NRNP 6566 WK1-5 Midterm
1.Describe cytochrome p450 system: Cytochrome p450 system is a
series of enzymes used to metabolize medications
2.Inhibitors: block metabolic activity from one or more CYP450 enzymes
3.Inducers: increase CYP450 enzyme activity by increasing enzyme
synthesis
4.Describe effect on low and high albumin levels on active drug levels es-
pecially for drugs that are highly protein bound: Albumin is the plasma
protein with the greatest capacity for binding drugs. Binding plasma
proteins affect drug distribution into tissues, because only drug that is
not bound is available to penetrate tissues, bind to receptors, and exert
activity. As free drug leaves the blood stream, more bound drug is
released from binding sites.
5.Low albumin levels: malnutrition, chronic illness
6.Highly protein bound drugs can lead to: toxicity in patients with low
albumin levels, example malnutrition or chronic illness. This is because
there are fewer than the normal sites for the drug to bind
7.Describe the ways the hepatic first pass effect- which is metabolism
1/
14
, during first pass through the liver: Alternative routes include:
suppository
intravenous
intramuscular
inhalational
aerosol
transdermal
sublingual
These allow drugs to bypass the first-pass effect and be absorbed
directly into systemic circulation
8.Be able to calculate creatinine clearance using Cockgraft Gault equation::
- Male = 140-age times weight in kilograms divided by serum creatinine
times 72. Women = CRCL (male) times 0.85
9.Describe what determines the frequency of drug administration: half
life plasma concentration
10.Be familiar with the beers criteria and how to use it: Potentially
Inappropriate Medication Use in Older Adults
to call attention to medications that are most commonly problematic
2/
14
1.Describe cytochrome p450 system: Cytochrome p450 system is a
series of enzymes used to metabolize medications
2.Inhibitors: block metabolic activity from one or more CYP450 enzymes
3.Inducers: increase CYP450 enzyme activity by increasing enzyme
synthesis
4.Describe effect on low and high albumin levels on active drug levels es-
pecially for drugs that are highly protein bound: Albumin is the plasma
protein with the greatest capacity for binding drugs. Binding plasma
proteins affect drug distribution into tissues, because only drug that is
not bound is available to penetrate tissues, bind to receptors, and exert
activity. As free drug leaves the blood stream, more bound drug is
released from binding sites.
5.Low albumin levels: malnutrition, chronic illness
6.Highly protein bound drugs can lead to: toxicity in patients with low
albumin levels, example malnutrition or chronic illness. This is because
there are fewer than the normal sites for the drug to bind
7.Describe the ways the hepatic first pass effect- which is metabolism
1/
14
, during first pass through the liver: Alternative routes include:
suppository
intravenous
intramuscular
inhalational
aerosol
transdermal
sublingual
These allow drugs to bypass the first-pass effect and be absorbed
directly into systemic circulation
8.Be able to calculate creatinine clearance using Cockgraft Gault equation::
- Male = 140-age times weight in kilograms divided by serum creatinine
times 72. Women = CRCL (male) times 0.85
9.Describe what determines the frequency of drug administration: half
life plasma concentration
10.Be familiar with the beers criteria and how to use it: Potentially
Inappropriate Medication Use in Older Adults
to call attention to medications that are most commonly problematic
2/
14
