STUDY
GUIDE QUESTIONS AND VERIFIED
ANSWERS
GUARANTEED GRADED A+
MODULE 1
1. What are the BON rules and regulations for prescriptive
authority for the advance practice nurse?
1. Texas is very restricted
2. Describe the pharmacokinetic processes of absorption,
distribution, metabolism and elimination and how differences
in these areas affect drug action. 1.
Absorption
1. Drug's movement from the site of administration into the
blood.
2. Distribution
1. Drug's movement from the blood into the interstitial
space of tissues and from there into cells.
3. Metabolism
1. Biotransformation is the enzymatically mediated
alteration of drug structure.
4. Elimination
1. Combination of metabolism and excretion
3. Compare and contrast pharmacokinetics and pharmacodynamics
of special populations—pediatrics, older adults and those that are
pregnant.
1. Pediatrics—they have organ immaturity, elderly—they have
organ degeneration, loss of nephrons, excretion of drug is
decreased and you have to give this population a lower dose of
medication. Medication can pass through milk of lactating
females.
NURS 5334 PHARM UPDATED 2024 STUDY GUIDE QUESTIONS AND
VERIFIED ANSWERS GUARANTEED A+
, 4. Analyze a drug interaction to determine an appropriate course of
action.
1. Basic mechanism of drug-drug interactions through
pharmacokinetic interactions are altered absorption, altered
distribution, altered metabolism, and altered renal excretion.
5. Identify medications with a narrow therapeutic index requiring
drug level monitoring.
1.
6. Discuss the effect of ionization and pH on absorption.
1. Drugs that are weak acids are best absorbed in acidic
environments. Acidic drugs accumulate on the alkaline side,
basic drugs accumulate on the acidic side known
as ion trapping. Ionization of the drugs is pH dependent, when
the pH and the fluid on one side of the membrane differs from
the pH on the other side, drug molecules tend to accumulate on
the side where the pH most favors ionization.
7. Discuss factors affecting drug distribution.
1. Competition for protein binding and alteration of extracellular pH
8. Discuss barriers affecting drug distribution—such as placental
membrane, blood brain barrier and volume of distribution.
1. Placental membrane: drugs are easily passed through the
placental membrance
2. Blood brain barrier: the PGP pumps drugs back into the blood
and thereby limits their access to the brain.
3. Volume of distribution:
9. Discuss the "first-pass effect"—what effect can this have on
distribution of a drug?
1. Rapid hepatic inactivation of certain oral drugs. When drugs are
absorbed by the Gl tract, they are carried directly to the liver
through the hepatic portal vein before entering the systemic
circulation. If the capacity of the liver to metabolize the drug is
extremely high, this drug can be completely inactivated on its
first pass through the liver.
10. Discuss the significance of the Cytochrome P450 system on
metabolism of drugs.
1. It is a group of 12 closely related enzyme families. CYPI, CYP2,
CYP3 metabolize drugs. The other 9 families metabolize
endogenous compounds (ex. Fatty acids, steroids).
11. Discuss the major hepatotoxic drugs and possible effects on
drug metabolism. 1.
NURS 5334 PHARM UPDATED 2024 STUDY GUIDE QUESTIONS AND
VERIFIED ANSWERS GUARANTEED A+