NUR-641E Advanced Pathophysiology
and Pharmacology for the Nurse
Educator
Pharmacokinetics - (Correct answer)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 answer) 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 answer) variable and erratic absorption
Steady state (SS) - (Correct answer) is usually reached within 4-5 half-lives of a drug
The half-life of a drug is defined as - (Correct answer) how long it takes for half the drug to be excreted
from the body
Half-life of a drug determines:
Predicts: - (Correct answer) Drug administration frequently
How long toxic effects can last
Half-life is constant with: - (Correct answer) First-order pharmacokinetics of a drug
,Zero-order (nonlinear) pharmacokinetics means a drug is metabolized at a constant rate per unit time,
independent of the concentration.
CYP3A4 substrate drugs - (Correct answer) May have enhanced activity if any CYP3A4 inducer drugs are
used along with it.
Drug development steps (according to the FDA) - (Correct answer) 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 answer)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 answer)Two basic type of ADRs: pharmacological and
idiosyncratic.
85% to 90% of ADRs are pharmacological.
Polypharmacy involves using multiple healthcare providers for care, using multiple medications, and
using several pharmacies for prescription filling.
ADRs are usually - (Correct answer)Preventable;
Frequently occur in a hospital or nursing home setting;
Include medication errors, adverse effects, allergic and idiosyncratic type reactions;
Not commonly reported;
Not mandated for reporting by the FDA.
Angiotensin converting enzyme inhibitors (ACEIs): - (Correct answer)Lisinopril, captopril, enalapril,
ramipril, benazepril, fosinopril;
*ACEIs reduce blood pressure by suppressing the release of angiotensin-converting enzyme.
*Important side effects of ACE inhibitors include cough and angioedema; discontinue the ACEI if
angioedema occurs.
Angiotensin II receptor blocking agents (ARBs): - (Correct answer)Candesartan (Atacand), eprosartan
(Teveten), irbesartan (Avapro),
losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan).
ARBs reduce blood pressure by blocking angiotensin II receptors.
Cardio -
Essential (primary) hypertension - (Correct answer)Accounts for 90% of cases;
Secondary hypertension may be caused by chronic renal failure.
Nitroglycerin - (Correct answer)Nitrate drug used in the treatment of angina;
Can be administered via IV, SL, topical ointment, and transdermal patch
PDE-5 inhibitors - (Correct answer)Pulmonary hypertension therapy (or erectile disfunction therapy)
and Pharmacology for the Nurse
Educator
Pharmacokinetics - (Correct answer)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 answer) 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 answer) variable and erratic absorption
Steady state (SS) - (Correct answer) is usually reached within 4-5 half-lives of a drug
The half-life of a drug is defined as - (Correct answer) how long it takes for half the drug to be excreted
from the body
Half-life of a drug determines:
Predicts: - (Correct answer) Drug administration frequently
How long toxic effects can last
Half-life is constant with: - (Correct answer) First-order pharmacokinetics of a drug
,Zero-order (nonlinear) pharmacokinetics means a drug is metabolized at a constant rate per unit time,
independent of the concentration.
CYP3A4 substrate drugs - (Correct answer) May have enhanced activity if any CYP3A4 inducer drugs are
used along with it.
Drug development steps (according to the FDA) - (Correct answer) 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 answer)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 answer)Two basic type of ADRs: pharmacological and
idiosyncratic.
85% to 90% of ADRs are pharmacological.
Polypharmacy involves using multiple healthcare providers for care, using multiple medications, and
using several pharmacies for prescription filling.
ADRs are usually - (Correct answer)Preventable;
Frequently occur in a hospital or nursing home setting;
Include medication errors, adverse effects, allergic and idiosyncratic type reactions;
Not commonly reported;
Not mandated for reporting by the FDA.
Angiotensin converting enzyme inhibitors (ACEIs): - (Correct answer)Lisinopril, captopril, enalapril,
ramipril, benazepril, fosinopril;
*ACEIs reduce blood pressure by suppressing the release of angiotensin-converting enzyme.
*Important side effects of ACE inhibitors include cough and angioedema; discontinue the ACEI if
angioedema occurs.
Angiotensin II receptor blocking agents (ARBs): - (Correct answer)Candesartan (Atacand), eprosartan
(Teveten), irbesartan (Avapro),
losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan).
ARBs reduce blood pressure by blocking angiotensin II receptors.
Cardio -
Essential (primary) hypertension - (Correct answer)Accounts for 90% of cases;
Secondary hypertension may be caused by chronic renal failure.
Nitroglycerin - (Correct answer)Nitrate drug used in the treatment of angina;
Can be administered via IV, SL, topical ointment, and transdermal patch
PDE-5 inhibitors - (Correct answer)Pulmonary hypertension therapy (or erectile disfunction therapy)
