NSG 6005 Advanced Pharmacology Midterm—Study Guide
There will be 75 questions on the Midterm. Most will be multiple choice. There are a couple
True/False and 5 matching questions. I suggest you review your PowerPoints
...
NSG 6005 Advanced Pharmacology Midterm—Study Guide
There will be 75 questions on the Midterm. Most will be multiple choice. There are a couple
True/False and 5 matching questions. I suggest you review your PowerPoints and Textbook
Assignments. I hope this study guide is helpful
Make sure you know the following topics very well.
• When a medication is listed below, make sure you know all about it and how to apply
it to different patient situations: What disease process it is used for?, how does it
work?, when should it not be used?, adverse effects, pros/cons, interactions, patient
education factors (should it be taken w/ food? At bedtime?), tapering, preliminary and
post treatment labs, black box warnings/CI, etc.
• If a disease process is mentioned below—know how to diagnose and recommended
treatment guidelines.
1) General principles of pharmacokinetics and dynamics?
PHARMACOKINETICS- What the body does to the drug”
Absorption –Entry of drug to the blood stream. Usually depends on passive diffusion of
drug through cell membranes.
• Absorption depends on: blood flow at site, drugs lipid soluability (> lipic, >
soluabililty that directly penetrate the memebrane), local PH and drug ionization
(non-ionized absorb better), pharmaceutical processing (coatings and additives.
• Blood brain barrier: allow lipid soluable only. May pump out any drug that it sees
as foreign, hard to treat CNS infections.
• Placenta: allows lipid drugs so does not protect from lipid soluable drugs, which
is why pregnant women are limited to drugs. Know gestation age.
•
Distribution
: fat ratio changes may alter distribution, especially a people age.
• Fat soluable drugs may be accumulated: weight loss will release these drugs.
• Water soluable drugs are affected by dehydration
Biotransformation (Metabolism) : Drugs become more hydrophilic (water soluable) for
excretion.
• Also referred to as the P450 system or cytochrome P450 system. (a group
of enzymes in the liver identified for their ability to breakdown drugs.)
2
• Hepatic “First Pass Effect” (parenteral (IV or IM) meds
bypass this enzymatic effect)
• breaks PO meds down to some degree, some are protected
with coating but they don’t always work
• Metabolites
Usually less active, less toxic, easier
• to excrete
• Prodrugs - inactive in form given but metabolized to active
drug (ex: enalapril)
• Liver function determined by liver enzymes
• Failing liver produces fewer enzymes, drugs available
longer: caution
•
• Excretion: Process by which medications are eliminated from the body
unchanged or as metabolites
• Kidneys are main organ of excretion
• If poor renal function, drug may accumulate, may
wish to prescribe less of drug
• Also eliminated via r
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