NR565 Advanced Pharmacology Fundamentals questions and solutions

NR565 Advanced Pharmacology Fundamentals questions
and solutions

Pharmacokinetics - answersThe process by which drugs are absorbed, distributed within the body, metabolized, and ak ak ak ak ak ak ak ak ak ak ak ak ak ak




excreted.
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Pharmacodynamics - answersThe study of what the drug does to the body ak ak ak ak ak ak ak ak ak ak ak




Factors Affecting Drug Absorption - answersRate of dissolution
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Surface area ak




Blood flow ak




Lipid solubility
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pH partitioning
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Factors Affecting Drug Distribution - answersBlood flow to tissues
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Ability to exit the vascular system
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Blood-brain barrier ak




Protein-binding capacity ak




Xenobiotics - answerssubstances that are foreign to the body, usually synthetic chemical compounds; medications are
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common example
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Cytochrome P450 (CYP450) - answersxenobiotic-metabolizing enzymes necessary for the production of cholesterol
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and steroids and the detoxification of chemicals and drug metabolism.
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Function of Cytochrome P450 (CYP450) - answersresponsible for phase 1 metabolism in which drugs are oxidized,
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reduced, or hydrolyzed
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Phase 1 Metabolism of Drugs via P450 - answersOxidation; Reduction; Hydrolysis
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Three possible outcomes of phase 1 drug metabolism. - answers-Drug becomes completely inactive
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-Drug becomes partially inactive but one or more metabolites remain active
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-Original drug is not pharmacologically active but one metabolite remains active
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CYP450 Inducers - answersMedications that can increase the rate of another drug's metabolism by elevating CYP450
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enzyme activity via increasing enzyme synthesis. decreasing the concentration of the "parent drug"
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CYP450 Inducer Medications - answersCRAPGPS ak ak ak ak




Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
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,Phenobarbital
Sulfonylureas

CYP450 Inhibitors - answersMedications that inhibit the metabolic activity of one or more of the CYP450 enzymes. High
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risk for toxicity; prolongs the pharmacological effect of the "parent drug".
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CYP450 Inhibitor Medications - answersVISACKGQ
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Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
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Quinidine

Beers Criteria - answers-potentially Inappropriate Medication (PIM) use in older adults
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-potentially Inappropriate Medication (PIM) use in older adults due to medication-disease or medication-syndrome
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interactions that may exacerbate the disease or syndrome
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-medications to be used cautiously in older adults ak ak ak ak ak ak ak




-clinically significant drug interactions that should be avoided in older adults
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-medications to be avoided or dosage decreased in the presence of impaired kidney function in older adults
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Pharmacokinetic Interactions - answerswhen one medication systemically alters the potency of another medication. ak ak ak ak ak ak ak ak ak ak ak ak




Absorption Interaction - answersresult of a change due to one medication's effect on another medication's route of entry
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into the body.
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Distribution Interaction - answerscaused by the amount of unbound/free medications available at the various target site
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Metabolism Interaction - answersconcentration of the medication after biotransformation into active and inactive
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metabolites in higher or lower than expected.
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Elimination Interaction - answersthe body's ability to eliminate medications in pure form or by altering a metabolite from
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the body.
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Pharmacodynamic Interactions - answersdoes not alter or impact absorption, distribution, metabolism, or elimination ak ak ak ak ak ak ak ak ak ak ak ak




because of the one medication's ability to manipulate the effect of another medication at its site of action
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Practice Authority - answersrefers to the nurse practitioner's ability to practice without physician oversight
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prescriptive authority - answersrefers to the nurse practitioner's authority to prescribe medications.
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Full-practice scope - answersNurse practitioners have the autonomy to evaluate patients, diagnose, order and interpre
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tests, initiate and manage treatments and prescribe medications, including controlled substances without physician
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oversight.
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Reduced-practice scope - answersNurse practitioners are limited in at least one element of practice. The state requires ak ak ak ak ak ak ak ak ak ak ak ak ak ak ak ak




formal collaborative agreement with an outside health discipline for the nurse practitioner to provide patient care.
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,Restricted practice scope - answersNurse practitioners are limited in at least one element of practice by requiringak ak ak ak ak ak ak ak ak ak ak ak ak ak ak ak




supervision, delegation, or team management by an outside health discipline for the nurse practitioner to provide patien
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care.
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Drugs that cannot be ordered via E-Script - answersDEA Scheduled Drugs
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Drugs that cannot be prescribed or refilled via phone - answersSchedule II drugs
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Acute Pain - answersAn occurrence of fewer than three months and is often precipitated by trauma and acute medical
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conditions or treatment.
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Types of Acute Pain - answersReferred Pain ak ak ak ak ak ak




Acute Somatic Pain ak ak




Acute visceral pain ak ak




Chronic pain - answersepisode of pain that lasts for 6 months or longer; may be intermittent or continuous
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Referred Pain - answerspain that is felt in a location other than where the pain originates ak ak ak ak ak ak ak ak ak ak ak ak ak ak ak




Acute Somatic Pain - answers-Arises from connective tissue, muscle, bone and skin.
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-Sharp and localized or dull and non-localized ak ak ak ak ak ak




-Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates, local anesthetics, ice, massage ak ak ak ak ak ak ak ak ak ak




Acute Visceral Pain - answersPain in the internal organs and abdomen
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Poorly localized (C-fibers) ak ak




Radiates
Most responsive to opiates ak ak ak




May also use corticosteroids, NSAIDs ak ak ak ak




Opioids - answersany drug, natural or synthetic, that has actions similar to those of morphine
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Opioid Receptor Families - answersMu (μ) ak ak ak ak ak




Kappa (k) ak




Delta (δ) ak




At each type of receptor, a drug can act in one of three ways: - answers(1) pure opioid agonists, (2) agonist-antagonist
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opioids, (3) pure opioid antagonists.
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Mu (u) Receptor - answersOpioid receptor most responsible for mediating analgesic properties
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Pure opioid agonists - answersactivate µ receptors and κ receptors. produce analgesia, euphoria, sedation, respiratory
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depression, physical dependence, constipation, and other effects
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Prototype Drug: MORPHINE ak ak




Morphine - answersPrototype drug of pure opioid agonist; Strong Opioid Agonist ak ak ak ak ak ak ak ak ak ak




Fentanyl - answersA strong opioid analgesic with a high milligram potency (about 100 times that of morphine).
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