NRNP 6566 WK1-5 Midterm exam questions
with 100% correct answers
Describe |cytochrome |p450 |system |- |VERIFIED |ANSWER✔✔-Cytochrome |p450 |system |is |a |series |of |
enzymes |used |to |metabolize |medications
Inhibitors |- |VERIFIED |ANSWER✔✔-block |metabolic |activity |from |one |or |more |CYP450 |enzymes
Inducers |- |VERIFIED |ANSWER✔✔-increase |CYP450 |enzyme |activity |by |increasing |enzyme |synthesis
Describe |effect |on |low |and |high |albumin |levels |on |active |drug |levels |especially |for |drugs |that |are |
highly |protein |bound |- |VERIFIED |ANSWER✔✔-Albumin |is |the |plasma |protein |with |the |greatest |
capacity |for |binding |drugs. |Binding |plasma |proteins |affect |drug |distribution |into |tissues, |because |only |
drug |that |is |not |bound |is |available |to |penetrate |tissues, |bind |to |receptors, |and |exert |activity. |As |free |
drug |leaves |the |blood |stream, |more |bound |drug |is |released |from |binding |sites.
Low |albumin |levels |- |VERIFIED |ANSWER✔✔-malnutrition, |chronic |illness
Highly |protein |bound |drugs |can |lead |to |- |VERIFIED |ANSWER✔✔-toxicity |in |patients |with |low |albumin |
levels, |example |malnutrition |or |chronic |illness. |This |is |because |there |are |fewer |than |the |normal |sites |
for |the |drug |to |bind
Describe |the |ways |the |hepatic |first |pass |effect- |which |is |metabolism |during |first |pass |through |the |
liver |- |VERIFIED |ANSWER✔✔-Alternative |routes |include:
suppository
intravenous
intramuscular
inhalational |aerosol
transdermal
sublingual
, These |allow |drugs |to |bypass |the |first-pass |effect |and |be |absorbed |directly |into |systemic |circulation
Be |able |to |calculate |creatinine |clearance |using |Cockgraft |Gault |equation: |- |VERIFIED |ANSWER✔✔-
Male |= |140-age |times |weight |in |kilograms |divided |by |serum |creatinine |times |72.
Women |= |CRCL |(male) |times |0.85
Describe |what |determines |the |frequency |of |drug |administration |- |VERIFIED |ANSWER✔✔-half |life
plasma |concentration
Be |familiar |with |the |beers |criteria |and |how |to |use |it |- |VERIFIED |ANSWER✔✔-Potentially |Inappropriate
|Medication |Use |in |Older |Adults
to |call |attention |to |medications |that |are |most |commonly |problematic |and |thus |should |be |avoided |in |
older |adults
Describe |factors |that |affect |absorption |- |VERIFIED |ANSWER✔✔-low |blood |state |(shock |or |arrest), |
contact |time |with |GI |tract |too |fast |(diarrhea |= |cant |absorb), |delayed |stomach |emptying |(large |meal |= |
delayed |absorption)Drug- |to |drug |or |drug |to |food |interactions
Describe |the |factors |that |affect |distribution |- |VERIFIED |ANSWER✔✔-low |albumin |levels, |body |
composition, |cardiac |decompensation |(heart |failure), |age
Describe |the |factors |that |affect |metabolism |- |VERIFIED |ANSWER✔✔-genetics, |age, |organ |function
Describe |factors |that |affect |excretion |- |VERIFIED |ANSWER✔✔-affected |by |abnormal |kidney |or |liver |
function, |age, |drug |interactions
Define |narrow |therapeutic |index. |How |would |you |monitor |a |patient |with |a |narrow |therapeutic |index?
|- |VERIFIED |ANSWER✔✔-Therapeutic |index |is |the |dose |range |of |effiency |of |med |is |optimized |while |
side |effects |are |minimized
Narrow |therapeutic |index |drugs |are |defined |as |those |drugs |where |small |differences |in |dose |or |blood |
concentration |may |lead |to |dose |and |blood |concentration |dependant, |serious |therapeutic |failures |or |
adverse |drug |reactions.
with 100% correct answers
Describe |cytochrome |p450 |system |- |VERIFIED |ANSWER✔✔-Cytochrome |p450 |system |is |a |series |of |
enzymes |used |to |metabolize |medications
Inhibitors |- |VERIFIED |ANSWER✔✔-block |metabolic |activity |from |one |or |more |CYP450 |enzymes
Inducers |- |VERIFIED |ANSWER✔✔-increase |CYP450 |enzyme |activity |by |increasing |enzyme |synthesis
Describe |effect |on |low |and |high |albumin |levels |on |active |drug |levels |especially |for |drugs |that |are |
highly |protein |bound |- |VERIFIED |ANSWER✔✔-Albumin |is |the |plasma |protein |with |the |greatest |
capacity |for |binding |drugs. |Binding |plasma |proteins |affect |drug |distribution |into |tissues, |because |only |
drug |that |is |not |bound |is |available |to |penetrate |tissues, |bind |to |receptors, |and |exert |activity. |As |free |
drug |leaves |the |blood |stream, |more |bound |drug |is |released |from |binding |sites.
Low |albumin |levels |- |VERIFIED |ANSWER✔✔-malnutrition, |chronic |illness
Highly |protein |bound |drugs |can |lead |to |- |VERIFIED |ANSWER✔✔-toxicity |in |patients |with |low |albumin |
levels, |example |malnutrition |or |chronic |illness. |This |is |because |there |are |fewer |than |the |normal |sites |
for |the |drug |to |bind
Describe |the |ways |the |hepatic |first |pass |effect- |which |is |metabolism |during |first |pass |through |the |
liver |- |VERIFIED |ANSWER✔✔-Alternative |routes |include:
suppository
intravenous
intramuscular
inhalational |aerosol
transdermal
sublingual
, These |allow |drugs |to |bypass |the |first-pass |effect |and |be |absorbed |directly |into |systemic |circulation
Be |able |to |calculate |creatinine |clearance |using |Cockgraft |Gault |equation: |- |VERIFIED |ANSWER✔✔-
Male |= |140-age |times |weight |in |kilograms |divided |by |serum |creatinine |times |72.
Women |= |CRCL |(male) |times |0.85
Describe |what |determines |the |frequency |of |drug |administration |- |VERIFIED |ANSWER✔✔-half |life
plasma |concentration
Be |familiar |with |the |beers |criteria |and |how |to |use |it |- |VERIFIED |ANSWER✔✔-Potentially |Inappropriate
|Medication |Use |in |Older |Adults
to |call |attention |to |medications |that |are |most |commonly |problematic |and |thus |should |be |avoided |in |
older |adults
Describe |factors |that |affect |absorption |- |VERIFIED |ANSWER✔✔-low |blood |state |(shock |or |arrest), |
contact |time |with |GI |tract |too |fast |(diarrhea |= |cant |absorb), |delayed |stomach |emptying |(large |meal |= |
delayed |absorption)Drug- |to |drug |or |drug |to |food |interactions
Describe |the |factors |that |affect |distribution |- |VERIFIED |ANSWER✔✔-low |albumin |levels, |body |
composition, |cardiac |decompensation |(heart |failure), |age
Describe |the |factors |that |affect |metabolism |- |VERIFIED |ANSWER✔✔-genetics, |age, |organ |function
Describe |factors |that |affect |excretion |- |VERIFIED |ANSWER✔✔-affected |by |abnormal |kidney |or |liver |
function, |age, |drug |interactions
Define |narrow |therapeutic |index. |How |would |you |monitor |a |patient |with |a |narrow |therapeutic |index?
|- |VERIFIED |ANSWER✔✔-Therapeutic |index |is |the |dose |range |of |effiency |of |med |is |optimized |while |
side |effects |are |minimized
Narrow |therapeutic |index |drugs |are |defined |as |those |drugs |where |small |differences |in |dose |or |blood |
concentration |may |lead |to |dose |and |blood |concentration |dependant, |serious |therapeutic |failures |or |
adverse |drug |reactions.
