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NURS 5334 PHARM FINAL EXAM 2024 LATEST ACTUAL EXAM DETAILED QUESTIONS AND GUARANTEED ANSWERS ALREADY GRADED A+
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NURS 5334 PHARM FINAL EXAM 2024 LATEST ACTUAL EXAM DETAILED QUESTIONS AND GUARANTEED ANSWERS ALREADY GRADED A+

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  • September 5, 2024
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  • 2024/2025
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NURS 5334 PHARM FINAL EXAM 2024 LATEST ACTUAL
EXAM DETAILED QUESTIONS AND GUARANTEED
ANSWERS ALREADY GRADED A+

MODULE v1
1. What vare vthe vBON vrules vand vregulations vfor vprescriptive vauthority vfor vthe
vadvance vpractice vnurse?

1. Texas vis vvery vrestricted
2. Describe vthe vpharmacokinetic vprocesses vof vabsorption, vdistribution, vmetabolism
vand velimination vand vhow vdifferences vin vthese vareas vaffect vdrug vaction.

1. Absorption
1. Drug’s vmovement vfrom vthe vsite vof vadministration vinto vthe vblood.
2. Distribution
1. Drug’s vmovement vfrom vthe vblood vinto vthe vinterstitial vspace
vof vtissues vand vfrom vthere vinto vcells.

3. Metabolism
1. Biotransformation vis vthe venzymatically vmediated valteration vof
vdrug vstructure.

4. Elimination
1. Combination vof vmetabolism vand vexcretion
3. Compare vand vcontrast vpharmacokinetics vand vpharmacodynamics vof
vspecial vpopulations—pediatrics, volder vadults vand vthose vthat vare vpregnant.

1. Pediatrics—they vhave vorgan vimmaturity, velderly—they vhave vorgan
vdegeneration, vloss vof vnephrons, vexcretion vof vdrug vis vdecreased vand vyou vhave

vto vgive vthis vpopulation va vlower vdose vof vmedication. vMedication vcan vpass

vthrough vmilk vof vlactating vfemales.

4. Analyze va vdrug vinteraction vto vdetermine van vappropriate vcourse vof vaction.
1. Basic vmechanism vof vdrug-drug vinteractions vthrough vpharmacokinetic
vinteractions vare valtered vabsorption, valtered vdistribution, valtered vmetabolism,

vand valtered vrenal vexcretion.

5. Identify vmedications vwith va vnarrow vtherapeutic vindex vrequiring vdrug
vlevel vmonitoring.

1.
6. Discuss vthe veffect vof vionization vand vpH von vabsorption.
1. Drugs vthat vare vweak vacids vare vbest vabsorbed vin vacidic venvironments. vAcidic
vdrugs vaccumulate von vthe valkaline vside, vbasic vdrugs vaccumulate von vthe vacidic

vside vknown vas vion vtrapping. vIonization vof vthe vdrugs vis vpH vdependent, vwhen vthe

vpH vand vthe vfluid von vone vside vof vthe vmembrane vdiffers vfrom vthe vpH von vthe

vother vside, vdrug vmolecules vtend vto vaccumulate von vthe vside vwhere vthe vpH vmost

vfavors vionization.

7. Discuss vfactors vaffecting vdrug vdistribution.
1. Competition vfor vprotein vbinding vand valteration vof vextracellular vpH
8. Discuss vbarriers vaffecting vdrug vdistribution—such vas vplacental vmembrane,
vblood vbrain vbarrier vand vvolume vof vdistribution.

1. Placental vmembrane: vdrugs vare veasily vpassed vthrough vthe vplacental vmembrance
2. Blood vbrain vbarrier: vthe vPGP vpumps vdrugs vback vinto vthe vblood vand vthereby
vlimits vtheir vaccess vto vthe vbrain.

3. Volume vof vdistribution:

,9. Discuss vthe v“first-pass veffect”—what veffect vcan vthis vhave von vdistribution vof va vdrug?
1. Rapid vhepatic vinactivation vof vcertain voral vdrugs. vWhen vdrugs vare vabsorbed vby
vthe vGI vtract, vthey vare vcarried vdirectly vto vthe vliver vthrough vthe vhepatic vportal

vvein

, before ventering vthe vsystemic vcirculation. vIf vthe vcapacity vof vthe vliver vto vmetabolize
vthe vdrug vis vextremely vhigh, vthis vdrug vcan vbe vcompletely vinactivated von vits vfirst

vpass vthrough vthe vliver.

10. Discuss vthe vsignificance vof vthe vCytochrome vP450 vsystem von vmetabolism vof vdrugs.
1. It vis va vgroup vof v12 vclosely vrelated venzyme vfamilies. vCYP1, vCYP2, vCYP3
vmetabolize vdrugs. vThe vother v9 vfamilies vmetabolize vendogenous vcompounds

v(ex. vFatty vacids, vsteroids).

11. Discuss vthe vmajor vhepatotoxic vdrugs vand vpossible veffects von vdrug
vmetabolism. v1.

12. List vvarious vroutes vof vdrug velimination—review vnormal vrenal vfunction vincluding
vglomerular vfiltration, vpassive vtubular vreabsorption vand vactive vtubular vsecretion;

vdescribe vthe vimplications von vdrug vclearance vand vhow velimination vaffects

vprescribing.

1.
13. Discuss vterms vused vto vdescribe vdrug vactions-agonist, vpartial vagonist, vantagonist.
1. Agonist: vmolecules vthat vactivate vreceptors
2. Partial vagonist: vOnly vhas vmoderate vintrinsic vactivity. vMaximal veffect vthat va
vpartial vagonist vcan vproduce vis vlower vthan vthat vof va vfull vagonist.

3. Antagonist: vProduce vtheir veffects vby vpreventing vreceptor vactivation vby
vendogenous vregulatory vmolecules vand vdrugs.

14. Discuss vthe vimpact vof vfood von vdrug vabsorption, vdrug vmetabolism vand von vdrug
vtoxicity vand vaction—as vwell vas vthe vtiming vof vdrug vadministration.

LIFESPAN
1. Hepatic vmetabolism vand vGFR vincrease vduring vpregnancy, vdosages vof vsome
vdrugs vmay vneed vto vbe vincreased.

2. Rate vof valbumin vto vwater vdecreases
1. Third vtrimester: vRenal vblood vflow vis vdoubled vand vrenal vexcretion
vis vaccelerated v(drugs vexcreted vrapidly)

2. Tone vand vmobility vof vbowel vdecrease
3. Prolongation vof vdrug veffects vTotal v(½ vlife vincreases)
3. Understand vstages vof vdevelopment vin vpregnancy
1. Conception: vthrough vweek v2
2. Embryonic vperiod: vweek v3-week v8
a) Gross vmalformations vcan vbe vproduced vby vteratogens
3. Fetal vperiod: vweek v9-delivery
4. Understand vpregnancy vlabeling
1. 3 vcategories vnow
a) Pregnancy, vlactation, vmale v& vfemale vreproductive vpotential
5. How vdo vyou vdecrease vrisk vin vthe vinfant vduring vbreastfeeding?
1. Take vmeds vimmediately vafter vbreastfeeding, vavoid vdrugs vthat
vhave vlong vhalf-lives, vchoose vdrugs vthat vtend vto vbe vexcluded vfrom vmilk,

vavoid vdrugs vthat vare vknown vto vbe vhazardous.

6. How vdo vpediatric vpatients vdiffer vin vtheir vresponse vto vmedications?
1. Absorption
a) Oral?

, 1. Neonates: vdrug vremain vin vthe vstomach vlonger vwhich
vincreases vthe vlevels, vlow vacidity vcan vaffect vthe vabsorption

vof vacid vlabile vdrugs

b) Parenteral?
1. Reponses vare vslow vand verratic.
2. Infancy: vabsorption vis vmore vrapid vthan vin vneonates v& vadults
3. Best vavoided vin vinfants
c) Transdermal?
1. Greater vskin vpermeability vwhich vincreases vtopical
vdrug vabsorption vand vincreases vthe vrisk vfor vtoxicity

2. Distribution
a) Protein vbinding
1. Neonates: vless vprotein-binding—increased vavailability vof
vhighly vprotein vbound vdrugs vsuch vas vphenytoin, vdiazepam,

vand vphenobarbital. vReduced vdosages vneeded vin vthese

vhighly vbound vdrugs.

b) Blood vBrain vBarrier
1. Not vfully vdeveloped vat vbirth, vdrugs vhave veasy vaccess vto
vthe vCNS, vdoses vshould vbe vreduced.

3. Metabolism
a) Hepatic vfunction?
1. Liver vhasn’t vreached vfull vmaturation—sensitive vto
vdrugs veliminated vby vthe vCYP450. vLiver’s vability vto

vmetabolize vdrugs vincreases vabout vone vmonth vafter

vbirth.

b) T vhalf vlife
1. Decreased vby vas vmuch vas v48-72 vhours
4. Excretion
a) Renal?
1. GFR vis vsignificantly vreduced vat vbirth, vdrugs veliminated
vby vthe vkidneys vmust vbe vgiven vin va vreduced vdosage vand

vlonger vdosing vintervals.

7. What veducation vneeds vto vbe vgiven vto vparents?
1. What vto vdo vif vchild vspits vout vmedication vor vthrows vit vup
2. Effective veducation: vdosage vsize vand vtiming, vroute, vtechnique
vof vadministration, vduration vof vtreatment, vhow vto vstore vthe vdrug,

vnature vand vtime vcourse vof vthe vdesired vresponse, vnature vand vtime

vcourse vof vadverse vreactions.

8. How vdo vyou vconvert vpounds vto vKG?
1. Divide vweight vby v2.2
9. What vis vdefinition vof vpolypharmacy? vIs vpolypharmacy valways
vinappropriate? vWhat vis vBeer’s vList?

1. Polypharmacy: v3 vor vmore vprescription vdrugs vin vconjunction-+
vwith v3 vor vmore vdietary vsupplements.

2. No
3. List vthat videntifies vdrugs vwith va vhigh vlikelihood vof vcausing
vadverse veffects vin vthe velderly

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