NRNP 6566 WK1-5 Midterm Questions And Answers Latest Top Score.
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NRNP 6566 WK1-5
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NRNP 6566 WK1-5
NRNP 6566 WK1-5 Midterm Questions And Answers Latest Top Score.
Describe cytochrome p450 system - correct answer. Cytochrome p450 system is a series of enzymes used to metabolize medications
Inhibitors - correct answer. block metabolic activity from one or more CYP450 enzymes
...
Describe effect on low and high albumin levels on active drug levels especially for drugs
that are highly protein bound - correct 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 - correct answer. malnutrition, chronic illness
Highly protein bound drugs can lead to - correct 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 - correct 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: - correct
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 - correct answer. half
life
plasma concentration
Be familiar with the beers criteria and how to use it - correct 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 - correct 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 - correct answer. low albumin levels, body
composition, cardiac decompensation (heart failure), age
Describe the factors that affect metabolism - correct answer. genetics, age, organ
function
Describe factors that affect excretion - correct 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? - correct 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.
You will need to monitor blood tests to monitor blood concentrations and dose
adjustments accordingly.
Describe how aging can affect absorption, distribution, metabolism and excretion -
correct answer. decreased organ function, poorly tolerate drugs that require
metabolism, lower rates of excretion
decrease in small-bowel surface area, slowed gastric emptying, increase in gastric PH,
changes in drug absorption
With age, body fat generally increases and total body water decreases. Increased fat
increases the volume of distribution for highly lipophilic drugs (for example, diazepam
and chlordiazepoxide), which may increase their elimination half-lives.
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