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Exam 1: NURS 615/ NURS615 (Latest 2024/ 2025 Update) Advanced Pharmacotherapeutics Complete Guide |Qs & As| 100% Correct| Grade A (Verified Answers) - Maryville

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Exam 1: NURS 615/ NURS615 (Latest 2024/ 2025 Update) Advanced Pharmacotherapeutics Complete Guide |Qs & As| 100% Correct| Grade A (Verified Answers) Q: Explain first pass metabolism Answer: much of the drug is lost in the absorption process. The liver metabolizes many drugs, thus reduces the bio-availability of the drug. Q: What is the fasted route of absorption: Answer: The fastest route of absorption is inhalation, and not as mistakenly considered the IV administration. Q: Why does the GI tract take longer to absorb? Answer: The GI tract is lined with epithelial cells; drugs must permeate through these cells in order to be absorbed into the circulatory system. Q: What is One particular cellular barrier that may prevent absorption of a given drug? Answer: 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. Q: What is solubility? Answer: 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. Q: Why does absorption occur at a slower rate for oral, IM, SQ routes? Answer: Absorption occurs at a slower rate because the complex membrane systems of GI mucosal layers, muscle, and skin delay drug passage. Q: The ability of a drug to cross a cell membrane depends on: Answer: 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. Q: As a drug travels through the body, it comes in contact with? Answer: 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. Q: Identify drug metabolism and the role of isoenzymes in the p450 system Answer: CYPs are the are the major enzymes involved in drug metabolism accounting for about 75% of the total metabolism. Q: Naturally occurring compounds may induce or inhibit CYP activity. Answer: 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. Q: What does grapefruit have to do with CYP? Answer: Grapefruit is an inhibitor and will decrease the metabolism of drugs by the cyp enzymes Q: When 2 drugs are both metabolized by the p450 system the drug should be Answer: 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)

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ExamI1:INURSI615/INURS615I(LatestI2024
/I2025IUpdate)IAdvancedI
PharmacotherapeuticsICompleteIGuideI|QsI
&IAs|I100%ICorrect|IGradeIAI(VerifiedI
Answers)
Q:IExplainIfirstIpassImetabolism

Answer:
muchIofItheIdrugIisIlostIinItheIabsorptionIprocess.ITheIliverImetabolizesImanyIdrugs,IthusIred
ucesItheIbio-availabilityIofItheIdrug.




Q:IWhatIisItheIfastedIrouteIofIabsorption:

Answer:
TheIfastestIrouteIofIabsorptionIisIinhalation,IandInotIasImistakenlyIconsideredItheIIVIadminist
ration.




Q:IWhyIdoesItheIGIItractItakeIlongerItoIabsorb?

Answer:
TheIGIItractIisIlinedIwithIepithelialIcells;IdrugsImustIpermeateIthroughItheseIcellsIinIorderItoI
beIabsorbedIintoItheIcirculatoryIsystem.




Q:IWhatIisIOneIparticularIcellularIbarrierIthatImayIpreventIabsorptionIofIaIgivenIdrug?

,Answer:
theIcellImembrane.ICellImembranesIareIessentiallyIlipidIbilayersIwhichIformIaIsemipermeable
Imembrane.IPureIlipidIbilayersIareIgenerallyIpermeableIonlyItoIsmallIandIunchargedIsolutes,Ih
enceIwhetherIorInotIaImoleculeIisIionizedIwillIaffectIitsIabsorption,IsinceIionicImoleculesIareI
charged.




Q:IWhatIisIsolubility?

Answer:
SolubilityIfavorsIchargedIspecies,IpermeabilityIfavorsIneutralIspecies.ISomeImoleculesIhaveIsp
ecialIexchangeIproteinsIandIchannelsItoIfacilitateImovementIfromItheIlumenIintoItheIcirculatio
n.




Q:IWhyIdoesIabsorptionIoccurIatIaIslowerIrateIforIoral,IIM,ISQIroutes?

Answer:
AbsorptionIoccursIatIaIslowerIrateIbecauseItheIcomplexImembraneIsystemsIofIGIImucosalIlay
ers,Imuscle,IandIskinIdelayIdrugIpassage.




Q:ITheIabilityIofIaIdrugItoIcrossIaIcellImembraneIdependsIon:

Answer:
whetherItheIdrugIisIwaterIorIlipidI(fat)Isoluble.ILipid-
solubleIdrugsIeasilyIcrossIthroughIcellImembranes;Iwater-solubleIdrugsIcan't.ILipid-
solubleIdrugsIcanIalsoIcrossItheIblood-brainIbarrierIandIenterItheIbrain.




Q:IAsIaIdrugItravelsIthroughItheIbody,IitIcomesIinIcontactIwith?

Answer:

,proteinsIsuchIasItheIplasmaIproteinIalbumin.ITheIdrugIcanIremainIfreeIorIbindItoItheIprotein.I
TheIportionIofIaIdrugIthat'sIboundItoIaIproteinIisIinactiveIandIcan'tIexertIaItherapeuticIeffect.I
OnlyItheIfree,IorIunbound,IportionIremainsIactive.IAIdrugIisIsaidItoIbeIhighlyIprotein-
boundIifImoreIthanI80%IofItheIdrugIisIboundItoIprotein.




Q:IIdentifyIdrugImetabolismIandItheIroleIofIisoenzymesIinItheIp450Isystem

Answer:
CYPsIareItheIareItheImajorIenzymesIinvolvedIinIdrugImetabolismIaccountingIforIaboutI75%Io
fItheItotalImetabolism.




Q:INaturallyIoccurringIcompoundsImayIinduceIorIinhibitICYPIactivity.

Answer:
ForIexample,IbioactiveIcompoundsIfoundIinIgrapefruitIjuiceIandIsomeIotherIfruitIjuicesIinclud
ingIdihydroxyIforgottenIandIparasitinIAIhaveIbeenIfoundItoIinhibitICYP3a4ImediatedImetabol
ismIofIcertainImedicationsIleadingItoIincreasedIbioavailabilityIandItheIstrongIpossibilityIofIov
erdosing.




Q:IWhatIdoesIgrapefruitIhaveItoIdoIwithICYP?

Answer:
GrapefruitIisIanIinhibitorIandIwillIdecreaseItheImetabolismIofIdrugsIbyItheIcypIenzymes




Q:IWhenI2IdrugsIareIbothImetabolizedIbyItheIp450IsystemItheIdrugIshouldIbe

Answer:

, administeredIatIseparateItimesItoIpreventItheImetabolismIofIoneIdrugIresultingIinItoxicIeffects
IofItheIotherIdrug.I(becauseIitIwouldIhaveIlessIproteinItoIbindItoo,IthusImoreIfreeIfloatingIdru
g)




Q:IWhatIisItheIefficacyIofIaIdrug?

Answer:
EfficacyIisItheImaximumIresponseIachievableIfromIaIdrug.IEffectivenessIrefersItoItheIabilityIo
fItheIdrugItoIproduceIaIbeneficialIeffect.




Q:IOnItheIdrugIconcentrationIcurveIwhatIisItheIfirstIsignIofIaItherapeuticIeffect?

Answer:
TheIonsetIofIaction




Q:IWhatIisItheIpurposeIofIaIpeakIandItroughIlevel?

Answer:
ToIdetermineIifItheIdrugIisIinItherapeuticIrange.




Q:IDescribeItheIpurposeIofIbloodIbrainIbarrier

Answer:
TheIBBBIisIaIhighlyIselectiveIpermeabilityIbarrierIthatIseparatesItheIcirculatingIbloodIfromIth
eIbrainIandIextracellularIfluidIinItheICNS.ITheIBBBIisIformedIbyIbrainIendothelialIcellsIwhic
hIareIconnectedIbyItightIjunctionsIwithIanIextremelyIhighIelectricalIresistivityIofIatIleastI0.1I
micron.ITheIBBBIallowsItheIpassageIofIwater,IsomeIgases,IandIlipidIsolubleImoleculesIbyIpas
siveIdiffusionIasIwellIasItheIselectiveItransportImoleculesIsuchIasIglucoseIandIaminoIacidsItha
tIareIcrucialItoIneuroIfunction.

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