NUR 641E final questions with correct answers
Pharmacokinetics involves Correct Answer-absorption, distribution,
metabolism and elimination).
Absorption: Correct Answer-absorption from the administration site
either directly or indirectly into the blood/plasma.
Distribution: Correct Answer-reversibly or irreversibly move from the
bloodstream into the interstitial and intracellular
Metabolism: Correct Answer-biotransformed via hepatic metabolism or
by other tissues.
Elimination: Correct Answer-tissues. lastly, the drug and its metabolites
are eliminated from the body.
route of administration with the highest bioavailability Correct Answer-
intravenous; putting entire dose into a patient's vein and bypassing
absorption.
avoids first-pass metabolism Correct Answer-Intravenous route
administration has variable and erratic absorption. n Correct Answer-
Rectal administration
,4. Steady state (SS) Correct Answer-absorption. n is usually reached
within 4-5 half-lives of drug.
Half-life of a drug is Correct Answer-how long it takes for half the drug
to be excreted from the body. Determines how frequently the drug must
be administered. Predicts how long toxic effects can last.is constant with
first-order pharmacokinetics of a drug.
Zero-order (nonlinear) pharmacokinetics Correct Answer-means a drug
is metabolized at a constant rate per unit time.
CYP3A4 substrate drugs Correct Answer-may have enhanced activity if
any CYP3A4 inducer drugs are used along with it.
Drug development process involves these steps according to the FDA:
Correct Answer-Discovery: laboratory research to develop the new drug.
Preclinical research with animal testing for safety (Phase I). Clinical
research on human subjects for medication safety (Phase II). Clinical
research in humans comparing the new drug to accepted medications
placebo depending on the study (Phase III). FDA review of the results to
determine approval. Post marketing study to identify adverse effects not
found in earlier clinical studies (Phase IV)
2. Medication safety organizations Correct Answer-The Institute for
Safe Medication Practices (ISMP) The Institute of Medicine (IOM) The
Joint Commission The National Coordinating Council for Medication
Error Reporting and Prevention (NCC MERP) Food and Drug
Administration (FDA) Safe Use Initiative
,Two basic type of ADRS: Correct Answer-pharmacological and
idiosyncratic.
85% to 90% of ADRS Correct Answer-are pharmacological.
Adverse drug reactions are usually preventable, Correct Answer-
frequently occur in a hospital or nursing home setting, and include
medication errors, adverse drug effects, and allergic idiosyncratic type
reactions.
ADRS are not commonly reported; Correct Answer-the FDA does not
mandate that ADRS be reported.
Polypharmacy Correct Answer-involves using multiple health care
providers for care, using multiple medications, and using several
pharmacies prescription filling.
Angiotensin converting enzyme inhibitors (ACEIS): Correct Answer-
lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril.
ACEIS reduce blood pressure enzyme. Correct Answer-by suppressing
the release of angiotensin-converting enzyme.
, Important side effects of ACE inhibitors Correct Answer-Important
include cough and angioedema; discontinue the ACEI if angioedema
occurs.
Angiotensin II receptor blocking agents (ARBS): Correct Answer-
Icandesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro),
losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan).
ARBS reduce blood pressure Correct Answer-by blocking angiotensin II
receptors.
Essential (primary) hypertension Correct Answer-Essential (primary)
accounts for 90% of cases; secondary hypertension may caused by
chronic renal failure.
Nitroglycerin Correct Answer-Nitroglycerin is a nitrate drug that can be
administered IV, SL, a topical ointment and as a transdermal patch.
Nitrates are contraindicated Correct Answer-with PDE-5 inhibitors (e.g.,
sildenafil and vardenafil)
Amiodarone is the antiarrhythmic Correct Answer-Of choice when there
is coexisting heart failure; can cause thyroid and pulmonary toxicity.
Alpha-1 adrenergic stimulation Correct Answer-results in
vasoconstriction and increased blood pressure.
Pharmacokinetics involves Correct Answer-absorption, distribution,
metabolism and elimination).
Absorption: Correct Answer-absorption from the administration site
either directly or indirectly into the blood/plasma.
Distribution: Correct Answer-reversibly or irreversibly move from the
bloodstream into the interstitial and intracellular
Metabolism: Correct Answer-biotransformed via hepatic metabolism or
by other tissues.
Elimination: Correct Answer-tissues. lastly, the drug and its metabolites
are eliminated from the body.
route of administration with the highest bioavailability Correct Answer-
intravenous; putting entire dose into a patient's vein and bypassing
absorption.
avoids first-pass metabolism Correct Answer-Intravenous route
administration has variable and erratic absorption. n Correct Answer-
Rectal administration
,4. Steady state (SS) Correct Answer-absorption. n is usually reached
within 4-5 half-lives of drug.
Half-life of a drug is Correct Answer-how long it takes for half the drug
to be excreted from the body. Determines how frequently the drug must
be administered. Predicts how long toxic effects can last.is constant with
first-order pharmacokinetics of a drug.
Zero-order (nonlinear) pharmacokinetics Correct Answer-means a drug
is metabolized at a constant rate per unit time.
CYP3A4 substrate drugs Correct Answer-may have enhanced activity if
any CYP3A4 inducer drugs are used along with it.
Drug development process involves these steps according to the FDA:
Correct Answer-Discovery: laboratory research to develop the new drug.
Preclinical research with animal testing for safety (Phase I). Clinical
research on human subjects for medication safety (Phase II). Clinical
research in humans comparing the new drug to accepted medications
placebo depending on the study (Phase III). FDA review of the results to
determine approval. Post marketing study to identify adverse effects not
found in earlier clinical studies (Phase IV)
2. Medication safety organizations Correct Answer-The Institute for
Safe Medication Practices (ISMP) The Institute of Medicine (IOM) The
Joint Commission The National Coordinating Council for Medication
Error Reporting and Prevention (NCC MERP) Food and Drug
Administration (FDA) Safe Use Initiative
,Two basic type of ADRS: Correct Answer-pharmacological and
idiosyncratic.
85% to 90% of ADRS Correct Answer-are pharmacological.
Adverse drug reactions are usually preventable, Correct Answer-
frequently occur in a hospital or nursing home setting, and include
medication errors, adverse drug effects, and allergic idiosyncratic type
reactions.
ADRS are not commonly reported; Correct Answer-the FDA does not
mandate that ADRS be reported.
Polypharmacy Correct Answer-involves using multiple health care
providers for care, using multiple medications, and using several
pharmacies prescription filling.
Angiotensin converting enzyme inhibitors (ACEIS): Correct Answer-
lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril.
ACEIS reduce blood pressure enzyme. Correct Answer-by suppressing
the release of angiotensin-converting enzyme.
, Important side effects of ACE inhibitors Correct Answer-Important
include cough and angioedema; discontinue the ACEI if angioedema
occurs.
Angiotensin II receptor blocking agents (ARBS): Correct Answer-
Icandesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro),
losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan).
ARBS reduce blood pressure Correct Answer-by blocking angiotensin II
receptors.
Essential (primary) hypertension Correct Answer-Essential (primary)
accounts for 90% of cases; secondary hypertension may caused by
chronic renal failure.
Nitroglycerin Correct Answer-Nitroglycerin is a nitrate drug that can be
administered IV, SL, a topical ointment and as a transdermal patch.
Nitrates are contraindicated Correct Answer-with PDE-5 inhibitors (e.g.,
sildenafil and vardenafil)
Amiodarone is the antiarrhythmic Correct Answer-Of choice when there
is coexisting heart failure; can cause thyroid and pulmonary toxicity.
Alpha-1 adrenergic stimulation Correct Answer-results in
vasoconstriction and increased blood pressure.
