NURS 5334 FINAL EXAM 3 STUDY GUIDE LATEST
VERSION GRADED A+ 2025
•
Proper0RX0-0ans--✔✔Providers0name0and0address,0Telephone
DEA
Pt0name/DOB/Addres
Name0of0Drug,0strength,0SIG(directions)0with0indication/Route0and0frequency,0Quantity0a
nd0signature.
Prescribing0basics0-0ans--✔✔Prescribing0is0regulated0by0state0BON
Drug0Schedules:0Most0addictive0to0least0-0ans-- 1:0Heroin,LSD,0MJ
2:0hydrocodone,0cocaine,0Methamphetamine,0methadone,0oxycodone,0meperidine,0fenta
nyl,0adderall,0ritalin
3:0codeine,0ketamine,0testosterone
4:0xanax,0valium,0soma,0ambient,0tramadol
5:0antidiarrheal,0antitussives,0lomotil,0lyrica
Pharmicodyamics0-0ans--
The0effects0of0drug0on0the0body.0Receptors0are0large0molecules0usually0proteins,0tha
t0interact0and0mediate0the0action0of0drugs
agonist0-0ans--
produce0receptor0stimulation0and0a0conformational0change0every0time0they0bind.0Do0
not0need0all0available0receptors0to0produce0a0maximum0response
Partial0agonist0-0ans--
drugs0that0have0properties0in0b/w0those0of0full0agonist0and0antagonist.0They0bind0to0r
eceptors0but0when0they0occupy0the0receptor0sites,0they0stimulate0only0some0of0the0recep
tors.
antagonist0-0ans--
drugs0with0affinity0for0a0receptor0but0with0no0intrinsic0activity.0Affinity0allows0the0antag
onist0to0bind0to0receptors,0but0lack0of0intrinsic0activity0prevents0the0bound0antagonist0fro
m0causing0receptor0activation.0The0block0action0of0drugs0(ex.0Narcan)
,Bioavailabity0-0ans--
%0of0administered0dosage0of0the0drug0that0survives0the0first0pass0through0the0liver0an
d0reaches0the0blood0stream
half0life0-0ans--
Time0required0for0the0amount0of0a0drug0in0the0body0to0decline0by050%,0drugs0with0sh
orter0half0lives0must0be0administer0frequently.04.5-
5.50times0the0half0life0to0get0steady0state0and0to0be0limited0from0the0body
what0the0body0does0to0the0drug0-0ans--✔✔absorption,0distribution,0metabolism,0excretion
Distribution0-0ans--
movement0of0absorbed0drug0in0bodily0fluids0throughout0the0body0to0target0tissue.0Pro
perties0affecting:0lipid/water0solubility,0PH0affects0ionization0of0drug,0protein0binding,0size
0of0molecule0(smaller0molecules0are0more0able0to0diffuse)
Tissue:0fat,0bone,0blood/brain0barrier0(only0lipid0soluble0will0pass),0placental0barrier0(man
y0drugs0can0pass)
Protein0binding0-0ans--
unbound0drug0is0free0which0is0active,0crosses0membrane.0Low0plasma0proteins0resul
t0in0more0free0drug.0Competition:0when020highly0bound0drugs0are0given0it0increases0the0l
evel0of0both0drugs
Metabolism0-0ans--
take0place0in0the0liver0mostly.0Chemical0change0of0a0drug0structure0to:0
Enhance0excretion,0inactivate0the0drug,0increase0therapeutic0action,0active0a0prodrug0(in
active0until0metabolized0in0the0body0into0the0active0compound,0ex:0levodopa),0increase0o
r0decrease0toxicity
CYP4500-0ans--
enzymes0constitutes0the0most0important0of0the0phase0I0metabolizing0enzymes0(acco
unt0for0about075%0of0drug0metabolism0in0the0liver)
Phase02:0conjugation0reaction0occur0leading0to0large0increases0in0hydrophilicity0of0the0su
bstrates0rendering0them0more0readily0excretable
Substrate0-0ans--
an0agent0that0is0metabolized0by0an0enzyme0into0a0metabolite0and0product0and0event
ually0excreted
Inhibitors0-0ans--
compete0with0other0drugs0for0a0particular0enzyme0affecting0the0metabolism0(decreas
ed)0of0the0substrate0and0decreases0the0excretion0of0the0substrate0and0increasing0the0circ
ulating0drug
, inducer0-0ans--
competes0with0other0drugs0for0a0particular0enzyme0affecting0metabolism0of0the0subst
rate0(increases)0decreasing0the0efficacy0of0the0drug
excretion0-0ans--
renal:0passive0glomerular0filtration,0active0tubular0secretion,0tubular0reabsorption,0gi0t
ract,0lung,0sweat0and0salivary,0mammary
genomics0-0ans--
study0of0the0complete0set0of0genetic0information0present0in0a0cell,0an0organism,0or0sp
ecies
pharmacogenetics0-0ans--
the0study0of0the0influence0of0hereditary0factors0on0the0response0of0individual0organis
ms0to0drugs,0and0the0study0of0variations0of0DNA0and0RNA0characteristics0as0related0to0dr
ug0response
Pharmacogenetics0tests0-0ans--
Mentioned0on0drug0labels0can0be0classified0as0"test0required,"0"test0recommended,"0
and0"information0only."0Currently,0four0drugs0are0required0to0have0pharmacogenetics0test
ing0performed0before0they0are0prescribed:0cetuximab,0trastuzumab,0maraviroc0and0dasat
inib
wafarin,0carbamazepine,0valproic0acid0and0abacavir0are0recommended0to0tests0prior0to0i
nitial0dosing
Carbamazepine0and0Asisans0-0ans--
Initiating0carbamazepine0therapy0in0these0patients0(allele0HLA-
B*1502)0are0at0high0risk0for0developing0Steven0Johnson0syndrome0or0toxic0epidermal0ne
crolysis0(TEN)
The0ability0of0the0anesthetic0to0penetrate0the0axon0membrane0is0determined0by030propert
ies.0What0are0they?0-0ans--
Molecular0size,0Lipid0solubility,0degree0of0ionization0at0tissue0pH
Why0is0epinephrine0given0with0local0anesthetics?0-0ans--
Decreases0local0blood0flow0(decreased0risk0of0bleeding)
Delays0systemic0absorption0of0the0anesthetic
prolongs0anesthesia
reduces0the0risk0of0toxicity
What0is0the0most0widely0used0local0anesthetic?0-0ans--✔✔Lidocaine
What0is0a0possible0fatal0reaction0to0benzocaine0-0ans--✔✔Methemoglobinemia
VERSION GRADED A+ 2025
•
Proper0RX0-0ans--✔✔Providers0name0and0address,0Telephone
DEA
Pt0name/DOB/Addres
Name0of0Drug,0strength,0SIG(directions)0with0indication/Route0and0frequency,0Quantity0a
nd0signature.
Prescribing0basics0-0ans--✔✔Prescribing0is0regulated0by0state0BON
Drug0Schedules:0Most0addictive0to0least0-0ans-- 1:0Heroin,LSD,0MJ
2:0hydrocodone,0cocaine,0Methamphetamine,0methadone,0oxycodone,0meperidine,0fenta
nyl,0adderall,0ritalin
3:0codeine,0ketamine,0testosterone
4:0xanax,0valium,0soma,0ambient,0tramadol
5:0antidiarrheal,0antitussives,0lomotil,0lyrica
Pharmicodyamics0-0ans--
The0effects0of0drug0on0the0body.0Receptors0are0large0molecules0usually0proteins,0tha
t0interact0and0mediate0the0action0of0drugs
agonist0-0ans--
produce0receptor0stimulation0and0a0conformational0change0every0time0they0bind.0Do0
not0need0all0available0receptors0to0produce0a0maximum0response
Partial0agonist0-0ans--
drugs0that0have0properties0in0b/w0those0of0full0agonist0and0antagonist.0They0bind0to0r
eceptors0but0when0they0occupy0the0receptor0sites,0they0stimulate0only0some0of0the0recep
tors.
antagonist0-0ans--
drugs0with0affinity0for0a0receptor0but0with0no0intrinsic0activity.0Affinity0allows0the0antag
onist0to0bind0to0receptors,0but0lack0of0intrinsic0activity0prevents0the0bound0antagonist0fro
m0causing0receptor0activation.0The0block0action0of0drugs0(ex.0Narcan)
,Bioavailabity0-0ans--
%0of0administered0dosage0of0the0drug0that0survives0the0first0pass0through0the0liver0an
d0reaches0the0blood0stream
half0life0-0ans--
Time0required0for0the0amount0of0a0drug0in0the0body0to0decline0by050%,0drugs0with0sh
orter0half0lives0must0be0administer0frequently.04.5-
5.50times0the0half0life0to0get0steady0state0and0to0be0limited0from0the0body
what0the0body0does0to0the0drug0-0ans--✔✔absorption,0distribution,0metabolism,0excretion
Distribution0-0ans--
movement0of0absorbed0drug0in0bodily0fluids0throughout0the0body0to0target0tissue.0Pro
perties0affecting:0lipid/water0solubility,0PH0affects0ionization0of0drug,0protein0binding,0size
0of0molecule0(smaller0molecules0are0more0able0to0diffuse)
Tissue:0fat,0bone,0blood/brain0barrier0(only0lipid0soluble0will0pass),0placental0barrier0(man
y0drugs0can0pass)
Protein0binding0-0ans--
unbound0drug0is0free0which0is0active,0crosses0membrane.0Low0plasma0proteins0resul
t0in0more0free0drug.0Competition:0when020highly0bound0drugs0are0given0it0increases0the0l
evel0of0both0drugs
Metabolism0-0ans--
take0place0in0the0liver0mostly.0Chemical0change0of0a0drug0structure0to:0
Enhance0excretion,0inactivate0the0drug,0increase0therapeutic0action,0active0a0prodrug0(in
active0until0metabolized0in0the0body0into0the0active0compound,0ex:0levodopa),0increase0o
r0decrease0toxicity
CYP4500-0ans--
enzymes0constitutes0the0most0important0of0the0phase0I0metabolizing0enzymes0(acco
unt0for0about075%0of0drug0metabolism0in0the0liver)
Phase02:0conjugation0reaction0occur0leading0to0large0increases0in0hydrophilicity0of0the0su
bstrates0rendering0them0more0readily0excretable
Substrate0-0ans--
an0agent0that0is0metabolized0by0an0enzyme0into0a0metabolite0and0product0and0event
ually0excreted
Inhibitors0-0ans--
compete0with0other0drugs0for0a0particular0enzyme0affecting0the0metabolism0(decreas
ed)0of0the0substrate0and0decreases0the0excretion0of0the0substrate0and0increasing0the0circ
ulating0drug
, inducer0-0ans--
competes0with0other0drugs0for0a0particular0enzyme0affecting0metabolism0of0the0subst
rate0(increases)0decreasing0the0efficacy0of0the0drug
excretion0-0ans--
renal:0passive0glomerular0filtration,0active0tubular0secretion,0tubular0reabsorption,0gi0t
ract,0lung,0sweat0and0salivary,0mammary
genomics0-0ans--
study0of0the0complete0set0of0genetic0information0present0in0a0cell,0an0organism,0or0sp
ecies
pharmacogenetics0-0ans--
the0study0of0the0influence0of0hereditary0factors0on0the0response0of0individual0organis
ms0to0drugs,0and0the0study0of0variations0of0DNA0and0RNA0characteristics0as0related0to0dr
ug0response
Pharmacogenetics0tests0-0ans--
Mentioned0on0drug0labels0can0be0classified0as0"test0required,"0"test0recommended,"0
and0"information0only."0Currently,0four0drugs0are0required0to0have0pharmacogenetics0test
ing0performed0before0they0are0prescribed:0cetuximab,0trastuzumab,0maraviroc0and0dasat
inib
wafarin,0carbamazepine,0valproic0acid0and0abacavir0are0recommended0to0tests0prior0to0i
nitial0dosing
Carbamazepine0and0Asisans0-0ans--
Initiating0carbamazepine0therapy0in0these0patients0(allele0HLA-
B*1502)0are0at0high0risk0for0developing0Steven0Johnson0syndrome0or0toxic0epidermal0ne
crolysis0(TEN)
The0ability0of0the0anesthetic0to0penetrate0the0axon0membrane0is0determined0by030propert
ies.0What0are0they?0-0ans--
Molecular0size,0Lipid0solubility,0degree0of0ionization0at0tissue0pH
Why0is0epinephrine0given0with0local0anesthetics?0-0ans--
Decreases0local0blood0flow0(decreased0risk0of0bleeding)
Delays0systemic0absorption0of0the0anesthetic
prolongs0anesthesia
reduces0the0risk0of0toxicity
What0is0the0most0widely0used0local0anesthetic?0-0ans--✔✔Lidocaine
What0is0a0possible0fatal0reaction0to0benzocaine0-0ans--✔✔Methemoglobinemia
