Nurs 615 Pharm Exam 1 - 2023
How does hypoalbuminemia affect the process of prescribing? - answerLow albumin = more free drug
(bc the drug can't bind to albumin aka protein) = increased adverse effects
What is a Black Box Warning: - answeris considered a contraindication to administer that drug.
What is the drugs half-life? - answerHalf-life specifically means the amount of time it takes for an
administered drug to be halfway cleared from the system.
Peak of action: - answerthe time between drug administration and maximum concentration of drug in
the blood stream. Best therapeutic effect.
Duration of action: - answerthe time between onset of action and metabolism of drug below the
minimum needed for an effect. The length of time you have the drug in your system.
According to the WHO what is the first step in the prescribing process? - answerThe first step is to define
the patient's problem
The second step is to - answerspecify the therapeutic objective
The third step is to - answerchoose which drug or treatment is needed.
Step 4 of the WHO approach: - answerStart the treatment
Step 5 of the WHO approach: - answerEducate the patient
,Step 6 of the WHO approach: - answerMonitor the treatment
Phase 1 of drug development: - answerThe drug is tested on healthy volunteers
Phase 2 of drug development: - answertrials with people who have the disease for which the drug is
thought to be effective
Phase 3 of drug development: - answerLarge numbers of patients in medical research centers receive
the drug in phase 3. This larger sampling provides information about infrequent or rare adverse effects.
The FFA will approve a new drug application if phase 3 studies are satisfactory.
Phase 4 of drug development: - answerThis phase is voluntary and involves postmarket surveillance of
the drug's therapeutic effects at the completion of phase 3. The pharmaceutical company receives
reports from doctors and other health care professionals about the therapeutic results and adverse
effects of the drug. Some medications, for example, have been found to be toxic and have been
removed from the market after their initial release.
Explain first pass metabolism - answermuch of the drug is lost in the absorption process. The liver
metabolizes many drugs, thus reduces the bioavailabilty of the drug.
What is the fasted route of absorption: - answerThe fastest route of absorption is inhalation, and not as
mistakenly considered the IV administration.
Why does the GI tract take longer to absorb? - answerThe GI tract is lined with epithelial cells; drugs
must permeate through these cells in order to be absorbed into the circulatory system.
What is One particular cellular barrier that may prevent absorption of a given drug? - answerthe cell
membrane. Cell membranes are essentially lipid bilayers which form a semipermeable membrane. Pure
lipid bilayers are generally permeable only to small and uncharged solutes, hence whether or not a
molecule is ionized will affect its absorption, since ionic molecules are charged.
, What is solubility? - answerSolubility favors charged species, permeability favors neutral species. Some
molecules have special exchange proteins and channels to facilitate movement from the lumen into the
circulation.
Why does absorption occur at a slower rate for oral, IM, SQ routes? - answerAbsorption occurs at a
slower rate because the complex membrane systems of GI mucosal layers, muscle, and skin delay drug
passage.
The ability of a drug to cross a cell membrane depends on: - answerwhether the drug is water or lipid
(fat) soluble. Lipid-soluble drugs easily cross through cell membranes; water-soluble drugs can't. Lipid-
soluble drugs can also cross the blood-brain barrier and enter the brain.
As a drug travels through the body, it comes in contact with? - answerproteins such as the plasma
protein albumin. The drug can remain free or bind to the protein. The portion of a drug that's bound to a
protein is inactive and can't exert a therapeutic effect. Only the free, or unbound, portion remains
active. A drug is said to be highly protein-bound if more than 80% of the drug is bound to protein.
Identify drug metabolism and the role of isoenzymes in the p450 system - answerCYPs are the are the
major enzymes involved in drug metabolism accounting for about 75% of the total metabolism.
Naturally occurring compounds may induce or inhibit CYP activity. - answerFor example, bioactive
compounds found in grapefruit juice and some other fruit juices including dihydroxy forgotten and
parasitin A have been found to inhibit CYP3a4 mediated metabolism of certain medications leading to
increased bioavailability and the strong possibility of overdosing.
What does grapefruit have to do with CYP? - answerGrapefruit is an inhibitor and will decrease the
metabolism of drugs by the cyp enzymes
When 2 drugs are both metabolized by the p450 system the drug should be - answeradministered at
separate times to prevent the metabolism of one drug resulting in toxic effects of the other drug.
(because it would have less protein to bind too, thus more free floating drug)
How does hypoalbuminemia affect the process of prescribing? - answerLow albumin = more free drug
(bc the drug can't bind to albumin aka protein) = increased adverse effects
What is a Black Box Warning: - answeris considered a contraindication to administer that drug.
What is the drugs half-life? - answerHalf-life specifically means the amount of time it takes for an
administered drug to be halfway cleared from the system.
Peak of action: - answerthe time between drug administration and maximum concentration of drug in
the blood stream. Best therapeutic effect.
Duration of action: - answerthe time between onset of action and metabolism of drug below the
minimum needed for an effect. The length of time you have the drug in your system.
According to the WHO what is the first step in the prescribing process? - answerThe first step is to define
the patient's problem
The second step is to - answerspecify the therapeutic objective
The third step is to - answerchoose which drug or treatment is needed.
Step 4 of the WHO approach: - answerStart the treatment
Step 5 of the WHO approach: - answerEducate the patient
,Step 6 of the WHO approach: - answerMonitor the treatment
Phase 1 of drug development: - answerThe drug is tested on healthy volunteers
Phase 2 of drug development: - answertrials with people who have the disease for which the drug is
thought to be effective
Phase 3 of drug development: - answerLarge numbers of patients in medical research centers receive
the drug in phase 3. This larger sampling provides information about infrequent or rare adverse effects.
The FFA will approve a new drug application if phase 3 studies are satisfactory.
Phase 4 of drug development: - answerThis phase is voluntary and involves postmarket surveillance of
the drug's therapeutic effects at the completion of phase 3. The pharmaceutical company receives
reports from doctors and other health care professionals about the therapeutic results and adverse
effects of the drug. Some medications, for example, have been found to be toxic and have been
removed from the market after their initial release.
Explain first pass metabolism - answermuch of the drug is lost in the absorption process. The liver
metabolizes many drugs, thus reduces the bioavailabilty of the drug.
What is the fasted route of absorption: - answerThe fastest route of absorption is inhalation, and not as
mistakenly considered the IV administration.
Why does the GI tract take longer to absorb? - answerThe GI tract is lined with epithelial cells; drugs
must permeate through these cells in order to be absorbed into the circulatory system.
What is One particular cellular barrier that may prevent absorption of a given drug? - answerthe cell
membrane. Cell membranes are essentially lipid bilayers which form a semipermeable membrane. Pure
lipid bilayers are generally permeable only to small and uncharged solutes, hence whether or not a
molecule is ionized will affect its absorption, since ionic molecules are charged.
, What is solubility? - answerSolubility favors charged species, permeability favors neutral species. Some
molecules have special exchange proteins and channels to facilitate movement from the lumen into the
circulation.
Why does absorption occur at a slower rate for oral, IM, SQ routes? - answerAbsorption occurs at a
slower rate because the complex membrane systems of GI mucosal layers, muscle, and skin delay drug
passage.
The ability of a drug to cross a cell membrane depends on: - answerwhether the drug is water or lipid
(fat) soluble. Lipid-soluble drugs easily cross through cell membranes; water-soluble drugs can't. Lipid-
soluble drugs can also cross the blood-brain barrier and enter the brain.
As a drug travels through the body, it comes in contact with? - answerproteins such as the plasma
protein albumin. The drug can remain free or bind to the protein. The portion of a drug that's bound to a
protein is inactive and can't exert a therapeutic effect. Only the free, or unbound, portion remains
active. A drug is said to be highly protein-bound if more than 80% of the drug is bound to protein.
Identify drug metabolism and the role of isoenzymes in the p450 system - answerCYPs are the are the
major enzymes involved in drug metabolism accounting for about 75% of the total metabolism.
Naturally occurring compounds may induce or inhibit CYP activity. - answerFor example, bioactive
compounds found in grapefruit juice and some other fruit juices including dihydroxy forgotten and
parasitin A have been found to inhibit CYP3a4 mediated metabolism of certain medications leading to
increased bioavailability and the strong possibility of overdosing.
What does grapefruit have to do with CYP? - answerGrapefruit is an inhibitor and will decrease the
metabolism of drugs by the cyp enzymes
When 2 drugs are both metabolized by the p450 system the drug should be - answeradministered at
separate times to prevent the metabolism of one drug resulting in toxic effects of the other drug.
(because it would have less protein to bind too, thus more free floating drug)
