NURSING 326 FINAL EXAM COMPREHENSIVE
SCRIPT 2026 FULL STUDY GUIDE COMPLETE
RESPONSES
◉ Factors that Affect Ability of Drug to Exit Vascular System.
Answer: - Blood-brain barrier: some lipid-soluble drugs can pass,
others use transport systems
- Placenta: some can cross (can be unsafe for pregnancy)
- Protein binding: can bind with protein, usually albumin, too big to
cross membrane
◉ Metabolism Overview. Answer: A pharmacokinetic factor
involving enzymatic process that affect drug (biotransformation).
Mostly in liver, usually with hepatic microsomal enzyme system
(P450)
◉ Metabolism Effects. Answer: - Accelerated renal excretion
- Drug inactivation (i.e. anesthesia)
- Increased therapeutic effects
- Activation of drugs
- Increased or decreased toxicity
,◉ Factors that Influence Metabolism. Answer: - Age: liver
development/decline
- Induction of drug-metabolizing enzymes: some drugs cause liver to
increase enzyme production
- First-pass effect: rapid hepatic inactivation, only with oral
medications. Inactivated on first pass to liver, may do sublingual (i.e.
nitroglycerine) or different route
- Nutrition
- Drug competition: if same metabolic pathway
◉ Excretion Overview. Answer: A pharmacokinetic factor involving
movement of drug/metabolites out of body, usually kidneys
◉ Excretion Steps. Answer: I) Glomerular filtration (all except bound
to albumin)
II) Passive tubular reabsorption:
- Lipid-soluble reabsorbed in blood
- Non-lipid-soluble excreted
III) Active tubular secretion:
- Pump drugs into urine
,◉ Factors that Affect Renal Excretion. Answer: - pH-dependent
ionization: can speed up excretion (i.e. induced pH change from
aspirin poisoning)
- Competition for active transport (may be used on purpose)
- Age
◉ MEC. Answer: Minimum effective concentration
◉ TC. Answer: Toxic concentration
◉ Plasma Drug Levels. Answer: Monitored for safety and
effectiveness, must be between MEC and TC
◉ Half-life. Answer: Time required for amount of drug in body to
decrease by 50%. Dictates dosing interval.
- Short half-life: excreted quickly, short dosing interval
- Long half-life: excreted slowly, long dosing interval
◉ Drug Dosing Types. Answer: - Single dosing: when drug only given
once. Plasma levels increase, reaches therapeutic range when gets to
MEC. Therapeutic effects go away when drops below MEC
, - Multiple dosing: multiple doses, leads to accumulation in body
◉ Plateau. Answer: A constant level of drug in blood, takes about 4
half-lives to get to this stable range
◉ Loading Dose. Answer: A large dose, done when can't wait to
reach plateau
◉ Maintenance Dose. Answer: A lower dose to maintain plateau
◉ Peak/Trough. Answer: Highest/lowest level of concentration.
Trough needs to be above MEC, peak needs to be below TC
◉ Pharmacodynamics Overview. Answer: Study of biochemical and
physical effects of drug on body, action, therapeutic effects, side
effects, interactions
◉ Dose-Response Relationships. Answer: Relationship between size
of dose and intensity of response. Determines minimum amount to
produce desired effects
◉ Maximum Efficacy. Answer: Greatest amount of effect possible (i.e.
tylenol vs. morphine)
SCRIPT 2026 FULL STUDY GUIDE COMPLETE
RESPONSES
◉ Factors that Affect Ability of Drug to Exit Vascular System.
Answer: - Blood-brain barrier: some lipid-soluble drugs can pass,
others use transport systems
- Placenta: some can cross (can be unsafe for pregnancy)
- Protein binding: can bind with protein, usually albumin, too big to
cross membrane
◉ Metabolism Overview. Answer: A pharmacokinetic factor
involving enzymatic process that affect drug (biotransformation).
Mostly in liver, usually with hepatic microsomal enzyme system
(P450)
◉ Metabolism Effects. Answer: - Accelerated renal excretion
- Drug inactivation (i.e. anesthesia)
- Increased therapeutic effects
- Activation of drugs
- Increased or decreased toxicity
,◉ Factors that Influence Metabolism. Answer: - Age: liver
development/decline
- Induction of drug-metabolizing enzymes: some drugs cause liver to
increase enzyme production
- First-pass effect: rapid hepatic inactivation, only with oral
medications. Inactivated on first pass to liver, may do sublingual (i.e.
nitroglycerine) or different route
- Nutrition
- Drug competition: if same metabolic pathway
◉ Excretion Overview. Answer: A pharmacokinetic factor involving
movement of drug/metabolites out of body, usually kidneys
◉ Excretion Steps. Answer: I) Glomerular filtration (all except bound
to albumin)
II) Passive tubular reabsorption:
- Lipid-soluble reabsorbed in blood
- Non-lipid-soluble excreted
III) Active tubular secretion:
- Pump drugs into urine
,◉ Factors that Affect Renal Excretion. Answer: - pH-dependent
ionization: can speed up excretion (i.e. induced pH change from
aspirin poisoning)
- Competition for active transport (may be used on purpose)
- Age
◉ MEC. Answer: Minimum effective concentration
◉ TC. Answer: Toxic concentration
◉ Plasma Drug Levels. Answer: Monitored for safety and
effectiveness, must be between MEC and TC
◉ Half-life. Answer: Time required for amount of drug in body to
decrease by 50%. Dictates dosing interval.
- Short half-life: excreted quickly, short dosing interval
- Long half-life: excreted slowly, long dosing interval
◉ Drug Dosing Types. Answer: - Single dosing: when drug only given
once. Plasma levels increase, reaches therapeutic range when gets to
MEC. Therapeutic effects go away when drops below MEC
, - Multiple dosing: multiple doses, leads to accumulation in body
◉ Plateau. Answer: A constant level of drug in blood, takes about 4
half-lives to get to this stable range
◉ Loading Dose. Answer: A large dose, done when can't wait to
reach plateau
◉ Maintenance Dose. Answer: A lower dose to maintain plateau
◉ Peak/Trough. Answer: Highest/lowest level of concentration.
Trough needs to be above MEC, peak needs to be below TC
◉ Pharmacodynamics Overview. Answer: Study of biochemical and
physical effects of drug on body, action, therapeutic effects, side
effects, interactions
◉ Dose-Response Relationships. Answer: Relationship between size
of dose and intensity of response. Determines minimum amount to
produce desired effects
◉ Maximum Efficacy. Answer: Greatest amount of effect possible (i.e.
tylenol vs. morphine)
