ExamI1:INURSI615/INURS615I(New
IUpdate)IAdvancedI
PharmacotherapeuticsICompleteIReviewI
withIQsI&IAs|I100%ICorrect|IGradeIAI
(VerifiedIAnswers)-IMaryville
QUESTION
IdentifyIdrugImetabolismIandItheIroleIofItheIisoenzymesIofItheIP450Isystem.
Answer:
ICYPsIareItheImajorIenzymeIinvolvedIinIdrugImetabolismIaccountIforI75%IofItotalImetabolis
mI
MostIdrugsIdeactivatedIareIdirectlyIaffectedIorIfacilitatedIbyICYPIexcretionIfromItheIbody
ManyIsubstancesIbioactivatedIbyICYPsItoIformIactiveIcompounds
ManyIdrugsIincreaseIorIdecreaseItheIactivityIofIvariousIisoactiveIenzymesIbyIinducingIbiosynt
hesisIofItheIisozymeI(enzymeIinduction)IorIbyIdirectlyIinhibitingItheIactivityIofICYPI(enzyme
Iinhibition)I
MAJORISOURCEIOFIADVERSEIDRUGIREACTIONSIchangesIinICYPIactivityIaffectImetab
olismIandIclearanceIofIvariousIdrugs
InteractionsIbetweenItwoImedsIcanIleadItoItoxicityIprescribersImayIneedItoIadjustIdosagesIorI
chooseIdrugsIthatIdoInotIinteractI
IMPORTANTIINIDRUGSIw/ISMALLITHERAPEUTICIWINDOWS
Example:IAntiepileticIdrugsI&IAmiodarone,IGrapefruitIjuiceI&ImedicationsIleadingItoIincreas
eIbioavailabilityIandIoverdose
QUESTION
WhatIisItheIefficacyIofItheIdrug?
,Answer:
IMaximumIresponseIachievableIfromIaIdrug
IntrinsicIactivityI
Effectiveness--abilityItoIproduceIbeneficialIeffect
QUESTION
OnItheIdrugIconcentrationIcurveIwhatIisItheIfirstIsignIofIaItherapeuticIeffect?
Answer:
ITheIonsetIofIaction
QUESTION
WhatIisItheIpurposeIofIaIpeakIandItroughIlevel?
Answer:
IToIdetermineIifIdrugIisIinItherapeuticIrangeIrefersItoIdosageIrangeIorIserumIconcentration.ISo
meIpatientsIrequireImoreIorIlessIthanIthisIrange.ISomeImayIexperienceItoxicityIwithinIthisIran
ge
QUESTION
DescribeItheIpurposeIofItheIbloodIbrainIbarrierIandItheIfetalIplacentalIbarrier.
Answer:
IBBB:IHighlyIselectiveIpermeableImembraneIthatIprotectsItheICNSIconnectedIbyItightIjunctio
nsIbrainIandIethelialIcells
AllowsItheIpassageIofIwater,IsomeIgases,IlipidIsolubleIfluidsIwithIpassiveIdiffusion
GlucoseIandIaminoIacidsIareIallowedItoIcross
, FPB:IImpedesIcertainIchemicalsImostIfatIsolubleIchemicalsIcanIcross
MoreIwaterIsolubleIdrugsIandIhigherImolecularIweightICANNOTIcross.IIfIdrugIbindsItoIlarge
ImoleculeIsuchIasIalbuminIitIwillInotIcross
QUESTION
HowIwillIrenalIinsufficiencyIaffectIdrugIelimination?
Answer:
IKidneyIprimaryIorganIofIexcretionI
RateIdependsIonIrenalIbloodIflowIGFRI(glomerularIfiltrationIrate)
renalIfunctionItestedIbyIcreatinine
QUESTION
AccordingItoItheIWHO,IwhatIisItheIfirstIstepIinItheIprescribingIprocess?
Answer:
IDefineIpatient'sIproblemItoIdetermineIaIclearIindicationIforItreatment
ConsiderIotherImedications,Iallergies,Ipregnancy,Icomorbidities
SummaryIofIdiagnosticIpartIofIconsultationI
SECONDISTEP:ITherapeuticIobjective;IincludesImonitoringItherapeuticItreatment
THIRD:IChooseIdrugIorIstepIneededI(a)IselectionIofIprofessionalIpersonalIdrugIofIfirstIchoice
I(b)IconfirmationIofIsuitabilityIforIpatientIinIquestionI
IncludesIcheckingIforIcontraindications
FOURTH:IMakingIaIchoiceIandIwritingIRxIstartingItreatment
FIFTH:IGivingIpatientIinstructionsIandIwarningIaboutItreatment
SIXTH:IMonitoringIEffectiveITreatmentI(continue,Iadjust,IstopItreatment?)
IUpdate)IAdvancedI
PharmacotherapeuticsICompleteIReviewI
withIQsI&IAs|I100%ICorrect|IGradeIAI
(VerifiedIAnswers)-IMaryville
QUESTION
IdentifyIdrugImetabolismIandItheIroleIofItheIisoenzymesIofItheIP450Isystem.
Answer:
ICYPsIareItheImajorIenzymeIinvolvedIinIdrugImetabolismIaccountIforI75%IofItotalImetabolis
mI
MostIdrugsIdeactivatedIareIdirectlyIaffectedIorIfacilitatedIbyICYPIexcretionIfromItheIbody
ManyIsubstancesIbioactivatedIbyICYPsItoIformIactiveIcompounds
ManyIdrugsIincreaseIorIdecreaseItheIactivityIofIvariousIisoactiveIenzymesIbyIinducingIbiosynt
hesisIofItheIisozymeI(enzymeIinduction)IorIbyIdirectlyIinhibitingItheIactivityIofICYPI(enzyme
Iinhibition)I
MAJORISOURCEIOFIADVERSEIDRUGIREACTIONSIchangesIinICYPIactivityIaffectImetab
olismIandIclearanceIofIvariousIdrugs
InteractionsIbetweenItwoImedsIcanIleadItoItoxicityIprescribersImayIneedItoIadjustIdosagesIorI
chooseIdrugsIthatIdoInotIinteractI
IMPORTANTIINIDRUGSIw/ISMALLITHERAPEUTICIWINDOWS
Example:IAntiepileticIdrugsI&IAmiodarone,IGrapefruitIjuiceI&ImedicationsIleadingItoIincreas
eIbioavailabilityIandIoverdose
QUESTION
WhatIisItheIefficacyIofItheIdrug?
,Answer:
IMaximumIresponseIachievableIfromIaIdrug
IntrinsicIactivityI
Effectiveness--abilityItoIproduceIbeneficialIeffect
QUESTION
OnItheIdrugIconcentrationIcurveIwhatIisItheIfirstIsignIofIaItherapeuticIeffect?
Answer:
ITheIonsetIofIaction
QUESTION
WhatIisItheIpurposeIofIaIpeakIandItroughIlevel?
Answer:
IToIdetermineIifIdrugIisIinItherapeuticIrangeIrefersItoIdosageIrangeIorIserumIconcentration.ISo
meIpatientsIrequireImoreIorIlessIthanIthisIrange.ISomeImayIexperienceItoxicityIwithinIthisIran
ge
QUESTION
DescribeItheIpurposeIofItheIbloodIbrainIbarrierIandItheIfetalIplacentalIbarrier.
Answer:
IBBB:IHighlyIselectiveIpermeableImembraneIthatIprotectsItheICNSIconnectedIbyItightIjunctio
nsIbrainIandIethelialIcells
AllowsItheIpassageIofIwater,IsomeIgases,IlipidIsolubleIfluidsIwithIpassiveIdiffusion
GlucoseIandIaminoIacidsIareIallowedItoIcross
, FPB:IImpedesIcertainIchemicalsImostIfatIsolubleIchemicalsIcanIcross
MoreIwaterIsolubleIdrugsIandIhigherImolecularIweightICANNOTIcross.IIfIdrugIbindsItoIlarge
ImoleculeIsuchIasIalbuminIitIwillInotIcross
QUESTION
HowIwillIrenalIinsufficiencyIaffectIdrugIelimination?
Answer:
IKidneyIprimaryIorganIofIexcretionI
RateIdependsIonIrenalIbloodIflowIGFRI(glomerularIfiltrationIrate)
renalIfunctionItestedIbyIcreatinine
QUESTION
AccordingItoItheIWHO,IwhatIisItheIfirstIstepIinItheIprescribingIprocess?
Answer:
IDefineIpatient'sIproblemItoIdetermineIaIclearIindicationIforItreatment
ConsiderIotherImedications,Iallergies,Ipregnancy,Icomorbidities
SummaryIofIdiagnosticIpartIofIconsultationI
SECONDISTEP:ITherapeuticIobjective;IincludesImonitoringItherapeuticItreatment
THIRD:IChooseIdrugIorIstepIneededI(a)IselectionIofIprofessionalIpersonalIdrugIofIfirstIchoice
I(b)IconfirmationIofIsuitabilityIforIpatientIinIquestionI
IncludesIcheckingIforIcontraindications
FOURTH:IMakingIaIchoiceIandIwritingIRxIstartingItreatment
FIFTH:IGivingIpatientIinstructionsIandIwarningIaboutItreatment
SIXTH:IMonitoringIEffectiveITreatmentI(continue,Iadjust,IstopItreatment?)