NR 565 - ADVANCED PHARMACOLOGY MIDTERM - CHAMBERLAIN

NR 565 - ADVANCED PHARMACOLOGY
MIDTERM - CHAMBERLAIN


Duringoowhatootrimesterooisooaoopregnantoowomanoomostooatooriskooforooadverseoodrugoor
eactionsoowithoopotentialoolongootermooconsequences?oo-ooans--
1stootrimesteroo(fetusoomostooatooriskood/toorapidoogrowth)

WhatooisooBEERSoocriteria?oo-ooans--
Recommendationsooofoomedicationsooinappropriateooforooelderlyoo(65ooandooolder),oopre
scriberooultimatelyoodecides

WhatooisootheooCYP450oo(cytochromeooP450)oo-ooans--
liverooenzymeoosystemoowhereoomedicationsooareoometabolized,oocanooeitheroobeooinduc
ersooorooinhibitorsooandoocreateoodrug-drugoointeractions

CYP450ooinducersoo-ooans--
Speedooupoometabolismooofoodrugsoo(drugooisooclearedoofaster),oodrugoohasoolesserooeffe
ctoo(decreaseoobloodoolevelsooofoodrug),ooelevateooCYP450ooenzymes

CYP450ooinducersoopneumonicoo-ooans--"BullshitooCrapooGPSooINDUCESoorage"

CYP450ooinduceroodrugoonamesoo-ooans--
Barbituates,ooStooJohnoowort,ooCarbamazepine,oorifampin,ooalcohol,oophenytoin,oogriseof
ulvin,oophenobarbital,oosulfonylureas

CYP450ooinhibitorsoo-ooans--
inhibitoometabolism,ooincreaseoobloodoolevelsooofoomedications

CYP450oopneumonicoo-
ooans--"VISAoocreditoocardoodebtooINHIBITSoospendingooonoodesignersoolikeooCKootoooloo
kooGQ"

CYP450ooinhibitorsoodrugoonamesoo-ooans--
Valproate,ooisoniazid,oosulfonamides,ooamiodarone,oochloramphenicol,ooketoconazole,oo
grapefruitoojuice,ooquinidine

Physiologicaloochangesooduringoopregnancyoothatooimpactoopharmacodynamicsooandoop
harmacokineticoopropertiesooofoodrugs?oo-ooans--
increaseooglomerularoofiltrationoorateooleadsootoooincreaseoodurgooexcretionoo
increaseoohepaticoometabolism

,decreaseootoneooandoomotilityooofoobowel
increaseoodrugooabsorption

Examplesooofoomedicationsoothatoocanoobeooteratogenicoo-ooans--
Antiepilepticoodrugs,ooantimicrobialsoosuchooasootetracyclinesooandoofluoroquinolones,oovi
taminooAooinoolargeoodoses,oosomeooanticoagulants,ooandoohormonaloomedicationsoosuch
ooasoodiethylstilbestroloo(DES).


Howooisooabsorptionooofoointramuscularoomedicationsoodifferentooinooneonates?oo-ooans--
slowooandooerraticoodueootooolowoobloodooflowooinoomusclesoofirstoofewoodaysooofoolife

Whyooisooabsorptionooofoomedicationooinootheoostomachooincreasedooinooinfancy?oo-
ooans--delayedoogastricooemptying


Someoomedicationsoothatooshouldoobeooavoidedooinootheoopediatricoopatient?oo-ooans--
glucocorticoids,oodiscolorationooofoodevelopingooteethoowithootetracyclines,ooandookernict
erusoowithoosulfonamides,oolevofloxacinoo(antibiotics)oo
aspirinoo(Severeoointoxicationoofromooacuteoooverdose)

whatooshouldoobeooincludedooinoomedicationooadministrationoopatientooeducation?oo-
ooans--dosageoosizeooandootiming
routeooandootechniqueooofooadministration
durationooofootreatment
drugoostorage
natureooandootimeoocourseooofoodesiredooresponses
natureooandootimeoocourseooofooadverseooresponses
finishootakingooantibiotic

Whatooareoosomeoothingsoothatooputootheooelderlyoopatientooatoohigherooriskooforooadverse
oodrugooreactions?oo-ooans--reducedoorenaloofunctionoo
polypharmacyoo(theoouseooofoofiveoooroomoreoomedicationsoodaily)
greaterooseverityooofooillness
presenceooofoocomorbidities
useooofoodrugsoothatoohaveooaoolowootherapeuticooindexoo(e.g.,oodigoxin)
increasedooindividualoovariationoosecondaryootoooalteredoopharmacokinetics
inadequateoosupervisionooofoolong-termootherapy
pooroopatientooadherence

Howoocanoohealthcareooprovidersoodecreaseoolikelihoodooofooanooelderlyoopatientooexperi
encingooanooadverseoodrugooreaction?oo-ooans--
obtainingooaoothoroughoodrugoohistoryoothatooincludesooover-the-counteroomedications
consideringoopharmacokineticooandoopharmacodynamicsoochangesoodueootoooage
monitoringootheoopatient'sooclinicalooresponseooandooplasmaoodrugoolevels
usingootheoosimplestooregimenoopossible
monitoringooforoodrug-drugoointeractionsooandooiatrogenicooillness
periodicallyooreviewingootheooneedooforoocontinuedoodrugootherapy

, encouragingootheoopatientootooodisposeooofoooldoomedications
takingoostepsootooopromoteooadherenceooandootoooavoidoodrugsooonootheooBeersoolist

Howoocanooweoopromoteoomedicationooadherenceoowithooelderlyoopatients?oo-ooans--
simplifyingoodrugooregimens
providingooclearooandooconciseooverbalooandoowrittenooinstructions
usingooanooappropriateoodosageooform
clearlyoolabelingooandoodispensingooeasy-to-openoocontainers
developingoodailyooreminders
monitoringoofrequently
affordabilityooofoodrugs
supportoosystems

Whyoodooonitratesooneedootooobeootakenoonooolateroothanoo4ooPM?oo-ooans--
Needoonitrateoofreeoointervaloosoootoleranceoodoesn'toodevelop

Nineoofactorsoothatooimpactoooutcomeooofoomedication?oo-ooans--Genderooandoorace
Geneticsooandoopharmacogenomics
Variabilityooinooabsorption
placeboooeffect
Tolerance
patho
age
bodyweight

Doooyouooneedooinformedooconsentooforoogeneticootesting?oo-ooans--yes

WhatooisootheoopurposeooofootheooGeneticooInformationooNon-DiscriminatoryooAct?oo-
ooans--
Protectsoopatientsoofromoodiscriminationoobyooemployersooandooinsuranceooprovidersooba
sedooonoogeneticooinformation

Differenceoobetweenoopracticeooauthorityooandooprescriptiveooauthority?oo-ooans--
Practiceooauthorityoorefersootoootheoonurseoopractitioner'sooabilityootooopracticeoowithoutoo
physicianoooversight,oowhereasooprescriptiveooauthorityoorefersootoootheoonurseoopractitio
ner'sooauthorityootoooprescribeoomedicationsooindependentlyooandoowithoutoolimitations.

Whoooregulatesooprescriptiveooauthority?oo-ooans--
theoojurisdictionooofooaoohealthooprofessionalooboard.ooThisoomayoobeootheooStateooBoard
ooofooNursing,ootheooStateooBoardooofooMedicine,ooorootheooStateooBoardooofooPharmacy,o
oasoodeterminedoobyooeachoostate.


Whatooisooscopeooofoopracticeoodeterminedooby?oo-ooans--
isoodeterminedoobyoostateoopracticeooandoolicensureoolaws.