Advanced Pharmacology Exam 1 Test Questions with Answers Graded A+
Once you graduate from an NP program, in order to -Advanced nurse prescriber license
prescribe you'll need: -DEA #
What is the purpose of a DEA #? Needed to prescribed scheduled drugs
-Written script needed
Rules for prescribing Schedule II drugs: -1 month supply only
-No refills
Prescription Drug Monitoring Program
What is the PDMP?
Used to ettectively track patient's controlled substance
uses across ditterent health facilities (in the same state)
Recommendations that are intended to optimize patient
care that are informed by a systematic review of the evi-
dence and an assessment of the benefits/harms of alter-
What are clinical practice guidelines?
native care practices
Ex: sepsis, CAP
-Illegible writing
-Drug names that sound alike
Common causes of medication errors:
-Medications that look alike
-Administering a drug with the wrong route
What the body does to the drug
1. Absorption
What is pharmacokinetics? What are its 4 categories?
2. Metabolism
3. Distribution
4. Excretion
IV = quickest
Quickest route of absorption? Slowest?
IM = slowest
Passive dittusion
,What is the most common way drugs pass through cell
membranes?
What characteristics of a drug allow it to pass most quickly
Small, uncharged (unionized), lipid soluble--pass through
through cell membranes (usually through passive dittu-
membrane without any energy
sion)?
It means that the drug is stuck in the compartment it was
What does it mean when a drug is ionized? ionized in and has to be moved to the next compartment
(cannot be absorbed into the bloodstream)
Where do weak acids absorb? Stomach
Where do weak bases absorb? Small intestine
pH of stomach: 2-4
pH of small intestine: 6-7
pH of large intestine: 6-7
pH of bloodstream: 7.35-7.45
pH of bladder: 5-8
pH of breastmilk: 7.1
In the small intestine (since the stomach has a pH of
Where will a drug absorb if it is a weak base that ionizes 2-4, so the drug will become ionized and move to the
at a pH of 4 and lower? small intestine where it will be able to absorb into the
bloodstream)
Drugs that are weak acids (aspirin) can be trapped and
excreted through the urine.
How can we manipulate the urine pH in cases of overdose?
We raise pH of the urine (with sodium bicarb) to force the
drug to ionize and allow it to be excreted, not reabsorbed
through the bloodstream.
How a drug will be transported to the tissues it needs to
What is distribution?
go to in order for it to exert its ettects
, -Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
Drug factors related to distribution:
-Therapeutic ettects
-Toxic ettects
(lipid soluble, small, and non-ionized drugs will distribute
more quickly)
-Vascularity (poor perfusion, disruption of blood flow due
to trauma--diflculty distributing)
-Blood barriers (blood-brain-barrier can be problematic
if we need to get drugs to the brain--will need very high
dosing since only a small amount of the drug will get
Body factors related to distribution: through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
-Drug interactions
What is the key plasma protein involved with protein bind-
Albumin
ing for medications?
Indicative of nutritional status and how well pro-
Why do we monitor albumin? tein-bound drugs will be transported to their target loca-
tions
The drug does not bind to the protein (albumin) as much
What happens to the therapeutic ettect of a drug when
as expected, so there is a lot of free drug floating in the
the patient is elderly and has very low levels of albumin?
plasma; high risk for drug toxicity
Once you graduate from an NP program, in order to -Advanced nurse prescriber license
prescribe you'll need: -DEA #
What is the purpose of a DEA #? Needed to prescribed scheduled drugs
-Written script needed
Rules for prescribing Schedule II drugs: -1 month supply only
-No refills
Prescription Drug Monitoring Program
What is the PDMP?
Used to ettectively track patient's controlled substance
uses across ditterent health facilities (in the same state)
Recommendations that are intended to optimize patient
care that are informed by a systematic review of the evi-
dence and an assessment of the benefits/harms of alter-
What are clinical practice guidelines?
native care practices
Ex: sepsis, CAP
-Illegible writing
-Drug names that sound alike
Common causes of medication errors:
-Medications that look alike
-Administering a drug with the wrong route
What the body does to the drug
1. Absorption
What is pharmacokinetics? What are its 4 categories?
2. Metabolism
3. Distribution
4. Excretion
IV = quickest
Quickest route of absorption? Slowest?
IM = slowest
Passive dittusion
,What is the most common way drugs pass through cell
membranes?
What characteristics of a drug allow it to pass most quickly
Small, uncharged (unionized), lipid soluble--pass through
through cell membranes (usually through passive dittu-
membrane without any energy
sion)?
It means that the drug is stuck in the compartment it was
What does it mean when a drug is ionized? ionized in and has to be moved to the next compartment
(cannot be absorbed into the bloodstream)
Where do weak acids absorb? Stomach
Where do weak bases absorb? Small intestine
pH of stomach: 2-4
pH of small intestine: 6-7
pH of large intestine: 6-7
pH of bloodstream: 7.35-7.45
pH of bladder: 5-8
pH of breastmilk: 7.1
In the small intestine (since the stomach has a pH of
Where will a drug absorb if it is a weak base that ionizes 2-4, so the drug will become ionized and move to the
at a pH of 4 and lower? small intestine where it will be able to absorb into the
bloodstream)
Drugs that are weak acids (aspirin) can be trapped and
excreted through the urine.
How can we manipulate the urine pH in cases of overdose?
We raise pH of the urine (with sodium bicarb) to force the
drug to ionize and allow it to be excreted, not reabsorbed
through the bloodstream.
How a drug will be transported to the tissues it needs to
What is distribution?
go to in order for it to exert its ettects
, -Lipid solubility
-Molecular size
-Degree of ionization
-Duration of action
-Cellular binding
Drug factors related to distribution:
-Therapeutic ettects
-Toxic ettects
(lipid soluble, small, and non-ionized drugs will distribute
more quickly)
-Vascularity (poor perfusion, disruption of blood flow due
to trauma--diflculty distributing)
-Blood barriers (blood-brain-barrier can be problematic
if we need to get drugs to the brain--will need very high
dosing since only a small amount of the drug will get
Body factors related to distribution: through)
-Transport mechanisms
-Plasma binding proteins
-Disease states
-Volume of distribution
-Drug interactions
What is the key plasma protein involved with protein bind-
Albumin
ing for medications?
Indicative of nutritional status and how well pro-
Why do we monitor albumin? tein-bound drugs will be transported to their target loca-
tions
The drug does not bind to the protein (albumin) as much
What happens to the therapeutic ettect of a drug when
as expected, so there is a lot of free drug floating in the
the patient is elderly and has very low levels of albumin?
plasma; high risk for drug toxicity
