NUR 3145 Exam 1EXAM QUESTIONS AND ALL CORRECT ANSWERS (ALREADY
GRADED A+) (2024 UPDATE) 100% GUARANTEED
Therapeutic drug serum levels - ANSWER- narrow range of medication in bloodstream, for
desired results; clinical status of patient is appropriate for condition; peak and trough levels
(measured by serum blood levels)
nontherapeutic drug serum levels can be either: - ANSWER- undertherapeutic or toxic
toxic drug serum levels - ANSWER- greater than therapeutic dose range; increased adverse
effects
under-therapeutic drug serum levels - ANSWER- not enough drug for desired effect; may
contribute to drug-resistant organisms
o Drug Bioavailability - ANSWER- % of active drug absorbed that reaches target tissues
o Drug Bioavailability: determinants - ANSWER- route/form of drug; blood flow; liver/kidney
function; acid-base environment; presence of food, resident bacteria, motility in GI tract; presence
of pain/stress; other drugs
o Oral Absorption (PO): - ANSWER- absorbed from GI tract to body tissues; slower
-Diffuses across cell membrane; assisted by carrier enzymes or proteins; engulfed by cellular
membranes (pinocytosis)
-Easier, more convenient, less expensive; safer than injection; dosage easier to reverse through
intervention in case of accident
,o Parenteral Absorption: - ANSWER- by injection; bypass GI tract
Intravenous - ANSWER- absorbed directly into bloodstream
• Rapid onset, since drug is administered directly to bloodstream
• Allows for more direct control of drug level in blood; Gives option of larger fluid volume,
therefore diluting irritating drugs
• Avoids first-pass metabolism
Intramuscular - ANSWER- : absorbed from blood supply of muscles
• Good for poorly soluble drugs, often given in "depot" preparation form and then absorbed over
a long period of time
• Onsets of action depend on route
Subcutaneous: - ANSWER- absorbed through capillaries
• Same benefits as IM
o Other routes:
Topical - ANSWER- : transdermal
• Delivers medication directly to affected area; decreases likelihood of systemic drug effects
o Other routes: Inhalational - ANSWER- • Provides rapid absorption; drug delivered directly
to lung tissue, where most of these drugs exert their action
,o Other routes: Sublingual, buccal - ANSWER- • Absorbed more rapidly from oral mucosa,
leading to a more rapid onset; avoids breakdown of drug by stomach acids; avoids first-pass
metabolism
o Other routes: Rectal (Suppository) - ANSWER- • Relatively rapid absorption, good
alternative when oral route is not available; good for local or systemic drug delivery; usually leads
to mixed first-pass and non-first-pass metabolism
What does the protein-binding ability level of a drug mean? How do albumin levels affect drug
levels in the bloodstream? - ANSWER- o Lower albumin (protein) levels increase drug levels
in the bloodstream, because there are less proteins available to create bound, drug-protein
complexes (inactive drugs, too large to pass through capillary walls of tissues)
4. Why is cytochrome P-450 so important? - ANSWER- o Microsomal enzymes; aid in
metabolism of medications; target lipid soluble (non-polar, lipophilic, fat-loving) drugs, which are
typically difficult to eliminate
What happens when grapefruit juice is taken with a drug that interacts with cytochrome P-450? -
ANSWER-
o Side effect: - ANSWER- : expected averse drug reaction
Undesirable = unexpected (i.e. allergic reaction: hypersensitivity response involving immune
system)
o Adverse reaction: - ANSWER- : any undesirable drug occurrence
, Adverse reaction: Idiosyncratic reaction: - ANSWER- occurs unexpectedly in individual
patient; genetically inherited traits
Idiosyncratic reaction:
• Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD): - ANSWER- ): when exposed to
drugs such as sulfonamides, anti-malarials, and aspirin, patients may suffer life-threatening
hemolysis of RBCs; (13-20%) African-American, Kurdish Jewish (50%), Sardinians (14%)
adverse reaction: Drug-induced teratogenesis - ANSWER- : cause fetal structural defects;
BLACK BOX WARNING
adverse reaction: Mutagenic effects: - ANSWER- permanently changes genetic composition of
living cells
Adverse reactions: carcinogenic reactions - ANSWER- cancer causing
adverse reactions: drug-drug interactions - ANSWER- when two or more drugs come together
and either work together to create a synergistic, antagonistic, or additive effect
o Agonist: - ANSWER- drug binds to the receptor, there is a response
Ex: morphine stimulates opioid receptors
Partial Agonist: - ANSWER- drug binds to receptor, diminished response
o Antagonist: - ANSWER- drug binds to receptor; there is no response. Drug prevents binding
of agonist.
GRADED A+) (2024 UPDATE) 100% GUARANTEED
Therapeutic drug serum levels - ANSWER- narrow range of medication in bloodstream, for
desired results; clinical status of patient is appropriate for condition; peak and trough levels
(measured by serum blood levels)
nontherapeutic drug serum levels can be either: - ANSWER- undertherapeutic or toxic
toxic drug serum levels - ANSWER- greater than therapeutic dose range; increased adverse
effects
under-therapeutic drug serum levels - ANSWER- not enough drug for desired effect; may
contribute to drug-resistant organisms
o Drug Bioavailability - ANSWER- % of active drug absorbed that reaches target tissues
o Drug Bioavailability: determinants - ANSWER- route/form of drug; blood flow; liver/kidney
function; acid-base environment; presence of food, resident bacteria, motility in GI tract; presence
of pain/stress; other drugs
o Oral Absorption (PO): - ANSWER- absorbed from GI tract to body tissues; slower
-Diffuses across cell membrane; assisted by carrier enzymes or proteins; engulfed by cellular
membranes (pinocytosis)
-Easier, more convenient, less expensive; safer than injection; dosage easier to reverse through
intervention in case of accident
,o Parenteral Absorption: - ANSWER- by injection; bypass GI tract
Intravenous - ANSWER- absorbed directly into bloodstream
• Rapid onset, since drug is administered directly to bloodstream
• Allows for more direct control of drug level in blood; Gives option of larger fluid volume,
therefore diluting irritating drugs
• Avoids first-pass metabolism
Intramuscular - ANSWER- : absorbed from blood supply of muscles
• Good for poorly soluble drugs, often given in "depot" preparation form and then absorbed over
a long period of time
• Onsets of action depend on route
Subcutaneous: - ANSWER- absorbed through capillaries
• Same benefits as IM
o Other routes:
Topical - ANSWER- : transdermal
• Delivers medication directly to affected area; decreases likelihood of systemic drug effects
o Other routes: Inhalational - ANSWER- • Provides rapid absorption; drug delivered directly
to lung tissue, where most of these drugs exert their action
,o Other routes: Sublingual, buccal - ANSWER- • Absorbed more rapidly from oral mucosa,
leading to a more rapid onset; avoids breakdown of drug by stomach acids; avoids first-pass
metabolism
o Other routes: Rectal (Suppository) - ANSWER- • Relatively rapid absorption, good
alternative when oral route is not available; good for local or systemic drug delivery; usually leads
to mixed first-pass and non-first-pass metabolism
What does the protein-binding ability level of a drug mean? How do albumin levels affect drug
levels in the bloodstream? - ANSWER- o Lower albumin (protein) levels increase drug levels
in the bloodstream, because there are less proteins available to create bound, drug-protein
complexes (inactive drugs, too large to pass through capillary walls of tissues)
4. Why is cytochrome P-450 so important? - ANSWER- o Microsomal enzymes; aid in
metabolism of medications; target lipid soluble (non-polar, lipophilic, fat-loving) drugs, which are
typically difficult to eliminate
What happens when grapefruit juice is taken with a drug that interacts with cytochrome P-450? -
ANSWER-
o Side effect: - ANSWER- : expected averse drug reaction
Undesirable = unexpected (i.e. allergic reaction: hypersensitivity response involving immune
system)
o Adverse reaction: - ANSWER- : any undesirable drug occurrence
, Adverse reaction: Idiosyncratic reaction: - ANSWER- occurs unexpectedly in individual
patient; genetically inherited traits
Idiosyncratic reaction:
• Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD): - ANSWER- ): when exposed to
drugs such as sulfonamides, anti-malarials, and aspirin, patients may suffer life-threatening
hemolysis of RBCs; (13-20%) African-American, Kurdish Jewish (50%), Sardinians (14%)
adverse reaction: Drug-induced teratogenesis - ANSWER- : cause fetal structural defects;
BLACK BOX WARNING
adverse reaction: Mutagenic effects: - ANSWER- permanently changes genetic composition of
living cells
Adverse reactions: carcinogenic reactions - ANSWER- cancer causing
adverse reactions: drug-drug interactions - ANSWER- when two or more drugs come together
and either work together to create a synergistic, antagonistic, or additive effect
o Agonist: - ANSWER- drug binds to the receptor, there is a response
Ex: morphine stimulates opioid receptors
Partial Agonist: - ANSWER- drug binds to receptor, diminished response
o Antagonist: - ANSWER- drug binds to receptor; there is no response. Drug prevents binding
of agonist.
