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NRNP 6566 WK1-5 Midterm Exam Questions and Complete Solutions Graded A+
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NRNP 6566 WK1-5 Midterm Exam Questions and Complete Solutions Graded A+
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NRNP 6566 WK1-5Midterm Exam
Questions and Complete
Solutions Graded A+
Describe cytochrome p450 system - Answer: Cytochrome p450 system is a series of enzymes used to
metabolize medications
Inhibitors - Answer: block metabolic activity from one or more CYP450 enzymes
Inducers - Answer: increase CYP450 enzyme activity by increasing enzyme synthesis
Describe effect on low and high albumin levels on active drug levels especially for drugs that are highly
protein bound - 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 - Answer: malnutrition, chronic illness
Highly protein bound drugs can lead to - 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 -
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: - 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 - Answer: half life
plasma concentration
Be familiar with the beers criteria and how to use it - 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 - 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 - Answer: low albumin levels, body composition, cardiac
decompensation (heart failure), age
Describe the factors that affect metabolism - Answer: genetics, age, organ function
Describe factors that affect excretion - Answer: affected by abnormal kidney or liver function, age, drug
interactions
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