ADVANCED PHARMACOLOGY BLUEPRINT FOR QUIZ
INCLUDING MODULES 1 THRU 3, AND STUDY
QUESTIONS
Advanced Pharmacology for Nurse Practitioners (The University of Texas at
Arlington)
,
, Blueprint Quiz 1 Mod 1 - 3 Blueprint, Pointers and Study Qs For best print, download first as pdf.
Quiz 1 3/9 Wed 8 pm to 3/12 Sat 8m WE WILL BE TESTED ON MATERIAL FROM OUR READINGS (required) AND LECTURES.
Module Objectives
-Apply pharmacology principles when writing prescriptions for patients; Apply prescribing basics and the BON requirements for
prescriptive authority and apply this knowledge as it relates to NP practice by writing prescriptions that fulfill the legal requirements for
legal practice Study Questions of Module 1 are already in first part of Blueprint (BP). Mod 2/Mod3 are very long, so are at
end of BP.
What is the first-pass effect? Sibo This shows movement of drugs following a GI absorption.
● refers to rapid hepatic inactivation of certain
oral drugs.
● When the drugs are absorbed from the GI tract,
● carried directly to the liver through hepatic
portal vein before entering systemic circulation.
How does this affect the distribution of the drug?Sibo
● If capacity of liver to metabolize drug
is extremely high,
● this drug can be completely inactivated on
its first-pass through the liver.
● Need to increase dosage for 1st dose.
How do the pharmacokinetics and pharmacodynamics compare for special populations such as the elderly,
the pregnant female, and children? Sibo (All answers from Drugs across Lifespan)
● The aging process can affect all phases of pharmacokinetics.
● From early adulthood on, there is a gradual, progressive decline in organ function.
● not enough studies have been done on pregnant woman, the young
● so we must balance the risk of the unknown with the benefits
● for the young/pregnant clients, less prescriptions are better.
Drug sensitivity varies with age.
● Infants and older adults are especially sensitive to drugs.
● In the very young, heightened drug sensitivity is the result of organ immaturity.
● In older adults it is due to decline of organ function
● Older adults also have more severe illnesses, multiple illnesses, and treatment with multiple drugs.
● the plasma drug levels are higher in the infants than in adults.
Pharmacokinetic factors (first remember before dosing:)
● determine the concentration of a drug at its sites of action
● hence determine the intensity and duration of responses.
● If drug levels are elevated, responses will be more intense.
● If drug elimination is delayed, responses will be prolonged.
, Neonates and Infants Children one year and older
Pharmacokinetics in Neonates and Infants: SIMILAR TO ADULTS pharmacokinetically
● immature organ systems that regulate drug levels ● pharm+acokinetic parameters are similar
● so they are at risk for both drug effects to adults.
● that are unusually intense and prolonged. ● drug sensitivity more similar to adults than
for children less than one year.
Our role for safe, effective therapy ● absorption metabolism, distribution
● By accounting for pharmacokinetic differences in the metabolism, and elimination, similar
very young, to adults.
● we increase the chances that drug treatment will be DIFFERENCE pharmacokinetically
effective and safe ● metabolize drugs faster than adults.
● Drug-metabolizing capacity is
markedly elevated til age 2 years;
then gradually declines.
The drug-metabolizing
● capacity of newborns is low. ● Complete maturation of the liver develops
● As a result, neonates are especially sensitive to drugs by 1 year.
that are eliminated primarily by hepatic metabolism.
● When these drugs are used, dosages must be reduced.
● The capacity of the liver to metabolize many drugs
increases rapidly about 1 month after birth
● and approaches adult levels a few months later.
The increased drug sensitivity of infants is due largely to:
immature state of five pharmacokinetic processes:
(1) drug absorption,
(2) protein binding of drugs,
(3) exclusion of drugs from the central nervous
system (CNS) by the blood-brain barrier,
(4) hepatic drug metabolism, and
(5) renal drug excretion.
Gastrointestinal physiology in the infant
● is very different from that in the adult.
● So drug absorption may be enhanced or impeded,
● depending on the physicochemical properties of the
drug involved.
● Gastric emptying time is both prolonged and irregular in
early infancy,
● then gradually reaches adult values by 6 to 8 months.
Renal drug excretion ● Adult levels of renal function are achieved
● is significantly reduced at birth. by 1 year.
● Renal blood flow, glomerular filtration, and active
tubular secretion are all low during infancy.
● drug-excreting capacity of infants is limited,
● drugs that are eliminated primarily by renal excretion
-must be given in reduced dosage
-or at longer dosing intervals, or both.
INCLUDING MODULES 1 THRU 3, AND STUDY
QUESTIONS
Advanced Pharmacology for Nurse Practitioners (The University of Texas at
Arlington)
,
, Blueprint Quiz 1 Mod 1 - 3 Blueprint, Pointers and Study Qs For best print, download first as pdf.
Quiz 1 3/9 Wed 8 pm to 3/12 Sat 8m WE WILL BE TESTED ON MATERIAL FROM OUR READINGS (required) AND LECTURES.
Module Objectives
-Apply pharmacology principles when writing prescriptions for patients; Apply prescribing basics and the BON requirements for
prescriptive authority and apply this knowledge as it relates to NP practice by writing prescriptions that fulfill the legal requirements for
legal practice Study Questions of Module 1 are already in first part of Blueprint (BP). Mod 2/Mod3 are very long, so are at
end of BP.
What is the first-pass effect? Sibo This shows movement of drugs following a GI absorption.
● refers to rapid hepatic inactivation of certain
oral drugs.
● When the drugs are absorbed from the GI tract,
● carried directly to the liver through hepatic
portal vein before entering systemic circulation.
How does this affect the distribution of the drug?Sibo
● If capacity of liver to metabolize drug
is extremely high,
● this drug can be completely inactivated on
its first-pass through the liver.
● Need to increase dosage for 1st dose.
How do the pharmacokinetics and pharmacodynamics compare for special populations such as the elderly,
the pregnant female, and children? Sibo (All answers from Drugs across Lifespan)
● The aging process can affect all phases of pharmacokinetics.
● From early adulthood on, there is a gradual, progressive decline in organ function.
● not enough studies have been done on pregnant woman, the young
● so we must balance the risk of the unknown with the benefits
● for the young/pregnant clients, less prescriptions are better.
Drug sensitivity varies with age.
● Infants and older adults are especially sensitive to drugs.
● In the very young, heightened drug sensitivity is the result of organ immaturity.
● In older adults it is due to decline of organ function
● Older adults also have more severe illnesses, multiple illnesses, and treatment with multiple drugs.
● the plasma drug levels are higher in the infants than in adults.
Pharmacokinetic factors (first remember before dosing:)
● determine the concentration of a drug at its sites of action
● hence determine the intensity and duration of responses.
● If drug levels are elevated, responses will be more intense.
● If drug elimination is delayed, responses will be prolonged.
, Neonates and Infants Children one year and older
Pharmacokinetics in Neonates and Infants: SIMILAR TO ADULTS pharmacokinetically
● immature organ systems that regulate drug levels ● pharm+acokinetic parameters are similar
● so they are at risk for both drug effects to adults.
● that are unusually intense and prolonged. ● drug sensitivity more similar to adults than
for children less than one year.
Our role for safe, effective therapy ● absorption metabolism, distribution
● By accounting for pharmacokinetic differences in the metabolism, and elimination, similar
very young, to adults.
● we increase the chances that drug treatment will be DIFFERENCE pharmacokinetically
effective and safe ● metabolize drugs faster than adults.
● Drug-metabolizing capacity is
markedly elevated til age 2 years;
then gradually declines.
The drug-metabolizing
● capacity of newborns is low. ● Complete maturation of the liver develops
● As a result, neonates are especially sensitive to drugs by 1 year.
that are eliminated primarily by hepatic metabolism.
● When these drugs are used, dosages must be reduced.
● The capacity of the liver to metabolize many drugs
increases rapidly about 1 month after birth
● and approaches adult levels a few months later.
The increased drug sensitivity of infants is due largely to:
immature state of five pharmacokinetic processes:
(1) drug absorption,
(2) protein binding of drugs,
(3) exclusion of drugs from the central nervous
system (CNS) by the blood-brain barrier,
(4) hepatic drug metabolism, and
(5) renal drug excretion.
Gastrointestinal physiology in the infant
● is very different from that in the adult.
● So drug absorption may be enhanced or impeded,
● depending on the physicochemical properties of the
drug involved.
● Gastric emptying time is both prolonged and irregular in
early infancy,
● then gradually reaches adult values by 6 to 8 months.
Renal drug excretion ● Adult levels of renal function are achieved
● is significantly reduced at birth. by 1 year.
● Renal blood flow, glomerular filtration, and active
tubular secretion are all low during infancy.
● drug-excreting capacity of infants is limited,
● drugs that are eliminated primarily by renal excretion
-must be given in reduced dosage
-or at longer dosing intervals, or both.
