mn 553 Pharmacology final exam
review Questions and Answers
regulations - -∙all states have title protection for NPs
•the board of nursing regulates practice
-5 states have joint oversight with medical board
•scope of practice is determined by NP license
- investigational new drug (IND) - -•required before an investigational drug
or bio product can be administered to a human
•the IND app is a compilation of all known information about the compound
•it also includes a description of the clinical research plan for the product
•specific protocol for phase I study
- phases of clinical study - -•phase I clinical eval is the 1st testing of a new
compound in subjects for the purpose of establishing the tolerance of
healthy human subjects
•phase II clinical eval is controlled studies performed on pts having the
target disease or disorder to determine a compound's potential usefulness
and short term risks
•phase III trials are controlled and uncontrolled clinical trials of a drug's
safety and efficacy in hospital and outpt settings
•phase III trials verify that the acceptable risk/benefit ratio seen in II persists
under conditions of anticipated usage in groups of pts large enough to
identify statistically and clinically significant responses
- clinical judgment in prescribing - -•is there clear indication for drug?
•what drugs are effective for the disease?
•what are the goals of therapy?
•monitoring to see if drug is meeting goals
•duplications in med pts is taking
•otc vs prescription
•cost
•sources of info
- the process of prescribing - -•identify the pts problem
•specify the therapeutic objective
•collab with the pt
•choose the treatment
•edu the pt
•mt for effectiveness
•individualize drug choice
- special population: pregnancy - -•avoid ACEI, consider BB
, •bulk laxative
- special population: nursing moms - -avoid ACEI, consider BB
- special population: pediatric - -•best pharmaceuticals for children act
(BPCA)
•authorizes research to promote efficacy and safety
- special population: older adults - -•beers criteria
-looks at potential risk
-does not look at effectiveness
- pediatric distribution - -•newborns and infants have higher percentage of
water
•BBB is incomplete and permeable in newborn
•infants younger than 6 mths of age have decreased plasma proteins
available for drug binding
•in infants dosing needs to be decreased if metabolized by kidneys
- older adults - -•take more meds than any other age group
•PD and PK are altered
•ADRs common
•risk increase with number of drugs used
•decreased protein impacts absorption
- medication metabolisms - -•some meds need a loading dose
- first pass - -occurs when metabolized by the liver
- peak levels - -important to have this to achieve desired effect
- half-life - -•ibuprofen ~2 hours
•SSRI~ 22 hours
- antacids: clinical use and dosing - -•GERD
-antacids are OTC and often used first before care
-may be given 30-60 min until symptoms subside
-maintenance after meals and bedtimes
-H2RAs receptor antagonists or PPIs are first line therapy
-ranitidine followed by PPI
- drugs used for GERD - -•H2 receptor antagonists
•PPIs
•antacids
Prokinetics
•cytoprotective agents
review Questions and Answers
regulations - -∙all states have title protection for NPs
•the board of nursing regulates practice
-5 states have joint oversight with medical board
•scope of practice is determined by NP license
- investigational new drug (IND) - -•required before an investigational drug
or bio product can be administered to a human
•the IND app is a compilation of all known information about the compound
•it also includes a description of the clinical research plan for the product
•specific protocol for phase I study
- phases of clinical study - -•phase I clinical eval is the 1st testing of a new
compound in subjects for the purpose of establishing the tolerance of
healthy human subjects
•phase II clinical eval is controlled studies performed on pts having the
target disease or disorder to determine a compound's potential usefulness
and short term risks
•phase III trials are controlled and uncontrolled clinical trials of a drug's
safety and efficacy in hospital and outpt settings
•phase III trials verify that the acceptable risk/benefit ratio seen in II persists
under conditions of anticipated usage in groups of pts large enough to
identify statistically and clinically significant responses
- clinical judgment in prescribing - -•is there clear indication for drug?
•what drugs are effective for the disease?
•what are the goals of therapy?
•monitoring to see if drug is meeting goals
•duplications in med pts is taking
•otc vs prescription
•cost
•sources of info
- the process of prescribing - -•identify the pts problem
•specify the therapeutic objective
•collab with the pt
•choose the treatment
•edu the pt
•mt for effectiveness
•individualize drug choice
- special population: pregnancy - -•avoid ACEI, consider BB
, •bulk laxative
- special population: nursing moms - -avoid ACEI, consider BB
- special population: pediatric - -•best pharmaceuticals for children act
(BPCA)
•authorizes research to promote efficacy and safety
- special population: older adults - -•beers criteria
-looks at potential risk
-does not look at effectiveness
- pediatric distribution - -•newborns and infants have higher percentage of
water
•BBB is incomplete and permeable in newborn
•infants younger than 6 mths of age have decreased plasma proteins
available for drug binding
•in infants dosing needs to be decreased if metabolized by kidneys
- older adults - -•take more meds than any other age group
•PD and PK are altered
•ADRs common
•risk increase with number of drugs used
•decreased protein impacts absorption
- medication metabolisms - -•some meds need a loading dose
- first pass - -occurs when metabolized by the liver
- peak levels - -important to have this to achieve desired effect
- half-life - -•ibuprofen ~2 hours
•SSRI~ 22 hours
- antacids: clinical use and dosing - -•GERD
-antacids are OTC and often used first before care
-may be given 30-60 min until symptoms subside
-maintenance after meals and bedtimes
-H2RAs receptor antagonists or PPIs are first line therapy
-ranitidine followed by PPI
- drugs used for GERD - -•H2 receptor antagonists
•PPIs
•antacids
Prokinetics
•cytoprotective agents
