Nur 641 E Final Exam Study Guide Grand Canyon ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
University questions with verified detailed ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
solutions
Pharmacokinetics involves - correct answer✔✔absorption, distribution, metabolism, excretion ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Pharmacokinetic absorption - correct answer✔✔absorption from the administration site ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
either directly or indirectly in the blood plasma
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Parmacokinetic distribution - correct answer✔✔reversibly or irreversibly move from the ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
bloodstream into the interstitial and intracellular fluid ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Pharmacokinetics metabolism - correct answer✔✔biotransformed via hepatic metabolism or ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
by other tissue
||//\\|| ||//\\||
Intravenous medications - correct answer✔✔1. highest bioavailability ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. places entire does into venin thus bypassing absorption
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3. avoids hepatic first pass metabolism in the liver
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
steady state medication - correct answer✔✔usually reached within 4-5 half lives of the drug
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
drug half life - correct answer✔✔1.the time required for the elimination process to reduce
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2.the concentration of the drug to one half what it was at initial administration
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3.determines drug frequency ||//\\|| ||//\\||
4. predicts length of toxic effects
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
5. constant first order pharmacokinetics of a drug
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,zero order (nonlinear) - correct answer✔✔drug is metabolized at a constant rate per unit
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
CYP3A4 - correct answer✔✔metabolizes 50% drugs ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
inhibit: grapefruit juice ||//\\|| ||//\\||
- increase drug -> adverse effects
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
may have enhanced activity with any other CYP3A4
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Six steps in drug development process - correct answer✔✔1. discovery or laboratory for
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
development
2. Phase 1 begins with animal testing
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3. phase 2 human subjects
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
4. compare drug to placebo or other drug that is effective
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
5.FDA then reviews result and determines approval
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
6. Post market study to determine other side effects that were not seen while lab testing
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
organizations for medication safety - correct answer✔✔1.Institute of Safe mediation Practice ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. Institute of Medicine
||//\\|| ||//\\|| ||//\\||
3. Joint commission
||//\\|| ||//\\||
4.National Coordinating Council form mediation error reporting and prevention ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
5. Food and Drug Administration (safe use initiative)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Adverse Drug Reaction (ADR) - correct answer✔✔1.Also known as a side effect, an
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
undesirable reaction that accompanies the principal response for which the drug was taken ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
include allergic reactions and adverse drug effects ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. Either pharmacological or idiosyncratic
||//\\|| ||//\\|| ||//\\|| ||//\\||
3. 85-90% of ADRs are pharmacological
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, 4. Reporting is not mandated by FDA thus are not commonly reported
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
5. usually preventable occur in hospital and nursing homes due to med errors
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
6. Polypharmacy, multiple doctors and multiple pharmacies increase risk
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Angiotensin-converting enzyme (ACE) inhibitors - correct answer✔✔1. end in pril: lisinopril, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
captopril, enalapril, ramipril, benazepril and fosinopril ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. suppress release of angiotensin converting enzyme
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3. side effects include cough and angioedema, with angioedema the medication should be
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
discontinued
Angiotensin II Receptor Blockers (ARBs) - correct answer✔✔1. -sartan: candesartan, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
eprosartan, ibesartan, Isosartan, telmisartan, valsartan ||//\\|| ||//\\|| ||//\\|| ||//\\||
2.block angiotensin 11 receptors ||//\\|| ||//\\|| ||//\\||
Essential vs Secondary HTN - correct answer✔✔Essential HTN accounts for 90% of cases and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
is also called primary, secondary may be caused by CKD
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Nitroglycerin (Nitrate) - correct answer✔✔use: angina pectoris ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
action: dilate veins and arteries and thereby reducing ischemia and relieving pain by
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
decreasing myocardial O2 consumption ||//\\|| ||//\\|| ||//\\|| ||//\\||
Side effects: throbbing HA, flushing, hypotension tachycardia
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
available: IV, SL, topical ointment and transdermal patch ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
contraindicated with PDE-5 (sildanfil and vardenafil) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Amiodarone - correct answer✔✔1. antiarrhythmic of choice when there is coexisting heart ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
failure
2. can cause thyroid and pulmonary toxicity
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
University questions with verified detailed ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
solutions
Pharmacokinetics involves - correct answer✔✔absorption, distribution, metabolism, excretion ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Pharmacokinetic absorption - correct answer✔✔absorption from the administration site ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
either directly or indirectly in the blood plasma
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Parmacokinetic distribution - correct answer✔✔reversibly or irreversibly move from the ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
bloodstream into the interstitial and intracellular fluid ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Pharmacokinetics metabolism - correct answer✔✔biotransformed via hepatic metabolism or ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
by other tissue
||//\\|| ||//\\||
Intravenous medications - correct answer✔✔1. highest bioavailability ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. places entire does into venin thus bypassing absorption
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3. avoids hepatic first pass metabolism in the liver
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
steady state medication - correct answer✔✔usually reached within 4-5 half lives of the drug
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
drug half life - correct answer✔✔1.the time required for the elimination process to reduce
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2.the concentration of the drug to one half what it was at initial administration
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3.determines drug frequency ||//\\|| ||//\\||
4. predicts length of toxic effects
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
5. constant first order pharmacokinetics of a drug
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,zero order (nonlinear) - correct answer✔✔drug is metabolized at a constant rate per unit
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
CYP3A4 - correct answer✔✔metabolizes 50% drugs ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
inhibit: grapefruit juice ||//\\|| ||//\\||
- increase drug -> adverse effects
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
may have enhanced activity with any other CYP3A4
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Six steps in drug development process - correct answer✔✔1. discovery or laboratory for
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
development
2. Phase 1 begins with animal testing
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3. phase 2 human subjects
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
4. compare drug to placebo or other drug that is effective
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
5.FDA then reviews result and determines approval
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
6. Post market study to determine other side effects that were not seen while lab testing
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
organizations for medication safety - correct answer✔✔1.Institute of Safe mediation Practice ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. Institute of Medicine
||//\\|| ||//\\|| ||//\\||
3. Joint commission
||//\\|| ||//\\||
4.National Coordinating Council form mediation error reporting and prevention ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
5. Food and Drug Administration (safe use initiative)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Adverse Drug Reaction (ADR) - correct answer✔✔1.Also known as a side effect, an
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
undesirable reaction that accompanies the principal response for which the drug was taken ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
include allergic reactions and adverse drug effects ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. Either pharmacological or idiosyncratic
||//\\|| ||//\\|| ||//\\|| ||//\\||
3. 85-90% of ADRs are pharmacological
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, 4. Reporting is not mandated by FDA thus are not commonly reported
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
5. usually preventable occur in hospital and nursing homes due to med errors
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
6. Polypharmacy, multiple doctors and multiple pharmacies increase risk
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Angiotensin-converting enzyme (ACE) inhibitors - correct answer✔✔1. end in pril: lisinopril, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
captopril, enalapril, ramipril, benazepril and fosinopril ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
2. suppress release of angiotensin converting enzyme
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
3. side effects include cough and angioedema, with angioedema the medication should be
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
discontinued
Angiotensin II Receptor Blockers (ARBs) - correct answer✔✔1. -sartan: candesartan, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
eprosartan, ibesartan, Isosartan, telmisartan, valsartan ||//\\|| ||//\\|| ||//\\|| ||//\\||
2.block angiotensin 11 receptors ||//\\|| ||//\\|| ||//\\||
Essential vs Secondary HTN - correct answer✔✔Essential HTN accounts for 90% of cases and
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
is also called primary, secondary may be caused by CKD
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Nitroglycerin (Nitrate) - correct answer✔✔use: angina pectoris ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
action: dilate veins and arteries and thereby reducing ischemia and relieving pain by
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
decreasing myocardial O2 consumption ||//\\|| ||//\\|| ||//\\|| ||//\\||
Side effects: throbbing HA, flushing, hypotension tachycardia
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
available: IV, SL, topical ointment and transdermal patch ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
contraindicated with PDE-5 (sildanfil and vardenafil) ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Amiodarone - correct answer✔✔1. antiarrhythmic of choice when there is coexisting heart ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
failure
2. can cause thyroid and pulmonary toxicity
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
