NUR 641E MidtERM stUdy GUidE ExaM With QUEstioNs aNd CoRRECt aNsWERs -Affected by chemical stability, solubility, and first pass-Correct answer-Steady state (of a drug) - correct answer-stable level of drug in the body, occurs in 5 half liv

NUR 641E MidtERM stUdy GUidE ExaM With QUEstioNs aNd CoRRECt aNsWERs 2024- 2025 -Affected by chemical stability, solubility, and first pass-Correct answer-Steady state (of a drug) - correct answer-stable level of drug in the body, occurs in 5 half lives of the drug -rate of drug being added to system is equal to amount being eliminated from system-Correct answerPharmacokinetics - correct answer-The process by which drugs are absorbed, distributed within the body, metabolized, and excreted. -what the body does to the drug-Correct answer-First pass - correct answer-the fact that a medication in the GI tract passes through the liver before entering other organs-Correct answer-does not - correct answer-bioequivalence does/does not affect bioavailability-Correct answer-Bioequivalence - correct answer-relative therapeutic effectiveness of chemically equivalent drugs.-Correct answer-Bioavailability (is affected by) - correct answer--chemical instability -solubility -first pass metabolism-Correct answer-Cytochrome P450 - correct answer--enzymes that function to metabolize potentially toxic compounds, including drugs and products of endogenous metabolism such as bilirubin, principally in the liver. -genetics influence presence of enzymes -affects metabolism of warfarin, antidepressants, antiepileptics, and statins. -the levels of these drugs are higher when taken with certain drugs that are inhibitors (ex. warfarin with omeprazole) because there is competition for enzyme metabolism. -inducers lead to decreased plasma concentration of drug.-Correct answer-cytochrome p450 inducer - correct answer-An inducer increases the metabolism of a substrate resulting in a decreased level or effect of the substrate-Correct answer-cytochrome p450 inhibitor - correct answer-An inhibitor decreases the metabolism of a substrate resulting in an increased level or effect of the substrate.-Correct answer-Clopidogrel - correct answer-prodrug that must be activated by hepatic CYP2C19 metabolism; individuals who are poor metabolizers may not form the active metabolite and have reduced antiplatelet response-Correct answer-half-life (determines) - correct answer-how often a drug is administeredCorrect answer-4-5 - correct answer-steady state is reached in _-_ times the half-life-Correct answerWarfarin (MOA) - correct answer--Vitamin K antagonist -Factors II, VII, IX, X -takes several days to take effect -monitor INR-Correct answer-Vitamin K - correct answer-warfarin antidote-Correct answer-Heparin (MOA) - correct answer--rapid anticoagulation by binding with antithrombin III and inhibits factors IXa, Xa, XIIa, and XIII -aPTT monitoring (low dose SQ does not require monitoring)-Correct answer-Apixaban (MOA) - correct answer-direct factor Xa inhibitor-Correct answer-parenteral administration - correct answer--directly into systemic circulation -poor absorption or unstable in GI tract (ex. heparin, insulin), rapid absorption, unable to take meds PO -IV, IM, SQ, ID-Correct answer-IV - correct answer--into the vein -can be given through bolus (rapid peak) or infusion (lower peak, longer duration) -ex. rocuronium (neuromuscular blocker)-Correct answer-IM - correct answer--aqua solutions absorbed rapidly -depot absorbed slowly in a nonaqueous solution such as polyethene glycol (simple diffusion)-Correct answer-SQ - correct answer--absorption via simple diffusion -constant, slow, and sustained effects -not for drugs that cause tissue irritation d/t pain and necrosis-Correct answer-ID - correct answer-- diagnostic determination and allergy sensitivity-Correct answer-inhalation - correct answer--drug effects as rapid as IV bolus -minimizes systemic side effects of respiratory drugs-Correct answer-oral - correct answer--antidotes may be provided -most common, convenient, and economical method of drug administration -most complicated drug pathway -low gastric pH inactivates some drugs -20-60 minutes for effects -enteric, extended-release-Correct answer-enteric-coated - correct answer--protects the drug from stomach acid -delivers to less acidic intestine -useful for drugs that are acid labile or irritating to stomach (ex. omeprazole, aspirin)-Correct answerextended-release - correct answer--control drug release -maintain therapeutic range over longer period -good for drugs with short half-life (i.e. morphine with half-life of 2-4 hours)-Correct answer-aPTT - correct answer-activated partial thromboplastin time-Correct answer-30-40 seconds - correct answerNormal activated partial thromboplastin time (APTT)-Correct answer-1.5-2.5 - correct answertherapeutic aPTT is x more than normal aPTT-Correct answer-low dose heparin - correct answer--5000 units BID -does not require aPTT monitoring-Correct answer-INR - correct answer-international normalized ratioCorrect answer-2-3 (INR) - correct answer-therapeutic INR for warfarin-Correct answer-<1.1 - correct answer-normal INR-Correct answer-Dabigatran (Pradaxa) - correct answer--direct thrombin inhibitor -anticoagulant -blood factor IIa inhibitor-Correct answer-idarucizumab - correct answer-antidote for dabigatran-Correct answer-factor xa inhibitors - correct answer-apixaban, edoxaban, rivarozaban, fondaparinux-Correct answer-apixiban (MOA) - correct answer--Factor Xa inhibitor -Eliquis-Correct answer-Edoxaban (MOA) - correct answer--Factor Xa inhibitor