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NUR641E Advanced Pathophysiology and Pharmacology for the Nurse Educator Already Passed
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NUR-641E Advanced Pathophysiology andPharmacology for the Nurse Educator Already
Passed
1). Pharmacokinetics
Ans: Involves ADME (absorption, distribution, metabolism and elimination).
Absorption: absorption from the administration site either directly or indirectly into the
blood/plasma.
Distribution: reversibly or irreversibly move from the bloodstream into the interstitial and
intracellular fluid.
Metabolism: bio-transformed via hepatic metabolism or by other tissues.
Elimination: lastly, the drug & its metabolites are eliminated from the body
2). The route of administration with the highest bio-availability is
Ans: Intravenous; putting entire dose into a patient's vein and bypassing absorption.
Intravenous route avoids first-pass metabolism in the liver.
3). Rectal administration disadvantages
Ans: variable and erratic absorption
4). Steady state (ss)
Ans: is usually reached within 4-5 half-lives of a drug
5). The half-life of a drug is defined as
Ans: how long it takes for half the drug to be excreted from the body
6). Half-life of a drug
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, Ans: Determines how frequently the drug must be administered
Predicts how long toxic effects can last
Half-life is constant with first-order pharmacokinetics of a drug
Zero-order (nonlinear) pharmacokinetics means a drug is metabolized at a constant rate
per unit time.
7). Cyp3a4 substrate drugs
Ans: May have enhanced activity if any CYP3A4 inducer drugs are used along with it.
8). Drug development steps (according to the fda)
Ans: Discovery: laboratory research to develop the new drug
Pre-clinical research with animal testing for safety (Phase I)
Clinical research on human subjects for medication safety (Phase II)
Clinical research in humans comparing the new drug to accepted medications or
placebo depending on the study (Phase III)
FDA review of the results to determine approval
Post-marketing study to identify adverse effects not found in earlier clinical studies
(Phase IV)
9). Medication safety organizations
Ans: The Institute for Safe Medication Practices (ISMP)
The Institute of Medicine (IOM)
The Joint Commission
The National Coordinating Council for Medication Error Reporting and Prevention
(NCCMERP)
Food and Drug Administration (FDA) Safe Use Initiative
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, 10). Adverse drug reactions (adrs)
Ans: Two basic type of ADRs: pharmacological and idiosyncratic.
85% to 90% of ADRs are pharmacological.
Adverse drug reactions are usually preventable, frequently occur in a hospital or nursing
home setting, and include medication errors, adverse drug effects, allergic and
idiosyncratic type reactions.
ADRs are not commonly reported; the FDA does not mandate that ADRs be reported.
Polypharmacy involves using multiple healthcare providers for care, using multiple
medications, and using several pharmacies for prescription filling.
11). Cardiovascular-angiotensin converting enzyme inhibitors (aceis):
Ans: Lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril;
*ACEIs reduce blood pressure by suppressing the release of angiotensin-converting
enzyme.
*Important side effects of ACE inhibitors include cough and angioedema; discontinue
the ACEI if angioedema occurs.
12). Angiotensin ii receptor blocking agents (arbs):
Ans: Candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan
(Cozaar), telmisartan (Micardis) and valsartan (Diovan).
ARBs reduce blood pressure by blocking angiotensin II receptors.
13). Cardiovascular-essential (primary) hypertension
Ans: Accounts for 90% of cases; secondary hypertension may be caused by chronic
renal failure.
14). Nitroglycerin
Ans: nitrate drug used in the treatment of angina; a nitrate drug that can be
administered IV, SL, a topical ointment and as a transdermal patch
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