NR565 ADVANCED PHARMACOLOGY FUNDAMENTALS

NR 565 - advanced pharmacology FINAL -
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Chamberlain Practice EXAM
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NR565 ADVANCED PHARMACOLOGY
FUNDAMENTALS

Pharmacokineticsvb-vbanswer--
Thevbprocessvbbyvbwhichvbdrugsvbarevbabsorbed,vbdistributedvbwithinvbthevbbody,vbmetabolized,vbandvbexcreted.

Pharmacodynamicsvb-vbanswer--Thevbstudyvbofvbwhatvbthevbdrugvbdoesvbtovbthevbbody

FactorsvbAffectingvbDrugvbAbsorptionvb-vbanswer--Ratevbofvbdissolution
Surfacevbarea
Bloodvbflow
Lipidvbsolubility
pHvbpartitioning

FactorsvbAffectingvbDrugvbDistributionvb-vbanswer--Bloodvbflowvbtovbtissues
Abilityvbtovbexitvbthevbvascularvbsystem
Blood-brainvbbarrier
Protein-bindingvbcapacity

Xenobioticsvb-vbanswer--
substancesvbthatvbarevbforeignvbtovbthevbbody,vbusuallyvbsyntheticvbchemicalvbcompounds;vbmedicationsvbarevbavbcomm
vbexample



CytochromevbP450vb(CYP450)vb-vbanswer--xenobiotic-
metabolizingvbenzymesvbnecessaryvbforvbthevbproductionvbofvbcholesterolvbandvbsteroidsvbandvbthevbdetoxificationvbofvbc
emicalsvbandvbdrugvbmetabolism.

FunctionvbofvbCytochromevbP450vb(CYP450)vb-vbanswer--
responsiblevbforvbphasevb1vbmetabolismvbinvbwhichvbdrugsvbarevboxidized,vbreduced,vborvbhydrolyzed

Phasevb1vbMetabolismvbofvbDrugsvbviavbP450vb-vbanswer--Oxidation;vbReduction;vbHydrolysis

Threevbpossiblevboutcomesvbofvbphasevb1vbdrugvbmetabolism.vb-vbanswer---Drugvbbecomesvbcompletelyvbinactive

-Drugvbbecomesvbpartiallyvbinactivevbbutvbonevborvbmorevbmetabolitesvbremainvbactive

-Originalvbdrugvbisvbnotvbpharmacologicallyvbactivevbbutvbonevbmetabolitevbremainsvbactive

CYP450vbInducersvb-vbanswer--
Medicationsvbthatvbcanvbincreasevbthevbratevbofvbanothervbdrug'svbmetabolismvbbyvbelevatingvbCYP450vbenzymevbactivit
viavbincreasingvbenzymevbsynthesis.vbdecreasingvbthevbconcentrationvbofvbthevb"parentvbdrug"

CYP450vbInducervbMedicationsvb-vbanswer--CRAPGPS
Carbamazepine
Rifampin
Alcohol
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, NR 565 - advanced pharmacology FINAL -
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Chamberlain Practice EXAM
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Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas

CYP450vbInhibitorsvb-vbanswer--
MedicationsvbthatvbinhibitvbthevbmetabolicvbactivityvbofvbonevborvbmorevbofvbthevbCYP450vbenzymes.vbHighervbriskvbforvbto
ity;vbprolongsvbthevbpharmacologicalvbeffectvbofvbthevb"parentvbdrug".

CYP450vbInhibitorvbMedicationsvb-vbanswer--VISACKGQ
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
GrapefruitvbJuice
Quinidine

BeersvbCriteriavb-vbanswer---potentiallyvbInappropriatevbMedicationvb(PIM)vbusevbinvboldervbadults
-potentiallyvbInappropriatevbMedicationvb(PIM)vbusevbinvboldervbadultsvbduevbtovbmedication-diseasevborvbmedication-
syndromevbinteractionsvbthatvbmayvbexacerbatevbthevbdiseasevborvbsyndrome
-medicationsvbtovbbevbusedvbcautiouslyvbinvboldervbadults
-clinicallyvbsignificantvbdrugvbinteractionsvbthatvbshouldvbbevbavoidedvbinvboldervbadults
-
medicationsvbtovbbevbavoidedvborvbdosagevbdecreasedvbinvbthevbpresencevbofvbimpairedvbkidneyvbfunctionvbinvboldervbadu
s

PharmacokineticvbInteractionsvb-vbanswer--
whenvbonevbmedicationvbsystemicallyvbaltersvbthevbpotencyvbofvbanothervbmedication.

AbsorptionvbInteractionvb-vbanswer--
resultvbofvbavbchangevbduevbtovbonevbmedication'svbeffectvbonvbanothervbmedication'svbroutevbofvbentryvbintovbthevbbody.

DistributionvbInteractionvb-vbanswer--causedvbbyvbthevbamountvbofvbunbound/
freevbmedicationsvbavailablevbatvbthevbvariousvbtargetvbsites.

MetabolismvbInteractionvb-vbanswer--
concentrationvbofvbthevbmedicationvbaftervbbiotransformationvbintovbactivevbandvbinactivevbmetabolitesvbinvbhighervborvblo
ervbthanvbexpected.

EliminationvbInteractionvb-vbanswer--
thevbbody'svbabilityvbtovbeliminatevbmedicationsvbinvbpurevbformvborvbbyvbalteringvbavbmetabolitevbfromvbthevbbody.

PharmacodynamicvbInteractionsvb-vbanswer--
doesvbnotvbaltervborvbimpactvbabsorption,vbdistribution,vbmetabolism,vborvbeliminationvbbecausevbofvbthevbonevbmedicatio
svbabilityvbtovbmanipulatevbthevbeffectvbofvbanothervbmedicationvbatvbitsvbsitevbofvbaction

PracticevbAuthorityvb-vbanswer--refersvbtovbthevbnursevbpractitioner'svbabilityvbtovbpracticevbwithoutvbphysicianvboversigh

prescriptivevbauthorityvb-vbanswer--refersvbtovbthevbnursevbpractitioner'svbauthorityvbtovbprescribevbmedications.
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, NR 565 - advanced pharmacology FINAL -
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Chamberlain Practice EXAM
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Full-practicevbscopevb-vbanswer--
Nursevbpractitionersvbhavevbthevbautonomyvbtovbevaluatevbpatients,vbdiagnose,vbordervbandvbinterpretvbtests,vbinitiatevba
vbmanagevbtreatmentsvbandvbprescribevbmedications,vbincludingvbcontrolledvbsubstancesvbwithoutvbphysicianvboversigh



Reduced-practicevbscopevb-vbanswer--
Nursevbpractitionersvbarevblimitedvbinvbatvbleastvbonevbelementvbofvbpractice.vbThevbstatevbrequiresvbavbformalvbcollaborat
vbagreementvbwithvbanvboutsidevbhealthvbdisciplinevbforvbthevbnursevbpractitionervbtovbprovidevbpatientvbcare.



Restrictedvbpracticevbscopevb-vbanswer--
Nursevbpractitionersvbarevblimitedvbinvbatvbleastvbonevbelementvbofvbpracticevbbyvbrequiringvbsupervision,vbdelegation,vbor
eamvbmanagementvbbyvbanvboutsidevbhealthvbdisciplinevbforvbthevbnursevbpractitionervbtovbprovidevbpatientvbcare.

DrugsvbthatvbcannotvbbevborderedvbviavbE-Scriptvb-vbanswer--DEAvbScheduledvbDrugs

Drugsvbthatvbcannotvbbevbprescribedvborvbrefilledvbviavbphonevb-vbanswer--SchedulevbIIvbdrugs

AcutevbPainvb-vbanswer--
Anvboccurrencevbofvbfewervbthanvbthreevbmonthsvbandvbisvboftenvbprecipitatedvbbyvbtraumavbandvbacutevbmedicalvbcondit
svborvbtreatment.

TypesvbofvbAcutevbPainvb-vbanswer--ReferredvbPain
AcutevbSomaticvbPain
Acutevbvisceralvbpain

Chronicvbpainvb-vbanswer--
episodevbofvbpainvbthatvblastsvbforvb6vbmonthsvborvblonger;vbmayvbbevbintermittentvborvbcontinuous

ReferredvbPainvb-vbanswer--painvbthatvbisvbfeltvbinvbavblocationvbothervbthanvbwherevbthevbpainvboriginates

AcutevbSomaticvbPainvb-vbanswer---Arisesvbfromvbconnectivevbtissue,vbmuscle,vbbonevbandvbskin.
-Sharpvbandvblocalizedvborvbdullvbandvbnon-localized
-Respondsvbbestvbto:vbacetaminophen,vbcorticosteroids,vbNSAIDs,vbopiates,vblocalvbanesthetics,vbice,vbmassage

AcutevbVisceralvbPainvb-vbanswer--Painvbinvbthevbinternalvborgansvbandvbabdomen
Poorlyvblocalizedvb(C-fibers)
Radiates
Mostvbresponsivevbtovbopiates
Mayvbalsovbusevbcorticosteroids,vbNSAIDs

Opioidsvb-vbanswer--anyvbdrug,vbnaturalvborvbsynthetic,vbthatvbhasvbactionsvbsimilarvbtovbthosevbofvbmorphine

OpioidvbReceptorvbFamiliesvb-vbanswer--Muvb(μ)
Kappavb(k)
Deltavb(δ)

Atvbeachvbtypevbofvbreceptor,vbavbdrugvbcanvbactvbinvbonevbofvbthreevbways:vb-vbanswer--
(1)vbpurevbopioidvbagonists,vb(2)vbagonist-antagonistvbopioids,vb(3)vbpurevbopioidvbantagonists.

Muvb(u)vbReceptorvb-vbanswer--Opioidvbreceptorvbmostvbresponsiblevbforvbmediatingvbanalgesicvbproperties

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