NUR 641E FINAL EXAM STUDY GUIDE
Absorption - Answers - from the administration site either directly or indirectly into the
blood/plasma
Distribution - Answers - Reversibly or irreversibly move from bloodstream into the
interstitial and intracellular fluid
Metabolism - Answers - Biotransformed via hepatic metabolism or by other tissues
Elimination - Answers - Lastly, the drug and its metabolites are eliminated from the body
IV - Answers - -highest bioavailability
-bypasses absorption
-*avoids first pass in the liver*
rectal - Answers - -erratic and variable absorption
4-5 - Answers - SS achieved in _-_ half lives
Half-life - Answers - -how long it takes for drug to be excreted from the body
-determines frequency of administration
-predicts how long toxic effects can last
first-order (linear) pharmacokinetics - Answers - metabolism is directly proportional to
the free concentration of the drug
zero-order (nonlinear) pharmacokinetics - Answers - drug is metabolized at a constant
rate per unit of time
CYP3A4 substrates - Answers - may have decreased activity if any CYP3A4 inducer
drugs are used along with it
Discovery - Answers - laboratory research to develop the new drug
Preclinical research - Answers - animal testing for safety
Phase I - Answers - clinical research on healthy human subjects to assess medication
PK
Phase II - Answers - clinical research in humans primarily for medication safety usually
in a population for which the treatment is intended
Phase III - Answers - clinical research in humans comparing the new drug to accepted
medications or placebo for efficacy and safety
,Phase IV - Answers - post marketing surveillance. Reporting of adverse effects not
identified in earlier clinical studies
medication safety organizations - Answers - -ISMP
-IOM
-Joint Commission
-NCC MERP
-FDA Safe Use Initiative
pharmacological ADR - Answers - -80-90% of ADRs
-an extension of the pharmacological affect of the drug
-ex. overdose
idiosyncratic ADR - Answers - -separate from the pharmacological affect of the drug
-commonly immune mediated response
does not - Answers - the FDA does/does not mandate that ADRs be reported
Polypharmacy - Answers - involves using multiple health care providers for care, using
multiple medications, and using several pharmacies for prescription filling
ACEI - Answers - -Lisinopril, captopril, enalopil, ramipril, benazepril, fosinopril
-suppress the release of ACE
ACEI (side effects) - Answers - -cough
-angioedema
-discontinue the ACEI if angioedema occurs
ARBs - Answers - -block angiotensin II receptors
primary hypertension - Answers - -denotes high blood pressure from an unidentified
cause; also called essential hypertension
-90% of cases
secondary hypertension - Answers - -high blood pressure caused by the effects of
another disease
-example: chronic renal failure
Nitroglycerin - Answers - -IV/SL/topical/transdermal
-contraindicated with PDE-5 inhibitors
nitrates (contraindications) - Answers - sildenafil, verdenafil
amiodarone - Answers - -antiarrhythmic of choice with coexisting heart failure
-can cause thyroid and pulmonary toxicity
, alpha-1 stimulation - Answers - -vasoconstriction
-increased blood pressure
alpha-1 blockade - Answers - -vasodilation
-reduced blood pressure
beta-1 stimulation - Answers - -increased HR
-increased BP
-increased CO
beta-1 blockade - Answers - -reduced heart rate
-reduced BP
-reduced CO
beta agonists - Answers - -isoproternol
LHF - Answers - -decreased delivery of O2 to body tissues
RHF - Answers - -associated with pulmonary disease and increased pulmonary
resistance
furosemide - Answers - relieves heart failure symptoms but does not reduce mortality is
furosemide
loop diuretics - Answers - -potent diuretics
-can cause diuretic resistance and hypokalemia
-work on receptors in the thick ascending renal loop of Henle
-inhibit the reabsorption of sodium and chloride
potassium-sparing diuretics - Answers - -spironolactone
-triameterne
milrinone - Answers - phosphodiesterase inhibitor used for acute heart failure
squatting - Answers - children with tetralogy of fallot can stop hypoxic spells by
PDA (s/s) - Answers - -continuous machine like murmur heard over the left sternal
border in both systole and diastole
-bounding pulse
-thrill on palpations
-treated with IV NSAIDs including indomethacin
Raynaud's disease - Answers - -vasospastic disorder seen in colder weather
-involves the small artiers and arterioles in the fingers; ocasionally the toes are also
involved
Absorption - Answers - from the administration site either directly or indirectly into the
blood/plasma
Distribution - Answers - Reversibly or irreversibly move from bloodstream into the
interstitial and intracellular fluid
Metabolism - Answers - Biotransformed via hepatic metabolism or by other tissues
Elimination - Answers - Lastly, the drug and its metabolites are eliminated from the body
IV - Answers - -highest bioavailability
-bypasses absorption
-*avoids first pass in the liver*
rectal - Answers - -erratic and variable absorption
4-5 - Answers - SS achieved in _-_ half lives
Half-life - Answers - -how long it takes for drug to be excreted from the body
-determines frequency of administration
-predicts how long toxic effects can last
first-order (linear) pharmacokinetics - Answers - metabolism is directly proportional to
the free concentration of the drug
zero-order (nonlinear) pharmacokinetics - Answers - drug is metabolized at a constant
rate per unit of time
CYP3A4 substrates - Answers - may have decreased activity if any CYP3A4 inducer
drugs are used along with it
Discovery - Answers - laboratory research to develop the new drug
Preclinical research - Answers - animal testing for safety
Phase I - Answers - clinical research on healthy human subjects to assess medication
PK
Phase II - Answers - clinical research in humans primarily for medication safety usually
in a population for which the treatment is intended
Phase III - Answers - clinical research in humans comparing the new drug to accepted
medications or placebo for efficacy and safety
,Phase IV - Answers - post marketing surveillance. Reporting of adverse effects not
identified in earlier clinical studies
medication safety organizations - Answers - -ISMP
-IOM
-Joint Commission
-NCC MERP
-FDA Safe Use Initiative
pharmacological ADR - Answers - -80-90% of ADRs
-an extension of the pharmacological affect of the drug
-ex. overdose
idiosyncratic ADR - Answers - -separate from the pharmacological affect of the drug
-commonly immune mediated response
does not - Answers - the FDA does/does not mandate that ADRs be reported
Polypharmacy - Answers - involves using multiple health care providers for care, using
multiple medications, and using several pharmacies for prescription filling
ACEI - Answers - -Lisinopril, captopril, enalopil, ramipril, benazepril, fosinopril
-suppress the release of ACE
ACEI (side effects) - Answers - -cough
-angioedema
-discontinue the ACEI if angioedema occurs
ARBs - Answers - -block angiotensin II receptors
primary hypertension - Answers - -denotes high blood pressure from an unidentified
cause; also called essential hypertension
-90% of cases
secondary hypertension - Answers - -high blood pressure caused by the effects of
another disease
-example: chronic renal failure
Nitroglycerin - Answers - -IV/SL/topical/transdermal
-contraindicated with PDE-5 inhibitors
nitrates (contraindications) - Answers - sildenafil, verdenafil
amiodarone - Answers - -antiarrhythmic of choice with coexisting heart failure
-can cause thyroid and pulmonary toxicity
, alpha-1 stimulation - Answers - -vasoconstriction
-increased blood pressure
alpha-1 blockade - Answers - -vasodilation
-reduced blood pressure
beta-1 stimulation - Answers - -increased HR
-increased BP
-increased CO
beta-1 blockade - Answers - -reduced heart rate
-reduced BP
-reduced CO
beta agonists - Answers - -isoproternol
LHF - Answers - -decreased delivery of O2 to body tissues
RHF - Answers - -associated with pulmonary disease and increased pulmonary
resistance
furosemide - Answers - relieves heart failure symptoms but does not reduce mortality is
furosemide
loop diuretics - Answers - -potent diuretics
-can cause diuretic resistance and hypokalemia
-work on receptors in the thick ascending renal loop of Henle
-inhibit the reabsorption of sodium and chloride
potassium-sparing diuretics - Answers - -spironolactone
-triameterne
milrinone - Answers - phosphodiesterase inhibitor used for acute heart failure
squatting - Answers - children with tetralogy of fallot can stop hypoxic spells by
PDA (s/s) - Answers - -continuous machine like murmur heard over the left sternal
border in both systole and diastole
-bounding pulse
-thrill on palpations
-treated with IV NSAIDs including indomethacin
Raynaud's disease - Answers - -vasospastic disorder seen in colder weather
-involves the small artiers and arterioles in the fingers; ocasionally the toes are also
involved
