NUR 3145 Exam 1 UPDATED ACTUAL
Exam Questions and CORRECT Answers
Therapeutic drug serum levels - CORRECT 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: - CORRECT ANSWER undertherapeutic
or toxic
toxic drug serum levels - CORRECT ANSWER greater than therapeutic dose range;
increased adverse effects
under-therapeutic drug serum levels - CORRECT ANSWER not enough drug for desired
effect; may contribute to drug-resistant organisms
o Drug Bioavailability - CORRECT ANSWER % of active drug absorbed that reaches
target tissues
o Drug Bioavailability: determinants - CORRECT 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): - CORRECT 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: - CORRECT ANSWER by injection; bypass GI tract
,Intravenous - CORRECT 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 - CORRECT 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: - CORRECT ANSWER absorbed through capillaries
• Same benefits as IM
o Other routes:
Topical - CORRECT ANSWER : transdermal
• Delivers medication directly to affected area; decreases likelihood of systemic drug effects
o Other routes: Inhalational - CORRECT ANSWER • Provides rapid absorption; drug
delivered directly to lung tissue, where most of these drugs exert their action
o Other routes: Sublingual, buccal - CORRECT 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) - CORRECT 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? - CORRECT 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? - CORRECT 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? -
CORRECT ANSWER
o Side effect: - CORRECT ANSWER : expected averse drug reaction
Undesirable = unexpected (i.e. allergic reaction: hypersensitivity response involving immune
system)
o Adverse reaction: - CORRECT ANSWER : any undesirable drug occurrence
Adverse reaction: Idiosyncratic reaction: - CORRECT ANSWER occurs unexpectedly in
individual patient; genetically inherited traits
Idiosyncratic reaction:
• Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD): - CORRECT 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 - CORRECT ANSWER : cause fetal
structural defects; BLACK BOX WARNING
adverse reaction: Mutagenic effects: - CORRECT ANSWER permanently changes genetic
composition of living cells
Exam Questions and CORRECT Answers
Therapeutic drug serum levels - CORRECT 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: - CORRECT ANSWER undertherapeutic
or toxic
toxic drug serum levels - CORRECT ANSWER greater than therapeutic dose range;
increased adverse effects
under-therapeutic drug serum levels - CORRECT ANSWER not enough drug for desired
effect; may contribute to drug-resistant organisms
o Drug Bioavailability - CORRECT ANSWER % of active drug absorbed that reaches
target tissues
o Drug Bioavailability: determinants - CORRECT 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): - CORRECT 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: - CORRECT ANSWER by injection; bypass GI tract
,Intravenous - CORRECT 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 - CORRECT 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: - CORRECT ANSWER absorbed through capillaries
• Same benefits as IM
o Other routes:
Topical - CORRECT ANSWER : transdermal
• Delivers medication directly to affected area; decreases likelihood of systemic drug effects
o Other routes: Inhalational - CORRECT ANSWER • Provides rapid absorption; drug
delivered directly to lung tissue, where most of these drugs exert their action
o Other routes: Sublingual, buccal - CORRECT 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) - CORRECT 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? - CORRECT 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? - CORRECT 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? -
CORRECT ANSWER
o Side effect: - CORRECT ANSWER : expected averse drug reaction
Undesirable = unexpected (i.e. allergic reaction: hypersensitivity response involving immune
system)
o Adverse reaction: - CORRECT ANSWER : any undesirable drug occurrence
Adverse reaction: Idiosyncratic reaction: - CORRECT ANSWER occurs unexpectedly in
individual patient; genetically inherited traits
Idiosyncratic reaction:
• Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD): - CORRECT 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 - CORRECT ANSWER : cause fetal
structural defects; BLACK BOX WARNING
adverse reaction: Mutagenic effects: - CORRECT ANSWER permanently changes genetic
composition of living cells
