NUR-641E Advanced Pathophysiology |\ |\ |\
and Pharmacology for the Nurse
|\ |\ |\ |\ |\
Educator – questions with answers |\ |\ |\ |\
Pharmacokinetics - CORRECT ANSWERS ✔✔Involves |\ |\ |\ |\ |\
ADME (absorption, distribution, metabolism and
|\ |\ |\ |\ |\
elimination).
Absorption: absorption from the administration site either
|\ |\ |\ |\ |\ |\ |\
directly or indirectly into the blood/plasma.
|\ |\ |\ |\ |\
Distribution: reversibly or irreversibly move from the
|\ |\ |\ |\ |\ |\ |\
bloodstream into the interstitial and intracellular fluid.
|\ |\ |\ |\ |\ |\
Metabolism: bio-transformed via hepatic metabolism or
|\ |\ |\ |\ |\ |\
by other tissues.
|\ |\
Elimination: lastly, the drug & its metabolites are
|\ |\ |\ |\ |\ |\ |\ |\
eliminated from the body |\ |\ |\
The route of administration with the highest bio-
|\ |\ |\ |\ |\ |\ |\
availability is - CORRECT ANSWERS ✔✔Intravenous;
|\ |\ |\ |\ |\ |\
putting entire dose into a patient's vein and bypassing
|\ |\ |\ |\ |\ |\ |\ |\ |\
,absorption. Intravenous route avoids first-pass|\ |\ |\ |\ |\
metabolism in the liver. |\ |\ |\
rectal administration disadvantages - CORRECT ANSWERS
|\ |\ |\ |\ |\
✔✔variable and erratic absorption
|\ |\ |\ |\
Steady state (SS) - CORRECT ANSWERS ✔✔is usually
|\ |\ |\ |\ |\ |\ |\ |\
reached within 4-5 half-lives of a drug
|\ |\ |\ |\ |\ |\
The half-life of a drug is defined as - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔how long it takes for half the drug to be excreted from
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the body
|\
Half-life of a drug - CORRECT ANSWERS ✔✔Determines
|\ |\ |\ |\ |\ |\ |\ |\
how frequently the drug must be administered
|\ |\ |\ |\ |\ |\
Predicts how long toxic effects can last
|\ |\ |\ |\ |\ |\
Half-life is constant with first-order pharmacokinetics of a
|\ |\ |\ |\ |\ |\ |\ |\
drug
Zero-order (nonlinear) pharmacokinetics means a drug is
|\ |\ |\ |\ |\ |\ |\
metabolized at a constant rate per unit time. |\ |\ |\ |\ |\ |\ |\
,CYP3A4 substrate drugs - CORRECT ANSWERS ✔✔May
|\ |\ |\ |\ |\ |\ |\
have enhanced activity if any CYP3A4 inducer drugs are
|\ |\ |\ |\ |\ |\ |\ |\ |\
used along with it.
|\ |\ |\
Drug development steps (according to the FDA) -
|\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔Discovery: laboratory research to
|\ |\ |\ |\ |\ |\
develop the new drug |\ |\ |\ |\
Pre-clinical research with animal testing for safety (Phase
|\ |\ |\ |\ |\ |\ |\ |\
I)
Clinical research on human subjects for medication safety
|\ |\ |\ |\ |\ |\ |\
(Phase II)
|\ |\
Clinical research in humans comparing the new drug to
|\ |\ |\ |\ |\ |\ |\ |\ |\
accepted medications or placebo depending on the study
|\ |\ |\ |\ |\ |\ |\ |\
(Phase III) |\ |\
FDA review of the results to determine approval
|\ |\ |\ |\ |\ |\ |\
Post-marketing study to identify adverse effects not found |\ |\ |\ |\ |\ |\ |\
in earlier clinical studies (Phase IV)
|\ |\ |\ |\ |\ |\
Medication safety organizations - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\
✔✔The Institute for Safe Medication Practices (ISMP)
|\ |\ |\ |\ |\ |\
, The Institute of Medicine (IOM)
|\ |\ |\ |\
The Joint Commission
|\ |\
The National Coordinating Council for Medication Error
|\ |\ |\ |\ |\ |\ |\
Reporting and Prevention (NCCMERP) |\ |\ |\
Food and Drug Administration (FDA) Safe Use Initiative
|\ |\ |\ |\ |\ |\ |\
Adverse Drug Reactions (ADRs) - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔Two basic type of ADRs: pharmacological and
|\ |\ |\ |\ |\ |\ |\
idiosyncratic.
85% to 90% of ADRs are pharmacological.
|\ |\ |\ |\ |\ |\
Adverse drug reactions are usually preventable,
|\ |\ |\ |\ |\ |\
frequently occur in a hospital or nursing home setting,
|\ |\ |\ |\ |\ |\ |\ |\ |\
and include medication errors, adverse drug effects,
|\ |\ |\ |\ |\ |\ |\
allergic and idiosyncratic type reactions.
|\ |\ |\ |\ |\
ADRs are not commonly reported; the FDA does not
|\ |\ |\ |\ |\ |\ |\ |\ |\
mandate that ADRs be reported.|\ |\ |\ |\
and Pharmacology for the Nurse
|\ |\ |\ |\ |\
Educator – questions with answers |\ |\ |\ |\
Pharmacokinetics - CORRECT ANSWERS ✔✔Involves |\ |\ |\ |\ |\
ADME (absorption, distribution, metabolism and
|\ |\ |\ |\ |\
elimination).
Absorption: absorption from the administration site either
|\ |\ |\ |\ |\ |\ |\
directly or indirectly into the blood/plasma.
|\ |\ |\ |\ |\
Distribution: reversibly or irreversibly move from the
|\ |\ |\ |\ |\ |\ |\
bloodstream into the interstitial and intracellular fluid.
|\ |\ |\ |\ |\ |\
Metabolism: bio-transformed via hepatic metabolism or
|\ |\ |\ |\ |\ |\
by other tissues.
|\ |\
Elimination: lastly, the drug & its metabolites are
|\ |\ |\ |\ |\ |\ |\ |\
eliminated from the body |\ |\ |\
The route of administration with the highest bio-
|\ |\ |\ |\ |\ |\ |\
availability is - CORRECT ANSWERS ✔✔Intravenous;
|\ |\ |\ |\ |\ |\
putting entire dose into a patient's vein and bypassing
|\ |\ |\ |\ |\ |\ |\ |\ |\
,absorption. Intravenous route avoids first-pass|\ |\ |\ |\ |\
metabolism in the liver. |\ |\ |\
rectal administration disadvantages - CORRECT ANSWERS
|\ |\ |\ |\ |\
✔✔variable and erratic absorption
|\ |\ |\ |\
Steady state (SS) - CORRECT ANSWERS ✔✔is usually
|\ |\ |\ |\ |\ |\ |\ |\
reached within 4-5 half-lives of a drug
|\ |\ |\ |\ |\ |\
The half-life of a drug is defined as - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
✔✔how long it takes for half the drug to be excreted from
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the body
|\
Half-life of a drug - CORRECT ANSWERS ✔✔Determines
|\ |\ |\ |\ |\ |\ |\ |\
how frequently the drug must be administered
|\ |\ |\ |\ |\ |\
Predicts how long toxic effects can last
|\ |\ |\ |\ |\ |\
Half-life is constant with first-order pharmacokinetics of a
|\ |\ |\ |\ |\ |\ |\ |\
drug
Zero-order (nonlinear) pharmacokinetics means a drug is
|\ |\ |\ |\ |\ |\ |\
metabolized at a constant rate per unit time. |\ |\ |\ |\ |\ |\ |\
,CYP3A4 substrate drugs - CORRECT ANSWERS ✔✔May
|\ |\ |\ |\ |\ |\ |\
have enhanced activity if any CYP3A4 inducer drugs are
|\ |\ |\ |\ |\ |\ |\ |\ |\
used along with it.
|\ |\ |\
Drug development steps (according to the FDA) -
|\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔Discovery: laboratory research to
|\ |\ |\ |\ |\ |\
develop the new drug |\ |\ |\ |\
Pre-clinical research with animal testing for safety (Phase
|\ |\ |\ |\ |\ |\ |\ |\
I)
Clinical research on human subjects for medication safety
|\ |\ |\ |\ |\ |\ |\
(Phase II)
|\ |\
Clinical research in humans comparing the new drug to
|\ |\ |\ |\ |\ |\ |\ |\ |\
accepted medications or placebo depending on the study
|\ |\ |\ |\ |\ |\ |\ |\
(Phase III) |\ |\
FDA review of the results to determine approval
|\ |\ |\ |\ |\ |\ |\
Post-marketing study to identify adverse effects not found |\ |\ |\ |\ |\ |\ |\
in earlier clinical studies (Phase IV)
|\ |\ |\ |\ |\ |\
Medication safety organizations - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\
✔✔The Institute for Safe Medication Practices (ISMP)
|\ |\ |\ |\ |\ |\
, The Institute of Medicine (IOM)
|\ |\ |\ |\
The Joint Commission
|\ |\
The National Coordinating Council for Medication Error
|\ |\ |\ |\ |\ |\ |\
Reporting and Prevention (NCCMERP) |\ |\ |\
Food and Drug Administration (FDA) Safe Use Initiative
|\ |\ |\ |\ |\ |\ |\
Adverse Drug Reactions (ADRs) - CORRECT ANSWERS
|\ |\ |\ |\ |\ |\ |\
✔✔Two basic type of ADRs: pharmacological and
|\ |\ |\ |\ |\ |\ |\
idiosyncratic.
85% to 90% of ADRs are pharmacological.
|\ |\ |\ |\ |\ |\
Adverse drug reactions are usually preventable,
|\ |\ |\ |\ |\ |\
frequently occur in a hospital or nursing home setting,
|\ |\ |\ |\ |\ |\ |\ |\ |\
and include medication errors, adverse drug effects,
|\ |\ |\ |\ |\ |\ |\
allergic and idiosyncratic type reactions.
|\ |\ |\ |\ |\
ADRs are not commonly reported; the FDA does not
|\ |\ |\ |\ |\ |\ |\ |\ |\
mandate that ADRs be reported.|\ |\ |\ |\
