NUR 641E MIDTERM STUDY GUIDE
Prodrug - Answers :An inactive drug dosage form that is converted to an active
metabolite by various biochemical reactions once it is inside the body.
-Cytochrome P450
-Ex. Aspirin, psilocybin, heroin
Bioavailability - Answers :the rate at and the extent to which a nutrient is absorbed and
used
-Affected by route of administration and drug dosage
-Drug clearance (rate drug leaves circulation)
-Steady state concentration
-Affected by chemical stability, solubility, and first pass
Steady state (of a drug) - Answers :stable level of drug in the body, occurs in 5 half lives
of the drug
-rate of drug being added to system is equal to amount being eliminated from system
Pharmacokinetics - Answers :The process by which drugs are absorbed, distributed
within the body, metabolized, and excreted.
-what the body does to the drug
First pass - Answers :the fact that a medication in the GI tract passes through the liver
before entering other organs
does not - Answers :bioequivalence does/does not affect bioavailability
Bioequivalence - Answers :relative therapeutic effectiveness of chemically equivalent
drugs.
Bioavailability (is affected by) - Answers :-chemical instability
-solubility
-first pass metabolism
Cytochrome P450 - Answers :-enzymes that function to metabolize potentially toxic
compounds, including drugs and products of endogenous metabolism such as bilirubin,
principally in the liver.
-genetics influence presence of enzymes
-affects metabolism of warfarin, antidepressants, antiepileptics, and statins.
-the levels of these drugs are higher when taken with certain drugs that are inhibitors
(ex. warfarin with omeprazole) because there is competition for enzyme metabolism.
-inducers lead to decreased plasma concentration of drug.
cytochrome p450 inducer - Answers :An inducer increases the metabolism of a
substrate resulting in a decreased level or effect of the substrate
, cytochrome p450 inhibitor - Answers :An inhibitor decreases the metabolism of a
substrate resulting in an increased level or effect of the substrate.
Clopidogrel - Answers :prodrug that must be activated by hepatic CYP2C19
metabolism; individuals who are poor metabolizers may not form the active metabolite
and have reduced antiplatelet response
half-life (determines) - Answers :how often a drug is administered
4-5 - Answers :steady state is reached in _-_ times the half-life
Warfarin (MOA) - Answers :-Vitamin K antagonist
-Factors II, VII, IX, X
-takes several days to take effect
-monitor INR
Vitamin K - Answers :warfarin antidote
Heparin (MOA) - Answers :-rapid anticoagulation by binding with antithrombin III and
inhibits factors IXa, Xa, XIIa, and XIII
-aPTT monitoring (low dose SQ does not require monitoring)
Apixaban (MOA) - Answers :direct factor Xa inhibitor
parenteral administration - Answers :-directly into systemic circulation
-poor absorption or unstable in GI tract (ex. heparin, insulin), rapid absorption, unable to
take meds PO
-IV, IM, SQ, ID
IV - Answers :-into the vein
-can be given through bolus (rapid peak) or infusion (lower peak, longer duration)
-ex. rocuronium (neuromuscular blocker)
IM - Answers :-aqua solutions absorbed rapidly
-depot absorbed slowly in a nonaqueous solution such as polyethene glycol (simple
diffusion)
SQ - Answers :-absorption via simple diffusion
-constant, slow, and sustained effects
-not for drugs that cause tissue irritation d/t pain and necrosis
ID - Answers :-diagnostic determination and allergy sensitivity
inhalation - Answers :-drug effects as rapid as IV bolus
-minimizes systemic side effects of respiratory drugs
Prodrug - Answers :An inactive drug dosage form that is converted to an active
metabolite by various biochemical reactions once it is inside the body.
-Cytochrome P450
-Ex. Aspirin, psilocybin, heroin
Bioavailability - Answers :the rate at and the extent to which a nutrient is absorbed and
used
-Affected by route of administration and drug dosage
-Drug clearance (rate drug leaves circulation)
-Steady state concentration
-Affected by chemical stability, solubility, and first pass
Steady state (of a drug) - Answers :stable level of drug in the body, occurs in 5 half lives
of the drug
-rate of drug being added to system is equal to amount being eliminated from system
Pharmacokinetics - Answers :The process by which drugs are absorbed, distributed
within the body, metabolized, and excreted.
-what the body does to the drug
First pass - Answers :the fact that a medication in the GI tract passes through the liver
before entering other organs
does not - Answers :bioequivalence does/does not affect bioavailability
Bioequivalence - Answers :relative therapeutic effectiveness of chemically equivalent
drugs.
Bioavailability (is affected by) - Answers :-chemical instability
-solubility
-first pass metabolism
Cytochrome P450 - Answers :-enzymes that function to metabolize potentially toxic
compounds, including drugs and products of endogenous metabolism such as bilirubin,
principally in the liver.
-genetics influence presence of enzymes
-affects metabolism of warfarin, antidepressants, antiepileptics, and statins.
-the levels of these drugs are higher when taken with certain drugs that are inhibitors
(ex. warfarin with omeprazole) because there is competition for enzyme metabolism.
-inducers lead to decreased plasma concentration of drug.
cytochrome p450 inducer - Answers :An inducer increases the metabolism of a
substrate resulting in a decreased level or effect of the substrate
, cytochrome p450 inhibitor - Answers :An inhibitor decreases the metabolism of a
substrate resulting in an increased level or effect of the substrate.
Clopidogrel - Answers :prodrug that must be activated by hepatic CYP2C19
metabolism; individuals who are poor metabolizers may not form the active metabolite
and have reduced antiplatelet response
half-life (determines) - Answers :how often a drug is administered
4-5 - Answers :steady state is reached in _-_ times the half-life
Warfarin (MOA) - Answers :-Vitamin K antagonist
-Factors II, VII, IX, X
-takes several days to take effect
-monitor INR
Vitamin K - Answers :warfarin antidote
Heparin (MOA) - Answers :-rapid anticoagulation by binding with antithrombin III and
inhibits factors IXa, Xa, XIIa, and XIII
-aPTT monitoring (low dose SQ does not require monitoring)
Apixaban (MOA) - Answers :direct factor Xa inhibitor
parenteral administration - Answers :-directly into systemic circulation
-poor absorption or unstable in GI tract (ex. heparin, insulin), rapid absorption, unable to
take meds PO
-IV, IM, SQ, ID
IV - Answers :-into the vein
-can be given through bolus (rapid peak) or infusion (lower peak, longer duration)
-ex. rocuronium (neuromuscular blocker)
IM - Answers :-aqua solutions absorbed rapidly
-depot absorbed slowly in a nonaqueous solution such as polyethene glycol (simple
diffusion)
SQ - Answers :-absorption via simple diffusion
-constant, slow, and sustained effects
-not for drugs that cause tissue irritation d/t pain and necrosis
ID - Answers :-diagnostic determination and allergy sensitivity
inhalation - Answers :-drug effects as rapid as IV bolus
-minimizes systemic side effects of respiratory drugs