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NUR 641E final Exam 2024_2025 fully solved & updated
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NUR 641E final Exam 2024_2025 fully solved & updated
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NUR 641E final Exam 2024/2025 fullysolved & updated
Pharmacokinetics involves - ANSWER-absorption, distribution, metabolism and
elimination).
Absorption: - ANSWER-absorption from the administration site either directly or
indirectly into the blood/plasma.
Distribution: - ANSWER-reversibly or irreversibly move from the bloodstream into
the interstitial and intracellular
Metabolism: - ANSWER-biotransformed via hepatic metabolism or by other
tissues.
Elimination: - ANSWER-tissues. lastly, the drug and its metabolites are eliminated
from the body.
route of administration with the highest bioavailability - ANSWER-intravenous;
putting entire dose into a patient's vein and bypassing absorption.
avoids first-pass metabolism - ANSWER-Intravenous route
administration has variable and erratic absorption. n - ANSWER-Rectal
administration
4. Steady state (SS) - ANSWER-absorption. n is usually reached within 4-5 half-
lives of drug.
Half-life of a drug is - 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 - ANSWER-means a drug is metabolized
at a constant rate per unit time.
CYP3A4 substrate drugs - 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: -
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 - 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: - ANSWER-pharmacological and idiosyncratic.
85% to 90% of ADRS - ANSWER-are pharmacological.
Adverse drug reactions are usually preventable, - 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; - ANSWER-the FDA does not mandate that
ADRS be reported.
Polypharmacy - ANSWER-involves using multiple health care providers for care,
using multiple medications, and using several pharmacies prescription filling.
Angiotensin converting enzyme inhibitors (ACEIS): - ANSWER-lisinopril,
captopril, enalapril, ramipril, benazepril, fosinopril.
ACEIS reduce blood pressure enzyme. - ANSWER-by suppressing the release of
angiotensin-converting enzyme.
, Important side effects of ACE inhibitors - ANSWER-Important include cough and
angioedema; discontinue the ACEI if angioedema occurs.
Angiotensin II receptor blocking agents (ARBS): - ANSWER-Icandesartan
(Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar),
telmisartan (Micardis) and valsartan (Diovan).
ARBS reduce blood pressure - ANSWER-by blocking angiotensin II receptors.
Essential (primary) hypertension - ANSWER-Essential (primary) accounts for 90%
of cases; secondary hypertension may caused by chronic renal failure.
Nitroglycerin - ANSWER-Nitroglycerin is a nitrate drug that can be administered
IV, SL, a topical ointment and as a transdermal patch.
Nitrates are contraindicated - ANSWER-with PDE-5 inhibitors (e.g., sildenafil and
vardenafil)
Amiodarone is the antiarrhythmic - ANSWER-Of choice when there is coexisting
heart failure; can cause thyroid and pulmonary toxicity.
Alpha-1 adrenergic stimulation - ANSWER-results in vasoconstriction and
increased blood pressure.
Alpha-1 adrenergic blockade - ANSWER-results in vasodilation and reduced
blood pressure.
Beta-1 adrenergic stimulation - ANSWER-by beta agonists (e.g., isoproterenol)
results in increased heart rate, increased blood pressure, and increased cardiac
output.
Beta-1 adrenergic blockade results - ANSWER-in reduced heart rate, reduced
blood pressure, and reduced cardiac output.
Left heart failure - ANSWER-causes reduced delivery of oxygenated blood to the
body tissues.
Right heart failure - ANSWER-is associated with pulmonary disease and
increased pulmonary vascular resistance.
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