Exam (elaborations)
NUR 641E final (1)
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Exam of 20 pages for the course Millwright. Bearings at Millwright. Bearings (NUR 641E final (1))
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NUR 641E finalPharmacokinetics involves - CORRECT ANSWER-absorption, distribution,
metabolism and elimination).
Absorption: - CORRECT ANSWER-absorption from the administration site either
directly or indirectly into the blood/plasma.
Distribution: - CORRECT ANSWER-reversibly or irreversibly move from the
bloodstream into the interstitial and intracellular
Metabolism: - CORRECT ANSWER-biotransformed via hepatic metabolism or by
other tissues.
Elimination: - CORRECT ANSWER-tissues. lastly, the drug and its metabolites are
eliminated from the body.
route of administration with the highest bioavailability - CORRECT
ANSWER-intravenous; putting entire dose into a patient's vein and bypassing
absorption.
avoids first-pass metabolism - CORRECT ANSWER-Intravenous route
administration has variable and erratic absorption. n - CORRECT ANSWER-Rectal
administration
4. Steady state (SS) - CORRECT ANSWER-absorption. n is usually reached within
4-5 half-lives of drug.
Half-life of a drug is - CORRECT ANSWER-how long it takes for half the drug to be
excreted from the body. Determines how frequently the drug must be administered.
Predicts how long toxic effects can last.is constant with first-order pharmacokinetics
of a drug.
Zero-order (nonlinear) pharmacokinetics - CORRECT ANSWER-means a drug is
metabolized at a constant rate per unit time.
CYP3A4 substrate drugs - CORRECT ANSWER-may have enhanced activity if any
CYP3A4 inducer drugs are used along with it.
,Drug development process involves these steps according to the FDA: - CORRECT
ANSWER-Discovery: laboratory research to develop the new drug. Preclinical
research with animal testing for safety (Phase I). Clinical research on human
subjects for medication safety (Phase II). Clinical research in humans comparing the
new drug to accepted medications placebo depending on the study (Phase III). FDA
review of the results to determine approval. Post marketing study to identify adverse
effects not found in earlier clinical studies (Phase IV)
2. Medication safety organizations - CORRECT ANSWER-The Institute for Safe
Medication Practices (ISMP) The Institute of Medicine (IOM) The Joint Commission
The National Coordinating Council for Medication Error Reporting and Prevention
(NCC MERP) Food and Drug Administration (FDA) Safe Use Initiative
Two basic type of ADRS: - CORRECT ANSWER-pharmacological and idiosyncratic.
85% to 90% of ADRS - CORRECT ANSWER-are pharmacological.
Adverse drug reactions are usually preventable, - CORRECT ANSWER-frequently
occur in a hospital or nursing home setting, and include medication errors, adverse
drug effects, and allergic idiosyncratic type reactions.
ADRS are not commonly reported; - CORRECT ANSWER-the FDA does not
mandate that ADRS be reported.
Polypharmacy - CORRECT ANSWER-involves using multiple health care providers
for care, using multiple medications, and using several pharmacies prescription
filling.
Angiotensin converting enzyme inhibitors (ACEIS): - CORRECT ANSWER-lisinopril,
captopril, enalapril, ramipril, benazepril, fosinopril.
ACEIS reduce blood pressure enzyme. - CORRECT ANSWER-by suppressing the
release of angiotensin-converting enzyme.
Important side effects of ACE inhibitors - CORRECT ANSWER-Important include
cough and angioedema; discontinue the ACEI if angioedema occurs.
, Angiotensin II receptor blocking agents (ARBS): - CORRECT
ANSWER-Icandesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro),
losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan).
ARBS reduce blood pressure - CORRECT ANSWER-by blocking angiotensin II
receptors.
Essential (primary) hypertension - CORRECT ANSWER-Essential (primary)
accounts for 90% of cases; secondary hypertension may caused by chronic renal
failure.
Nitroglycerin - CORRECT ANSWER-Nitroglycerin is a nitrate drug that can be
administered IV, SL, a topical ointment and as a transdermal patch.
Nitrates are contraindicated - CORRECT ANSWER-with PDE-5 inhibitors (e.g.,
sildenafil and vardenafil)
Amiodarone is the antiarrhythmic - CORRECT ANSWER-Of choice when there is
coexisting heart failure; can cause thyroid and pulmonary toxicity.
Alpha-1 adrenergic stimulation - CORRECT ANSWER-results in vasoconstriction
and increased blood pressure.
Alpha-1 adrenergic blockade - CORRECT ANSWER-results in vasodilation and
reduced blood pressure.
Beta-1 adrenergic stimulation - CORRECT ANSWER-by beta agonists (e.g.,
isoproterenol) results in increased heart rate, increased blood pressure, and
increased cardiac output.
Beta-1 adrenergic blockade results - CORRECT ANSWER-in reduced heart rate,
reduced blood pressure, and reduced cardiac output.
Left heart failure - CORRECT ANSWER-causes reduced delivery of oxygenated
blood to the body tissues.
Right heart failure - CORRECT ANSWER-is associated with pulmonary disease and
increased pulmonary vascular resistance.
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