6521N Advanced Pharmacology
Midterm – Comprehensive Study
Guide, Key Concepts, and Exam
Review
What are the two components of The right to prescribe independently
prescriptive authority And the right to prescribewithout limitation
The regulation for prescriptive Authority The State Board of Nursing
comes from The State Board of Medicine
State Board of Pharmacy
What is the most importantfunction to Hepatic and renal function
evaluate when prescribing a medication
What must you pay attention to 1. Is this a newer medication for a patient
when performing a refill 2.changing the dose of frequency
3.am I adding new medicines to their regimen
4. is this patient having undesired effects
5.How long has it been since I've seen the patient
6.Is this a Schedule II medication
*If the answer to any of these questions is yes consider
a shorter time period for a refill (one to three
months)
,What should be included in the teaching for What test is
drug monitoring needed When is test
required
Where will testing take place
Why is testing necessary
How does the patient prepare for testing
What periodic Laboratory Testing is needed Potassium/ creatinine
with Ace and ARB These drugs can cause hyperkalemia
Renal perfusion is dependent on Angiotensin in some patients
increased creatinine may require a change in medication
What LaboratoryTesting is required with Liver function, thyroid function, pulmonary function and
amiodarone chest x-rays
Hepatoxicity is an adverse effect
Either hypo or hyperthyroidism may occur
Pulmonary toxicity is not uncommon, affects maybe
permanent
What Laboratory Testing is required with Serum drug levels-some have a very narrow therapeutic index
anticonvulsants
What Laboratory Testing is required with CBC, lithium level, thyroid function, renal function, serum
lithium electrolytes
This drug has a narrow therapeutic margin,
lithium can cause leukocyte elevation
Both hypo and hyperthyroidism may occur
Renal damage is a serious adverse effect
Nephrogenic diabetes insipidus May occur, and hyponatremia
can create complications
What are the four basic pharmacokinetic absorption, distribution, metabolism, excretion
processes
What is the combination of metabolism and Elimination
excretion called
What determines the concentration of a The four pharmacokinetic processes acting in concert
drug at its site of action
What are the three ways for drugs to cross Passage through channels or pores
the cell membrane Passage with the aid of a transport system
Direct penetration of the membrane
Of all three direct penetration of the membrane is most
common
What is an example of a drug that can pass Sodium or potassium
through a Channel or poor
, What are common drug transporters Pgp- P - glycoprotein
What is the general rule in chemistry dissolve like Membranes are composed primarily of lipids-
therefore to directly penetrate membranes a drug must
be lipid soluble or lipophilic
What is a kind of moleculethat is not Polar molecules and ions
lipid soluble and therefore cannot
penetrate membranes
What is a polar molecule? a molecule in which the charges are unevenly distributed
Example is water
What are ions Charged particles that have a net electrical charge
determined by the pH of the surrounding medium.
Acids tend to ionize and basic alkaline media, whereas bases
tend to ionize in acidic media
Therefore drugs that are weak acids are best absorbed in an
acidic environment such as gastric acid
Example is aspirin
what is the pH partitioning or ion trapping The process whereby a drug accumulates on the side of a
membrane where the pH most favors its ionization
acidic drugs accumulate on the_____side alkaline
basic drugs accumulate on the_____side acidic
What are the two terms associated Chemical equivalence and bioavailability
with absorption of drugs
What is bioavailability Fraction of administered drug that reaches systemic
circulation unchanged.
What are the factors that affect drug rate of dissolution, surface area, blood flow, lipid solubility, pH
absorption partitioning
What is a major detriment of the rate of Surface area
absorption
When the surface area is larger absorption Faster
is The small intestine is a larger area because of the
microvilli,the stomach is a relatively small surface area
Absorption of orally administered drugs is Small intestine
usually greatest in the
Midterm – Comprehensive Study
Guide, Key Concepts, and Exam
Review
What are the two components of The right to prescribe independently
prescriptive authority And the right to prescribewithout limitation
The regulation for prescriptive Authority The State Board of Nursing
comes from The State Board of Medicine
State Board of Pharmacy
What is the most importantfunction to Hepatic and renal function
evaluate when prescribing a medication
What must you pay attention to 1. Is this a newer medication for a patient
when performing a refill 2.changing the dose of frequency
3.am I adding new medicines to their regimen
4. is this patient having undesired effects
5.How long has it been since I've seen the patient
6.Is this a Schedule II medication
*If the answer to any of these questions is yes consider
a shorter time period for a refill (one to three
months)
,What should be included in the teaching for What test is
drug monitoring needed When is test
required
Where will testing take place
Why is testing necessary
How does the patient prepare for testing
What periodic Laboratory Testing is needed Potassium/ creatinine
with Ace and ARB These drugs can cause hyperkalemia
Renal perfusion is dependent on Angiotensin in some patients
increased creatinine may require a change in medication
What LaboratoryTesting is required with Liver function, thyroid function, pulmonary function and
amiodarone chest x-rays
Hepatoxicity is an adverse effect
Either hypo or hyperthyroidism may occur
Pulmonary toxicity is not uncommon, affects maybe
permanent
What Laboratory Testing is required with Serum drug levels-some have a very narrow therapeutic index
anticonvulsants
What Laboratory Testing is required with CBC, lithium level, thyroid function, renal function, serum
lithium electrolytes
This drug has a narrow therapeutic margin,
lithium can cause leukocyte elevation
Both hypo and hyperthyroidism may occur
Renal damage is a serious adverse effect
Nephrogenic diabetes insipidus May occur, and hyponatremia
can create complications
What are the four basic pharmacokinetic absorption, distribution, metabolism, excretion
processes
What is the combination of metabolism and Elimination
excretion called
What determines the concentration of a The four pharmacokinetic processes acting in concert
drug at its site of action
What are the three ways for drugs to cross Passage through channels or pores
the cell membrane Passage with the aid of a transport system
Direct penetration of the membrane
Of all three direct penetration of the membrane is most
common
What is an example of a drug that can pass Sodium or potassium
through a Channel or poor
, What are common drug transporters Pgp- P - glycoprotein
What is the general rule in chemistry dissolve like Membranes are composed primarily of lipids-
therefore to directly penetrate membranes a drug must
be lipid soluble or lipophilic
What is a kind of moleculethat is not Polar molecules and ions
lipid soluble and therefore cannot
penetrate membranes
What is a polar molecule? a molecule in which the charges are unevenly distributed
Example is water
What are ions Charged particles that have a net electrical charge
determined by the pH of the surrounding medium.
Acids tend to ionize and basic alkaline media, whereas bases
tend to ionize in acidic media
Therefore drugs that are weak acids are best absorbed in an
acidic environment such as gastric acid
Example is aspirin
what is the pH partitioning or ion trapping The process whereby a drug accumulates on the side of a
membrane where the pH most favors its ionization
acidic drugs accumulate on the_____side alkaline
basic drugs accumulate on the_____side acidic
What are the two terms associated Chemical equivalence and bioavailability
with absorption of drugs
What is bioavailability Fraction of administered drug that reaches systemic
circulation unchanged.
What are the factors that affect drug rate of dissolution, surface area, blood flow, lipid solubility, pH
absorption partitioning
What is a major detriment of the rate of Surface area
absorption
When the surface area is larger absorption Faster
is The small intestine is a larger area because of the
microvilli,the stomach is a relatively small surface area
Absorption of orally administered drugs is Small intestine
usually greatest in the
