1. Describe cy- Cytochrome p450 system is a series of enzymes used to
tochrome p450 metabolize medications
system
2. Inhibitors block metabolic activity from one or more CYP450 en-
zymes
3. Inducers increase CYP450 enzyme activity by increasing enzyme
synthesis
4. Describe effect Albumin is the plasma protein with the greatest capacity
on low and high for binding drugs. Binding plasma proteins affect drug dis-
albumin levels tribution into tissues, because only drug that is not bound
on active drug is available to penetrate tissues, bind to receptors, and
levels especially exert activity. As free drug leaves the blood stream, more
for drugs that bound drug is released from binding sites.
are highly protein
bound
5. Low albumin lev- malnutrition, chronic illness
els
6. Highly protein toxicity in patients with low albumin levels, example mal-
bound drugs can nutrition or chronic illness. This is because there are fewer
lead to than the normal sites for the drug to bind
7. Describe the Alternative routes include:
ways the hepatic suppository
first pass effect- intravenous
which is metabo- intramuscular
lism during first inhalational aerosol
pass through the transdermal
liver sublingual
These allow drugs to bypass the first-pass effect and be
absorbed directly into systemic circulation
8. Be able to cal- Male = 140-age times weight in kilograms divided by
culate creatinine serum creatinine times 72.
clearance using Women = CRCL (male) times 0.85
1/7
, NRNP 6566 WK1-5 Midterm
Cockgraft Gault
equation:
9. Describe what half life
determines the plasma concentration
frequency of
drug administra-
tion
10. Be familiar with Potentially Inappropriate Medication Use in Older Adults
the beers criteria to call attention to medications that are most commonly
and how to use it problematic and thus should be avoided in older adults
11. Describe factors low blood state (shock or arrest), contact time with GI
that affect ab- tract too fast (diarrhea = cant absorb), delayed stomach
sorption emptying (large meal = delayed absorption)Drug- to drug
or drug to food interactions
12. Describe the fac- low albumin levels, body composition, cardiac decompen-
tors that affect sation (heart failure), age
distribution
13. Describe the fac- genetics, age, organ function
tors that affect
metabolism
14. Describe factors affected by abnormal kidney or liver function, age, drug
that affect excre- interactions
tion
15. Define narrow Therapeutic index is the dose range of effiency of med is
therapeutic in- optimized while side effects are minimized
dex. How would Narrow therapeutic index drugs are defined as those
you monitor a pa- drugs where small differences in dose or blood concentra-
tient with a nar- tion may lead to dose and blood concentration dependant,
row therapeutic serious therapeutic failures or adverse drug reactions.
index? You will need to monitor blood tests to monitor blood
concentrations and dose adjustments accordingly.
16.
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