______________________________________
NR 565
ADVANCED PHARMACOLOGY
FUNDAMENTALS
FINAL STUDY GUIDE
(WEEK 1 – 8)
(AT CHAMBERLAIN COLLEGE OF
NURSING)
EXAM- QUESTIONS & (UPDATED)
ANSWERS
EXAM COVER SHEET
COURSE NAME: NR 565 – Advanced Pharmacology
Fundamentals
EXAM NAME: NR 565 Advanced Pharmacology Fundamentals
FINAL Exam Study Guide
PROGRAM: Nursing
KEY TOPICS & EXAM PREPARATION STRATEGIES
, Week 1-4
Week 1 Week 3
Blood Flow Impact on Distribution Adverse Psychological Effects of High-
• Drug must be distributed to sites of action Dose Marijuana
throughout the body via vascular system. To ▪ In high doses, marijuana can have serious
enter target tissue, it must exit vascular adverse psychological effects. The user may
system. Blood flow and drug ability to exit experience hallucinations, delusions, and
vascular system and enter cells and the paranoia.
degree of plasma protein binding. Codeine and Analgesic Efficacy
Blood-Brain Barrier Impact • For analgesic, codeine is formulated alone
• Refers to the unique anatomy of capillaries in and in combination with nonopioid analgesics
the CNS (aspirin or acetaminophen)
• Drugs must be lipid soluble to penetrate • Because codeine and nonopioid analgesics
membranes relieve pain by different mechanisms with
• Only drugs that are lipid soluble or have a combinations can produce greater pain relief
transport system can cross the BBB than either agent alone
First-Pass Effect Fentanyl Transmucosal Use
• Only approved for breakthrough cancer pain
• Refers to the rapid hepatic inactivation of
in patients at least 18 years old who are
certain oral drugs.
already taking opioids around the clock and
• Drugs are absorbed from the GI tract then have developed some degree of tolerance,
carried directly to the liver through the hepatic defined as needing for 1 week or longer at
portal vein before they enter the systemic least: 60 mg of oral morphine a day, or 30 mg
circulation. If the capacity of the liver to of oral oxycodone a day, or 25 mg or oral
metabolize a drug is extremely high, that drug oxymorphone a day, or 8 mg oral
can be completely inactivated on its first pass hydromorphone a day, or 25 mcg fentanyl per
through the liver. hour, or an equianalgesic dose of another
• To circumvent first-pass effect, a drug that opioid.
undergoes rapid hepatic metabolism is often Opioid Withdrawal
administered parenterally Opioids in Pregnancy
Lipid Solubility and Absorption ▪ Taking opioids in early pregnancy can increase
• Highly lipid-soluble drugs are absorbed more the risk for congenital heart defects, spina bifida,
rapidly than drugs whose lipid solubility is low and gastroschisis.
• Channels or pores, passage with the aid of a
transport system, direct penetration of the
membrane
• P-glycoprotein or multidrug transporter
protein, transports a wide variety of drugs out
of cells
• Drugs must be lipid soluble to penetrate
membranes
• Absorption is the movement of a drug from its
site of administration into the systemic
circulation.
Medication Administration
• IV: absorption is bypassed, rapid onset
• IM: capillary wall (easy to pass) rapid with
water-soluble drugs, slow with poorly soluble
drugs
• subQ: same as IM
• Oral: epithelial lining of GI tract; capillary wall,
slow and variable
Placental Drug Transfer
, • Drugs that are lipid soluble cross the placenta
easily, whereas drugs that are ionized, highly
polar, or protein bound cross with difficulty.
Providers should assume that any drug taken
during pregnancy will reach the fetus.
NR 565
ADVANCED PHARMACOLOGY
FUNDAMENTALS
FINAL STUDY GUIDE
(WEEK 1 – 8)
(AT CHAMBERLAIN COLLEGE OF
NURSING)
EXAM- QUESTIONS & (UPDATED)
ANSWERS
EXAM COVER SHEET
COURSE NAME: NR 565 – Advanced Pharmacology
Fundamentals
EXAM NAME: NR 565 Advanced Pharmacology Fundamentals
FINAL Exam Study Guide
PROGRAM: Nursing
KEY TOPICS & EXAM PREPARATION STRATEGIES
, Week 1-4
Week 1 Week 3
Blood Flow Impact on Distribution Adverse Psychological Effects of High-
• Drug must be distributed to sites of action Dose Marijuana
throughout the body via vascular system. To ▪ In high doses, marijuana can have serious
enter target tissue, it must exit vascular adverse psychological effects. The user may
system. Blood flow and drug ability to exit experience hallucinations, delusions, and
vascular system and enter cells and the paranoia.
degree of plasma protein binding. Codeine and Analgesic Efficacy
Blood-Brain Barrier Impact • For analgesic, codeine is formulated alone
• Refers to the unique anatomy of capillaries in and in combination with nonopioid analgesics
the CNS (aspirin or acetaminophen)
• Drugs must be lipid soluble to penetrate • Because codeine and nonopioid analgesics
membranes relieve pain by different mechanisms with
• Only drugs that are lipid soluble or have a combinations can produce greater pain relief
transport system can cross the BBB than either agent alone
First-Pass Effect Fentanyl Transmucosal Use
• Only approved for breakthrough cancer pain
• Refers to the rapid hepatic inactivation of
in patients at least 18 years old who are
certain oral drugs.
already taking opioids around the clock and
• Drugs are absorbed from the GI tract then have developed some degree of tolerance,
carried directly to the liver through the hepatic defined as needing for 1 week or longer at
portal vein before they enter the systemic least: 60 mg of oral morphine a day, or 30 mg
circulation. If the capacity of the liver to of oral oxycodone a day, or 25 mg or oral
metabolize a drug is extremely high, that drug oxymorphone a day, or 8 mg oral
can be completely inactivated on its first pass hydromorphone a day, or 25 mcg fentanyl per
through the liver. hour, or an equianalgesic dose of another
• To circumvent first-pass effect, a drug that opioid.
undergoes rapid hepatic metabolism is often Opioid Withdrawal
administered parenterally Opioids in Pregnancy
Lipid Solubility and Absorption ▪ Taking opioids in early pregnancy can increase
• Highly lipid-soluble drugs are absorbed more the risk for congenital heart defects, spina bifida,
rapidly than drugs whose lipid solubility is low and gastroschisis.
• Channels or pores, passage with the aid of a
transport system, direct penetration of the
membrane
• P-glycoprotein or multidrug transporter
protein, transports a wide variety of drugs out
of cells
• Drugs must be lipid soluble to penetrate
membranes
• Absorption is the movement of a drug from its
site of administration into the systemic
circulation.
Medication Administration
• IV: absorption is bypassed, rapid onset
• IM: capillary wall (easy to pass) rapid with
water-soluble drugs, slow with poorly soluble
drugs
• subQ: same as IM
• Oral: epithelial lining of GI tract; capillary wall,
slow and variable
Placental Drug Transfer
, • Drugs that are lipid soluble cross the placenta
easily, whereas drugs that are ionized, highly
polar, or protein bound cross with difficulty.
Providers should assume that any drug taken
during pregnancy will reach the fetus.
