NUR 641E Midterm Study Guide questions with ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
accurate detailed solutions ||//\\|| ||//\\||
Prodrug - correct answer✔✔An inactive drug dosage form that is converted to an active
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
metabolite by various biochemical reactions once it is inside the body. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Cytochrome P450 ||//\\|| ||//\\||
-Ex. Aspirin, psilocybin, heroin
||//\\|| ||//\\|| ||//\\||
Bioavailability - correct answer✔✔the rate at and the extent to which a nutrient is absorbed ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
and used
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-Affected by route of administration and drug dosage ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Drug clearance (rate drug leaves circulation)
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-Steady state concentration ||//\\|| ||//\\|| ||//\\||
-Affected by chemical stability, solubility, and first pass ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Steady state (of a drug) - correct answer✔✔stable level of drug in the body, occurs in 5 half
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
lives of the drug
||//\\|| ||//\\|| ||//\\||
-rate of drug being added to system is equal to amount being eliminated from system
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Pharmacokinetics - correct answer✔✔The process by which drugs are absorbed, distributed ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
within the body, metabolized, and excreted.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-what the body does to the drug||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
First pass - correct answer✔✔the fact that a medication in the GI tract passes through the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
liver before entering other organs
||//\\|| ||//\\|| ||//\\|| ||//\\||
does not - correct answer✔✔bioequivalence does/does not affect bioavailability
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,Bioequivalence - correct answer✔✔relative therapeutic effectiveness of chemically equivalent ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
drugs.
||//\\||
Bioavailability (is affected by) - correct answer✔✔-chemical instability ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-solubility ||//\\||
-first pass metabolism
||//\\|| ||//\\||
Cytochrome P450 - correct answer✔✔-enzymes that function to metabolize potentially toxic ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
compounds, including drugs and products of endogenous metabolism such as bilirubin, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
principally in the liver. ||//\\|| ||//\\|| ||//\\|| ||//\\||
-genetics influence presence of enzymes ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-affects metabolism of warfarin, antidepressants, antiepileptics, and statins.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-the levels of these drugs are higher when taken with certain drugs that are inhibitors (ex.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
warfarin with omeprazole) because there is competition for enzyme metabolism.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-inducers lead to decreased plasma concentration of drug.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
cytochrome p450 inducer - correct answer✔✔An inducer increases the metabolism of a ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
substrate resulting in a decreased level or effect of the substrate
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
cytochrome p450 inhibitor - correct answer✔✔An inhibitor decreases the metabolism of a||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
substrate resulting in an increased level or effect of the substrate.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Clopidogrel - correct answer✔✔prodrug that must be activated by hepatic CYP2C19 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
metabolism; individuals who are poor metabolizers may not form the active metabolite and ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
have reduced antiplatelet response
||//\\|| ||//\\|| ||//\\||
half-life (determines) - correct answer✔✔how often a drug is administered
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, 4-5 - correct answer✔✔steady state is reached in _-_ times the half-life
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Warfarin (MOA) - correct answer✔✔-Vitamin K antagonist ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Factors II, VII, IX, X ||//\\|| ||//\\|| ||//\\|| ||//\\||
-takes several days to take effect ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-monitor INR ||//\\||
Vitamin K - correct answer✔✔warfarin antidote ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Heparin (MOA) - correct answer✔✔-rapid anticoagulation by binding with antithrombin III
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
and inhibits factors IXa, Xa, XIIa, and XIII
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-aPTT monitoring (low dose SQ does not require monitoring)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Apixaban (MOA) - correct answer✔✔direct factor Xa inhibitor ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
parenteral administration - correct answer✔✔-directly into systemic circulation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-poor absorption or unstable in GI tract (ex. heparin, insulin), rapid absorption, unable to
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
take meds PO ||//\\|| ||//\\|| ||//\\||
-IV, IM, SQ, ID ||//\\|| ||//\\|| ||//\\||
IV - correct answer✔✔-into the vein
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-can be given through bolus (rapid peak) or infusion (lower peak, longer duration)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ex. rocuronium (neuromuscular blocker)
||//\\|| ||//\\|| ||//\\||
IM - correct answer✔✔-aqua solutions absorbed rapidly
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-depot absorbed slowly in a nonaqueous solution such as polyethene glycol (simple diffusion)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
accurate detailed solutions ||//\\|| ||//\\||
Prodrug - correct answer✔✔An inactive drug dosage form that is converted to an active
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
metabolite by various biochemical reactions once it is inside the body. ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Cytochrome P450 ||//\\|| ||//\\||
-Ex. Aspirin, psilocybin, heroin
||//\\|| ||//\\|| ||//\\||
Bioavailability - correct answer✔✔the rate at and the extent to which a nutrient is absorbed ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
and used
||//\\||
-Affected by route of administration and drug dosage ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Drug clearance (rate drug leaves circulation)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Steady state concentration ||//\\|| ||//\\|| ||//\\||
-Affected by chemical stability, solubility, and first pass ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Steady state (of a drug) - correct answer✔✔stable level of drug in the body, occurs in 5 half
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
lives of the drug
||//\\|| ||//\\|| ||//\\||
-rate of drug being added to system is equal to amount being eliminated from system
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Pharmacokinetics - correct answer✔✔The process by which drugs are absorbed, distributed ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
within the body, metabolized, and excreted.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-what the body does to the drug||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
First pass - correct answer✔✔the fact that a medication in the GI tract passes through the
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
liver before entering other organs
||//\\|| ||//\\|| ||//\\|| ||//\\||
does not - correct answer✔✔bioequivalence does/does not affect bioavailability
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
,Bioequivalence - correct answer✔✔relative therapeutic effectiveness of chemically equivalent ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
drugs.
||//\\||
Bioavailability (is affected by) - correct answer✔✔-chemical instability ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-solubility ||//\\||
-first pass metabolism
||//\\|| ||//\\||
Cytochrome P450 - correct answer✔✔-enzymes that function to metabolize potentially toxic ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
compounds, including drugs and products of endogenous metabolism such as bilirubin, ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
principally in the liver. ||//\\|| ||//\\|| ||//\\|| ||//\\||
-genetics influence presence of enzymes ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-affects metabolism of warfarin, antidepressants, antiepileptics, and statins.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-the levels of these drugs are higher when taken with certain drugs that are inhibitors (ex.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
warfarin with omeprazole) because there is competition for enzyme metabolism.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-inducers lead to decreased plasma concentration of drug.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
cytochrome p450 inducer - correct answer✔✔An inducer increases the metabolism of a ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
substrate resulting in a decreased level or effect of the substrate
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
cytochrome p450 inhibitor - correct answer✔✔An inhibitor decreases the metabolism of a||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
substrate resulting in an increased level or effect of the substrate.
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Clopidogrel - correct answer✔✔prodrug that must be activated by hepatic CYP2C19 ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
metabolism; individuals who are poor metabolizers may not form the active metabolite and ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
have reduced antiplatelet response
||//\\|| ||//\\|| ||//\\||
half-life (determines) - correct answer✔✔how often a drug is administered
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
, 4-5 - correct answer✔✔steady state is reached in _-_ times the half-life
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Warfarin (MOA) - correct answer✔✔-Vitamin K antagonist ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-Factors II, VII, IX, X ||//\\|| ||//\\|| ||//\\|| ||//\\||
-takes several days to take effect ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-monitor INR ||//\\||
Vitamin K - correct answer✔✔warfarin antidote ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Heparin (MOA) - correct answer✔✔-rapid anticoagulation by binding with antithrombin III
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
and inhibits factors IXa, Xa, XIIa, and XIII
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-aPTT monitoring (low dose SQ does not require monitoring)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
Apixaban (MOA) - correct answer✔✔direct factor Xa inhibitor ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
parenteral administration - correct answer✔✔-directly into systemic circulation ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-poor absorption or unstable in GI tract (ex. heparin, insulin), rapid absorption, unable to
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
take meds PO ||//\\|| ||//\\|| ||//\\||
-IV, IM, SQ, ID ||//\\|| ||//\\|| ||//\\||
IV - correct answer✔✔-into the vein
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-can be given through bolus (rapid peak) or infusion (lower peak, longer duration)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-ex. rocuronium (neuromuscular blocker)
||//\\|| ||//\\|| ||//\\||
IM - correct answer✔✔-aqua solutions absorbed rapidly
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
-depot absorbed slowly in a nonaqueous solution such as polyethene glycol (simple diffusion)
||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\|| ||//\\||
