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Nur 641 E Final Exam 2024_2025 fully solved & updated.
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Nur 641 E Final Exam 2024_2025 fully solved & updated.
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Nur 641 E Final Exam 2024/2025 fullysolved & updated
absorption, distribution, metabolism, excretion - ANSWER-Pharmacokinetics
involves
absorption from the administration site either directly or indirectly in the blood
plasma - ANSWER-Pharmacokinetic absorption
reversibly or irreversibly move from the bloodstream into the interstitial and
intracellular fluid - ANSWER-Pharmacokinetic distribution
biotransformed via hepatic metabolism or by other tissue - ANSWER-
Pharmacokinetics metabolism
1. highest bioavailability
2. places entire does into venin thus bypassing absorption
3. avoids hepatic first pass metabolism in the liver - ANSWER-Intravenous
medications
usually reached within 4-5 half lives of the drug - ANSWER-steady state
medication
1.the time required for the elimination process to reduce 2.the concentration of
the drug to one half what it was at initial administration
3.determines drug frequency
4. predicts length of toxic effects
5. constant first order pharmacokinetics of a drug - ANSWER-drug half life
drug is metabolized at a constant rate per unit - ANSWER-zero order (nonlinear)
metabolizes 50% drugs
,inhibit: grapefruit juice
- increase drug -> adverse effects
may have enhanced activity with any other CYP3A4 - ANSWER-CYP3A4
1. discovery or laboratory for development
2. Phase 1 begins with animal testing
3. phase 2 human subjects
4. compare drug to placebo or other drug that is effective
5.FDA then reviews result and determines approval
6. Post market study to determine other side effects that were not seen while lab
testing - ANSWER-Six steps in drug development process
1.Institute of Safe mediation Practice
2. Institute of Medicine
3. Joint commission
4.National Coordinating Council form mediation error reporting and prevention
5. Food and Drug Administration (safe use initiative) - ANSWER-organizations for
medication safety
1.Also known as a side effect, an undesirable reaction that accompanies the
principal response for which the drug was taken include allergic reactions and
adverse drug effects
2. Either pharmacological or idiosyncratic
3. 85-90% of ADRs are pharmacological
4. Reporting is not mandated by FDA thus are not commonly reported
5. usually preventable occur in hospital and nursing homes due to med errors
6. Polypharmacy, multiple doctors and multiple pharmacies increase risk -
ANSWER-Adverse Drug Reaction (ADR)
1. end in pril: lisinopril, captopril, enalapril, ramipril, benazepril and fosinopril
2. suppress release of angiotensin converting enzyme
3. side effects include cough and angioedema, with angioedema the medication
should be discontinued - ANSWER-Angiotensin-converting enzyme (ACE)
inhibitors
1. -sartan: candesartan, eprosartan, ibesartan, Isosartan, telmisartan, valsartan
2.block angiotensin 11 receptors - ANSWER-Angiotensin II Receptor Blockers
(ARBs)
Essential HTN accounts for 90% of cases and is also called primary, secondary
may be caused by CKD - ANSWER-Essential vs Secondary HTN
, use: angina pectoris
action: dilate veins and arteries and thereby reducing ischemia and relieving pain
by decreasing myocardial O2 consumption
Side effects: throbbing HA, flushing, hypotension tachycardia
available: IV, SL, topical ointment and transdermal patch
contraindicated with PDE-5 (sildanfil and vardenafil) - ANSWER-Nitroglycerin
(Nitrate)
1. antiarrhythmic of choice when there is coexisting heart failure
2. can cause thyroid and pulmonary toxicity - ANSWER-Amiodarone
vasoconstriction and increased blood pressure - ANSWER-Alpha 1 adrenergic
stimulation results
Decrease sympathetic stimulation causing vasodilation and decreased blood
pressure - ANSWER-alpha 1 blockade
stimulation by beta agonists (isoproterenol) result in increased heart rate, blood
pressure and cardiac output
2. blockade results in decreased heart rate, bp, and cardiac output - ANSWER-
beta 1 adrenergic
The heart does not adequately circulate blood to systemic system. Due to
pressure overload or volume overload causing a reduction of oxygenated blood
to body tissue - ANSWER-left heart failure
1.Associated with pulmonary disease and increased pulmonary vascular
resistance
2.The heart does not adequately circulate blood to the pulmonic system. Can be
due to volume overload or regurgitation in Tricuspid Valve or Pulmonic Valve.
Can lead to systemic edema, back up of blood in liver and lower extremities -
ANSWER-Right heart failure
1.Inhibit water transport across Loop of Henle work on receptors in ascending
renal loop
2.inhibit reabsorption of NaCL at site in kidney
3. potent diuretic (Lasix) can cause hypokalemia - ANSWER-Loop diuretics MOA
spironolactone, triamterene, amiloride - ANSWER-Potassium sparing diuretics
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