Nur 641 E Final Exam Study Guide Grand
Canyon University
absorption, distribution, metabolism, excretion - ANS Pharmacokinetics involves
absorption from the administration site either directly or indirectly in the blood plasma - ANS
Pharmacokinetic absorption
reversibly or irreversibly move from the bloodstream into the interstitial and intracellular fluid
- ANS Parmacokinetic distribution
biotransformed via hepatic metabolism or by other tissue - ANS Pharmacokinetics
metabolism
1. highest bioavailability
2. places entire does into venin thus bypassing absorption
3. avoids hepatic first pass metabolism in the liver - ANS Intravenous medications
usually reached within 4-5 half lives of the drug - ANS steady state medication
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 - ANS drug half life
drug is metabolized at a constant rate per unit - ANS zero order (nonlinear)
metabolizes 50% drugs
inhibit: grapefruit juice
- increase drug -> adverse effects
may have enhanced activity with any other CYP3A4 - ANS CYP3A4
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 -
ANS Six steps in drug development process
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) - ANS organizations for medication
safety
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 - ANS Adverse
Drug Reaction (ADR)
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 - ANS Angiotensin-converting enzyme (ACE) inhibitors
1. -sartan: candesartan, eprosartan, ibesartan, Isosartan, telmisartan, valsartan
2.block angiotensin 11 receptors - ANS Angiotensin II Receptor Blockers (ARBs)
Essential HTN accounts for 90% of cases and is also called primary, secondary may be
caused by CKD - ANS Essential vs Secondary HTN
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) - ANS Nitroglycerin (Nitrate)
1. antiarrhythmic of choice when there is coexisting heart failure
2. can cause thyroid and pulmonary toxicity - ANS Amiodarone
vasoconstriction and increased blood pressure - ANS Alpha 1 adrenergic stimulation results
Decrease sympathetic stimulation causing vasodilation and decreased blood pressure -
ANS alpha 1 blockade
stimulation by beta agonists (isoproterenol) result in increased heart rate, blood pressure
and cardiac output
2. blockade results in decreased heart rate, bp, and cardiac output - ANS beta 1 adrenergic
The heart does not adequately circulate blood to systemic system. Due to pressure overload
or volume overload causing a reduction of oxygenated blood to body tissue - ANS left heart
failure
1.Associated with pulmonary disease and increased pulmonary vascular resistance
2.The heart does not adequately circulate blood to the pulmonic system. Can be due to
volume overload or regurgitation in Tricuspid Valve or Pulmonic Valve.
Can lead to systemic edema, back up of blood in liver and lower extremities - ANS Right
heart failure
1.Inhibit water transport across Loop of Henle work on receptors in ascending renal loop
2.inhibit reabsorption of NaCL at site in kidney
3. potent diuretic (Lasix) can cause hypokalemia - ANS Loop diuretics MOA
spironolactone, triamterene, amiloride - ANS Potassium sparing diuretics
phosphodiesterase inhibitor used to treat acute heart failure - ANS Milrinone (Primacor)
children squat to compensate for hypoxia - ANS Tetrallogy of Fallot squatting
Canyon University
absorption, distribution, metabolism, excretion - ANS Pharmacokinetics involves
absorption from the administration site either directly or indirectly in the blood plasma - ANS
Pharmacokinetic absorption
reversibly or irreversibly move from the bloodstream into the interstitial and intracellular fluid
- ANS Parmacokinetic distribution
biotransformed via hepatic metabolism or by other tissue - ANS Pharmacokinetics
metabolism
1. highest bioavailability
2. places entire does into venin thus bypassing absorption
3. avoids hepatic first pass metabolism in the liver - ANS Intravenous medications
usually reached within 4-5 half lives of the drug - ANS steady state medication
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 - ANS drug half life
drug is metabolized at a constant rate per unit - ANS zero order (nonlinear)
metabolizes 50% drugs
inhibit: grapefruit juice
- increase drug -> adverse effects
may have enhanced activity with any other CYP3A4 - ANS CYP3A4
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 -
ANS Six steps in drug development process
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) - ANS organizations for medication
safety
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 - ANS Adverse
Drug Reaction (ADR)
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 - ANS Angiotensin-converting enzyme (ACE) inhibitors
1. -sartan: candesartan, eprosartan, ibesartan, Isosartan, telmisartan, valsartan
2.block angiotensin 11 receptors - ANS Angiotensin II Receptor Blockers (ARBs)
Essential HTN accounts for 90% of cases and is also called primary, secondary may be
caused by CKD - ANS Essential vs Secondary HTN
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) - ANS Nitroglycerin (Nitrate)
1. antiarrhythmic of choice when there is coexisting heart failure
2. can cause thyroid and pulmonary toxicity - ANS Amiodarone
vasoconstriction and increased blood pressure - ANS Alpha 1 adrenergic stimulation results
Decrease sympathetic stimulation causing vasodilation and decreased blood pressure -
ANS alpha 1 blockade
stimulation by beta agonists (isoproterenol) result in increased heart rate, blood pressure
and cardiac output
2. blockade results in decreased heart rate, bp, and cardiac output - ANS beta 1 adrenergic
The heart does not adequately circulate blood to systemic system. Due to pressure overload
or volume overload causing a reduction of oxygenated blood to body tissue - ANS left heart
failure
1.Associated with pulmonary disease and increased pulmonary vascular resistance
2.The heart does not adequately circulate blood to the pulmonic system. Can be due to
volume overload or regurgitation in Tricuspid Valve or Pulmonic Valve.
Can lead to systemic edema, back up of blood in liver and lower extremities - ANS Right
heart failure
1.Inhibit water transport across Loop of Henle work on receptors in ascending renal loop
2.inhibit reabsorption of NaCL at site in kidney
3. potent diuretic (Lasix) can cause hypokalemia - ANS Loop diuretics MOA
spironolactone, triamterene, amiloride - ANS Potassium sparing diuretics
phosphodiesterase inhibitor used to treat acute heart failure - ANS Milrinone (Primacor)
children squat to compensate for hypoxia - ANS Tetrallogy of Fallot squatting
