NR565 Advanced Pharmacology
Fundamentals
The process by which drugs are absorbed, distributed within the body, metabolized,
and excreted. - ANSWER Pharmacokinetics
The study of what the drug does to the body - ANSWER Pharmacodynamics
Rate of dissolution
Surface area
Blood flow
Lipid solubility
pH partitioning - ANSWER Factors Affecting Drug Absorption
Blood flow to tissues
Ability to exit the vascular system
Blood-brain barrier
Protein-binding capacity - ANSWER Factors Affecting Drug Distribution
substances that are foreign to the body, usually synthetic chemical compounds;
medications are a common example - ANSWER Xenobiotics
xenobiotic-metabolizing enzymes necessary for the production of cholesterol and
steroids and the detoxification of chemicals and drug metabolism. - ANSWER
Cytochrome P450 (CYP450)
responsible for phase 1 metabolism in which drugs are oxidized, reduced, or
hydrolyzed - ANSWER Function of Cytochrome P450 (CYP450)
Oxidation; Reduction; Hydrolysis - ANSWER Phase 1 Metabolism of Drugs via P450
-Drug becomes completely inactive
-Drug becomes partially inactive but one or more metabolites remain active
-Original drug is not pharmacologically active but one metabolite remains active -
ANSWER Three possible outcomes of phase 1 drug metabolism.
Medications that can increase the rate of another drug's metabolism by elevating
CYP450 enzyme activity via increasing enzyme synthesis. decreasing the
concentration of the "parent drug" - ANSWER CYP450 Inducers
CRAPGPS
Carbamazepine
Rifampin
Alcohol
,Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas - ANSWER CYP450 Inducer Medications
Medications that inhibit the metabolic activity of one or more of the CYP450
enzymes. Higher risk for toxicity; prolongs the pharmacological effect of the "parent
drug". - ANSWER CYP450 Inhibitors
VISACKGQ
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine - ANSWER CYP450 Inhibitor Medications
-potentially Inappropriate Medication (PIM) use in older adults
-potentially Inappropriate Medication (PIM) use in older adults due to medication-
disease or medication-syndrome interactions that may exacerbate the disease or
syndrome
-medications to be used cautiously in older adults
-clinically significant drug interactions that should be avoided in older adults
-medications to be avoided or dosage decreased in the presence of impaired kidney
function in older adults - ANSWER Beers Criteria
when one medication systemically alters the potency of another medication. -
ANSWER Pharmacokinetic Interactions
result of a change due to one medication's effect on another medication's route of
entry into the body. - ANSWER Absorption Interaction
caused by the amount of unbound/free medications available at the various target
sites. - ANSWER Distribution Interaction
concentration of the medication after biotransformation into active and inactive
metabolites in higher or lower than expected. - ANSWER Metabolism Interaction
the body's ability to eliminate medications in pure form or by altering a metabolite
from the body. - ANSWER Elimination Interaction
does not alter or impact absorption, distribution, metabolism, or elimination because
of the one medication's ability to manipulate the effect of another medication at its
site of action - ANSWER Pharmacodynamic Interactions
refers to the nurse practitioner's ability to practice without physician oversight -
ANSWER Practice Authority
, refers to the nurse practitioner's authority to prescribe medications. - ANSWER
prescriptive authority
Nurse practitioners have the autonomy to evaluate patients, diagnose, order and
interpret tests, initiate and manage treatments and prescribe medications, including
controlled substances without physician oversight. - ANSWER Full-practice scope
Nurse practitioners are limited in at least one element of practice. The state requires
a formal collaborative agreement with an outside health discipline for the nurse
practitioner to provide patient care. - ANSWER Reduced-practice scope
Nurse practitioners are limited in at least one element of practice by requiring
supervision, delegation, or team management by an outside health discipline for the
nurse practitioner to provide patient care. - ANSWER Restricted practice scope
DEA Scheduled Drugs - ANSWER Drugs that cannot be ordered via E-Script
Schedule II drugs - ANSWER Drugs that cannot be prescribed or refilled via phone
An occurrence of fewer than three months and is often precipitated by trauma and
acute medical conditions or treatment. - ANSWER Acute Pain
Referred Pain
Acute Somatic Pain
Acute visceral pain - ANSWER Types of Acute Pain
episode of pain that lasts for 6 months or longer; may be intermittent or continuous -
ANSWER Chronic pain
pain that is felt in a location other than where the pain originates - ANSWER
Referred Pain
-Arises from connective tissue, muscle, bone and skin.
-Sharp and localized or dull and non-localized
-Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates, local
anesthetics, ice, massage - ANSWER Acute Somatic Pain
Pain in the internal organs and abdomen
Poorly localized (C-fibers)
Radiates
Most responsive to opiates
May also use corticosteroids, NSAIDs - ANSWER Acute Visceral Pain
any drug, natural or synthetic, that has actions similar to those of morphine -
ANSWER Opioids
Mu (μ)
Kappa (k)
Delta (δ) - ANSWER Opioid Receptor Families
Fundamentals
The process by which drugs are absorbed, distributed within the body, metabolized,
and excreted. - ANSWER Pharmacokinetics
The study of what the drug does to the body - ANSWER Pharmacodynamics
Rate of dissolution
Surface area
Blood flow
Lipid solubility
pH partitioning - ANSWER Factors Affecting Drug Absorption
Blood flow to tissues
Ability to exit the vascular system
Blood-brain barrier
Protein-binding capacity - ANSWER Factors Affecting Drug Distribution
substances that are foreign to the body, usually synthetic chemical compounds;
medications are a common example - ANSWER Xenobiotics
xenobiotic-metabolizing enzymes necessary for the production of cholesterol and
steroids and the detoxification of chemicals and drug metabolism. - ANSWER
Cytochrome P450 (CYP450)
responsible for phase 1 metabolism in which drugs are oxidized, reduced, or
hydrolyzed - ANSWER Function of Cytochrome P450 (CYP450)
Oxidation; Reduction; Hydrolysis - ANSWER Phase 1 Metabolism of Drugs via P450
-Drug becomes completely inactive
-Drug becomes partially inactive but one or more metabolites remain active
-Original drug is not pharmacologically active but one metabolite remains active -
ANSWER Three possible outcomes of phase 1 drug metabolism.
Medications that can increase the rate of another drug's metabolism by elevating
CYP450 enzyme activity via increasing enzyme synthesis. decreasing the
concentration of the "parent drug" - ANSWER CYP450 Inducers
CRAPGPS
Carbamazepine
Rifampin
Alcohol
,Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas - ANSWER CYP450 Inducer Medications
Medications that inhibit the metabolic activity of one or more of the CYP450
enzymes. Higher risk for toxicity; prolongs the pharmacological effect of the "parent
drug". - ANSWER CYP450 Inhibitors
VISACKGQ
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine - ANSWER CYP450 Inhibitor Medications
-potentially Inappropriate Medication (PIM) use in older adults
-potentially Inappropriate Medication (PIM) use in older adults due to medication-
disease or medication-syndrome interactions that may exacerbate the disease or
syndrome
-medications to be used cautiously in older adults
-clinically significant drug interactions that should be avoided in older adults
-medications to be avoided or dosage decreased in the presence of impaired kidney
function in older adults - ANSWER Beers Criteria
when one medication systemically alters the potency of another medication. -
ANSWER Pharmacokinetic Interactions
result of a change due to one medication's effect on another medication's route of
entry into the body. - ANSWER Absorption Interaction
caused by the amount of unbound/free medications available at the various target
sites. - ANSWER Distribution Interaction
concentration of the medication after biotransformation into active and inactive
metabolites in higher or lower than expected. - ANSWER Metabolism Interaction
the body's ability to eliminate medications in pure form or by altering a metabolite
from the body. - ANSWER Elimination Interaction
does not alter or impact absorption, distribution, metabolism, or elimination because
of the one medication's ability to manipulate the effect of another medication at its
site of action - ANSWER Pharmacodynamic Interactions
refers to the nurse practitioner's ability to practice without physician oversight -
ANSWER Practice Authority
, refers to the nurse practitioner's authority to prescribe medications. - ANSWER
prescriptive authority
Nurse practitioners have the autonomy to evaluate patients, diagnose, order and
interpret tests, initiate and manage treatments and prescribe medications, including
controlled substances without physician oversight. - ANSWER Full-practice scope
Nurse practitioners are limited in at least one element of practice. The state requires
a formal collaborative agreement with an outside health discipline for the nurse
practitioner to provide patient care. - ANSWER Reduced-practice scope
Nurse practitioners are limited in at least one element of practice by requiring
supervision, delegation, or team management by an outside health discipline for the
nurse practitioner to provide patient care. - ANSWER Restricted practice scope
DEA Scheduled Drugs - ANSWER Drugs that cannot be ordered via E-Script
Schedule II drugs - ANSWER Drugs that cannot be prescribed or refilled via phone
An occurrence of fewer than three months and is often precipitated by trauma and
acute medical conditions or treatment. - ANSWER Acute Pain
Referred Pain
Acute Somatic Pain
Acute visceral pain - ANSWER Types of Acute Pain
episode of pain that lasts for 6 months or longer; may be intermittent or continuous -
ANSWER Chronic pain
pain that is felt in a location other than where the pain originates - ANSWER
Referred Pain
-Arises from connective tissue, muscle, bone and skin.
-Sharp and localized or dull and non-localized
-Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates, local
anesthetics, ice, massage - ANSWER Acute Somatic Pain
Pain in the internal organs and abdomen
Poorly localized (C-fibers)
Radiates
Most responsive to opiates
May also use corticosteroids, NSAIDs - ANSWER Acute Visceral Pain
any drug, natural or synthetic, that has actions similar to those of morphine -
ANSWER Opioids
Mu (μ)
Kappa (k)
Delta (δ) - ANSWER Opioid Receptor Families
