Midterm Exam: NR565/ NR 565 Advanced Pharmacology
Care of the Fundamentals Exam | Questions and Verified
Answers (2023/ 2024 Update)- Chamberlain
The process by which drugs are absorbed, distributed within the body, metabolized, and
excreted. - ANSWER Pharmacokinetics
The study of what the drug does to the body - ANSWER Pharmacodynamics
Rate of dissolution
Surface area
Blood flow
Lipid solubility
pH partitioning - ANSWER Factors Affecting Drug Absorption
Blood flow to tissues
Ability to exit the vascular system
Blood-brain barrier
Protein-binding capacity - ANSWER Factors Affecting Drug Distribution
substances that are foreign to the body, usually synthetic chemical compounds;
medications are a common example - ANSWER Xenobiotics
xenobiotic-metabolizing enzymes necessary for the production of cholesterol and
steroids and the detoxification of chemicals and drug metabolism. - ANSWER
Cytochrome P450 (CYP450)
responsible for phase 1 metabolism in which drugs are oxidized, reduced, or hydrolyzed
- ANSWER Function of Cytochrome P450 (CYP450)
Oxidation; Reduction; Hydrolysis - ANSWER Phase 1 Metabolism of Drugs via P450
-Drug becomes completely inactive
-Drug becomes partially inactive but one or more metabolites remain active
-Original drug is not pharmacologically active but one metabolite remains active -
ANSWER Three possible outcomes of phase 1 drug metabolism.
Medications that can increase the rate of another drug's metabolism by elevating
CYP450 enzyme activity via increasing enzyme synthesis. decreasing the concentration
of the "parent drug" - ANSWER CYP450 Inducers
,CRAPGPS
Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas - ANSWER CYP450 Inducer Medications
Medications that inhibit the metabolic activity of one or more of the CYP450 enzymes.
Higher risk for toxicity; prolongs the pharmacological effect of the "parent drug". -
ANSWER CYP450 Inhibitors
VISACKGQ
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine - ANSWER CYP450 Inhibitor Medications
-potentially Inappropriate Medication (PIM) use in older adults
-potentially Inappropriate Medication (PIM) use in older adults due to medication-
disease or medication-syndrome interactions that may exacerbate the disease or
syndrome
-medications to be used cautiously in older adults
-clinically significant drug interactions that should be avoided in older adults
-medications to be avoided or dosage decreased in the presence of impaired kidney
function in older adults - ANSWER Beers Criteria
when one medication systemically alters the potency of another medication. - ANSWER
Pharmacokinetic Interactions
result of a change due to one medication's effect on another medication's route of entry
into the body. - ANSWER Absorption Interaction
caused by the amount of unbound/free medications available at the various target sites.
- ANSWER Distribution Interaction
concentration of the medication after biotransformation into active and inactive
metabolites in higher or lower than expected. - ANSWER Metabolism Interaction
the body's ability to eliminate medications in pure form or by altering a metabolite from
the body. - ANSWER Elimination Interaction
,does not alter or impact absorption, distribution, metabolism, or elimination because of
the one medication's ability to manipulate the effect of another medication at its site of
action - ANSWER Pharmacodynamic Interactions
refers to the nurse practitioner's ability to practice without physician oversight -
ANSWER Practice Authority
refers to the nurse practitioner's authority to prescribe medications. - ANSWER
prescriptive authority
Nurse practitioners have the autonomy to evaluate patients, diagnose, order and
interpret tests, initiate and manage treatments and prescribe medications, including
controlled substances without physician oversight. - ANSWER Full-practice scope
Nurse practitioners are limited in at least one element of practice. The state requires a
formal collaborative agreement with an outside health discipline for the nurse
practitioner to provide patient care. - ANSWER Reduced-practice scope
Nurse practitioners are limited in at least one element of practice by requiring
supervision, delegation, or team management by an outside health discipline for the
nurse practitioner to provide patient care. - ANSWER Restricted practice scope
DEA Scheduled Drugs - ANSWER Drugs that cannot be ordered via E-Script
Schedule II drugs - ANSWER Drugs that cannot be prescribed or refilled via phone
An occurrence of fewer than three months and is often precipitated by trauma and acute
medical conditions or treatment. - ANSWER Acute Pain
Referred Pain
Acute Somatic Pain
Acute visceral pain - ANSWER Types of Acute Pain
episode of pain that lasts for 6 months or longer; may be intermittent or continuous -
ANSWER Chronic pain
pain that is felt in a location other than where the pain originates - ANSWER Referred
Pain
-Arises from connective tissue, muscle, bone and skin.
-Sharp and localized or dull and non-localized
-Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates, local anesthetics,
ice, massage - ANSWER Acute Somatic Pain
Pain in the internal organs and abdomen
, Poorly localized (C-fibers)
Radiates
Most responsive to opiates
May also use corticosteroids, NSAIDs - ANSWER Acute Visceral Pain
any drug, natural or synthetic, that has actions similar to those of morphine - ANSWER
Opioids
Mu (μ)
Kappa (k)
Delta (δ) - ANSWER Opioid Receptor Families
(1) pure opioid agonists, (2) agonist-antagonist opioids, (3) pure opioid antagonists. -
ANSWER At each type of receptor, a drug can act in one of three ways:
Opioid receptor most responsible for mediating analgesic properties - ANSWER Mu (u)
Receptor
activate µ receptors and κ receptors. produce analgesia, euphoria, sedation, respiratory
depression, physical dependence, constipation, and other effects
Prototype Drug: MORPHINE - ANSWER Pure opioid agonists
Prototype drug of pure opioid agonist; Strong Opioid Agonist - ANSWER Morphine
A strong opioid analgesic with a high milligram potency (about 100 times that of
morphine). - ANSWER Fentanyl
strong opioid agonists; moderate to strong opioid agonists - ANSWER Subcategory of
Pure Opioid Agonist
Oxycodone (Roxicodone, Oxycontin); Hydrocodone (Vicodin) - ANSWER Moderate to
Strong Pure Opioid Agonists
The actions of these drugs at µ and κ receptors When administered alone, produce
analgesia. However, if given to a patient who is taking a pure opioid agonist, can
antagonize analgesia
Prototype Drug: Pentazocine - ANSWER Agonist-Antagonist Opioids
drug is indicated for mild to moderate pain and is much less effective than morphine
against severe pain.
acts as an agonist at κ receptors and as an antagonist at µ receptors.
the drug produces analgesia, sedation, and respiratory depression.
If administered to a patient who is physically dependent on a pure opioid agonist, can
precipitate withdrawal; this is due to agonist effect at (mu) receptor which this drug
antagonizes. - ANSWER Pentazocine (Talwin)
Care of the Fundamentals Exam | Questions and Verified
Answers (2023/ 2024 Update)- Chamberlain
The process by which drugs are absorbed, distributed within the body, metabolized, and
excreted. - ANSWER Pharmacokinetics
The study of what the drug does to the body - ANSWER Pharmacodynamics
Rate of dissolution
Surface area
Blood flow
Lipid solubility
pH partitioning - ANSWER Factors Affecting Drug Absorption
Blood flow to tissues
Ability to exit the vascular system
Blood-brain barrier
Protein-binding capacity - ANSWER Factors Affecting Drug Distribution
substances that are foreign to the body, usually synthetic chemical compounds;
medications are a common example - ANSWER Xenobiotics
xenobiotic-metabolizing enzymes necessary for the production of cholesterol and
steroids and the detoxification of chemicals and drug metabolism. - ANSWER
Cytochrome P450 (CYP450)
responsible for phase 1 metabolism in which drugs are oxidized, reduced, or hydrolyzed
- ANSWER Function of Cytochrome P450 (CYP450)
Oxidation; Reduction; Hydrolysis - ANSWER Phase 1 Metabolism of Drugs via P450
-Drug becomes completely inactive
-Drug becomes partially inactive but one or more metabolites remain active
-Original drug is not pharmacologically active but one metabolite remains active -
ANSWER Three possible outcomes of phase 1 drug metabolism.
Medications that can increase the rate of another drug's metabolism by elevating
CYP450 enzyme activity via increasing enzyme synthesis. decreasing the concentration
of the "parent drug" - ANSWER CYP450 Inducers
,CRAPGPS
Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas - ANSWER CYP450 Inducer Medications
Medications that inhibit the metabolic activity of one or more of the CYP450 enzymes.
Higher risk for toxicity; prolongs the pharmacological effect of the "parent drug". -
ANSWER CYP450 Inhibitors
VISACKGQ
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine - ANSWER CYP450 Inhibitor Medications
-potentially Inappropriate Medication (PIM) use in older adults
-potentially Inappropriate Medication (PIM) use in older adults due to medication-
disease or medication-syndrome interactions that may exacerbate the disease or
syndrome
-medications to be used cautiously in older adults
-clinically significant drug interactions that should be avoided in older adults
-medications to be avoided or dosage decreased in the presence of impaired kidney
function in older adults - ANSWER Beers Criteria
when one medication systemically alters the potency of another medication. - ANSWER
Pharmacokinetic Interactions
result of a change due to one medication's effect on another medication's route of entry
into the body. - ANSWER Absorption Interaction
caused by the amount of unbound/free medications available at the various target sites.
- ANSWER Distribution Interaction
concentration of the medication after biotransformation into active and inactive
metabolites in higher or lower than expected. - ANSWER Metabolism Interaction
the body's ability to eliminate medications in pure form or by altering a metabolite from
the body. - ANSWER Elimination Interaction
,does not alter or impact absorption, distribution, metabolism, or elimination because of
the one medication's ability to manipulate the effect of another medication at its site of
action - ANSWER Pharmacodynamic Interactions
refers to the nurse practitioner's ability to practice without physician oversight -
ANSWER Practice Authority
refers to the nurse practitioner's authority to prescribe medications. - ANSWER
prescriptive authority
Nurse practitioners have the autonomy to evaluate patients, diagnose, order and
interpret tests, initiate and manage treatments and prescribe medications, including
controlled substances without physician oversight. - ANSWER Full-practice scope
Nurse practitioners are limited in at least one element of practice. The state requires a
formal collaborative agreement with an outside health discipline for the nurse
practitioner to provide patient care. - ANSWER Reduced-practice scope
Nurse practitioners are limited in at least one element of practice by requiring
supervision, delegation, or team management by an outside health discipline for the
nurse practitioner to provide patient care. - ANSWER Restricted practice scope
DEA Scheduled Drugs - ANSWER Drugs that cannot be ordered via E-Script
Schedule II drugs - ANSWER Drugs that cannot be prescribed or refilled via phone
An occurrence of fewer than three months and is often precipitated by trauma and acute
medical conditions or treatment. - ANSWER Acute Pain
Referred Pain
Acute Somatic Pain
Acute visceral pain - ANSWER Types of Acute Pain
episode of pain that lasts for 6 months or longer; may be intermittent or continuous -
ANSWER Chronic pain
pain that is felt in a location other than where the pain originates - ANSWER Referred
Pain
-Arises from connective tissue, muscle, bone and skin.
-Sharp and localized or dull and non-localized
-Responds best to: acetaminophen, corticosteroids, NSAIDs, opiates, local anesthetics,
ice, massage - ANSWER Acute Somatic Pain
Pain in the internal organs and abdomen
, Poorly localized (C-fibers)
Radiates
Most responsive to opiates
May also use corticosteroids, NSAIDs - ANSWER Acute Visceral Pain
any drug, natural or synthetic, that has actions similar to those of morphine - ANSWER
Opioids
Mu (μ)
Kappa (k)
Delta (δ) - ANSWER Opioid Receptor Families
(1) pure opioid agonists, (2) agonist-antagonist opioids, (3) pure opioid antagonists. -
ANSWER At each type of receptor, a drug can act in one of three ways:
Opioid receptor most responsible for mediating analgesic properties - ANSWER Mu (u)
Receptor
activate µ receptors and κ receptors. produce analgesia, euphoria, sedation, respiratory
depression, physical dependence, constipation, and other effects
Prototype Drug: MORPHINE - ANSWER Pure opioid agonists
Prototype drug of pure opioid agonist; Strong Opioid Agonist - ANSWER Morphine
A strong opioid analgesic with a high milligram potency (about 100 times that of
morphine). - ANSWER Fentanyl
strong opioid agonists; moderate to strong opioid agonists - ANSWER Subcategory of
Pure Opioid Agonist
Oxycodone (Roxicodone, Oxycontin); Hydrocodone (Vicodin) - ANSWER Moderate to
Strong Pure Opioid Agonists
The actions of these drugs at µ and κ receptors When administered alone, produce
analgesia. However, if given to a patient who is taking a pure opioid agonist, can
antagonize analgesia
Prototype Drug: Pentazocine - ANSWER Agonist-Antagonist Opioids
drug is indicated for mild to moderate pain and is much less effective than morphine
against severe pain.
acts as an agonist at κ receptors and as an antagonist at µ receptors.
the drug produces analgesia, sedation, and respiratory depression.
If administered to a patient who is physically dependent on a pure opioid agonist, can
precipitate withdrawal; this is due to agonist effect at (mu) receptor which this drug
antagonizes. - ANSWER Pentazocine (Talwin)
