ADV. PHARM NURS 8024 WEEK 1 QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

ADV. PHARM NURS 8024 WEEK 1 QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 Pharmacokinetics - Answers what the body does to the drug Pharmacodynamics - Answers what the drug does to the body Toxicology - Answers The undesirable effects of chemicals on living systems Pharmacotherapeutics - Answers dynamic that achieves the desired therapeutic effect of the drug without causing other undesirable effects Legend drugs - Answers another name for prescription drugs Pharmacogenomics - Answers the study of genetically determined variations in the response to drugs Pharmacologic Agonist - Answers agent binds to and activates the receptor - directly or indirectly causing an effect, full or partial agonists Pharmacological Antagonist - Answers Agent binds to receptor-completes with other molecules and prevents binding by other molecules-it inhibits other molecules from binding Pro-drug - Answers An inactive percursor chemical-must be abosorbed and distributed and converted to the active form of the drug by biologic processes. What is ADME? - Answers Absorption Distribution Metabolism Elimination Absorption - Answers entry of pharmacologic agent into plasma Distribution - Answers agent leaves the bloodstream and distributes to interstitial and intracellular fluids Metablosim - Answers chemical processes that occur to make the drug useful in the bloodstream--done by the liver, kidney, or other tissue Ellimination - Answers Leaving the body-via urine, bile, feces, lungs, sweat, breast milk 2 Major Administration Routes - Answers 1. Enteral -most common, easy, cheap-BUT drug absorption pathways can be complicated 2. Parenteral-IV, fast, more expensive, once in-cannot get back Enteral drug administration - Answers oral, sublingual, rectal drug absorption pathways complicated **First-pass metabolism can limit the amount of drug that enters systemic circulation influenced by food and other drugs What is first pass metabolism? - Answers The concentration of drug is greatly reduced BEFORE reaching systemic circulation. This mainly involves liver enzymes, but also includes gastric enzymes, gut wall enzymes, and bacterial enzymes. Bioavaliability is reduced. Parenteral drug administration - Answers -IV, IM, SubQ - More control over actual dose of drug - Directly into systemic circulation-bypass first pass metabolism - used for drugs poorly absorbed by GI -Rapid onset of action -Disadvantage: cannot take the drug back, infection risk Inhalation route of administration - Answers Rapid delivery, large surface area, good for gases, aerolsols, respiratory drugs Rectal Route of administration - Answers 50% of circulatory drainage BYPASSES portal circulation Meaning: Less first pass effect Drug Transport Methods: - Answers Passive diffusion (no E needed) Active transport (requires E) Endocytosis Passive diffusion (simple diffusion) - Answers no energy needed, related to concentration gradient across membrane, HIGHER concentration goes to LOWER concentration Active Transport - Answers requires energy (ATP), Able to move drug from LOWER to HIGHER concentration Endocytosis - Answers Transport large molecules Engulfment of drug molecule by cell membrane and transport into cell Exocytosis - Answers Process by which a cell releases large amounts of material Drug Absorption - Answers Drugs are typically weak acids or weak bases Role and size of MOLECULAR WEIGHT in drug absorption Drug Molecular Weights - Answers Most drugs weight from 100-1000 smaller sizes are easier to cross membranes However, drugs can vary in size from MW of 7 (Lithium) to 50,000 (thrombolytic enzymes) Solubility - Answers Hydrophilic (Lipophobic) Lipophilic (hydrophobic) Remember: Cell membranes tend to be LIPID filled--so LIPID based drugs tend to cross the lipid membrane easier What impacts drug absorption? - Answers Solubility (hydrophilic or lipophilic?), pH, pKa (how acidic the drug is), Molecular weight, partition coefficient (ratio of concentration) Factors that influence GI Absorption? - Answers Blood flow (intestinal blood flow is greater than stomach blood flow) pH-How acidic is the stomach? (is patient on PPI that decreases stomach acid?) Intestinal surface area- (microvilli)-there are 1000x more than stomach CONTACT TIME- Rapid vs slow GI Transport, Parasympathetic input--increases rate of gastric emptying Sympathetic input--delayed gastric emptying Food--delayed absorption (food is in the way) What is the bioavailability of a drug? - Answers Fraction of chemically unchanged drug that reaches systemic circulation What FACTORS influence BIOAVAILABILITY? - Answers first pass hepatic metabolism, solubility of the drug, chemical instability (ex; insulin in GI tract), nature of the drug formulation What should you do if a drug has a HIGH first pass effect? - Answers Give drug a different way OR give a higher dose of drug if given PO Hydrophilic drugs - Answers Poorly absorbed, water based which means poor absorption, unable to cross lipid-rich cell membranes Hydro (water), Philic (likes) Extremely Hydrophobic Drugs - Answers Hydro (water), Phobic (does not like) these drugs are also poorly absorbed--insoluble in aqueous body fluids What is ideal for drug absorption? - Answers Largely Hydrophobic, but with some solubility in aqueous solution, Highly lipid soluble drugs can be transported in aqueous solutions in the body VIA carrier proteins (ALBUMIN) What is the relationship of the drugs MW and absorption? - Answers The smaller the drugs size-the more easily it will move across the cell membrane and be absorbed. Bioavailability - Answers Highest to Lowest IV, IM, SC, PO, PR (Rectal), Inhalation, Transdermal What is Therapeutic Equivalence? - Answers Comparable clinical effectiveness and safety between similar drugs Two Drugs that are Bioequivalent MAY NOT be therapeutically equivalent--we focus on therapeutic equivalency What is the Clinical Effectiveness of a drug? - Answers It is dependent on the serum drug concentrations and the TIME it takes to reach PEAK drug concentrations What is drug distribution/delivery? - Answers Process in which drug reversibly leaves the blood stream and enters interstitium and/or cells. What is drug delivery dependent on? - Answers blood flow, capillary permeability, albumin level (plasma protein binding ability), drug structure, hydrophobicity Drug Distribution--Blood Flow - Answers Wide variance r/t unequal distribution of Cardiac Output (CO) - Highest in organs: heart, brain, lungs, kidneys, liver, gut -Lower in skeletal muscle _Still lower in adipose tissue Capillary Permeability and Drug Distribution - Answers • Capillary permeability • capillary structure & chemical nature of the drug • Variance in capillary structure: slit junctions between endothelial cells (liver and pancreas have this) • Allows passage of plasma proteins... and thus, drug molecules • Absent in the brain- "blood-brain barrier" Blood Brain Barrier (BBB) - Answers --physiological barrier between the circulatory system and the central nervous system that establishes a privileged blood supply, restricting the flow of substances into the CNS --Drugs must pass through the CNS capillaries or be actively transported -- Lipid soluble drugs penetrate the CNS by dissolving in the membrane of ENDOTHELIAL CELLS -- Ionized or polar drugs cannot pass due to the TIGHT KNIT CELLS WITHOUT SLIT JUNCTIONS! Plasma protein binding - Answers --A process in which medication molecules temporarily attach to proteins in the blood plasma, significantly altering medication distribution in the body. --Generally reversible and non-selective --drugs bind where other compounds--such as bilirubin--would normally attach --Plasma ALBUMIN--may act as a drug reservoir --As free drug concentration decreases-protein bound drug dissociates from the protein adipose tissue - Answers can store drugs and hormones Volume of distribution (Vd) - Answers Hypothetical volume into which a drug is "dispersed" Represents a relationship between the amount of drug in the body to the plasma concentration of drug in plasma or blood Water compartments: Plasma, Extracellular, Intracellular Drugs typically enter ALL compartments (also enters fetus and breast milk) Volume of Distribution and Drug Half Life - Answers -Large volume of distribution impacts half life -drug elimination dependent on amount of drug delivered to kidney and liver -dependent on blood flow and fraction of drug in plasma -if Vd is LARGE: majority of drug is NOT in the plasma, not available to excretory organs Factors that INCREASE Vd - Answers -- Increase half like---extends duration of action The longer the drug is present--the longer the duration of action. Competition for Plasma Protein Binding: Class I (most drugs) - Answers - Low dose/capacity ratio -Amount of drug albumin binding capacity -number of binding sites available drug Competition for Plasma Protein Binding: Class II (minority of drugs) - Answers -High dose/capacity ratio -Amount of drug albumin binding capacity -High proportion of drug in "free" state = not protein bound Clinical Implications of Plasma Protein Binding - Answers Drug displacement from albumin substantial source of drug interactions..... • Class I drug - warfarin • Highly protein bound - small fraction of free drug in plasma ↓ • Class II drug given - sulfa • Displaces warfarin from albumin • Rapid rise in free drug concentration • Increased therapeutic effect- toxic effect Drug Displacement and Vd - Answers --Dependent on Vd and therapeutic index of drug --Large Vd verses small Vd (drug is less around) What is the therapeutic index (TI)? - Answers Ratio of a drug's toxic level to the level that provides therapeutic benefits--Measure of drug safety--Safer Drug has a higher TI --If the Therapeutic Index is narrow--small increase in drug concentration can have a substantial clinical impact Ex: Digoxin (the closer the ratio is to 1 the less safe the drug) What are the components of calculation of TI? Toxic dose for 50 % of people divided by the effective does for 50% of people). Therapeutic Dose Divided by the Lethal Dose : TI = TD50 Divided by ED50 Drug Metabolism-First Order Kinetics (most drugs) - Answers --Metabolic transformation of drugs by enzymes