COX COLLEGE PHARMACOLOGY
FINAL REVIEW UPDATED ACTUAL
Exam Questions and CORRECT Answers
What is pharmacokinetics? - CORRECT ANSWER- ✔✔What the body does to the drug
What is ADME and what does it stand for? - CORRECT ANSWER- ✔✔•Absorption
•Distribution
•Metabolism
•Excretion
Pharmacokinetics
What is absorption? - CORRECT ANSWER- ✔✔•The first major phase of pharmacokinetics
•Absorption is the movement of a drug from its site of administration into the bloodstream
•The rate of absorption determines how soon effects will begin
•The amount of absorption helps determine how intense the effects will be
What is Drug Polymorphism? - CORRECT ANSWER- ✔✔refers to the effect of a patient's
age, gender, size, body composition, and other characteristics on the pharmacokinetics of
specific drugs
What is opioid naive and why is it important? - CORRECT ANSWER- ✔✔Patients who are
receiving opioid agonists for the first time or who do not routinely take opioid agonists.
How do agonist-antagonist work? (Opioid) - CORRECT ANSWER- ✔✔•Also called a
partial agonist or mixed agonist•When administered alone, the agonist-antagonist opioids
produce analgesia
•If given to a patient who is taking a pure opioid agonist, can antagonize analgesia caused by
the pure agonist
•Less respiratory depression than a pure agonist...but still a priority assessment!
•Examples include Talwin, Nubain, Stadol, and Buprenex
,What are the adverse effects for opioid agonists? - CORRECT ANSWER- ✔✔•M- miosis
(pupillary constriction)
•D- dependency (risk of)
•C- constipation
•A- all can cause N/V
•R- respiratory depression
•E- euphoria
•S- sedation (CNS depression)
•Itching
•Urinary retention
Note box 10-2, p. 149
What are the endogenous pain killers that the body makes? - CORRECT ANSWER-
✔✔•Enkephalins- are pentapeptides involved in regulating nociception; binds to the body's
opioid receptors•Endorphins- hormones secreted by the brain & nervous system; peptides that
activate the body's opioid receptors causing an analgesic effect
What are barbiturates, how do they work, when are they used, and what cautions should
nurses keep in mind? - CORRECT ANSWER- ✔✔•Were once the sedative/hypnotic drug of
choice
•Less commonly prescribed now due to the safer class of benzodiazepines
•Many unwanted side effects—habit forming
•Narrow therapeutic range & low therapeutic index
•May see used for long-term control of seizures and still an important part of anesthesia
•Should not stop abruptly
•Are controlled substances
What is the prototype barbiturate? - CORRECT ANSWER- ✔✔Phenobarbital
What are the therapeutic effects of barbiturates and what is the most common risk associated?
- CORRECT ANSWER- ✔✔•Sedation
•Anticonvulsant
,•Surgical procedures—Induction of anesthesia
•REMEMBER—There is a risk for respiratory depression
What part of the brain is affected by barbiturates? - CORRECT ANSWER- ✔✔Brain stem
and cerebral cortex
What are some abortive therapies for headaches? - CORRECT ANSWER- ✔✔§Selective
Serotonin Receptor Agonist (SSRA)
§Ergot alkaloid
§Some combination of an NSAID, acetaminophen, a barbiturate, and/or an opioid
What is phenobarbital, what is it used for, and what is the standard dose? - CORRECT
ANSWER- ✔✔◦Is a barbiturate
◦Sedation & fatigue are common S/E
◦Therapeutic effects are usually seen at serum drug levels of 10-40 mcg/mL
◦Has a long ½ life, allowing once daily dosing
◦Contraindications include-
◦Known allergy
◦Porphyria (known disorder of thesis of -heme in hemoglobin)
◦Liver or kidney impairment
Respiratory illness
◦Interacts with many drugs because is inducer of hepatic enzymes, including P-450 system
enzymes
◦Normal dosage- 15-20 mg/kg IV
◦Schedule IV
◦Very inexpensive—still commonly used in 3rd world countries
What are the side effects of barbiturates? - CORRECT ANSWER- ✔✔CNS: drowsiness,
lethargy, vertigo, mental depression, paradoxical restlessnessRESP: respiratory depression,
apnea, bronchospasms, and cough GI:nausea, vomiting, diarrhea, and constipation
Sleep:↓REM sleep→agitation & inability to deal with normal stress Other: agranulocytosis,
hypotension, and Stevens-Johnson syndrome
, What are some examples of traditional AED's? - CORRECT ANSWER- ✔✔◦Barbiturates-
◦Phenobarbital- PO, IV
◦Primidone (Mysoline)- PO
◦Hydantoins-◦Phenytoin (Dilantin)- PO, IV
◦Fosphenytoin (Cerebyx)- IV, IM
◦Iminostillbenes-◦Carbamazepine (Tegretol, Carbatrol)- PO
◦Oxcarbazepine (Trileptal)- PO
What are the commonly used first line drugs used to treat anxiety? - CORRECT ANSWER-
✔✔Benzodiazepines
What are some common benzodiazepines? - CORRECT ANSWER- ✔✔Alprazolam
(Xanax)Lorazepam (Ativan)
What are the most common risks associated with benzodiazepines? - CORRECT ANSWER-
✔✔In older adults these can cause a fall risk.
What is a common drug used to treat anxiety that is not a benzodiazepine? - CORRECT
ANSWER- ✔✔Buspirone (BuSpar)
How is buspirone different from benzodiazepines? - CORRECT ANSWER- ✔✔Not a CNS
depressant, not habit forming, and does not work as PRN
What part of the brain is affected by benzodiazepine? - CORRECT ANSWER- ✔✔Limbic
system, hypothalamus, and thalamus
What are the benzodiazepine indications? - CORRECT ANSWER- ✔✔•Anxiety
•Seizures
•Treatment of alcohol withdrawal
•Balanced anesthesia
•Moderate/conscious sedation
•Skeletal muscle relaxation
