NURS 5334-Advanced pharmacology (2024/2025) FINAL EXAM QUESTIONS WITH CORRECT DETAILED ANSWERS || ALREADY GRADED A+ <LATEST VERSION>
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NURS 5334
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NURS 5334
NURS 5334-Advanced pharmacology
(2024/2025) FINAL EXAM QUESTIONS
WITH CORRECT DETAILED ANSWERS ||
ALREADY GRADED A+
<LATEST VERSION>
How do drugs exit the vascular system? - ANSWER Typical capillary beds,
Drugs pass between capillary cells rather than through them.
blood-brain barr...
NURS 5334-Advanced pharmacology
(2024/2025) FINAL EXAM QUESTIONS
WITH CORRECT DETAILED ANSWERS ||
ALREADY GRADED A+
<LATEST VERSION>
How do drugs exit the vascular system? - ANSWER ✔ Typical capillary beds,
Drugs pass between capillary cells rather than through them.
blood-brain barrier - 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 - ANSWER ✔ membranes of the placenta do not constitute
an absolute barrier to the passage of drugs
risks with placental drug transfer - ANSWER ✔ Birth defects: Mental retardation,
gross malformations, low birth weight
Mother's use of habitual opioids: Birth of drug-dependent baby
protein binding - ANSWER ✔ ability of drugs to form reversible bonds w/ various
proteins
plasma albumin - ANSWER ✔ most abundant and important protein
large molecule that always remains in the bloodstream
,affects drug distribution
entering cells (distribution) - ANSWER ✔ some drugs need to enter cells to reach
site of action
most drugs must undergo metabolism and excretion
many drugs produce effects by binding w/ receptors on external surface of cell
membrane
drug metabolism (biotransformation) - ANSWER ✔ enzymatic alteration of drug
structure, often takes place in the liver
P450 system - ANSWER ✔ group of hepatic enzyme families in the liver which
metabolize drugs and endogenous compounds
prodrug - 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 - ANSWER ✔ reactant of an enzyme-catalyzed reaction
inducer - ANSWER ✔ A specific small molecule that inactivates the repressor in
an operon.
therapeutic consequences of drug metabolism - ANSWER ✔ - Accelerated renal
excretion of drugs
- Drug inactivation
- Increased therapeutic action
- Activation of "prodrugs"
- Increased toxicity
- Decreased toxicity
special considerations in drug metabolism - ANSWER ✔ - Age
- Induction of drug-metabolizing enzymes
- First-pass effect
- Nutritional status
- Competition between drugs
, Enterohepatic Recirculation of Drugs - ANSWER ✔ repeating cycle where drug is
transported from the liver -> bile duct -> duodenum -> back to liver via portal
blood
limited to drugs that have undergone glucuronidation (glucuronide can be removed
in duodenum, allowing transport bacl across intestinal wall into blood)
therapeutic consequences of drug metabolism - ANSWER ✔ - increased renal
drug excretion*
- drug inactivation
- increased therapeutic action
- activation of prodrugs
excretion - ANSWER ✔ removal of drugs and their metabolites exit the body
through urine, sweat, saliva, breast milk, or expired air
steps in renal drug excretion - ANSWER ✔ 1. glomerular filtration
2. passive tubular reabsorption
3. active tubular secretion
factors that modify renal drug excretion - ANSWER ✔ - pH-dependent ionization
- competition for active tubular transport
- age
nonrenal routes of drug excretion - ANSWER ✔ breast milk, bile (enterohepatic
recirculation), lungs, sweat, saliva
therapeutic range - ANSWER ✔ that concentration of drug in the blood serum that
produces the desired effect without causing toxicity
objective of drug dosing = maintain plasma drug levels w/in therapeutic range
single-dose time course - ANSWER ✔ duration of effects is determined largely by
the combination of metabolism and excretion
, therapeutic response maintained for drug levels above minimum effective dose
half-life - ANSWER ✔ the length of time required for the amount of drug in the
body to decrease by 50%
determines dosing interval
drug levels produced w/ repeated doses - ANSWER ✔ process by which plateau
drug levels are achieved
dose response relationship determines... - ANSWER ✔ relationship between the
size of an administered dose & intensity of response produced
determines:
- min amount of drug to be used
- max response drug can elicit
- how much to increase dose to produce desired increase in response
how much to increase dose to produce desired increase in response
- as dose increases -> response becomes larger
maximal efficacy - ANSWER ✔ the largest effect that a drug can produce (height
of the curve)
match the intensity of response w/ patient's need
very high max efficacy is not always more desirable
relative potency - ANSWER ✔ the amount of drug we must give to elicit an effect
rarely an important characteristic of the drug
can be important if lack of potency forces inconveniently large doses
implies nothing about max efficacy; refers to dose needed to produce effects
receptor - ANSWER ✔ any functional macromolecule in a cell to which drug
binds to produce its effects (generally proteins)
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