NURS 541 ADVANCED
PHARMACOLOGY FINAL EXAM
Who grants the authority for Np's to apply for and receive a DEA number? ANS: The state that the Np is
working in
Who ultimately has control over prescriptive privileges? ANS: The state.
What federal agency registers individuals who may prescribe narcotics and other controlled substances?
ANS: DEA (Drug Enforcement Agency)
The federal government has broad control over __________ _________, but it has no control over who
may ______, _____,or ______ drugs. ANS: 1. drug regulation
2. prescribe, dispense, or administer
What are the 2 types of prescriptive authority permitted in nursing legislation? ANS: 1. Dependent
authority
2. Independent authority
Describe dependent authority? ANS: Requires that the physician has ultimate authority through
counter-signature of scripts or a written agreement between the NP and the physician that outlines the
need for chart review, discussion, and oversight with the physician collaborator.
Describe independent authority? ANS: It allows the NP to prescribe alone. It could still be restricted,for
example by excluding the prescribing of controlled substances or limiting the scripts to a certain drug
formulary.
How do you apply for prescriptive authority in the state of Indiana? ANS: Master's prepared: Apply to
the ISBN with proof of completion of graduation from an accredited program, licenses, and collaborative
agreements.
,Bachelor's prepared: If you received a bachelor's degree rather than a graduate degree, you must
submit proof of current national certification,licenses, and collaborative agreements.
How do you apply for DEA license in the state of Indiana? ANS: Must apply for a CSR (Controlled
Substance Registration) through the ISBN and once that is obtained then you can apply to the DEA for
the DEA license.
Does an APN have to be nationally certified to practice in the state of Indiana? ANS: No, unless you only
have a BSN, then you must be certified nationally in the category that you intend to practice in.
Pharmacokinetics ANS: The movement of the drug through the body or
what the body does to the drug.
Includes: absorption, distribution, metabolism, and elimination.
Pharmacodynamics ANS: What the drug does to the body.
Absorption ANS: Describes how the drug leaves its site of administration.
Bio-availability ANS: Fraction of drug that reaches the circulation.
Therapeutic drug level ANS: The minimal effective concentration of a drug.
If medication is free-floating or unbound what does this cause? ANS: Toxicity
What affects all pharmacokinetic pathways? ANS: Blood pressure
,Why is protein so important in pharmacokinetics? ANS: Protein (albumin) binding is how medications
are transported or distributed. Low albumin or protein could create an increased level of unbound
medication and toxicity.
Explain the absorption process? ANS: Process occurs from the time the drug enters the body to the time
that it enters the bloodstream to be circulated.
What determines onset of action? ANS: Rate of absorption.
What is the first-pass effect? ANS: When drugs are given orally, absorbed from the GI tract, and carried
to the liver for metabolism via the portal circulation.
What are drug-related variables that affect pharmacokinetics? ANS: The route, dose, and frequency of
the medication.
What are patient-related variables that affect pharmacokinetics? ANS: Liver-metabolism, kidney-
elimination and metabolism, allergies, weight-lean vs fat, neuro status, respiratory status,
gender,ethnicity, previous meds, vital signs, age
Describe how pediatrics metabolize meds? ANS: They are ultra-metabolizers. May need higher doses
because they metabolize the drug more quickly.
2 ways that drugs are transported from the GI tract across cell membranes? ANS: Passive diffusion and
active transport
Bio-equivalence? ANS: Means that 2 drugs contain the same active ingredients and are identical in
strength or concentration, dosage form, and route of administration and have essentially the same rate
and extent of bio-availability.
, How much bio-equivalence variability is allowed in generic drugs? ANS: + or ANS: 20% of the proprietary
drug.
What is an example of a drug should never be prescribed in the generic form because of its narrow
therapeutic window? ANS: Lanoxin.
What drug characteristics affect drug absorption? ANS: Formulation of the drug, concentration of the
drug, lipophilic drug formulations (more readily absorbable), Acidic drugs (become non-ionized in the
stomach and are diffused across the membranes).
What part of pharmacokinetics are affected by a change in acidity in the stomach? ANS: Absorption
Passive diffusion ANS: Random movement of molecules across cell membranes from high to low
concentrations.
Active transport ANS: The movement of moderately-sized molecules across cell membranes on
transport carriers.
What 3 factors affect influence absorption? ANS: 1. Blood flow to the absorption site 2. Total surface
area for absorption 3. Contact time with absorption area.
What 4 factors influence bio-availability? ANS: 1. First pass hepatic metabolism 2. Solubility of the drug
3. Chemical instability 4. Nature of the drug formulation.
Describe distribution of meds in the body? ANS: After absorption, drugs are carried by the blood and the
tissues to sites of action,metabolism,and excretion.
Meds are distributed quickly to the? ANS: heart, liver and kidneys
PHARMACOLOGY FINAL EXAM
Who grants the authority for Np's to apply for and receive a DEA number? ANS: The state that the Np is
working in
Who ultimately has control over prescriptive privileges? ANS: The state.
What federal agency registers individuals who may prescribe narcotics and other controlled substances?
ANS: DEA (Drug Enforcement Agency)
The federal government has broad control over __________ _________, but it has no control over who
may ______, _____,or ______ drugs. ANS: 1. drug regulation
2. prescribe, dispense, or administer
What are the 2 types of prescriptive authority permitted in nursing legislation? ANS: 1. Dependent
authority
2. Independent authority
Describe dependent authority? ANS: Requires that the physician has ultimate authority through
counter-signature of scripts or a written agreement between the NP and the physician that outlines the
need for chart review, discussion, and oversight with the physician collaborator.
Describe independent authority? ANS: It allows the NP to prescribe alone. It could still be restricted,for
example by excluding the prescribing of controlled substances or limiting the scripts to a certain drug
formulary.
How do you apply for prescriptive authority in the state of Indiana? ANS: Master's prepared: Apply to
the ISBN with proof of completion of graduation from an accredited program, licenses, and collaborative
agreements.
,Bachelor's prepared: If you received a bachelor's degree rather than a graduate degree, you must
submit proof of current national certification,licenses, and collaborative agreements.
How do you apply for DEA license in the state of Indiana? ANS: Must apply for a CSR (Controlled
Substance Registration) through the ISBN and once that is obtained then you can apply to the DEA for
the DEA license.
Does an APN have to be nationally certified to practice in the state of Indiana? ANS: No, unless you only
have a BSN, then you must be certified nationally in the category that you intend to practice in.
Pharmacokinetics ANS: The movement of the drug through the body or
what the body does to the drug.
Includes: absorption, distribution, metabolism, and elimination.
Pharmacodynamics ANS: What the drug does to the body.
Absorption ANS: Describes how the drug leaves its site of administration.
Bio-availability ANS: Fraction of drug that reaches the circulation.
Therapeutic drug level ANS: The minimal effective concentration of a drug.
If medication is free-floating or unbound what does this cause? ANS: Toxicity
What affects all pharmacokinetic pathways? ANS: Blood pressure
,Why is protein so important in pharmacokinetics? ANS: Protein (albumin) binding is how medications
are transported or distributed. Low albumin or protein could create an increased level of unbound
medication and toxicity.
Explain the absorption process? ANS: Process occurs from the time the drug enters the body to the time
that it enters the bloodstream to be circulated.
What determines onset of action? ANS: Rate of absorption.
What is the first-pass effect? ANS: When drugs are given orally, absorbed from the GI tract, and carried
to the liver for metabolism via the portal circulation.
What are drug-related variables that affect pharmacokinetics? ANS: The route, dose, and frequency of
the medication.
What are patient-related variables that affect pharmacokinetics? ANS: Liver-metabolism, kidney-
elimination and metabolism, allergies, weight-lean vs fat, neuro status, respiratory status,
gender,ethnicity, previous meds, vital signs, age
Describe how pediatrics metabolize meds? ANS: They are ultra-metabolizers. May need higher doses
because they metabolize the drug more quickly.
2 ways that drugs are transported from the GI tract across cell membranes? ANS: Passive diffusion and
active transport
Bio-equivalence? ANS: Means that 2 drugs contain the same active ingredients and are identical in
strength or concentration, dosage form, and route of administration and have essentially the same rate
and extent of bio-availability.
, How much bio-equivalence variability is allowed in generic drugs? ANS: + or ANS: 20% of the proprietary
drug.
What is an example of a drug should never be prescribed in the generic form because of its narrow
therapeutic window? ANS: Lanoxin.
What drug characteristics affect drug absorption? ANS: Formulation of the drug, concentration of the
drug, lipophilic drug formulations (more readily absorbable), Acidic drugs (become non-ionized in the
stomach and are diffused across the membranes).
What part of pharmacokinetics are affected by a change in acidity in the stomach? ANS: Absorption
Passive diffusion ANS: Random movement of molecules across cell membranes from high to low
concentrations.
Active transport ANS: The movement of moderately-sized molecules across cell membranes on
transport carriers.
What 3 factors affect influence absorption? ANS: 1. Blood flow to the absorption site 2. Total surface
area for absorption 3. Contact time with absorption area.
What 4 factors influence bio-availability? ANS: 1. First pass hepatic metabolism 2. Solubility of the drug
3. Chemical instability 4. Nature of the drug formulation.
Describe distribution of meds in the body? ANS: After absorption, drugs are carried by the blood and the
tissues to sites of action,metabolism,and excretion.
Meds are distributed quickly to the? ANS: heart, liver and kidneys
