ADVANCED PHARMACOLOGY EXAM 1 QUESTIONS AND CORRECT SOLUTIONS

ADVANCED PHARMACOLOGY
EXAM 1 QUESTIONS AND CORRECT
SOLUTIONS



Once you graduate from an NP program, in order to prescribe you'll need: - CORRECT ANSWERS- -
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Advanced nurse prescriber license J J J




-DEA # J




What is the purpose of a DEA #? - CORRECT ANSWERS- Needed to prescribed scheduled drugs
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Rules for prescribing Schedule II drugs: - CORRECT ANSWERS- -Written script needed
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-1 month supply only
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-No refills J




What is the PDMP? - CORRECT ANSWERS- Prescription Drug Monitoring Program
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Used to effectively track patient's controlled substance uses across different health facilities (in the
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same state) J




What are clinical practice guidelines? - CORRECT ANSWERS-
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Recommendations that are intended to optimize patient care that are informed by a systematic rev
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iew of the evidence and an assessment of the benefits/harms of alternative care practices
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Ex: sepsis, CAP
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Common causes of medication errors: - CORRECT ANSWERS- -Illegible writing
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,-Drug names that sound alike J J J J




-Medications that look alike J J J




-Administering a drug with the wrong route J J J J J J




What is pharmacokinetics? What are its 4 categories? - CORRECT ANSWERS-
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What the body does to the drug
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1. AbsorptionJ




2. MetabolismJ




3. Distribution
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4. Excretion J




Quickest route of absorption? Slowest? - CORRECT ANSWERS- IV = quickest
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IM = slowest J J




What is the most common way drugs pass through cell membranes? - CORRECT ANSWERS-
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Passive diffusion
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What characteristics of a drug allow it to pass most quickly through cell membranes (usually throug
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h passive diffusion)? - CORRECT ANSWERS- Small, uncharged (unionized), lipid soluble--
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pass through membrane without any energy
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What does it mean when a drug is ionized? - CORRECT ANSWERS-
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It means that the drug is stuck in the compartment it was ionized in and has to be moved to the next c
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ompartment (cannot be absorbed into the bloodstream) J J J J J J




Where do weak acids absorb? - CORRECT ANSWERS- Stomach
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Where do weak bases absorb? - CORRECT ANSWERS- Small intestine
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,pH of stomach: - CORRECT ANSWERS- 2-4
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pH of small intestine: - CORRECT ANSWERS- 6-7
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pH of large intestine: - CORRECT ANSWERS- 6-7
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pH of bloodstream: - CORRECT ANSWERS- 7.35-7.45
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pH of bladder: - CORRECT ANSWERS- 5-8
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pH of breastmilk: - CORRECT ANSWERS- 7.1
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Where will a drug absorb if it is a weak base that ionizes at a pH of 4 and lower? - CORRECT ANSWERS-
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In the small intestine (since the stomach has a pH of 2-
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4, so the drug will become ionized and move to the small intestine where it will be able to absorb into
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the bloodstream) J




How can we manipulate the urine pH in cases of overdose? - CORRECT ANSWERS-
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Drugs that are weak acids (aspirin) can be trapped and excreted through the urine.
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We raise pH of the urine (with sodium bicarb) to force the drug to ionize and allow it to be excreted, n
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ot reabsorbed through the bloodstream.
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What is distribution? - CORRECT ANSWERS-
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How a drug will be transported to the tissues it needs to go to in order for it to exert its effects
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Drug factors related to distribution: - CORRECT ANSWERS- -Lipid solubility
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-Molecular size J




-Degree of ionization J J J




-Duration of action J J

, -Cellular binding J




-Therapeutic effects J J




-Toxic effects J




(lipid soluble, small, and non-ionized drugs will distribute more quickly)
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Body factors related to distribution: - CORRECT ANSWERS- -
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Vascularity (poor perfusion, disruption of blood flow due to trauma--difficulty distributing)
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-Blood barriers (blood-brain-barrier can be problematic if we need to get drugs to the brain--
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will need very high dosing since only a small amount of the drug will get through)
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-Transport mechanisms J J




-Plasma binding proteins J J J




-Disease states J




-Volume of distribution J J




-Drug interactions J




What is the key plasma protein involved with protein binding for medications? -
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CORRECT ANSWERS- Albumin
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Why do we monitor albumin? - CORRECT ANSWERS-
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Indicative of nutritional status and how well protein-
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bound drugs will be transported to their target locations
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What happens to the therapeutic effect of a drug when the patient is elderly and has very low levels
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of albumin? - CORRECT ANSWERS-
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The drug does not bind to the protein (albumin) as much as expected, so there is a lot of free drug flo
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ating in the plasma; high risk for drug toxicity
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Protein bound means: - CORRECT ANSWERS- J J J J J




Inactive form of the drug; does not have any therapeutic effect when bound to a protein
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