NRNP 6566 WK1-5 Midterm
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Cytochrome p450 system is a series of
Describe cytochrome p450 system enzymes used to metabolize medica-
tions
block metabolic activity from one or more
Inhibitors
CYP450 enzymes
increase CYP450 enzyme activity by in-
Inducers
creasing enzyme synthesis
Albumin is the plasma protein with the
greatest capacity for binding drugs. Bind-
ing plasma proteins affect drug distribu-
Describe effect on low and high albumin tion into tissues, because only drug that
levels on active drug levels especially for is not bound is available to penetrate tis-
drugs that are highly protein bound sues, bind to receptors, and exert activity.
As free drug leaves the blood stream,
more bound drug is released from bind-
ing sites.
Low albumin levels malnutrition, chronic illness
toxicity in patients with low albumin lev-
els, example malnutrition or chronic ill-
Highly protein bound drugs can lead to
ness. This is because there are fewer
than the normal sites for the drug to bind
Alternative routes include:
suppository
intravenous
intramuscular
Describe the ways the hepatic first pass inhalational aerosol
effect- which is metabolism during first transdermal
pass through the liver sublingual
These allow drugs to bypass the
first-pass effect and be absorbed directly
into systemic circulation
Male = 140-age times weight in kilo-
Be able to calculate creatinine clearance grams divided by serum creatinine times
using Cockgraft Gault equation: 72.
Women = CRCL (male) times 0.85
1/8
, NRNP 6566 WK1-5 Midterm
Study online at https://quizlet.com/_g0aaiz
Describe what determines the frequency half life
of drug administration plasma concentration
Potentially Inappropriate Medication Use
in Older Adults
Be familiar with the beers criteria and
to call attention to medications that are
how to use it
most commonly problematic and thus
should be avoided in older adults
low blood state (shock or arrest), contact
time with GI tract too fast (diarrhea =
Describe factors that affect absorption cant absorb), delayed stomach emptying
(large meal = delayed absorption)Drug-
to drug or drug to food interactions
low albumin levels, body composition,
Describe the factors that affect distribu-
cardiac decompensation (heart failure),
tion
age
Describe the factors that affect metabo-
genetics, age, organ function
lism
affected by abnormal kidney or liver func-
Describe factors that affect excretion
tion, age, drug interactions
Therapeutic index is the dose range of
effiency of med is optimized while side
effects are minimized
Narrow therapeutic index drugs are de-
fined as those drugs where small dif-
Define narrow therapeutic index. How
ferences in dose or blood concentration
would you monitor a patient with a nar-
may lead to dose and blood concentra-
row therapeutic index?
tion dependant, serious therapeutic fail-
ures or adverse drug reactions.
You will need to monitor blood tests to
monitor blood concentrations and dose
adjustments accordingly.
2/8
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