NURS 6380 FINAL EXAM
PREP
ADVANCED
PATHOPHARMACOLOGY
AND ADVANCED HEALTH
ASSESSMENT
ANSWERED
2023/2024
,1. What are the main differences between pharmacokinetics and pharmacodynamics? How do these concepts
affect the choice and dosage of drugs for different patients?
Answer: Pharmacokinetics is the study of how drugs move through the body, including absorption,
distribution, metabolism and excretion. Pharmacodynamics is the study of how drugs interact with their
targets, such as receptors, enzymes or ion channels, and produce their effects. These concepts affect the
choice and dosage of drugs for different patients because they determine the drug's efficacy, safety, onset,
duration and variability of response. Factors such as age, weight, genetics, organ function, disease state,
drug interactions and environmental influences can alter pharmacokinetics and pharmacodynamics and
require individualized drug therapy.
2. What are the main types of adverse drug reactions (ADRs)? Give an example of each type and explain how
they can be prevented or managed.
Answer: The main types of ADRs are type A (augmented), type B (bizarre), type C (chronic), type D
(delayed), type E (end-of-treatment) and type F (failure). Type A ADRs are dose-dependent and predictable,
such as nausea, vomiting or hypotension. They can be prevented or managed by adjusting the dose,
frequency or route of administration, monitoring the patient's vital signs and symptoms, and providing
supportive care. Type B ADRs are dose-independent and unpredictable, such as allergic reactions,
anaphylaxis or Stevens-Johnson syndrome. They can be prevented or managed by identifying and avoiding
the causative agent, administering antihistamines, corticosteroids or epinephrine as needed, and providing
emergency care. Type C ADRs are dose- and time-dependent and related to cumulative effects, such as
osteoporosis, diabetes or cataracts. They can be prevented or managed by limiting the duration of
treatment, using the lowest effective dose, monitoring the patient's laboratory tests and clinical outcomes,
and providing prophylactic or corrective measures. Type D ADRs are dose- and time-independent and related
to delayed effects, such as carcinogenesis, teratogenesis or mutagenesis. They can be prevented or
managed by avoiding or minimizing exposure to known or suspected carcinogens, teratogens or mutagens,
informing the patient of the potential risks and benefits of treatment, and conducting regular screening and
surveillance. Type E ADRs are dose-independent and related to withdrawal effects, such as rebound
hypertension, insomnia or seizures. They can be prevented or managed by tapering off the drug gradually,
switching to a longer-acting or alternative drug, or providing symptomatic relief. Type F ADRs are dose-
independent and related to lack of efficacy, such as treatment failure, resistance or tolerance. They can be
prevented or managed by selecting the appropriate drug for the indication, using adequate doses and
durations of treatment, monitoring the patient's response and adherence to therapy, and modifying the
regimen as needed.
3. What are the main mechanisms of drug resistance? Give an example of each mechanism and explain how
they can be overcome or avoided.
Answer: The main mechanisms of drug resistance are decreased drug uptake, increased drug efflux, altered
drug target, inactivated drug enzyme and alternative metabolic pathway. Decreased drug uptake occurs
when the cell membrane becomes less permeable to the drug or when the drug transporter is downregulated
or mutated. This reduces the intracellular concentration of the drug and its effect on the target. An
example is resistance to antifungal drugs such as amphotericin B or azoles by fungal cells. This can be
overcome or avoided by using higher doses of the drug, combining it with other drugs that enhance its
uptake or inhibit its efflux, or developing new drugs that can penetrate the cell membrane more effectively.
Increased drug efflux occurs when the cell membrane becomes more permeable to the drug or when the
drug transporter is upregulated or mutated. This increases the intracellular elimination of the drug and its
effect on the target. An example is resistance to anticancer drugs such as doxorubicin or paclitaxel by tumor
cells. This can be overcome or avoided by using lower doses of the drug,
combining it with other drugs that inhibit its efflux or enhance its uptake,
or developing new drugs that can evade the efflux pump more efficiently.
Altered drug target occurs when the molecular structure or function of
the target is changed by mutation,
, modification
or expression.
This reduces
the affinity
or activity
of
the
drug
on
the
target.
An
example
is
resistance
to
antibacterial
drugs
such
as
penicillin
or
vancomycin
by
bacterial cells.
This can be overcome or avoided by using higher doses of the drug,
combining it with
1. What are the main mechanisms of action of anticoagulants, antiplatelets and thrombolytics? How do
they differ in their indications, contraindications and adverse effects? Provide examples of each class of
drugs and their clinical applications.
2. What are the pharmacokinetics and pharmacodynamics of insulin and oral hypoglycemic agents? How do
they affect blood glucose levels and what are the potential complications of their use? Explain the
differences between type 1 and type 2 diabetes mellitus and how they influence the choice of therapy.
3. What are the major classes of antibiotics and how do they inhibit bacterial growth or kill bacteria? What
are the factors that contribute to antibiotic resistance and how can it be prevented or minimized?
Discuss the principles of rational antibiotic prescribing and the role of culture and sensitivity testing.
4. What are the pharmacological effects of opioids on the central nervous system, respiratory system,
gastrointestinal system and cardiovascular system? How do opioids relieve pain and what are the risks of
addiction, tolerance and dependence? Compare and contrast the properties of natural, synthetic and
semisynthetic opioids and their antagonists.
PREP
ADVANCED
PATHOPHARMACOLOGY
AND ADVANCED HEALTH
ASSESSMENT
ANSWERED
2023/2024
,1. What are the main differences between pharmacokinetics and pharmacodynamics? How do these concepts
affect the choice and dosage of drugs for different patients?
Answer: Pharmacokinetics is the study of how drugs move through the body, including absorption,
distribution, metabolism and excretion. Pharmacodynamics is the study of how drugs interact with their
targets, such as receptors, enzymes or ion channels, and produce their effects. These concepts affect the
choice and dosage of drugs for different patients because they determine the drug's efficacy, safety, onset,
duration and variability of response. Factors such as age, weight, genetics, organ function, disease state,
drug interactions and environmental influences can alter pharmacokinetics and pharmacodynamics and
require individualized drug therapy.
2. What are the main types of adverse drug reactions (ADRs)? Give an example of each type and explain how
they can be prevented or managed.
Answer: The main types of ADRs are type A (augmented), type B (bizarre), type C (chronic), type D
(delayed), type E (end-of-treatment) and type F (failure). Type A ADRs are dose-dependent and predictable,
such as nausea, vomiting or hypotension. They can be prevented or managed by adjusting the dose,
frequency or route of administration, monitoring the patient's vital signs and symptoms, and providing
supportive care. Type B ADRs are dose-independent and unpredictable, such as allergic reactions,
anaphylaxis or Stevens-Johnson syndrome. They can be prevented or managed by identifying and avoiding
the causative agent, administering antihistamines, corticosteroids or epinephrine as needed, and providing
emergency care. Type C ADRs are dose- and time-dependent and related to cumulative effects, such as
osteoporosis, diabetes or cataracts. They can be prevented or managed by limiting the duration of
treatment, using the lowest effective dose, monitoring the patient's laboratory tests and clinical outcomes,
and providing prophylactic or corrective measures. Type D ADRs are dose- and time-independent and related
to delayed effects, such as carcinogenesis, teratogenesis or mutagenesis. They can be prevented or
managed by avoiding or minimizing exposure to known or suspected carcinogens, teratogens or mutagens,
informing the patient of the potential risks and benefits of treatment, and conducting regular screening and
surveillance. Type E ADRs are dose-independent and related to withdrawal effects, such as rebound
hypertension, insomnia or seizures. They can be prevented or managed by tapering off the drug gradually,
switching to a longer-acting or alternative drug, or providing symptomatic relief. Type F ADRs are dose-
independent and related to lack of efficacy, such as treatment failure, resistance or tolerance. They can be
prevented or managed by selecting the appropriate drug for the indication, using adequate doses and
durations of treatment, monitoring the patient's response and adherence to therapy, and modifying the
regimen as needed.
3. What are the main mechanisms of drug resistance? Give an example of each mechanism and explain how
they can be overcome or avoided.
Answer: The main mechanisms of drug resistance are decreased drug uptake, increased drug efflux, altered
drug target, inactivated drug enzyme and alternative metabolic pathway. Decreased drug uptake occurs
when the cell membrane becomes less permeable to the drug or when the drug transporter is downregulated
or mutated. This reduces the intracellular concentration of the drug and its effect on the target. An
example is resistance to antifungal drugs such as amphotericin B or azoles by fungal cells. This can be
overcome or avoided by using higher doses of the drug, combining it with other drugs that enhance its
uptake or inhibit its efflux, or developing new drugs that can penetrate the cell membrane more effectively.
Increased drug efflux occurs when the cell membrane becomes more permeable to the drug or when the
drug transporter is upregulated or mutated. This increases the intracellular elimination of the drug and its
effect on the target. An example is resistance to anticancer drugs such as doxorubicin or paclitaxel by tumor
cells. This can be overcome or avoided by using lower doses of the drug,
combining it with other drugs that inhibit its efflux or enhance its uptake,
or developing new drugs that can evade the efflux pump more efficiently.
Altered drug target occurs when the molecular structure or function of
the target is changed by mutation,
, modification
or expression.
This reduces
the affinity
or activity
of
the
drug
on
the
target.
An
example
is
resistance
to
antibacterial
drugs
such
as
penicillin
or
vancomycin
by
bacterial cells.
This can be overcome or avoided by using higher doses of the drug,
combining it with
1. What are the main mechanisms of action of anticoagulants, antiplatelets and thrombolytics? How do
they differ in their indications, contraindications and adverse effects? Provide examples of each class of
drugs and their clinical applications.
2. What are the pharmacokinetics and pharmacodynamics of insulin and oral hypoglycemic agents? How do
they affect blood glucose levels and what are the potential complications of their use? Explain the
differences between type 1 and type 2 diabetes mellitus and how they influence the choice of therapy.
3. What are the major classes of antibiotics and how do they inhibit bacterial growth or kill bacteria? What
are the factors that contribute to antibiotic resistance and how can it be prevented or minimized?
Discuss the principles of rational antibiotic prescribing and the role of culture and sensitivity testing.
4. What are the pharmacological effects of opioids on the central nervous system, respiratory system,
gastrointestinal system and cardiovascular system? How do opioids relieve pain and what are the risks of
addiction, tolerance and dependence? Compare and contrast the properties of natural, synthetic and
semisynthetic opioids and their antagonists.
