NR 565 - ADVANCED PHARMACOLOGY MIDTERM - CHAMBERLAIN

NR 565 - ADVANCED PHARMACOLOGY
MIDTERM - CHAMBERLAIN


Duringpowhatpotrimesterpoispoapopregnantpowomanpomostpoatporiskpoforpoadversepodrugpor
eactionspowithpopotentialpolongpotermpoconsequences?po-poans--
1stpotrimesterpo(fetuspomostpoatporiskpod/tporapidpogrowth)

WhatpoispoBEERSpocriteria?po-poans--
Recommendationspoofpomedicationspoinappropriatepoforpoelderlypo(65poandpoolder),popre
scriberpoultimatelypodecides

WhatpoispothepoCYP450po(cytochromepoP450)po-poans--
liverpoenzymeposystempowherepomedicationspoarepometabolized,pocanpoeitherpobepoinduc
erspoorpoinhibitorspoandpocreatepodrug-drugpointeractions

CYP450poinducerspo-poans--
Speedpouppometabolismpoofpodrugspo(drugpoispoclearedpofaster),podrugpohaspolesserpoeffe
ctpo(decreasepobloodpolevelspoofpodrug),poelevatepoCYP450poenzymes

CYP450poinducerspopneumonicpo-poans--"BullshitpoCrappoGPSpoINDUCESporage"

CYP450poinducerpodrugponamespo-poans--
Barbituates,poStpoJohnpowort,poCarbamazepine,porifampin,poalcohol,pophenytoin,pogriseof
ulvin,pophenobarbital,posulfonylureas

CYP450poinhibitorspo-poans--
inhibitpometabolism,poincreasepobloodpolevelspoofpomedications

CYP450popneumonicpo-
poans--"VISApocreditpocardpodebtpoINHIBITSpospendingpoonpodesignerspolikepoCKpotopoloo
kpoGQ"

CYP450poinhibitorspodrugponamespo-poans--
Valproate,poisoniazid,posulfonamides,poamiodarone,pochloramphenicol,poketoconazole,po
grapefruitpojuice,poquinidine

,Physiologicalpochangespoduringpopregnancypothatpoimpactpopharmacodynamicspoandpop
harmacokineticpopropertiespoofpodrugs?po-poans--
increasepoglomerularpofiltrationporatepoleadspotopoincreasepodurgpoexcretionpo
increasepohepaticpometabolism
decreasepotonepoandpomotilitypoofpobowel
increasepodrugpoabsorption

Examplespoofpomedicationspothatpocanpobepoteratogenicpo-poans--
Antiepilepticpodrugs,poantimicrobialsposuchpoaspotetracyclinespoandpofluoroquinolones,povi
taminpoApoinpolargepodoses,posomepoanticoagulants,poandpohormonalpomedicationsposuch
poaspodiethylstilbestrolpo(DES).


Howpoispoabsorptionpoofpointramuscularpomedicationspodifferentpoinponeonates?po-poans--
slowpoandpoerraticpoduepotopolowpobloodpoflowpoinpomusclespofirstpofewpodayspoofpolife

Whypoispoabsorptionpoofpomedicationpoinpothepostomachpoincreasedpoinpoinfancy?po-
poans--delayedpogastricpoemptying


Somepomedicationspothatposhouldpobepoavoidedpoinpothepopediatricpopatient?po-poans--
glucocorticoids,podiscolorationpoofpodevelopingpoteethpowithpotetracyclines,poandpokernict
eruspowithposulfonamides,polevofloxacinpo(antibiotics)po
aspirinpo(Severepointoxicationpofrompoacutepooverdose)

whatposhouldpobepoincludedpoinpomedicationpoadministrationpopatientpoeducation?po-
poans--dosageposizepoandpotiming
routepoandpotechniquepoofpoadministration
durationpoofpotreatment
drugpostorage
naturepoandpotimepocoursepoofpodesiredporesponses
naturepoandpotimepocoursepoofpoadverseporesponses
finishpotakingpoantibiotic

Whatpoareposomepothingspothatpoputpothepoelderlypopatientpoatpohigherporiskpoforpoadverse
podrugporeactions?po-poans--reducedporenalpofunctionpo
polypharmacypo(thepousepoofpofivepoorpomorepomedicationspodaily)
greaterposeveritypoofpoillness
presencepoofpocomorbidities
usepoofpodrugspothatpohavepoapolowpotherapeuticpoindexpo(e.g.,podigoxin)
increasedpoindividualpovariationposecondarypotopoalteredpopharmacokinetics
inadequateposupervisionpoofpolong-termpotherapy
poorpopatientpoadherence

Howpocanpohealthcarepoproviderspodecreasepolikelihoodpoofpoanpoelderlypopatientpoexperi
encingpoanpoadversepodrugporeaction?po-poans--
obtainingpoapothoroughpodrugpohistorypothatpoincludespoover-the-counterpomedications
consideringpopharmacokineticpoandpopharmacodynamicspochangespoduepotopoage

, monitoringpothepopatient'spoclinicalporesponsepoandpoplasmapodrugpolevels
usingpotheposimplestporegimenpopossible
monitoringpoforpodrug-drugpointeractionspoandpoiatrogenicpoillness
periodicallyporeviewingpotheponeedpoforpocontinuedpodrugpotherapy
encouragingpothepopatientpotopodisposepoofpooldpomedications
takingpostepspotopopromotepoadherencepoandpotopoavoidpodrugspoonpothepoBeerspolist

Howpocanpowepopromotepomedicationpoadherencepowithpoelderlypopatients?po-poans--
simplifyingpodrugporegimens
providingpoclearpoandpoconcisepoverbalpoandpowrittenpoinstructions
usingpoanpoappropriatepodosagepoform
clearlypolabelingpoandpodispensingpoeasy-to-openpocontainers
developingpodailyporeminders
monitoringpofrequently
affordabilitypoofpodrugs
supportposystems

Whypodoponitratesponeedpotopobepotakenponopolaterpothanpo4poPM?po-poans--
Needponitratepofreepointervalposopotolerancepodoesn'tpodevelop

Ninepofactorspothatpoimpactpooutcomepoofpomedication?po-poans--Genderpoandporace
Geneticspoandpopharmacogenomics
Variabilitypoinpoabsorption
placebopoeffect
Tolerance
patho
age
bodyweight

Dopoyouponeedpoinformedpoconsentpoforpogeneticpotesting?po-poans--yes

WhatpoispothepopurposepoofpothepoGeneticpoInformationpoNon-DiscriminatorypoAct?po-
poans--
Protectspopatientspofrompodiscriminationpobypoemployerspoandpoinsurancepoproviderspoba
sedpoonpogeneticpoinformation

Differencepobetweenpopracticepoauthoritypoandpoprescriptivepoauthority?po-poans--
Practicepoauthorityporeferspotopotheponursepopractitioner'spoabilitypotopopracticepowithoutpo
physicianpooversight,powhereaspoprescriptivepoauthorityporeferspotopotheponursepopractitio
ner'spoauthoritypotopoprescribepomedicationspoindependentlypoandpowithoutpolimitations.

Whoporegulatespoprescriptivepoauthority?po-poans--
thepojurisdictionpoofpoapohealthpoprofessionalpoboard.poThispomaypobepothepoStatepoBoard
poofpoNursing,pothepoStatepoBoardpoofpoMedicine,poorpothepoStatepoBoardpoofpoPharmacy,p
oaspodeterminedpobypoeachpostate.