pain by decreasing myocardial O2
consumption
Side ettects: throbbing HA, flushing, hypotension tachy-
Nitroglycerin (Nitrate)
cardia
available: IV, SL, topical ointment and transdermal patch
contraindicated with PDE-5 (sildanfil and vardenafil)
1. antiarrhythmic of choice when there is coexisting heart
failure Amiodarone
2. can cause thyroid and pulmonary toxicity
vasoconstriction and increased blood pressure Alpha 1 adrenergic stimulation results
Decrease sympathetic stimulation causing vasodilation
alpha 1 blockade
and decreased blood pressure
stimulation by beta agonists (isoproterenol) result in in-
creased heart rate, blood pressure and cardiac output
beta 1 adrenergic
2. blockade results in decreased heart rate, bp, and car-
diac output
The heart does not adequately circulate blood to systemic
system. Due to pressure overload or volume overload left heart failure
causing a reduction of oxygenated blood to body tissue
1. Associated with pulmonary disease and increased pul-
monary vascular resistance
2. The heart does not adequately circulate blood to the
pulmonic system. Can be due to volume overload or re- Right heart failure
gurgitation in Tricuspid Valve or Pulmonic Valve.
Can lead to systemic edema, back up of blood in liver and
lower extremities
1. Inhibit water transport across Loop of Henle work on
Loop diuretics MOA
receptors in ascending renal loop
