NUR 641E FINAL EXAM STUDY GUIDE 2026/2027 | GRAND CANYON UNIVERSITY
| ADVANCED PATHOPHYSIOLOGY & PHARMACOLOGY
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
✔✔Pharmacokinetic distribution
bio transformed 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
| ADVANCED PATHOPHYSIOLOGY & PHARMACOLOGY
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
✔✔Pharmacokinetic distribution
bio transformed 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
