Advanced Pharmacology Exam 1
Study online at https://quizlet.com/_9xwkau
1. Once you graduate from an NP program, in order to prescribe you'll need:: -
-Advanced nurse prescriber license
-DEA #
2. What is the purpose of a DEA #?: Needed to prescribed scheduled drugs
3. Rules for prescribing Schedule II drugs:: -Written script needed
-1 month supply only
-No refills
4. What is the PDMP?: Prescription Drug Monitoring Program
Used to effectively track patient's controlled substance uses across different health facilities (in the same state)
5. What are clinical practice guidelines?: Recommendations that are intended to optimize patient
care that are informed by a systematic review of the evidence and an assessment of the benefits/harms of alternative
care practices
Ex: sepsis, CAP
6. Common causes of medication errors:: -Illegible writing
-Drug names that sound alike
-Medications that look alike
-Administering a drug with the wrong route
7. What is pharmacokinetics? What are its 4 categories?: What the body does to the drug
1. Absorption
2. Metabolism
3. Distribution
4. Excretion
8. Quickest route of absorption? Slowest?: IV = quickest
IM = slowest
9. What is the most common way drugs pass through cell membranes?: Passive
diffusion
10. What characteristics of a drug allow it to pass most quickly through cell mem-
branes (usually through passive diffusion)?: Small, uncharged (unionized), lipid soluble--pass
through membrane without any energy
, Advanced Pharmacology Exam 1
Study online at https://quizlet.com/_9xwkau
11. What does it mean when a drug is ionized?: It means that the drug is stuck in the compartment
it was ionized in and has to be moved to the next compartment (cannot be absorbed into the bloodstream)
12. Where do weak acids absorb?: Stomach
13. Where do weak bases absorb?: Small intestine
14. pH of stomach:: 2-4
15. pH of small intestine:: 6-7
16. pH of large intestine:: 6-7
17. pH of bloodstream:: 7.35-7.45
18. pH of bladder:: 5-8
19. pH of breastmilk:: 7.1
20. Where will a drug absorb if it is a weak base that ionizes at a pH of 4 and
lower?: In the small intestine (since the stomach has a pH of 2-4, so the drug will become ionized and move to the
small intestine where it will be able to absorb into the bloodstream)
21. How can we manipulate the urine pH in cases of overdose?: Drugs that are weak acids
(aspirin) can be trapped and excreted through the urine.
We raise pH of the urine (with sodium bicarb) to force the drug to ionize and allow it to be excreted, not reabsorbed
through the bloodstream.
22. What is distribution?: How a drug will be transported to the tissues it needs to go to in order for it to
exert its effects
23. Drug factors related to distribution:: -Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
-Therapeutic effects
-Toxic effects
(lipid soluble, small, and non-ionized drugs will distribute more quickly)
24. Body factors related to distribution:: -Vascularity (poor perfusion, disruption of blood flow due
to trauma--difficulty distributing)
-Blood barriers (blood-brain-barrier can be problematic if we need to get drugs to the brain--will need very high dosing
, Advanced Pharmacology Exam 1
Study online at https://quizlet.com/_9xwkau
since only a small amount of the drug will get through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
-Drug interactions
25. What is the key plasma protein involved with protein binding for medica-
tions?: Albumin
26. Why do we monitor albumin?: Indicative of nutritional status and how well protein-bound drugs will
be transported to their target locations
27. What happens to the therapeutic effect of a drug when the patient is elderly
and has very low levels of albumin?: The drug does not bind to the protein (albumin) as much as
expected, so there is a lot of free drug floating in the plasma; high risk for drug toxicity
28. Protein bound means:: Inactive form of the drug; does not have any therapeutic effect when bound to
a protein
29. Free drug means:: Active form of the drug (available for therapeutic effect)
30. What happens when a patient is on two drugs that are competing for the
same protein binding site on the albumin?: Some drug interactions can occur. Drugs fight for
binding position, but both drugs do not get enough as the usually would. Leads to higher free drug levels, decreased
overall albumin binding, and potential toxicity for both drugs.
**Unpredictable**
31. What is the 1st pass effect?: PO drug goes through GI tract and absorbs in the stomach or intestines
into local circulation that reaches the liver. The liver inactivates portions of the drug before it goes into systemic
circulation. Some drugs with a very high 1st pass effect may have to be given IV (goes directly into systemic circulation)
or in higher PO doses (watch for side effects)
32. What does a substrate for an enzyme mean?: It needs it to undergo metabolism
33. What is an enzyme inducer?: It increases clearance of the drug (decreased blood levels of drug--may
need dose increase)
34. What is an enzyme inhibitor?: It reduces clearance (increased blood levels of drug--may need dose
decrease)
Study online at https://quizlet.com/_9xwkau
1. Once you graduate from an NP program, in order to prescribe you'll need:: -
-Advanced nurse prescriber license
-DEA #
2. What is the purpose of a DEA #?: Needed to prescribed scheduled drugs
3. Rules for prescribing Schedule II drugs:: -Written script needed
-1 month supply only
-No refills
4. What is the PDMP?: Prescription Drug Monitoring Program
Used to effectively track patient's controlled substance uses across different health facilities (in the same state)
5. What are clinical practice guidelines?: Recommendations that are intended to optimize patient
care that are informed by a systematic review of the evidence and an assessment of the benefits/harms of alternative
care practices
Ex: sepsis, CAP
6. Common causes of medication errors:: -Illegible writing
-Drug names that sound alike
-Medications that look alike
-Administering a drug with the wrong route
7. What is pharmacokinetics? What are its 4 categories?: What the body does to the drug
1. Absorption
2. Metabolism
3. Distribution
4. Excretion
8. Quickest route of absorption? Slowest?: IV = quickest
IM = slowest
9. What is the most common way drugs pass through cell membranes?: Passive
diffusion
10. What characteristics of a drug allow it to pass most quickly through cell mem-
branes (usually through passive diffusion)?: Small, uncharged (unionized), lipid soluble--pass
through membrane without any energy
, Advanced Pharmacology Exam 1
Study online at https://quizlet.com/_9xwkau
11. What does it mean when a drug is ionized?: It means that the drug is stuck in the compartment
it was ionized in and has to be moved to the next compartment (cannot be absorbed into the bloodstream)
12. Where do weak acids absorb?: Stomach
13. Where do weak bases absorb?: Small intestine
14. pH of stomach:: 2-4
15. pH of small intestine:: 6-7
16. pH of large intestine:: 6-7
17. pH of bloodstream:: 7.35-7.45
18. pH of bladder:: 5-8
19. pH of breastmilk:: 7.1
20. Where will a drug absorb if it is a weak base that ionizes at a pH of 4 and
lower?: In the small intestine (since the stomach has a pH of 2-4, so the drug will become ionized and move to the
small intestine where it will be able to absorb into the bloodstream)
21. How can we manipulate the urine pH in cases of overdose?: Drugs that are weak acids
(aspirin) can be trapped and excreted through the urine.
We raise pH of the urine (with sodium bicarb) to force the drug to ionize and allow it to be excreted, not reabsorbed
through the bloodstream.
22. What is distribution?: How a drug will be transported to the tissues it needs to go to in order for it to
exert its effects
23. Drug factors related to distribution:: -Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
-Therapeutic effects
-Toxic effects
(lipid soluble, small, and non-ionized drugs will distribute more quickly)
24. Body factors related to distribution:: -Vascularity (poor perfusion, disruption of blood flow due
to trauma--difficulty distributing)
-Blood barriers (blood-brain-barrier can be problematic if we need to get drugs to the brain--will need very high dosing
, Advanced Pharmacology Exam 1
Study online at https://quizlet.com/_9xwkau
since only a small amount of the drug will get through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
-Drug interactions
25. What is the key plasma protein involved with protein binding for medica-
tions?: Albumin
26. Why do we monitor albumin?: Indicative of nutritional status and how well protein-bound drugs will
be transported to their target locations
27. What happens to the therapeutic effect of a drug when the patient is elderly
and has very low levels of albumin?: The drug does not bind to the protein (albumin) as much as
expected, so there is a lot of free drug floating in the plasma; high risk for drug toxicity
28. Protein bound means:: Inactive form of the drug; does not have any therapeutic effect when bound to
a protein
29. Free drug means:: Active form of the drug (available for therapeutic effect)
30. What happens when a patient is on two drugs that are competing for the
same protein binding site on the albumin?: Some drug interactions can occur. Drugs fight for
binding position, but both drugs do not get enough as the usually would. Leads to higher free drug levels, decreased
overall albumin binding, and potential toxicity for both drugs.
**Unpredictable**
31. What is the 1st pass effect?: PO drug goes through GI tract and absorbs in the stomach or intestines
into local circulation that reaches the liver. The liver inactivates portions of the drug before it goes into systemic
circulation. Some drugs with a very high 1st pass effect may have to be given IV (goes directly into systemic circulation)
or in higher PO doses (watch for side effects)
32. What does a substrate for an enzyme mean?: It needs it to undergo metabolism
33. What is an enzyme inducer?: It increases clearance of the drug (decreased blood levels of drug--may
need dose increase)
34. What is an enzyme inhibitor?: It reduces clearance (increased blood levels of drug--may need dose
decrease)
