NURS 530 ADVANCED PHARMACOLOGY
FINAL KEY PHARMACODYNAMICS &
KINETICS (>500 possibly helpful) tfing
Who .grants .the .authority .for .Np's .to .apply .for .and .receive .a .DEA .number? .- .(correct .answer) .-
The .state .that .the .Np .is .working .in
Who .ultimately .has .control .over .prescriptive .privileges? .- .(correct .answer) .-The .state.
What .federal .agency .registers .individuals .who .may .prescribe .narcotics .and .other .controlled .substanc
es? .- .(correct .answer) .-DEA .(Drug .Enforcement .Agency)
The .federal .government .has .broad .control .over .__________ ._________, .but .it .has .no .control .over .
who .may .______, ._____,or .______ .drugs. .- .(correct .answer) .-1. .drug .regulation
2. .prescribe, .dispense, .or .administer
What .are .the .2 .types .of .prescriptive .authority .permitted .in .nursing .legislation? .- .(correct .answer) .-1.
.Dependent .authority
2. .Independent .authority
Describe .dependent .authority? .- .(correct .answer) .-Requires .that .the .physician .has .ultimate .authority
.through .counter-
signature .of .scripts .or .a .written .agreement .between .the .NP .and .the .physician .that .outlines .the .nee
d .for .chart .review, .discussion, .and .oversight .with .the .physician .collaborator.
Describe .independent .authority? .- .(correct .answer) .-
It .allows .the .NP .to .prescribe .alone. .It .could .still .be .restricted,for .example .by .excluding .the .prescribi
ng .of .controlled .substances .or .limiting .the .scripts .to .a .certain .drug .formulary.
How .do .you .apply .for .prescriptive .authority .in .the .state .of .Indiana? .- .(correct .answer) .-
Master's .prepared: .Apply .to .the .ISBN .with .proof .of .completion .of .graduation .from .an .accredited .pr
ogram, .licenses, .and .collaborative .agreements.
Bachelor's .prepared: .If .you .received .a .bachelor's .degree .rather .than .a .graduate .degree, .you .must .s
ubmit .proof .of .current .national .certification,licenses, .and .collaborative .agreements.
,How .do .you .apply .for .DEA .license .in .the .state .of .Indiana? .- .(correct .answer) .-Must .apply .for .a .CSR .
(Controlled .Substance .Registration) .through .the .ISBN .and .once .that .is .obtained .then .you .can .apply .t
o .the .DEA .for .the .DEA .license.
Does .an .APN .have .to .be .nationally .certified .to .practice .in .the .state .of .Indiana? .- .(correct .answer) .-
No, .unless .you .only .have .a .BSN, .then .you .must .be .certified .nationally .in .the .category .that .you .inte
nd .to .practice .in.
Pharmacokinetics .- .(correct .answer) .-The .movement .of .the .drug .through .the .body .or .
what .the .body .does .to .the .drug.
Includes: .absorption, .distribution, .metabolism, .and .elimination.
Pharmacodynamics .- .(correct .answer) .-What .the .drug .does .to .the .body.
Absorption .- .(correct .answer) .-Describes .how .the .drug .leaves .its .site .of .administration.
Bio-availability .- .(correct .answer) .-Fraction .of .drug .that .reaches .the .circulation.
Therapeutic .drug .level .- .(correct .answer) .-The .minimal .effective .concentration .of .a .drug.
If .medication .is .free-floating .or .unbound .what .does .this .cause? .- .(correct .answer) .-Toxicity
What .affects .all .pharmacokinetic .pathways? .- .(correct .answer) .-Blood .pressure
Why .is .protein .so .important .in .pharmacokinetics? .- .(correct .answer) .-Protein .
(albumin) .binding .is .how .medications .are .transported .or .distributed. .Low .albumin .or .protein .could .c
reate .an .increased .level .of .unbound .medication .and .toxicity.
Explain .the .absorption .process? .- .(correct .answer) .-
Process .occurs .from .the .time .the .drug .enters .the .body .to .the .time .that .it .enters .the .bloodstream .t
o .be .circulated.
What .determines .onset .of .action? .- .(correct .answer) .-Rate .of .absorption.
What .is .the .first-pass .effect? .- .(correct .answer) .-
When .drugs .are .given .orally, .absorbed .from .the .GI .tract, .and .carried .to .the .liver .for .metabolism .via
.the .portal .circulation.
What .are .drug-related .variables .that .affect .pharmacokinetics? .- .(correct .answer) .-
The .route, .dose, .and .frequency .of .the .medication.
What .are .patient-related .variables .that .affect .pharmacokinetics? .- .(correct .answer) .-Liver-
metabolism, .kidney-elimination .and .metabolism, .allergies, .weight-
lean .vs .fat, .neuro .status, .respiratory .status, .gender,ethnicity, .previous .meds, .vital .signs, .age
,Describe .how .pediatrics .metabolize .meds? .- .(correct .answer) .-They .are .ultra-
metabolizers. .May .need .higher .doses .because .they .metabolize .the .drug .more .quickly.
2 .ways .that .drugs .are .transported .from .the .GI .tract .across .cell .membranes? .- .(correct .answer) .-
Passive .diffusion .and .active .transport
Bio-equivalence? .- .(correct .answer) .-Means .that .2 .drugs .contain .the .same .active .ingredients .and .are
.identical .in .strength .or .concentration, .dosage .form, .and .route .of .administration .and .have .essentiall
y .the .same .rate .and .extent .of .bio-availability.
How .much .bio-equivalence .variability .is .allowed .in .generic .drugs? .- .(correct .answer) .-
+ .or .- .20% .of .the .proprietary .drug.
What .is .an .example .of .a .drug .should .never .be .prescribed .in .the .generic .form .because .of .its .narrow
.therapeutic .window? .- .(correct .answer) .-Lanoxin.
What .drug .characteristics .affect .drug .absorption? .- .(correct .answer) .-
Formulation .of .the .drug, .concentration .of .the .drug, .lipophilic .drug .formulations .
(more .readily .absorbable), .Acidic .drugs .(become .non-
ionized .in .the .stomach .and .are .diffused .across .the .membranes).
What .part .of .pharmacokinetics .are .affected .by .a .change .in .acidity .in .the .stomach? .- .
(correct .answer) .-Absorption
Passive .diffusion .- .(correct .answer) .-
Random .movement .of .molecules .across .cell .membranes .from .high .to .low .concentrations.
Active .transport .- .(correct .answer) .-The .movement .of .moderately-
sized .molecules .across .cell .membranes .on .transport .carriers.
What .3 .factors .affect .influence .absorption? .- .(correct .answer) .-
1. .Blood .flow .to .the .absorption .site .2. .Total .surface .area .for .absorption .3. .Contact .time .with .absorp
tion .area.
What .4 .factors .influence .bio-availability? .- .(correct .answer) .-
1. .First .pass .hepatic .metabolism .2. .Solubility .of .the .drug .3. .Chemical .instability .4. .Nature .of .the .dru
g .formulation.
Describe .distribution .of .meds .in .the .body? .- .(correct .answer) .-
After .absorption, .drugs .are .carried .by .the .blood .and .the .tissues .to .sites .of .action,metabolism,and .ex
cretion.
Meds .are .distributed .quickly .to .the? .- .(correct .answer) .-heart, .liver .and .kidneys
Meds .are .distributed .more .slowly .to .the? .- .(correct .answer) .-internal .organs, .fat, .skin, .and .muscles.
, Explain .what .protein .binding .means? .- .(correct .answer) .-
Drug .molecules .that .are .bound .to .plasma .protein .
(albumin) .are .pharmacologically .inactive .due .to .their .large .size. .
(consider .temporary .storage .of .the .med) .Only .free .or .unbound .meds .can .act .on .the .body's .cells. .As
.the .free .or .unbound .meds .are .used, .the .protein .molecules .can .release .more .meds .into .the .circulati
on.
The .higher .the .degree .of .protein .binding .the .________ .the .potential .action .of .the .drug. .- .
(correct .answer) .-longer
If .two .drugs .compete .for .protein .binding .sites .what .will .happen? .- .(correct .answer) .-
One .med .will .remain .free .floating .and .become .potentially .toxic. .An .example .would .be .placing .a .pati
ent .on .an .antibiotic .when .a .patient .is .on .coumadin .(the .INR .will .get .very .toxic .quickly).
What .are .3 .highly .protein .bound .drugs? .- .(correct .answer) .-Coumadin, .Diazepam, .and .sulfonamides.
Why .would .long-term .malnutrition .affect .medication .distribution? .- .(correct .answer) .-
Decreased .protein .binding .sites .for .meds .to .be .transported .on. .Increased .drug .levels .or .the .med .wil
l .have .a .stronger .effect .on .the .patient.
Define .metabolism .of .medications? .- .(correct .answer) .-
Method .by .which .drugs .are .biotransformed .or .inactivated?
What .does .prodrug .mean? .- .(correct .answer) .-
Drugs .that .are .metabolized .and .then .they .become .active.
Most .drugs .are .metabolized .into ._________ .metabolites? .- .(correct .answer) .-inactive
Most .drugs .are .metabolized .by .______________? .- .(correct .answer) .-
Cytochrome .P450 .enzyme .system .in .the .liver
What .juice .can .inhibit .the .cytochrome .P450 .enzyme .system .in .the .liver? .- .(correct .answer) .-
Grapefruit .juice-competes .for .binding .sites
Besides .the .liver, .what .are .the .other .sites .of .for .drug .metabolism? .- .(correct .answer) .-
blood, .kidneys, .lungs, .and .GI .mucosa
What .is .required .for .good .excretion .of .medications? .- .(correct .answer) .-
a .good .circulatory .system, .good .functioning .of .the .kidneys, .bowels, .lungs, .and .the .skin.
Why .is .it .concerning .if .drugs .cross .the .placenta? .- .(correct .answer) .-
Fetuses .have .no .ability .to .to .metabolize .or .eliminate .medications.
What .are .the .pregnancy .categories? .- .(correct .answer) .-A-studied .and .safe .to .fetus .B-
probably .safe,but .only .studied .in .animals .C-
Animal .studies .have .shown .an .effect .on .the .fetus, .benefit .must .outweigh .the .risk .D-
