Question 1.
Pharmacokinetics involves
ANSWER
absorption, distribution, metabolism, excretion
Question 2.
Pharmacokinetic absorption
ANSWER
absorption from the administration site either directly or indirectly in the blood plasma
Question 3.
Parmacokinetic distribution
ANSWER
reversibly or irreversibly move from the bloodstream into the inter-stitial and intracellular fluid
Question 4.
Pharmacokinetics metabolism
ANSWER
biotransformed via hepatic metabolism or by other tissue
Question 5.
Intravenous medications
ANSWER
1. highest bioavailability
2. places entire does into venin thus bypassing absorption
3. avoids hepatic first pass metabolism in the liver
Question 6.
steady state medication
ANSWER
usually reached within 4-5 half lives of the drug
Question 7.
drug half life
ANSWER
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 3.determines drug
frequency
4. predicts length of toxic effects
5. constant first order pharmacokinetics of a drug
, Question 8.
zero order (nonlinear)
ANSWER
drug is metabolized at a constant rate per unit
Question 9.
CYP3A4
ANSWER
metabolizes 50% drugs inhibit: grapefruit juice
- increase drug -> adverse effects may have enhanced activity with any other CYP3A4
Question 10.
Six steps in drug development process
ANSWER
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 effective 5.FDA then reviews result and determines approval
6. Post market study to determine other side effects that were not seen while lab testing
Question 11.
organizations for medication safety
ANSWER
1.Institute of Safe mediation Practice
2. Institute of Medicine
3. Joint commission 4.National Coordinating Council form mediation error reporting and prevention
5. Food and Drug Administration (safe use initiative)
Question 12.
Adverse Drug Reaction (ADR)
ANSWER
1.Also known as a side effect, an undesirable reaction that accompanies the principal response for which the drug was taken include allergic reactions and
adverse drug effects
2. Either pharmacological or idiosyncratic
3. 85-90% of ADRs are pharmacological
4. Reporting is not mandated by FDA thus are not commonly re-ported
5. usually preventable occur in hospital and nursing homes due to med errors
6. Polypharmacy, multiple doctors and multiple pharmacies increase risk
Question 13.
Angiotensin-converting enzyme (ACE) inhibitors
ANSWER
1. end in pril: lisinopril, captopril, enalapril, ramipril, benazepril and fosinopril
2. suppress release of angiotensin converting enzyme
3. side effects include cough and angioedema, with angioedema the medication should be discontinued
, Question 14.
Angiotensin II Receptor Blockers (ARBs)
ANSWER
1. -sartan: candesartan, eprosartan, ibesartan, Isosartan, telmisartan, valsartan 2.block angiotensin 11 receptors
Question 15.
Essential vs Secondary HTN
ANSWER
Essential HTN accounts for 90% of cases and is also called primary, secondary may be caused by CKD
Question 16.
Nitroglycerin (Nitrate)
ANSWER
use: angina pectoris action: dilate veins and arteries and thereby reducing ischemia and relieving pain by decreasing myocardial O2 consumption Side
effects: throbbing HA, flushing, hypotension tachycardia available: IV, SL, topical ointment and transdermal patch contraindicated with PDE-5 (sildanfil and
vardenafil)
Question 17.
Amiodarone
ANSWER
1. antiarrhythmic of choice when there is coexisting heart failure
2. can cause thyroid and pulmonary toxicity
Question 18.
Alpha 1 adrenergic stimulation results
ANSWER
vasoconstriction and increased blood pressure
Question 19.
alpha 1 blockade
ANSWER
Decrease sympathetic stimulation causing vasodilation and decreased blood pressure
Question 20.
beta 1 adrenergic
ANSWER
stimulation by beta agonists (isoproterenol) result in increased heart rate, blood pressure and cardiac output
2. blockade results in decreased heart rate, bp, and cardiac output