Nurs 5334 pharm Study guide 2025-2026
Module 1
• What are the bon rules and regulations for prescriptive authority for the
advance practice nurse?
• Texas is very restricted
• Describe the pharmacokinetic processes of absorption, distribution, metabolism
and elimination and how differences in these areas affect drug action.
• Absorption
• Drug’s movement from the site of administration into the blood.
• Distribution
• Drug’s movement from the blood into the interstitial space of tissues and from
there into cells.
• Metabolism
• Biotransformation is the enzymatically mediated alteration of drug structure.
• Elimination
• Combination of metabolism and excretion
• Discuss the impact of food on drug absorption, drug metabolism and on drug
toxicity and action—as well as the timing of drug administration.
Lifespan
• Hepatic metabolism and gfr increase during pregnancy, dosages of some drugs
may need to be increased.
• Rate of albumin to water decreases
, • Third trimester: renal blood flow is doubled and renal excretion is accelerated
(drugs excreted rapidly)
• Tone and mobility of bowel decrease
• Prolongation of drug effects total (½ life increases)
Understand stages of development in pregnancy
• Conception: through week 2
• Embryonic period: week 3-week 8
A) gross malformations can be produced by teratogens
• Fetal period: week 9-delivery
• Understand labeling
pregnancy • 3 categories now
A) pregnancy, lactation, male & female reproductive potential
• How do you decrease risk in the infant during breastfeeding?
• take meds immediately after breastfeeding, avoid drugs that
have long half-lives, choose drugs that tend to be excluded from
milk, avoid drugs that are known to be hazardous.
• How do pediatric patients differ in their response to medications?
• Absorption
A) oral?
• Neonates: drug remain in the stomach longer
which increases the levels, low acidity can
affect the absorption of acid labile drugs
b) Parenteral?
• Reponses are slow and erratic.
, • Infancy: absorption is more rapid than in neonates &
adults
• Best avoided in infants
c) Transdermal?
• Greater skin permeability which increases
topical drug absorption and increases the
risk for toxicity
• Distribution
A) protein binding
1. Neonates: less protein-binding—increased availability
of highly protein bound drugs such as phenytoin,
diazepam, and phenobarbital. Reduced dosages
needed in these highly bound drugs.
B) blood brain barrier
1. Not fully developed at birth, drugs have easy access
to the cns, doses should be reduced.
• Metabolism
a) Hepatic function?
1. Liver hasn’t reached full maturation—sensitive to
drugs eliminated by the cyp450. Liver’s ability to
metabolize drugs increases about one month after
birth.
b) T half life
1. Decreased by as much as 48-72 hours
• Excretion
, a) Renal?
1. Gfr is significantly reduced at birth, drugs
eliminated by the kidneys must be given in a
reduced dosage and longer dosing intervals.
• What education needs to be given to parents?
• What to do if child spits out medication or throws it up
• Effective education: dosage size and timing, route, technique of
administration, duration of treatment, how to store the drug,
nature and time course of the desired response, nature and time
course of adverse reactions.
• Compare and contrast pharmacokinetics and
Pharmacodynamics of special populations—pediatrics, older
Adults and those that are pregnant.
• pediatrics—they have organ immaturity, elderly—they have organ
degeneration, loss of nephrons, excretion of drug is decreased and
you have to give this population a lower dose of medication.
Medication can pass through milk of lactating females.
• Analyze a drug interaction to determine an appropriate course of action.
• basic mechanism of drug-drug interactions through pharmacokinetic
interactions are altered absorption, altered distribution, altered
metabolism, and altered renal excretion.
Module 1
• What are the bon rules and regulations for prescriptive authority for the
advance practice nurse?
• Texas is very restricted
• Describe the pharmacokinetic processes of absorption, distribution, metabolism
and elimination and how differences in these areas affect drug action.
• Absorption
• Drug’s movement from the site of administration into the blood.
• Distribution
• Drug’s movement from the blood into the interstitial space of tissues and from
there into cells.
• Metabolism
• Biotransformation is the enzymatically mediated alteration of drug structure.
• Elimination
• Combination of metabolism and excretion
• Discuss the impact of food on drug absorption, drug metabolism and on drug
toxicity and action—as well as the timing of drug administration.
Lifespan
• Hepatic metabolism and gfr increase during pregnancy, dosages of some drugs
may need to be increased.
• Rate of albumin to water decreases
, • Third trimester: renal blood flow is doubled and renal excretion is accelerated
(drugs excreted rapidly)
• Tone and mobility of bowel decrease
• Prolongation of drug effects total (½ life increases)
Understand stages of development in pregnancy
• Conception: through week 2
• Embryonic period: week 3-week 8
A) gross malformations can be produced by teratogens
• Fetal period: week 9-delivery
• Understand labeling
pregnancy • 3 categories now
A) pregnancy, lactation, male & female reproductive potential
• How do you decrease risk in the infant during breastfeeding?
• take meds immediately after breastfeeding, avoid drugs that
have long half-lives, choose drugs that tend to be excluded from
milk, avoid drugs that are known to be hazardous.
• How do pediatric patients differ in their response to medications?
• Absorption
A) oral?
• Neonates: drug remain in the stomach longer
which increases the levels, low acidity can
affect the absorption of acid labile drugs
b) Parenteral?
• Reponses are slow and erratic.
, • Infancy: absorption is more rapid than in neonates &
adults
• Best avoided in infants
c) Transdermal?
• Greater skin permeability which increases
topical drug absorption and increases the
risk for toxicity
• Distribution
A) protein binding
1. Neonates: less protein-binding—increased availability
of highly protein bound drugs such as phenytoin,
diazepam, and phenobarbital. Reduced dosages
needed in these highly bound drugs.
B) blood brain barrier
1. Not fully developed at birth, drugs have easy access
to the cns, doses should be reduced.
• Metabolism
a) Hepatic function?
1. Liver hasn’t reached full maturation—sensitive to
drugs eliminated by the cyp450. Liver’s ability to
metabolize drugs increases about one month after
birth.
b) T half life
1. Decreased by as much as 48-72 hours
• Excretion
, a) Renal?
1. Gfr is significantly reduced at birth, drugs
eliminated by the kidneys must be given in a
reduced dosage and longer dosing intervals.
• What education needs to be given to parents?
• What to do if child spits out medication or throws it up
• Effective education: dosage size and timing, route, technique of
administration, duration of treatment, how to store the drug,
nature and time course of the desired response, nature and time
course of adverse reactions.
• Compare and contrast pharmacokinetics and
Pharmacodynamics of special populations—pediatrics, older
Adults and those that are pregnant.
• pediatrics—they have organ immaturity, elderly—they have organ
degeneration, loss of nephrons, excretion of drug is decreased and
you have to give this population a lower dose of medication.
Medication can pass through milk of lactating females.
• Analyze a drug interaction to determine an appropriate course of action.
• basic mechanism of drug-drug interactions through pharmacokinetic
interactions are altered absorption, altered distribution, altered
metabolism, and altered renal excretion.
