Maryville NURS 615 Pharm 1 exam with all the correct answers (100%
Verified 2020/2021 exam)
How does hypoalbuminemia affect the process of prescribing? -Ans>>Low albumin = more free drug
(bc the drug can't bind to albumin aka protein) = increased adverse effects
What is a Black Box Warning: -Ans>>is considered a contraindication to administer that drug.
What is the drugs half-life? -Ans>>Half-life specifically means the amount of time it takes for an
administered drug to be halfway cleared from the system.
Peak of action: -Ans>>the time between drug administration and maximum concentration of drug in
the blood stream. Best therapeutic effect.
Duration of action: -Ans>>the time between onset of action and metabolism of drug below the
minimum needed for an effect. The length of time you have the drug in your system.
According to the WHO what is the first step in the prescribing process? -Ans>>The first step is to
define the patient's problem
The second step is to -Ans>>specify the therapeutic objective
The third step is to -Ans>>choose which drug or treatment is needed.
Step 4 of the WHO approach: -Ans>>Start the treatment
Step 5 of the WHO approach: -Ans>>Educate the patient
Step 6 of the WHO approach: -Ans>>Monitor the treatment
Phase 1 of drug development: -Ans>>The drug is tested on healthy volunteers
Phase 2 of drug development: -Ans>>trials with people who have the disease for which the drug is
thought to be effective
Phase 3 of drug development: -Ans>>Large numbers of patients in medical research centers receive
the drug in phase 3. This larger sampling provides information about infrequent or rare adverse
effects. The FFA will approve a new drug application if phase 3 studies are satisfactory.
Phase 4 of drug development: -Ans>>This phase is voluntary and involves postmarket surveillance of
the drug's therapeutic effects at the completion of phase 3. The pharmaceutical company receives
reports from doctors and other health care professionals about the therapeutic results and adverse
effects of the drug. Some medications, for example, have been found to be toxic and have been
removed from the market after their initial release.
Explain first pass metabolism -Ans>>much of the drug is lost in the absorption process. The liver
metabolizes many drugs, thus reduces the bioavailabilty of the drug.
What is the fasted route of absorption: -Ans>>The fastest route of absorption is inhalation, and not as
mistakenly considered the IV administration.
Why does the GI tract take longer to absorb? -Ans>>The GI tract is lined with epithelial cells; drugs
must permeate through these cells in order to be absorbed into the circulatory system.
What is One particular cellular barrier that may prevent absorption of a given drug? -Ans>>the cell
membrane. Cell membranes are essentially lipid bilayers which form a semipermeable membrane.
, Pure lipid bilayers are generally permeable only to small and uncharged solutes, hence whether or not
a molecule is ionized will affect its absorption, since ionic molecules are charged.
What is solubility? -Ans>>Solubility favors charged species, permeability favors neutral species. Some
molecules have special exchange proteins and channels to facilitate movement from the lumen into
the circulation.
Why does absorption occur at a slower rate for oral, IM, SQ routes? -Ans>>Absorption occurs at a
slower rate because the complex membrane systems of GI mucosal layers, muscle, and skin delay
drug passage.
The ability of a drug to cross a cell membrane depends on: -Ans>>whether the drug is water or lipid
(fat) soluble. Lipid-soluble drugs easily cross through cell membranes; water-soluble drugs can't. Lipid-
soluble drugs can also cross the blood-brain barrier and enter the brain.
As a drug travels through the body, it comes in contact with? -Ans>>proteins such as the plasma
protein albumin. The drug can remain free or bind to the protein. The portion of a drug that's bound
to a protein is inactive and can't exert a therapeutic effect. Only the free, or unbound, portion
remains active. A drug is said to be highly protein-bound if more than 80% of the drug is bound to
protein.
Identify drug metabolism and the role of isoenzymes in the p450 system -Ans>>CYPs are the are the
major enzymes involved in drug metabolism accounting for about 75% of the total metabolism.
Naturally occurring compounds may induce or inhibit CYP activity. -Ans>>For example, bioactive
compounds found in grapefruit juice and some other fruit juices including dihydroxy forgotten and
parasitin A have been found to inhibit CYP3a4 mediated metabolism of certain medications leading to
increased bioavailability and the strong possibility of overdosing.
What does grapefruit have to do with CYP? -Ans>>Grapefruit is an inhibitor and will decrease the
metabolism of drugs by the cyp enzymes
When 2 drugs are both metabolized by the p450 system the drug should be -Ans>>administered at
separate times to prevent the metabolism of one drug resulting in toxic effects of the other drug.
(because it would have less protein to bind too, thus more free floating drug)
What is the efficacy of a drug? -Ans>>Efficacy is the maximum response achievable from a drug.
Effectiveness refers to the ability of the drug to produce a beneficial effect.
On the drug concentration curve what is the first sign of a therapeutic effect? -Ans>>The onset of
action
What is the purpose of a peak and trough level? -Ans>>To determine if the drug is in therapeutic
range.
Describe the purpose of blood brain barrier -Ans>>The BBB is a highly selective permeability barrier
that separates the circulating blood from the brain and extracellular fluid in the CNS. The BBB is
formed by brain endothelial cells which are connected by tight junctions with an extremely high
electrical resistivity of at least 0.1 micron. The BBB allows the passage of water, some gases, and lipid
soluble molecules by passive diffusion as well as the selective transport molecules such as glucose and
amino acids that are crucial to neuro function.
Describe the purpose of the fetal placental barrier -Ans>>the so-called placental barrier impedes
certain chemicals although it allows most fat soluble chemicals to cross. Drugs that are more water
soluble and that possess a higher molecular weight tend not to cross the placental barrier. In addition,
if a drug binds to a large molecule, such as a blood-borne protein like albumin, it is even less likely to
come into contact with fetus.
Verified 2020/2021 exam)
How does hypoalbuminemia affect the process of prescribing? -Ans>>Low albumin = more free drug
(bc the drug can't bind to albumin aka protein) = increased adverse effects
What is a Black Box Warning: -Ans>>is considered a contraindication to administer that drug.
What is the drugs half-life? -Ans>>Half-life specifically means the amount of time it takes for an
administered drug to be halfway cleared from the system.
Peak of action: -Ans>>the time between drug administration and maximum concentration of drug in
the blood stream. Best therapeutic effect.
Duration of action: -Ans>>the time between onset of action and metabolism of drug below the
minimum needed for an effect. The length of time you have the drug in your system.
According to the WHO what is the first step in the prescribing process? -Ans>>The first step is to
define the patient's problem
The second step is to -Ans>>specify the therapeutic objective
The third step is to -Ans>>choose which drug or treatment is needed.
Step 4 of the WHO approach: -Ans>>Start the treatment
Step 5 of the WHO approach: -Ans>>Educate the patient
Step 6 of the WHO approach: -Ans>>Monitor the treatment
Phase 1 of drug development: -Ans>>The drug is tested on healthy volunteers
Phase 2 of drug development: -Ans>>trials with people who have the disease for which the drug is
thought to be effective
Phase 3 of drug development: -Ans>>Large numbers of patients in medical research centers receive
the drug in phase 3. This larger sampling provides information about infrequent or rare adverse
effects. The FFA will approve a new drug application if phase 3 studies are satisfactory.
Phase 4 of drug development: -Ans>>This phase is voluntary and involves postmarket surveillance of
the drug's therapeutic effects at the completion of phase 3. The pharmaceutical company receives
reports from doctors and other health care professionals about the therapeutic results and adverse
effects of the drug. Some medications, for example, have been found to be toxic and have been
removed from the market after their initial release.
Explain first pass metabolism -Ans>>much of the drug is lost in the absorption process. The liver
metabolizes many drugs, thus reduces the bioavailabilty of the drug.
What is the fasted route of absorption: -Ans>>The fastest route of absorption is inhalation, and not as
mistakenly considered the IV administration.
Why does the GI tract take longer to absorb? -Ans>>The GI tract is lined with epithelial cells; drugs
must permeate through these cells in order to be absorbed into the circulatory system.
What is One particular cellular barrier that may prevent absorption of a given drug? -Ans>>the cell
membrane. Cell membranes are essentially lipid bilayers which form a semipermeable membrane.
, Pure lipid bilayers are generally permeable only to small and uncharged solutes, hence whether or not
a molecule is ionized will affect its absorption, since ionic molecules are charged.
What is solubility? -Ans>>Solubility favors charged species, permeability favors neutral species. Some
molecules have special exchange proteins and channels to facilitate movement from the lumen into
the circulation.
Why does absorption occur at a slower rate for oral, IM, SQ routes? -Ans>>Absorption occurs at a
slower rate because the complex membrane systems of GI mucosal layers, muscle, and skin delay
drug passage.
The ability of a drug to cross a cell membrane depends on: -Ans>>whether the drug is water or lipid
(fat) soluble. Lipid-soluble drugs easily cross through cell membranes; water-soluble drugs can't. Lipid-
soluble drugs can also cross the blood-brain barrier and enter the brain.
As a drug travels through the body, it comes in contact with? -Ans>>proteins such as the plasma
protein albumin. The drug can remain free or bind to the protein. The portion of a drug that's bound
to a protein is inactive and can't exert a therapeutic effect. Only the free, or unbound, portion
remains active. A drug is said to be highly protein-bound if more than 80% of the drug is bound to
protein.
Identify drug metabolism and the role of isoenzymes in the p450 system -Ans>>CYPs are the are the
major enzymes involved in drug metabolism accounting for about 75% of the total metabolism.
Naturally occurring compounds may induce or inhibit CYP activity. -Ans>>For example, bioactive
compounds found in grapefruit juice and some other fruit juices including dihydroxy forgotten and
parasitin A have been found to inhibit CYP3a4 mediated metabolism of certain medications leading to
increased bioavailability and the strong possibility of overdosing.
What does grapefruit have to do with CYP? -Ans>>Grapefruit is an inhibitor and will decrease the
metabolism of drugs by the cyp enzymes
When 2 drugs are both metabolized by the p450 system the drug should be -Ans>>administered at
separate times to prevent the metabolism of one drug resulting in toxic effects of the other drug.
(because it would have less protein to bind too, thus more free floating drug)
What is the efficacy of a drug? -Ans>>Efficacy is the maximum response achievable from a drug.
Effectiveness refers to the ability of the drug to produce a beneficial effect.
On the drug concentration curve what is the first sign of a therapeutic effect? -Ans>>The onset of
action
What is the purpose of a peak and trough level? -Ans>>To determine if the drug is in therapeutic
range.
Describe the purpose of blood brain barrier -Ans>>The BBB is a highly selective permeability barrier
that separates the circulating blood from the brain and extracellular fluid in the CNS. The BBB is
formed by brain endothelial cells which are connected by tight junctions with an extremely high
electrical resistivity of at least 0.1 micron. The BBB allows the passage of water, some gases, and lipid
soluble molecules by passive diffusion as well as the selective transport molecules such as glucose and
amino acids that are crucial to neuro function.
Describe the purpose of the fetal placental barrier -Ans>>the so-called placental barrier impedes
certain chemicals although it allows most fat soluble chemicals to cross. Drugs that are more water
soluble and that possess a higher molecular weight tend not to cross the placental barrier. In addition,
if a drug binds to a large molecule, such as a blood-borne protein like albumin, it is even less likely to
come into contact with fetus.
