NGR6172 Pharmacology
Midterm (Week #1-7) with
100% correct answers (latest
update)
Pharmacokinetics - answer Pharmacokinetics is the study of the action of
drugs in the body including absorption, distribution, metabolism and
elimination. What the body does to the drug.
Absorption: How the drug leaves its site of administration. Bioavailability
is important; f-value (portion of drug that reaches systemic circulation).
Distribution: Transport of a drug in body fluids from bloodstream.
Metabolism: Biotransformation; chemical inactivation of a drug through
conversion to a more water-soluble compound that can be excreted from
the body (e.g., liver, lungs, GI tract).
Elimination: Process by which drugs and their metabolites are removed
from the body (e.g., liver and kidneys).
Routes of administration: PO, topical, subqut, IM, IV, rectal (PR),
intradermal (ID), sublingual (SL), buccal, intaartivularm inhalation,
intravaginal, ophthalmic, aural
Fastest route?Intravenous
Pharmacodynamics - answer Pharmacodynamics is the study of the
biochemical and physiological effects of drugs and the mechanisms of
their actions; the effect of the drug on the body.
,Inhibitor: A drug that causes INHIBITION in the enzyme metabolization of
another drug. IF DRUG A (IS AN INHIBITOR) + DRUG B = THIS RESULTS IN A
DECREASED METABOLISM OF DRUG B, A DECREASED ELIMINATION OF
DRUG B, AND AN INCREASED AMOUNT OF DRUG B IN THE BLOODSTREAM
Substrate: Drug that is affected by a change in its enzyme metabolism.
Inducer: A drug that causes ACCELERATION in the enzyme metabolization
of another drug. IF DRUG A (IS AN INDUCER) + DRUG B = THIS RESULTS IN
AN INCREASED METABOLISM OF DRUG B, AN INCREASED ELIMINATION OF
DRUG B, AND A DECREASED AMOUNT OF DRUG B IN THE BLOODSTREAM
Metabolizer: Break down of a drug.
Adverse Effect - answer Common: Expected; should not stop patient from
taking medication.
Severe: May incapacitate pt or interfere with patient's ability to work or
complete ADLS; may be life threatening and result in death.
Drug Interactions - answer - Risk vs benefit of drug
-Increased risk with elderly and pts with comorbidities
Contraindications - answer Factors that prevent the use of a drug or
treatment
Prescriptive authority - answer A. Independent vs Dependent practice:
Independent means NP can prescribe alone. Dependent means physician
retains ultimate authority through countersignature of prescriptions and
or by a written agreement between the NP and physician.
,B. Meaning of delegable authority: Requires nurse to perform under a
physician; without it nurses cannot legally prescribe medications under
any circumstances but can recommend nonprescription medications.
C. Prescriptive authority regulation: Many states practice dependent
authority. Independent authority is restricted still in many states (e..g,
excluding controlled substances, limiting drugs to those listed in a
formulary, etc.)
NP scope of practice - answer A. DEA registration for NP: Registration of
all NPs who are authorized by state law to prescribe controlled
substances; mid-level providers (MLPs) differentiate NP DEA numbers from
that of physicians.
B. Issues common to all NPs: Prescribing controlled substances,
dispensing privileges.
c. Prescribing controlled-substances: MLPs DEA number. Varies from state
to state; specific state restrictions.
(Narcotic vs non-narcotic controlled substances: Family members, drug
prescribing etiquette)
D. CDC guidelines (not on exam) but review CH. 43
Special populations: Geriatrics
Changes that affect drug therapy?
Common concerns regarding medication use in elderly patients? - answer
Absorption - Passive; little to no change in absorption.
Distribution - Decline in total body weight, decrease body mass, decrease
serum albumin all lead to enhanced drug effect and/or toxicity.
Metabolism - Loss of hepatic reserve/decreased flow so lower doses may
be needed.
, Excretion - Age related changes in renal function, decreased creatinine
clearance (i.e., use modified Cockcroft-gault equation)
Common concerns?
-Adverse drug reactions, adherence
Special populations: Pediatrics
Calculation of pediatric dosages? - answer Package insert provided by
the manufacturer is the best source for pediatric dose recommendations.
If not available, based on weight, age or surface area.
Pediatric dosage rule based on weight
Clark's Rule = Dose x (weight (kg)/70)
Pediatric dosage rule based on age (not as accurate as weight based)
Special populations: Pregnant and nursing - answer Determinacy of
teratogenicity: Timing of drug exposure important; most critical period to
avoid drug exposures is weeks 3 to 8.
Counseling pregnant patient about drug use: Benefit vs risks.
Drugs contraindicated in the first trimester: ACE inhibitors (e.g., enalapril,
lisinopril) , ARBs (e.g., valsartan, losartan), statins
Components of the traditional prescription - answer Name and address of
the patient, date the perception is written, age and weight of patient,
drug (full name, strength or concentration), signature, any refills, DEA
number, if generic substitutions are okay or not.
Clinical decision-making components - answer Judging, evaluating,
critical thinking
Midterm (Week #1-7) with
100% correct answers (latest
update)
Pharmacokinetics - answer Pharmacokinetics is the study of the action of
drugs in the body including absorption, distribution, metabolism and
elimination. What the body does to the drug.
Absorption: How the drug leaves its site of administration. Bioavailability
is important; f-value (portion of drug that reaches systemic circulation).
Distribution: Transport of a drug in body fluids from bloodstream.
Metabolism: Biotransformation; chemical inactivation of a drug through
conversion to a more water-soluble compound that can be excreted from
the body (e.g., liver, lungs, GI tract).
Elimination: Process by which drugs and their metabolites are removed
from the body (e.g., liver and kidneys).
Routes of administration: PO, topical, subqut, IM, IV, rectal (PR),
intradermal (ID), sublingual (SL), buccal, intaartivularm inhalation,
intravaginal, ophthalmic, aural
Fastest route?Intravenous
Pharmacodynamics - answer Pharmacodynamics is the study of the
biochemical and physiological effects of drugs and the mechanisms of
their actions; the effect of the drug on the body.
,Inhibitor: A drug that causes INHIBITION in the enzyme metabolization of
another drug. IF DRUG A (IS AN INHIBITOR) + DRUG B = THIS RESULTS IN A
DECREASED METABOLISM OF DRUG B, A DECREASED ELIMINATION OF
DRUG B, AND AN INCREASED AMOUNT OF DRUG B IN THE BLOODSTREAM
Substrate: Drug that is affected by a change in its enzyme metabolism.
Inducer: A drug that causes ACCELERATION in the enzyme metabolization
of another drug. IF DRUG A (IS AN INDUCER) + DRUG B = THIS RESULTS IN
AN INCREASED METABOLISM OF DRUG B, AN INCREASED ELIMINATION OF
DRUG B, AND A DECREASED AMOUNT OF DRUG B IN THE BLOODSTREAM
Metabolizer: Break down of a drug.
Adverse Effect - answer Common: Expected; should not stop patient from
taking medication.
Severe: May incapacitate pt or interfere with patient's ability to work or
complete ADLS; may be life threatening and result in death.
Drug Interactions - answer - Risk vs benefit of drug
-Increased risk with elderly and pts with comorbidities
Contraindications - answer Factors that prevent the use of a drug or
treatment
Prescriptive authority - answer A. Independent vs Dependent practice:
Independent means NP can prescribe alone. Dependent means physician
retains ultimate authority through countersignature of prescriptions and
or by a written agreement between the NP and physician.
,B. Meaning of delegable authority: Requires nurse to perform under a
physician; without it nurses cannot legally prescribe medications under
any circumstances but can recommend nonprescription medications.
C. Prescriptive authority regulation: Many states practice dependent
authority. Independent authority is restricted still in many states (e..g,
excluding controlled substances, limiting drugs to those listed in a
formulary, etc.)
NP scope of practice - answer A. DEA registration for NP: Registration of
all NPs who are authorized by state law to prescribe controlled
substances; mid-level providers (MLPs) differentiate NP DEA numbers from
that of physicians.
B. Issues common to all NPs: Prescribing controlled substances,
dispensing privileges.
c. Prescribing controlled-substances: MLPs DEA number. Varies from state
to state; specific state restrictions.
(Narcotic vs non-narcotic controlled substances: Family members, drug
prescribing etiquette)
D. CDC guidelines (not on exam) but review CH. 43
Special populations: Geriatrics
Changes that affect drug therapy?
Common concerns regarding medication use in elderly patients? - answer
Absorption - Passive; little to no change in absorption.
Distribution - Decline in total body weight, decrease body mass, decrease
serum albumin all lead to enhanced drug effect and/or toxicity.
Metabolism - Loss of hepatic reserve/decreased flow so lower doses may
be needed.
, Excretion - Age related changes in renal function, decreased creatinine
clearance (i.e., use modified Cockcroft-gault equation)
Common concerns?
-Adverse drug reactions, adherence
Special populations: Pediatrics
Calculation of pediatric dosages? - answer Package insert provided by
the manufacturer is the best source for pediatric dose recommendations.
If not available, based on weight, age or surface area.
Pediatric dosage rule based on weight
Clark's Rule = Dose x (weight (kg)/70)
Pediatric dosage rule based on age (not as accurate as weight based)
Special populations: Pregnant and nursing - answer Determinacy of
teratogenicity: Timing of drug exposure important; most critical period to
avoid drug exposures is weeks 3 to 8.
Counseling pregnant patient about drug use: Benefit vs risks.
Drugs contraindicated in the first trimester: ACE inhibitors (e.g., enalapril,
lisinopril) , ARBs (e.g., valsartan, losartan), statins
Components of the traditional prescription - answer Name and address of
the patient, date the perception is written, age and weight of patient,
drug (full name, strength or concentration), signature, any refills, DEA
number, if generic substitutions are okay or not.
Clinical decision-making components - answer Judging, evaluating,
critical thinking
