NURS 5334 Advanced Pharmacology Exam1,2 and exam 3 complete solution all correct answers
NURS 5334 Advanced Pharmacology Module 1
What is prescriptive authority? - correct answer Legal right to prescribe drugs
Varies for nonphysician providers
Limitations tied to oversight by MD or DO
Arguments for full prescriptive authority - correct answer - APRNs are educated to practice
and prescribe independently without supervision
- National examinations validate ability to provide safe competent care
- Licensure ensures compliance with standards to promote public health and safety - Limited
prescriptive authority creates numerous barriers to quality, affordable, & accessible patient
care
Drug selection factors - correct answer cost, guidelines, availability, interactions, side effects,
allergies, liver & renal function, need for monitoring, special populations
Elements needed to complete a prescription - correct answer - Prescriber name, license
number, and contact information
- Prescriber DEA number, if applicable
- Patient name and date of birth
- Patient allergies
- Name of medication
- Indication of medication
- Medication strength (e.g., 25 mg, 500 mg/mL)
- Dose of medication and frequency (e.g., 12.5 mg once daily)
- Number of tablets/capsules to dispense
- Number of refills
Pharmokinetics - correct answer the study of drugs within the body, absorption ,
distribution, metabolism, excretion
3 ways drugs cross cell membrane - correct answer 1. channels & pores
2. transport systems (p glycoprotein)
3. direct penetration of membrane ( most common -> drugs too large to pass through pores &
channels)
,NURS 5334 Advanced Pharmacology Exam1,2 and exam 3 complete solution all correct answers
absorption - correct answer the movement of a drug from its site of administration into the
blood
rate of absorption determines how soon effects will begin
amount of absorption determine intensity of effects
factors affecting absorption - correct answer rate of dissolution, surface area, blood flow,
lipid solubility, pH partitioning
P-glycoprotein - correct answer Transmembrane protein that transports a wide variety of
drugs out of cells
How does the liver aid in pharmacokinetics? - correct answer transports drugs into bile for
elimination
How do the kidneys aid in pharmacokinetics? - correct answer pumps drugs into urine for
excretion
How does the placenta aid in pharmacokinetics? - correct answer transports drugs back into
the maternal blood
How does the brain aid in pharmacokinetics? - correct answer pumps drugs into blood to
limit drugs' access to the brain
passive diffusion - correct answer molecules move from one side of a barrier to another
without expending energy; moving from an area of higher concentration to lower concentration
"like dissolves like" rule - correct answer Cell membranes are composed primarily of lipids;
therefore, to directly penetrate membranes, a drug must be lipid soluble (lipophilic)
polar molecules - correct answer Molecules that have an unequal distribution of charges
No net charge
ions - correct answer molecules that have a net electrical charge
quaternary ammonium compounds - correct answer molecules that contain at least 1 atom
of nitrogen and carry a positive charge at all times
pH dependent ionization - correct answer Acid is a proton donor - tends to ionize in basic
(alkaline) media
Base is a proton acceptor - tends to ionize in acidic media
,NURS 5334 Advanced Pharmacology Exam1,2 and exam 3 complete solution all correct answers
ion trapping (pH partitioning) - correct answer acidic drugs accumulate on the alkaline side
basic drugs accumulate on the acidic side
blood flow to tissues - correct answer Drugs are carried by the blood to tissues and organs of
the body
Blood flow determines the rate of delivery
abscesses and tumors ___ blood flow. - correct answer decrease
How do drugs exit the vascular system? - correct answer Typical capillary beds, Drugs pass
between capillary cells rather than through them.
blood-brain barrier - correct answer Capillaries of CNS that have tight junctions preventing
free diffusion
Drugs must be able to pass through cells of capillary wall
Only lipid soluble drugs can cross BBB
placental drug transfer - correct answer membranes of the placenta do not constitute an
absolute barrier to the passage of drugs
risks with placental drug transfer - correct answer Birth defects: Mental retardation, gross
malformations, low birth weight
Mother's use of habitual opioids: Birth of drug-dependent baby
protein binding - correct answer ability of drugs to form reversible bonds w/ various proteins
plasma albumin - correct answer most abundant and important protein
large molecule that always remains in the bloodstream
affects drug distribution
entering cells (distribution) - correct answer some drugs need to enter cells to reach site of
action
, NURS 5334 Advanced Pharmacology Exam1,2 and exam 3 complete solution all correct answers
most drugs must undergo metabolism and excretion
many drugs produce effects by binding w/ receptors on external surface of cell membrane
drug metabolism (biotransformation) - correct answer enzymatic alteration of drug
structure, often takes place in the liver
P450 system - correct answer group of hepatic enzyme families in the liver which metabolize
drugs and endogenous compounds
prodrug - correct answer A drug that is inactive in its given form and must be metabolized to
its active form in the body, generally by the liver, to be effective.
substrate - correct answer reactant of an enzyme-catalyzed reaction
inducer - correct answer A specific small molecule that inactivates the repressor in an
operon.
therapeutic consequences of drug metabolism - correct answer - Accelerated renal excretion
of drugs
- Drug inactivation
- Increased therapeutic action
- Activation of "prodrugs"
- Increased toxicity
- Decreased toxicity
special considerations in drug metabolism - correct answer - Age
- Induction of drug-metabolizing enzymes
- First-pass effect
- Nutritional status
- Competition between drugs
Enterohepatic Recirculation of Drugs - correct answer repeating cycle where drug is
transported from the liver -> bile duct -> duodenum -> back to liver via portal blood
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