Nur 641 E Final Exam Study Guide
Grand Canyon University Questions and
Answers | Updates | 100% Correct –GCU.
reversibly or irreversibly move from the bloodstream into the interstitial and
intracellular fluid
Parmacokinetic distribution
absorption, distribution, metabolism, excretion
Pharmacokinetics involves
absorption from the administration site either directly or indirectly in the blood
plasma
Pharmacokinetic absorption
biotransformed via hepatic metabolism or by other tissue
Pharmacokinetics metabolism
1. highest bioavailability
2. places entire does into venin thus bypassing absorption
3. avoids hepatic first pass metabolism in the liver
Intravenous medications
usually reached within 4-5 half lives of the drug
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
drug half life
,drug is metabolized at a constant rate per unit
zero order (nonlinear)
metabolizes 50% drugs
inhibit: grapefruit juice
- increase drug -> adverse effects
may have enhanced activity with any other CYP3A4
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
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)
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
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
Angiotensin-converting enzyme (ACE) inhibitors
, 1. -sartan: candesartan, eprosartan, ibesartan, Isosartan, telmisartan, valsartan
2.block angiotensin 11 receptors
Angiotensin II Receptor Blockers (ARBs)
Essential HTN accounts for 90% of cases and is also called primary, secondary may
be caused by CKD
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)
Nitroglycerin (Nitrate)
1. antiarrhythmic of choice when there is coexisting heart failure
2. can cause thyroid and pulmonary toxicity
Amiodarone
vasoconstriction and increased blood pressure
Alpha 1 adrenergic stimulation results
Decrease sympathetic stimulation causing vasodilation and decreased blood
pressure
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
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
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
Right heart failure
Grand Canyon University Questions and
Answers | Updates | 100% Correct –GCU.
reversibly or irreversibly move from the bloodstream into the interstitial and
intracellular fluid
Parmacokinetic distribution
absorption, distribution, metabolism, excretion
Pharmacokinetics involves
absorption from the administration site either directly or indirectly in the blood
plasma
Pharmacokinetic absorption
biotransformed via hepatic metabolism or by other tissue
Pharmacokinetics metabolism
1. highest bioavailability
2. places entire does into venin thus bypassing absorption
3. avoids hepatic first pass metabolism in the liver
Intravenous medications
usually reached within 4-5 half lives of the drug
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
drug half life
,drug is metabolized at a constant rate per unit
zero order (nonlinear)
metabolizes 50% drugs
inhibit: grapefruit juice
- increase drug -> adverse effects
may have enhanced activity with any other CYP3A4
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
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)
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
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
Angiotensin-converting enzyme (ACE) inhibitors
, 1. -sartan: candesartan, eprosartan, ibesartan, Isosartan, telmisartan, valsartan
2.block angiotensin 11 receptors
Angiotensin II Receptor Blockers (ARBs)
Essential HTN accounts for 90% of cases and is also called primary, secondary may
be caused by CKD
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)
Nitroglycerin (Nitrate)
1. antiarrhythmic of choice when there is coexisting heart failure
2. can cause thyroid and pulmonary toxicity
Amiodarone
vasoconstriction and increased blood pressure
Alpha 1 adrenergic stimulation results
Decrease sympathetic stimulation causing vasodilation and decreased blood
pressure
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
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
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
Right heart failure
