NR 565 - advanced pharmacology FINAL -
vb vb vb vb vb vb
Chamberlain Practice EXAM
vb vb vb
NR565 ADVANCED PHARMACOLOGY
FUNDAMENTALS
Pharmacokineticsvb-vbanswer--
Thevbprocessvbbyvbwhichvbdrugsvbarevbabsorbed,vbdistributedvbwithinvbthevbbody,vbmetabolized,vbandvbexcreted.
Pharmacodynamicsvb-vbanswer--Thevbstudyvbofvbwhatvbthevbdrugvbdoesvbtovbthevbbody
FactorsvbAffectingvbDrugvbAbsorptionvb-vbanswer--Ratevbofvbdissolution
Surfacevbarea
Bloodvbflow
Lipidvbsolubility
pHvbpartitioning
FactorsvbAffectingvbDrugvbDistributionvb-vbanswer--Bloodvbflowvbtovbtissues
Abilityvbtovbexitvbthevbvascularvbsystem
Blood-brainvbbarrier
Protein-bindingvbcapacity
Xenobioticsvb-vbanswer--
substancesvbthatvbarevbforeignvbtovbthevbbody,vbusuallyvbsyntheticvbchemicalvbcompounds;vbmedicationsvbarevbavbcomm
vbexample
CytochromevbP450vb(CYP450)vb-vbanswer--xenobiotic-
metabolizingvbenzymesvbnecessaryvbforvbthevbproductionvbofvbcholesterolvbandvbsteroidsvbandvbthevbdetoxificationvbofvbc
emicalsvbandvbdrugvbmetabolism.
FunctionvbofvbCytochromevbP450vb(CYP450)vb-vbanswer--
responsiblevbforvbphasevb1vbmetabolismvbinvbwhichvbdrugsvbarevboxidized,vbreduced,vborvbhydrolyzed
Phasevb1vbMetabolismvbofvbDrugsvbviavbP450vb-vbanswer--Oxidation;vbReduction;vbHydrolysis
Threevbpossiblevboutcomesvbofvbphasevb1vbdrugvbmetabolism.vb-vbanswer---Drugvbbecomesvbcompletelyvbinactive
-Drugvbbecomesvbpartiallyvbinactivevbbutvbonevborvbmorevbmetabolitesvbremainvbactive
-Originalvbdrugvbisvbnotvbpharmacologicallyvbactivevbbutvbonevbmetabolitevbremainsvbactive
CYP450vbInducersvb-vbanswer--
Medicationsvbthatvbcanvbincreasevbthevbratevbofvbanothervbdrug'svbmetabolismvbbyvbelevatingvbCYP450vbenzymevbactivit
viavbincreasingvbenzymevbsynthesis.vbdecreasingvbthevbconcentrationvbofvbthevb"parentvbdrug"
CYP450vbInducervbMedicationsvb-vbanswer--CRAPGPS
Carbamazepine
Rifampin
Alcohol
1vb/
vb22
, NR 565 - advanced pharmacology FINAL -
vb vb vb vb vb vb
Chamberlain Practice EXAM
vb vb vb
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
CYP450vbInhibitorsvb-vbanswer--
MedicationsvbthatvbinhibitvbthevbmetabolicvbactivityvbofvbonevborvbmorevbofvbthevbCYP450vbenzymes.vbHighervbriskvbforvbto
ity;vbprolongsvbthevbpharmacologicalvbeffectvbofvbthevb"parentvbdrug".
CYP450vbInhibitorvbMedicationsvb-vbanswer--VISACKGQ
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
GrapefruitvbJuice
Quinidine
BeersvbCriteriavb-vbanswer---potentiallyvbInappropriatevbMedicationvb(PIM)vbusevbinvboldervbadults
-potentiallyvbInappropriatevbMedicationvb(PIM)vbusevbinvboldervbadultsvbduevbtovbmedication-diseasevborvbmedication-
syndromevbinteractionsvbthatvbmayvbexacerbatevbthevbdiseasevborvbsyndrome
-medicationsvbtovbbevbusedvbcautiouslyvbinvboldervbadults
-clinicallyvbsignificantvbdrugvbinteractionsvbthatvbshouldvbbevbavoidedvbinvboldervbadults
-
medicationsvbtovbbevbavoidedvborvbdosagevbdecreasedvbinvbthevbpresencevbofvbimpairedvbkidneyvbfunctionvbinvboldervbadu
s
PharmacokineticvbInteractionsvb-vbanswer--
whenvbonevbmedicationvbsystemicallyvbaltersvbthevbpotencyvbofvbanothervbmedication.
AbsorptionvbInteractionvb-vbanswer--
resultvbofvbavbchangevbduevbtovbonevbmedication'svbeffectvbonvbanothervbmedication'svbroutevbofvbentryvbintovbthevbbody.
DistributionvbInteractionvb-vbanswer--causedvbbyvbthevbamountvbofvbunbound/
freevbmedicationsvbavailablevbatvbthevbvariousvbtargetvbsites.
MetabolismvbInteractionvb-vbanswer--
concentrationvbofvbthevbmedicationvbaftervbbiotransformationvbintovbactivevbandvbinactivevbmetabolitesvbinvbhighervborvblo
ervbthanvbexpected.
EliminationvbInteractionvb-vbanswer--
thevbbody'svbabilityvbtovbeliminatevbmedicationsvbinvbpurevbformvborvbbyvbalteringvbavbmetabolitevbfromvbthevbbody.
PharmacodynamicvbInteractionsvb-vbanswer--
doesvbnotvbaltervborvbimpactvbabsorption,vbdistribution,vbmetabolism,vborvbeliminationvbbecausevbofvbthevbonevbmedicatio
svbabilityvbtovbmanipulatevbthevbeffectvbofvbanothervbmedicationvbatvbitsvbsitevbofvbaction
PracticevbAuthorityvb-vbanswer--refersvbtovbthevbnursevbpractitioner'svbabilityvbtovbpracticevbwithoutvbphysicianvboversigh
prescriptivevbauthorityvb-vbanswer--refersvbtovbthevbnursevbpractitioner'svbauthorityvbtovbprescribevbmedications.
2vb/
vb22
, NR 565 - advanced pharmacology FINAL -
vb vb vb vb vb vb
Chamberlain Practice EXAM
vb vb vb
Full-practicevbscopevb-vbanswer--
Nursevbpractitionersvbhavevbthevbautonomyvbtovbevaluatevbpatients,vbdiagnose,vbordervbandvbinterpretvbtests,vbinitiatevba
vbmanagevbtreatmentsvbandvbprescribevbmedications,vbincludingvbcontrolledvbsubstancesvbwithoutvbphysicianvboversigh
Reduced-practicevbscopevb-vbanswer--
Nursevbpractitionersvbarevblimitedvbinvbatvbleastvbonevbelementvbofvbpractice.vbThevbstatevbrequiresvbavbformalvbcollaborat
vbagreementvbwithvbanvboutsidevbhealthvbdisciplinevbforvbthevbnursevbpractitionervbtovbprovidevbpatientvbcare.
Restrictedvbpracticevbscopevb-vbanswer--
Nursevbpractitionersvbarevblimitedvbinvbatvbleastvbonevbelementvbofvbpracticevbbyvbrequiringvbsupervision,vbdelegation,vbor
eamvbmanagementvbbyvbanvboutsidevbhealthvbdisciplinevbforvbthevbnursevbpractitionervbtovbprovidevbpatientvbcare.
DrugsvbthatvbcannotvbbevborderedvbviavbE-Scriptvb-vbanswer--DEAvbScheduledvbDrugs
Drugsvbthatvbcannotvbbevbprescribedvborvbrefilledvbviavbphonevb-vbanswer--SchedulevbIIvbdrugs
AcutevbPainvb-vbanswer--
Anvboccurrencevbofvbfewervbthanvbthreevbmonthsvbandvbisvboftenvbprecipitatedvbbyvbtraumavbandvbacutevbmedicalvbcondit
svborvbtreatment.
TypesvbofvbAcutevbPainvb-vbanswer--ReferredvbPain
AcutevbSomaticvbPain
Acutevbvisceralvbpain
Chronicvbpainvb-vbanswer--
episodevbofvbpainvbthatvblastsvbforvb6vbmonthsvborvblonger;vbmayvbbevbintermittentvborvbcontinuous
ReferredvbPainvb-vbanswer--painvbthatvbisvbfeltvbinvbavblocationvbothervbthanvbwherevbthevbpainvboriginates
AcutevbSomaticvbPainvb-vbanswer---Arisesvbfromvbconnectivevbtissue,vbmuscle,vbbonevbandvbskin.
-Sharpvbandvblocalizedvborvbdullvbandvbnon-localized
-Respondsvbbestvbto:vbacetaminophen,vbcorticosteroids,vbNSAIDs,vbopiates,vblocalvbanesthetics,vbice,vbmassage
AcutevbVisceralvbPainvb-vbanswer--Painvbinvbthevbinternalvborgansvbandvbabdomen
Poorlyvblocalizedvb(C-fibers)
Radiates
Mostvbresponsivevbtovbopiates
Mayvbalsovbusevbcorticosteroids,vbNSAIDs
Opioidsvb-vbanswer--anyvbdrug,vbnaturalvborvbsynthetic,vbthatvbhasvbactionsvbsimilarvbtovbthosevbofvbmorphine
OpioidvbReceptorvbFamiliesvb-vbanswer--Muvb(μ)
Kappavb(k)
Deltavb(δ)
Atvbeachvbtypevbofvbreceptor,vbavbdrugvbcanvbactvbinvbonevbofvbthreevbways:vb-vbanswer--
(1)vbpurevbopioidvbagonists,vb(2)vbagonist-antagonistvbopioids,vb(3)vbpurevbopioidvbantagonists.
Muvb(u)vbReceptorvb-vbanswer--Opioidvbreceptorvbmostvbresponsiblevbforvbmediatingvbanalgesicvbproperties
3vb/
vb22
vb vb vb vb vb vb
Chamberlain Practice EXAM
vb vb vb
NR565 ADVANCED PHARMACOLOGY
FUNDAMENTALS
Pharmacokineticsvb-vbanswer--
Thevbprocessvbbyvbwhichvbdrugsvbarevbabsorbed,vbdistributedvbwithinvbthevbbody,vbmetabolized,vbandvbexcreted.
Pharmacodynamicsvb-vbanswer--Thevbstudyvbofvbwhatvbthevbdrugvbdoesvbtovbthevbbody
FactorsvbAffectingvbDrugvbAbsorptionvb-vbanswer--Ratevbofvbdissolution
Surfacevbarea
Bloodvbflow
Lipidvbsolubility
pHvbpartitioning
FactorsvbAffectingvbDrugvbDistributionvb-vbanswer--Bloodvbflowvbtovbtissues
Abilityvbtovbexitvbthevbvascularvbsystem
Blood-brainvbbarrier
Protein-bindingvbcapacity
Xenobioticsvb-vbanswer--
substancesvbthatvbarevbforeignvbtovbthevbbody,vbusuallyvbsyntheticvbchemicalvbcompounds;vbmedicationsvbarevbavbcomm
vbexample
CytochromevbP450vb(CYP450)vb-vbanswer--xenobiotic-
metabolizingvbenzymesvbnecessaryvbforvbthevbproductionvbofvbcholesterolvbandvbsteroidsvbandvbthevbdetoxificationvbofvbc
emicalsvbandvbdrugvbmetabolism.
FunctionvbofvbCytochromevbP450vb(CYP450)vb-vbanswer--
responsiblevbforvbphasevb1vbmetabolismvbinvbwhichvbdrugsvbarevboxidized,vbreduced,vborvbhydrolyzed
Phasevb1vbMetabolismvbofvbDrugsvbviavbP450vb-vbanswer--Oxidation;vbReduction;vbHydrolysis
Threevbpossiblevboutcomesvbofvbphasevb1vbdrugvbmetabolism.vb-vbanswer---Drugvbbecomesvbcompletelyvbinactive
-Drugvbbecomesvbpartiallyvbinactivevbbutvbonevborvbmorevbmetabolitesvbremainvbactive
-Originalvbdrugvbisvbnotvbpharmacologicallyvbactivevbbutvbonevbmetabolitevbremainsvbactive
CYP450vbInducersvb-vbanswer--
Medicationsvbthatvbcanvbincreasevbthevbratevbofvbanothervbdrug'svbmetabolismvbbyvbelevatingvbCYP450vbenzymevbactivit
viavbincreasingvbenzymevbsynthesis.vbdecreasingvbthevbconcentrationvbofvbthevb"parentvbdrug"
CYP450vbInducervbMedicationsvb-vbanswer--CRAPGPS
Carbamazepine
Rifampin
Alcohol
1vb/
vb22
, NR 565 - advanced pharmacology FINAL -
vb vb vb vb vb vb
Chamberlain Practice EXAM
vb vb vb
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
CYP450vbInhibitorsvb-vbanswer--
MedicationsvbthatvbinhibitvbthevbmetabolicvbactivityvbofvbonevborvbmorevbofvbthevbCYP450vbenzymes.vbHighervbriskvbforvbto
ity;vbprolongsvbthevbpharmacologicalvbeffectvbofvbthevb"parentvbdrug".
CYP450vbInhibitorvbMedicationsvb-vbanswer--VISACKGQ
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
GrapefruitvbJuice
Quinidine
BeersvbCriteriavb-vbanswer---potentiallyvbInappropriatevbMedicationvb(PIM)vbusevbinvboldervbadults
-potentiallyvbInappropriatevbMedicationvb(PIM)vbusevbinvboldervbadultsvbduevbtovbmedication-diseasevborvbmedication-
syndromevbinteractionsvbthatvbmayvbexacerbatevbthevbdiseasevborvbsyndrome
-medicationsvbtovbbevbusedvbcautiouslyvbinvboldervbadults
-clinicallyvbsignificantvbdrugvbinteractionsvbthatvbshouldvbbevbavoidedvbinvboldervbadults
-
medicationsvbtovbbevbavoidedvborvbdosagevbdecreasedvbinvbthevbpresencevbofvbimpairedvbkidneyvbfunctionvbinvboldervbadu
s
PharmacokineticvbInteractionsvb-vbanswer--
whenvbonevbmedicationvbsystemicallyvbaltersvbthevbpotencyvbofvbanothervbmedication.
AbsorptionvbInteractionvb-vbanswer--
resultvbofvbavbchangevbduevbtovbonevbmedication'svbeffectvbonvbanothervbmedication'svbroutevbofvbentryvbintovbthevbbody.
DistributionvbInteractionvb-vbanswer--causedvbbyvbthevbamountvbofvbunbound/
freevbmedicationsvbavailablevbatvbthevbvariousvbtargetvbsites.
MetabolismvbInteractionvb-vbanswer--
concentrationvbofvbthevbmedicationvbaftervbbiotransformationvbintovbactivevbandvbinactivevbmetabolitesvbinvbhighervborvblo
ervbthanvbexpected.
EliminationvbInteractionvb-vbanswer--
thevbbody'svbabilityvbtovbeliminatevbmedicationsvbinvbpurevbformvborvbbyvbalteringvbavbmetabolitevbfromvbthevbbody.
PharmacodynamicvbInteractionsvb-vbanswer--
doesvbnotvbaltervborvbimpactvbabsorption,vbdistribution,vbmetabolism,vborvbeliminationvbbecausevbofvbthevbonevbmedicatio
svbabilityvbtovbmanipulatevbthevbeffectvbofvbanothervbmedicationvbatvbitsvbsitevbofvbaction
PracticevbAuthorityvb-vbanswer--refersvbtovbthevbnursevbpractitioner'svbabilityvbtovbpracticevbwithoutvbphysicianvboversigh
prescriptivevbauthorityvb-vbanswer--refersvbtovbthevbnursevbpractitioner'svbauthorityvbtovbprescribevbmedications.
2vb/
vb22
, NR 565 - advanced pharmacology FINAL -
vb vb vb vb vb vb
Chamberlain Practice EXAM
vb vb vb
Full-practicevbscopevb-vbanswer--
Nursevbpractitionersvbhavevbthevbautonomyvbtovbevaluatevbpatients,vbdiagnose,vbordervbandvbinterpretvbtests,vbinitiatevba
vbmanagevbtreatmentsvbandvbprescribevbmedications,vbincludingvbcontrolledvbsubstancesvbwithoutvbphysicianvboversigh
Reduced-practicevbscopevb-vbanswer--
Nursevbpractitionersvbarevblimitedvbinvbatvbleastvbonevbelementvbofvbpractice.vbThevbstatevbrequiresvbavbformalvbcollaborat
vbagreementvbwithvbanvboutsidevbhealthvbdisciplinevbforvbthevbnursevbpractitionervbtovbprovidevbpatientvbcare.
Restrictedvbpracticevbscopevb-vbanswer--
Nursevbpractitionersvbarevblimitedvbinvbatvbleastvbonevbelementvbofvbpracticevbbyvbrequiringvbsupervision,vbdelegation,vbor
eamvbmanagementvbbyvbanvboutsidevbhealthvbdisciplinevbforvbthevbnursevbpractitionervbtovbprovidevbpatientvbcare.
DrugsvbthatvbcannotvbbevborderedvbviavbE-Scriptvb-vbanswer--DEAvbScheduledvbDrugs
Drugsvbthatvbcannotvbbevbprescribedvborvbrefilledvbviavbphonevb-vbanswer--SchedulevbIIvbdrugs
AcutevbPainvb-vbanswer--
Anvboccurrencevbofvbfewervbthanvbthreevbmonthsvbandvbisvboftenvbprecipitatedvbbyvbtraumavbandvbacutevbmedicalvbcondit
svborvbtreatment.
TypesvbofvbAcutevbPainvb-vbanswer--ReferredvbPain
AcutevbSomaticvbPain
Acutevbvisceralvbpain
Chronicvbpainvb-vbanswer--
episodevbofvbpainvbthatvblastsvbforvb6vbmonthsvborvblonger;vbmayvbbevbintermittentvborvbcontinuous
ReferredvbPainvb-vbanswer--painvbthatvbisvbfeltvbinvbavblocationvbothervbthanvbwherevbthevbpainvboriginates
AcutevbSomaticvbPainvb-vbanswer---Arisesvbfromvbconnectivevbtissue,vbmuscle,vbbonevbandvbskin.
-Sharpvbandvblocalizedvborvbdullvbandvbnon-localized
-Respondsvbbestvbto:vbacetaminophen,vbcorticosteroids,vbNSAIDs,vbopiates,vblocalvbanesthetics,vbice,vbmassage
AcutevbVisceralvbPainvb-vbanswer--Painvbinvbthevbinternalvborgansvbandvbabdomen
Poorlyvblocalizedvb(C-fibers)
Radiates
Mostvbresponsivevbtovbopiates
Mayvbalsovbusevbcorticosteroids,vbNSAIDs
Opioidsvb-vbanswer--anyvbdrug,vbnaturalvborvbsynthetic,vbthatvbhasvbactionsvbsimilarvbtovbthosevbofvbmorphine
OpioidvbReceptorvbFamiliesvb-vbanswer--Muvb(μ)
Kappavb(k)
Deltavb(δ)
Atvbeachvbtypevbofvbreceptor,vbavbdrugvbcanvbactvbinvbonevbofvbthreevbways:vb-vbanswer--
(1)vbpurevbopioidvbagonists,vb(2)vbagonist-antagonistvbopioids,vb(3)vbpurevbopioidvbantagonists.
Muvb(u)vbReceptorvb-vbanswer--Opioidvbreceptorvbmostvbresponsiblevbforvbmediatingvbanalgesicvbproperties
3vb/
vb22
