NURS 682 Pharmacology Midterm Review Questions And Answers Rated A+
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Course
NURS 682
Institution
NURS 682
NURS 682 Pharmacology Midterm Review Questions And Answers Rated A+
what the body does to the drug (absorption, distribution, metabolism, excretion) ANS Pharmacokinetics
what the drug does to the body; mechanism of action
Pharmacodynamic study= determining the effect of a specific medicatio...
NURS 682 Pharmacology Midterm Review Questions
And Answers Rated A+
what the body does to the drug (absorption, distribution, metabolism, excretion) ANS
Pharmacokinetics
what the drug does to the body; mechanism of action
Pharmacodynamic study= determining the effect of a specific medication dose in treating a disease
ANS Pharmacodynamics
-Percent of dose enter systemic circulation after PO administration
*Fraction of the administered drug that reaches systemic circulation* ANS Bioavailability
LESS drug there is in circulation and in the tissue, higher first pass effect
ex. Simvastatin ANS Lower bioavailability
the more of the drug that reaches systemic circulation, Lower first pass effect
ex. Atorvastatin ANS Higher bioavailability
Time to maximum drug level observed ANS Tmax
maximum or peak concentration of drug observed after administration ANS Cmax
Vd = (amount of drug in the body) / (plasma drug concentration)
-distribution of a medication between plasma and the rest of the body; the volume in which the
amount of drug would need to be uniformly distributed to produce the observed blood concentration
,ex. Vancomycin in serum testing for trough levels ANS Volume of distribution
-Healthy adults 20-30 vs. 60-80
-Older adults get more dehydrated
-Medications that are lipophilic will stay longer in the older adult and older adults get
-Liver shrinks with age and albumin is synthesized in the liver. There is freer drug available in highly
protein bound drugs—->Decrease in serum albumin
-Most drugs are biotransformed in the liver, with older adults there is slower transformation and
longer half lives ANS Volume of distribution: age related changes
Aging
-less free water, more body fat
-lower average serum albumin
Hydration Status
Compartment and volume ANS Factors that influence volume of distribution
Biostranformation and/or excretion of oral drug by hepatic mechanisms
-occurs prior to entering GI tract
Drugs absorbed from the GI tract
Extensive hepatic metabolism.extraciton
Ex. IV vs oral dosages ANS First Pass Effect (pre-systemic elimination)
Works primarily by stimulating the activity of a receptor site
,binds to a receptor, causes an effect similar to endogenous compound ANS Agonists
Clinical action= occupying a receptor site and inhibiting its endogenous activity ANS Antagonist
small differences in drug dose or blood concentration can be fatal
Any pharmaceutical which has <2-fold difference between the minimum toxic concentration and
minimum effective concentration in blood ANS Narrow therapeutic Index
Greater distance between effective dose and toxic dose
Ex. Fluoxetine does NOT need drug monitoring ANS Wide therapeutic index
Drug absorption, distribution, metabolism, excretion
Drug targets: Receptors, transporters, intracellular signaling pathways, enzymes and metabolic
pathways
Influence drug efficacy ANS Pharmacogenetics: PD genetic influences
Ventricular repolarization prolongation
Ectopic beats with long pause follow by baseline rhythm beat with marked prolonged QT interval
Underlying risk factors + Adding medications with QT prolonging effects
, Known: Amiodarone, Haldol ANS Drugs with QT prolongation
OLDER AGE ANS Known risk of QT prolongaiton
Older adults have....
-less % body weight as water
-less lean muscle mass
-higher % weight as fat
-LOWER SERIUM ALBUMIN**
-lower relative kidney weight
-less relative hepatic blood flow ANS Summary of Age-Related Changes
Unconditionally inappropriate meds & Generally best avoided regardless of circumstances
Usually alternative available
Conditioned upon disease state & dose
Likely only to be inappropriate in specific context ANS Beer's Criteria
Beer's Criteria
**Avoid medications with systemic anticholinergic ridged effect due to risk of confusion, urinary
retention, constipation, visual disturbance and hypotension
DO NOT continue unwise practices that are seen in daily clinical settings
Have multiple choices in a drug class, choose a product with a shorter half life
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