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N5334 Final Exam Questions and Complete Solutions Graded A+.
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N5334 Final Exam Questions and Complete Solutions Graded A+.
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N5334 Final ExamQuestions and
Complete Solutions
Graded A+
Denning [Date] [Course title]
,Prescribing basics - Answer: Prescribing is regulated by state BON
Proper RX - Answer: Providers name and address, Telephone
DEA
Pt name/DOB/Addres
Name of Drug, strength, SIG(directions) with indication/Route and frequency, Quantity and signature.
Drug Schedules: Most addictive to least - Answer: 1: Heroin,LSD, MJ
2: hydrocodone, cocaine, Methamphetamine, methadone, oxycodone, meperidine, fentanyl, adderall,
ritalin
3: codeine, ketamine, testosterone
4: xanax, valium, soma, ambient, tramadol
5: antidiarrheal, antitussives, lomotil, lyrica
Pharmicodyamics - Answer: The effects of drug on the body. Receptors are large molecules usually
proteins, that interact and mediate the action of drugs
agonist - Answer: produce receptor stimulation and a conformational change every time they bind. Do
not need all available receptors to produce a maximum response
Partial agonist - Answer: drugs that have properties in b/w those of full agonist and antagonist. They
bind to receptors but when they occupy the receptor sites, they stimulate only some of the receptors.
antagonist - Answer: drugs with affinity for a receptor but with no intrinsic activity. Affinity allows the
antagonist to bind to receptors, but lack of intrinsic activity prevents the bound antagonist from causing
receptor activation. The block action of drugs (ex. Narcan)
Bioavailabity - Answer: % of administered dosage of the drug that survives the first pass through the
liver and reaches the blood stream
,half life - Answer: Time required for the amount of a drug in the body to decline by 50%, drugs with
shorter half lives must be administer frequently. 4.5-5.5 times the half life to get steady state and to be
limited from the body
what the body does to the drug - Answer: absorption, distribution, metabolism, excretion
Distribution - Answer: movement of absorbed drug in bodily fluids throughout the body to target tissue.
Properties affecting: lipid/water solubility, PH affects ionization of drug, protein binding, size of molecule
(smaller molecules are more able to diffuse)
Tissue: fat, bone, blood/brain barrier (only lipid soluble will pass), placental barrier (many drugs can
pass)
Protein binding - Answer: unbound drug is free which is active, crosses membrane. Low plasma proteins
result in more free drug. Competition: when 2 highly bound drugs are given it increases the level of both
drugs
Metabolism - Answer: take place in the liver mostly. Chemical change of a drug structure to:
Enhance excretion, inactivate the drug, increase therapeutic action, active a prodrug (inactive until
metabolized in the body into the active compound, ex: levodopa), increase or decrease toxicity
CYP450 - Answer: enzymes constitutes the most important of the phase I metabolizing enzymes
(account for about 75% of drug metabolism in the liver)
Phase 2: conjugation reaction occur leading to large increases in hydrophilicity of the substrates
rendering them more readily excretable
Substrate - Answer: an agent that is metabolized by an enzyme into a metabolite and product and
eventually excreted
Inhibitors - Answer: compete with other drugs for a particular enzyme affecting the metabolism
(decreased) of the substrate and decreases the excretion of the substrate and increasing the circulating
drug
, inducer - Answer: competes with other drugs for a particular enzyme affecting metabolism of the
substrate (increases) decreasing the efficacy of the drug
excretion - Answer: renal: passive glomerular filtration, active tubular secretion, tubular reabsorption, gi
tract, lung, sweat and salivary, mammary
genomics - Answer: study of the complete set of genetic information present in a cell, an organism, or
species
pharmacogenetics - Answer: the study of the influence of hereditary factors on the response of
individual organisms to drugs, and the study of variations of DNA and RNA characteristics as related to
drug response
Pharmacogenetics tests - Answer: Mentioned on drug labels can be classified as "test required," "test
recommended," and "information only." Currently, four drugs are required to have pharmacogenetics
testing performed before they are prescribed: cetuximab, trastuzumab, maraviroc and dasatinib
wafarin, carbamazepine, valproic acid and abacavir are recommended to tests prior to initial dosing
Carbamazepine and Asisans - Answer: Initiating carbamazepine therapy in these patients (allele HLA-
B*1502) are at high risk for developing Steven Johnson syndrome or toxic epidermal necrolysis (TEN)
The ability of the anesthetic to penetrate the axon membrane is determined by 3 properties. What are
they? - Answer: Molecular size, Lipid solubility, degree of ionization at tissue pH
Why is epinephrine given with local anesthetics? - Answer: Decreases local blood flow (decreased risk of
bleeding)
Delays systemic absorption of the anesthetic
prolongs anesthesia
reduces the risk of toxicity
What is the most widely used local anesthetic? - Answer: Lidocaine
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