3 NURS 5334 Final Exam
Study Guide Latest Version
2023/2024
Prescribing basics - correct Answers ✔✔ -Prescribing is regulated by state
BON
Proper RX - correct Answers ✔✔ -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 - correct Answers ✔✔ -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 - correct Answers ✔✔ -The effects of drug on the body.
Receptors are large molecules usually proteins, that interact and mediate
the action of drugs
agonist - correct Answers ✔✔ -produce receptor stimulation and a
conformational change every time they bind. Do not need all available
receptors to produce a maximum response
Partial agonist - correct Answers ✔✔ -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 - correct Answers ✔✔ -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 - correct Answers ✔✔ -% of administered dosage of the drug
that survives the first pass through the liver and reaches the blood stream
half life - correct Answers ✔✔ -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 - correct Answers ✔✔ -absorption,
distribution, metabolism, excretion
Distribution - correct Answers ✔✔ -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 - correct Answers ✔✔ -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 - correct Answers ✔✔ -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 - correct Answers ✔✔ -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 - correct Answers ✔✔ -an agent that is metabolized by an
enzyme into a metabolite and product and eventually excreted
Inhibitors - correct Answers ✔✔ -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 - correct Answers ✔✔ -competes with other drugs for a particular
enzyme affecting metabolism of the substrate (increases) decreasing the
efficacy of the drug
excretion - correct Answers ✔✔ -renal: passive glomerular filtration, active
tubular secretion, tubular reabsorption, gi tract, lung, sweat and salivary,
mammary
genomics - correct Answers ✔✔ -study of the complete set of genetic
information present in a cell, an organism, or species
pharmacogenetics - correct Answers ✔✔ -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 - correct Answers ✔✔ -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 - correct Answers ✔✔ -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? - correct Answers ✔✔ -
Molecular size, Lipid solubility, degree of ionization at tissue pH
, Why is epinephrine given with local anesthetics? - correct Answers ✔✔ -
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? - correct Answers ✔✔ -
Lidocaine
What is a possible fatal reaction to benzocaine - correct Answers ✔✔ -
Methemoglobinemia
What is included in application guidelines for topical anesthetics - correct
Answers ✔✔ -avoid wrapping the site and heating the site, avoid
application to open skin
Which medication will not cause rebound headaches from overuse? -
correct Answers ✔✔ -propranolol (preventative)
What is the best option for menstural migraine? - correct Answers ✔✔ -low
dose estrogen about 3 days prior to menses
What food can trigger migraines? - correct Answers ✔✔ -Hot dog d/t
nitrates
What medication is a Seratonin 1B1D receptor agonist? - correct Answers
✔✔ -Sumatriptan
Butterbur can help as prevention for migraine therapy. What side effect
can occur? - correct Answers ✔✔ -Liver damage
What are the 3 main classes of opiod receptors? - correct Answers ✔✔ -Mu
kappa delta
Which of the following will reserve he effects caused by opioid agonist? -
correct Answers ✔✔ -naloxone
Which of the medications are used to treat OIC? - correct Answers ✔✔ -
Naloxegol, methylinaltrexone, lubiprostone
Tolerance is defined as - correct Answers ✔✔ -increased does of a med
needed to obtain the same response
