NUR 641 E FINAL PAPER EXAM SCRIPT
PRACTICE SOLUTION 2026 GUARANTEED TO
PASS
◍ absorption from the administration site either directly or indirectly
in the blood plasma. Answer: Pharmacokinetic absorption
◍ reversibly or irreversibly move from the bloodstream into the
interstitial and intracellular fluid. Answer: Parmacokinetic distribution
◍ biotransformed via hepatic metabolism or by other tissue. Answer:
Pharmacokinetics metabolism
◍ 1. highest bioavailability
2. places entire does into venin thus bypassing absorption
3. avoids hepatic first pass metabolism in the liver. Answer:
Intravenous medications
◍ usually reached within 4-5 half lives of the drug. Answer: steady
state medication
◍ 1.the time required for the elimination process to reduce 2.the
concentration of the drug to one half what it was at initial
administration
,3.determines drug frequency
4. predicts length of toxic effects
5. constant first order pharmacokinetics of a drug. Answer: drug half
life
◍ drug is metabolized at a constant rate per unit. Answer: zero order
(nonlinear)
◍ metabolizes 50% drugs
inhibit: grapefruit juice
- increase drug -> adverse effects
may have enhanced activity with any other CYP3A4. Answer:
CYP3A4
◍ 1. discovery or laboratory for development
2. Phase 1 begins with animal testing
3. phase 2 human subjects
4. compare drug to placebo or other drug that is effective
5.FDA then reviews result and determines approval
6. Post market study to determine other side effects that were not seen
while lab testing. Answer: Six steps in drug development process
◍ 1.Institute of Safe mediation Practice
2. Institute of Medicine
3. Joint commission
,4.National Coordinating Council form mediation error reporting and
prevention
5. Food and Drug Administration (safe use initiative). Answer:
organizations for medication safety
◍ 1.Also known as a side effect, an undesirable reaction that
accompanies the principal response for which the drug was taken
include allergic reactions and adverse drug effects
2. Either pharmacological or idiosyncratic
3. 85-90% of ADRs are pharmacological
4. Reporting is not mandated by FDA thus are not commonly reported
5. usually preventable occur in hospital and nursing homes due to
med errors
6. Polypharmacy, multiple doctors and multiple pharmacies increase
risk. Answer: Adverse Drug Reaction (ADR)
◍ 1. end in pril: lisinopril, captopril, enalapril, ramipril, benazepril
and fosinopril
2. suppress release of angiotensin converting enzyme
3. side effects include cough and angioedema, with angioedema the
medication should be discontinued. Answer: Angiotensin-converting
enzyme (ACE) inhibitors
◍ 1. -sartan: candesartan, eprosartan, ibesartan, Isosartan, telmisartan,
valsartan
2.block angiotensin 11 receptors. Answer: Angiotensin II Receptor
Blockers (ARBs)
, ◍ Essential HTN accounts for 90% of cases and is also called
primary, secondary may be caused by CKD. Answer: Essential vs
Secondary HTN
◍ use: angina pectoris
action: dilate veins and arteries and thereby reducing ischemia and
relieving pain by decreasing myocardial O2 consumption
Side effects: throbbing HA, flushing, hypotension tachycardia
available: IV, SL, topical ointment and transdermal patch
contraindicated with PDE-5 (sildanfil and vardenafil). Answer:
Nitroglycerin (Nitrate)
◍ 1. antiarrhythmic of choice when there is coexisting heart failure
2. can cause thyroid and pulmonary toxicity. Answer: Amiodarone
◍ vasoconstriction and increased blood pressure. Answer: Alpha 1
adrenergic stimulation results
◍ Decrease sympathetic stimulation causing vasodilation and
decreased blood pressure. Answer: alpha 1 blockade
◍ stimulation by beta agonists (isoproterenol) result in increased
heart rate, blood pressure and cardiac output
2. blockade results in decreased heart rate, bp, and cardiac output.
Answer: beta 1 adrenergic
PRACTICE SOLUTION 2026 GUARANTEED TO
PASS
◍ absorption from the administration site either directly or indirectly
in the blood plasma. Answer: Pharmacokinetic absorption
◍ reversibly or irreversibly move from the bloodstream into the
interstitial and intracellular fluid. Answer: Parmacokinetic distribution
◍ biotransformed via hepatic metabolism or by other tissue. Answer:
Pharmacokinetics metabolism
◍ 1. highest bioavailability
2. places entire does into venin thus bypassing absorption
3. avoids hepatic first pass metabolism in the liver. Answer:
Intravenous medications
◍ usually reached within 4-5 half lives of the drug. Answer: steady
state medication
◍ 1.the time required for the elimination process to reduce 2.the
concentration of the drug to one half what it was at initial
administration
,3.determines drug frequency
4. predicts length of toxic effects
5. constant first order pharmacokinetics of a drug. Answer: drug half
life
◍ drug is metabolized at a constant rate per unit. Answer: zero order
(nonlinear)
◍ metabolizes 50% drugs
inhibit: grapefruit juice
- increase drug -> adverse effects
may have enhanced activity with any other CYP3A4. Answer:
CYP3A4
◍ 1. discovery or laboratory for development
2. Phase 1 begins with animal testing
3. phase 2 human subjects
4. compare drug to placebo or other drug that is effective
5.FDA then reviews result and determines approval
6. Post market study to determine other side effects that were not seen
while lab testing. Answer: Six steps in drug development process
◍ 1.Institute of Safe mediation Practice
2. Institute of Medicine
3. Joint commission
,4.National Coordinating Council form mediation error reporting and
prevention
5. Food and Drug Administration (safe use initiative). Answer:
organizations for medication safety
◍ 1.Also known as a side effect, an undesirable reaction that
accompanies the principal response for which the drug was taken
include allergic reactions and adverse drug effects
2. Either pharmacological or idiosyncratic
3. 85-90% of ADRs are pharmacological
4. Reporting is not mandated by FDA thus are not commonly reported
5. usually preventable occur in hospital and nursing homes due to
med errors
6. Polypharmacy, multiple doctors and multiple pharmacies increase
risk. Answer: Adverse Drug Reaction (ADR)
◍ 1. end in pril: lisinopril, captopril, enalapril, ramipril, benazepril
and fosinopril
2. suppress release of angiotensin converting enzyme
3. side effects include cough and angioedema, with angioedema the
medication should be discontinued. Answer: Angiotensin-converting
enzyme (ACE) inhibitors
◍ 1. -sartan: candesartan, eprosartan, ibesartan, Isosartan, telmisartan,
valsartan
2.block angiotensin 11 receptors. Answer: Angiotensin II Receptor
Blockers (ARBs)
, ◍ Essential HTN accounts for 90% of cases and is also called
primary, secondary may be caused by CKD. Answer: Essential vs
Secondary HTN
◍ use: angina pectoris
action: dilate veins and arteries and thereby reducing ischemia and
relieving pain by decreasing myocardial O2 consumption
Side effects: throbbing HA, flushing, hypotension tachycardia
available: IV, SL, topical ointment and transdermal patch
contraindicated with PDE-5 (sildanfil and vardenafil). Answer:
Nitroglycerin (Nitrate)
◍ 1. antiarrhythmic of choice when there is coexisting heart failure
2. can cause thyroid and pulmonary toxicity. Answer: Amiodarone
◍ vasoconstriction and increased blood pressure. Answer: Alpha 1
adrenergic stimulation results
◍ Decrease sympathetic stimulation causing vasodilation and
decreased blood pressure. Answer: alpha 1 blockade
◍ stimulation by beta agonists (isoproterenol) result in increased
heart rate, blood pressure and cardiac output
2. blockade results in decreased heart rate, bp, and cardiac output.
Answer: beta 1 adrenergic
