NUR-641E Advanced Pathophysiology and
Pharmacology for the Nurse Educator UPDATED
ACTUAL QUESTIONS WITH CORRECT ANSWERS
Question 1.
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
Question 2.
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.
Question 3.
rectal administration disadvantages
ANSWER
variable and erratic absorption
Question 4.
Steady state (SS)
ANSWER
is usually reached within 4-5 half-lives of a drug
,Question 5.
The half-life of a drug is defined as
ANSWER
how long it takes for half the drug to be excreted from the body
Question 6.
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.
Question 7.
CYP3A4 substrate drugs
ANSWER
May have enhanced activity if any CYP3A4 inducer drugs are used along with it.
Question 8.
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)
,Question 9.
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
Question 10.
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.
Question 11.
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.
, Question 12.
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.
Question 13.
Cardiovascular-Essential (primary) hypertension
ANSWER
Accounts for 90% of cases; secondary hypertension may be caused by chronic renal failure.
Question 14.
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
Question 15.
PDE-5 inhibitors
ANSWER
-Pulmonary hypertension therapy
-Include sildenafil. Inhibit cGMP PDE5 and prolong vasodilatory effect of nitric oxide.
Question 16.
cGMP phosphodiesterase
ANSWER
an enzyme in cells that converts cGMP into GMP
Pharmacology for the Nurse Educator UPDATED
ACTUAL QUESTIONS WITH CORRECT ANSWERS
Question 1.
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
Question 2.
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.
Question 3.
rectal administration disadvantages
ANSWER
variable and erratic absorption
Question 4.
Steady state (SS)
ANSWER
is usually reached within 4-5 half-lives of a drug
,Question 5.
The half-life of a drug is defined as
ANSWER
how long it takes for half the drug to be excreted from the body
Question 6.
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.
Question 7.
CYP3A4 substrate drugs
ANSWER
May have enhanced activity if any CYP3A4 inducer drugs are used along with it.
Question 8.
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)
,Question 9.
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
Question 10.
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.
Question 11.
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.
, Question 12.
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.
Question 13.
Cardiovascular-Essential (primary) hypertension
ANSWER
Accounts for 90% of cases; secondary hypertension may be caused by chronic renal failure.
Question 14.
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
Question 15.
PDE-5 inhibitors
ANSWER
-Pulmonary hypertension therapy
-Include sildenafil. Inhibit cGMP PDE5 and prolong vasodilatory effect of nitric oxide.
Question 16.
cGMP phosphodiesterase
ANSWER
an enzyme in cells that converts cGMP into GMP
