NURS 334 PHARM FINAL EXAM QUESTIONS AND
ANSWERS A
+ GRADED
What is pharmacodynamics?
- The biologic, chemical, and physiologic actions of a particular drug within the body
- What the drug does to the body
- The pharmacodynamics of a drug are responsible for its therapeutic effects and
sometimes adverse effects
What is pharmacokinetics?
- The study of drug movement throughout the body
- What the body does to the drug
- Absorption, distribution, metabolism, and excretion
What are the four ways that drugs work within the body?
- Replace or act as a substitute for missing chemicals
- To increase or stimulate certain cellular activities
- To depress or slow cellular activities
- To interfere with the functioning of foreign cells
What is the process of pharmacokinetics? (ADME)
Absorption
Distribution
Metabolism
Excretion
What is absorption?
- The movement of the drug from the site of administration into the bloodstream
- What happens to a drug from the time it is introduced to the body until it reaches the
circulating fluids and tissues
What is distribution?
The movement of the drugs into the cells and body tissues
What is biotransformation (metabolism)?
- The conversion of the drug into another substance or substances
- Chemically converts drug so it can be easily removed from body
What is excretion?
- The removal of the drug
- Elimination of a drug or its metabolites from the body, most commonly via kidneys
(urine)
How are medications absorbed?
The vast majority of medications are taken orally and are broken down within the
gastrointestinal tract. Once the medication arrives, it is broken down by stomach acids
before it passes through the liver and then enters the bloodstream.
What factors affect absorption of medications?
- Dosage form
- Route of administration
,- Administration site blood flow
- GI function
- Presence of food or other drugs
What is metabolism (biotransformation process)?
Chemical alteration of the drug by the body
What is the first pass effect?
Loss of effectiveness during the first pass through the liver
What is protein binding? How does it relate to distribution?
Protein-bound drugs can't pass through capillary walls until bonds dissolve, dosages
calculated based on the protein-binding characteristics, Low "albumin level", more
unbound, more toxicity
What is the blood brain barrier? How does it relate to distribution?
Cells in the capillary walls are tightly packed, keeps toxins and poisons out of the brain
Placenta membrane and lactation, how does it relate to distribution?
Not a barrier like the blood-brain barrier, any drug that can pass through a membrane
can pas through the placenta, always ask if a pt is pregnant or lactating
What is the hepatic microsomal (P-450 enzyme) system?
Liver metabolism predominately achieved by specific liver enzymes called cytochrome
P-450
What is pharmacogenomics?
Genotyping for allleles that alllow for abnormal metabolism of certain drugs by the P-
450 sytem
What is the process of excretion?
Elimination of a drug or its metabolites from the body, most commonly via kidneys
(urine)
Requires adequate function of:
- Circulatory system
- Kidneys, bowel
- Lungs
- Skin
What is the half-life of a drug?
The amount of time required to remove half (50%) of the blood concentration of a drug
What factors that can influence the actual effectiveness of drugs in the body?
- Type of drug
- Quantity of drug used
- Method of drug use
- Time taken to consume
- Tolerance
- Gender, size and amount of muscle
What is peptic ulcer disease?
- Lesion in stomach called gastric ulcer
- Lesion in small intestine called duodenal ulcer
- Symptoms: gnawing, burning pain, often occurring after meals
- Can occur in two different areas: gastric ulcer and duodenal ulcer
Two things to understand:
, - Mucosal lining creates a barrier to protect stomach
- Then you have gastric acid
- Inadequate mucous or poor barrier can contribute to developing an ulcer, medications
such as NSAIDs and steroids can cause ulcers
What are the adverse affects that drugs have on the GI system?
A lot of meds that can have increased GI risk
Ex. NSAIDs and steroids (prednisone)
What is helicobacter pylori?
- Primary cause of peptic ulcers
- Mutates rapidly: that's the reason you have to have a multi drug treatment
What is the #1 treatment for GERD?
Should be nonpharmacologic
- Watching what you eat
- Don't wear tight pants
- Don't lay down after eating
What causes GERD?
Caused by loosening of sphincter between esophagus and stomach
Acidic stomach contents move up into esophagus
What are the effects of drugs on GI secretions?
- Decrease GI secretory activity
- Block the action of GI secretions
- Form protective coverings on the GI lining to prevent erosion from GI secretions
- Replace missing GI enzymes (pancrelipase) that the GI tract or ancillary glands and
organs can no longer produce
Is pancrelipase used to treat GERD?
No, used for cystic fibrosis
Wha drugs are used to treat ulcers?
- Histamine-2 (H2) antagonists
- Antacids
- Proton pump inhibitors
- Antipeptic agents
- Prostaglandins
What is the mechanism of action of histamine-2 (H2) antagonists?
- Block the release of hydrochloric acid in response to gastrin
- Doesn't block it completely, but decreases
- More immediate reaction
What is the mechanism of action of antacids?
- Interact with acids at the chemical level to neutralize them
- Antacids = neutralize
What is the mechanism of action of proton pump inhibitors?
- Suppress the secretion of hydrochloric acid into the lumen of the stomach
- Suppress acid secretion much better than H2
- This is the best medication
- Takes longer to work bc it's suppressing it at the end of the gastric acid production
cycle
What is the mechanism of action of antipeptic agents?
ANSWERS A
+ GRADED
What is pharmacodynamics?
- The biologic, chemical, and physiologic actions of a particular drug within the body
- What the drug does to the body
- The pharmacodynamics of a drug are responsible for its therapeutic effects and
sometimes adverse effects
What is pharmacokinetics?
- The study of drug movement throughout the body
- What the body does to the drug
- Absorption, distribution, metabolism, and excretion
What are the four ways that drugs work within the body?
- Replace or act as a substitute for missing chemicals
- To increase or stimulate certain cellular activities
- To depress or slow cellular activities
- To interfere with the functioning of foreign cells
What is the process of pharmacokinetics? (ADME)
Absorption
Distribution
Metabolism
Excretion
What is absorption?
- The movement of the drug from the site of administration into the bloodstream
- What happens to a drug from the time it is introduced to the body until it reaches the
circulating fluids and tissues
What is distribution?
The movement of the drugs into the cells and body tissues
What is biotransformation (metabolism)?
- The conversion of the drug into another substance or substances
- Chemically converts drug so it can be easily removed from body
What is excretion?
- The removal of the drug
- Elimination of a drug or its metabolites from the body, most commonly via kidneys
(urine)
How are medications absorbed?
The vast majority of medications are taken orally and are broken down within the
gastrointestinal tract. Once the medication arrives, it is broken down by stomach acids
before it passes through the liver and then enters the bloodstream.
What factors affect absorption of medications?
- Dosage form
- Route of administration
,- Administration site blood flow
- GI function
- Presence of food or other drugs
What is metabolism (biotransformation process)?
Chemical alteration of the drug by the body
What is the first pass effect?
Loss of effectiveness during the first pass through the liver
What is protein binding? How does it relate to distribution?
Protein-bound drugs can't pass through capillary walls until bonds dissolve, dosages
calculated based on the protein-binding characteristics, Low "albumin level", more
unbound, more toxicity
What is the blood brain barrier? How does it relate to distribution?
Cells in the capillary walls are tightly packed, keeps toxins and poisons out of the brain
Placenta membrane and lactation, how does it relate to distribution?
Not a barrier like the blood-brain barrier, any drug that can pass through a membrane
can pas through the placenta, always ask if a pt is pregnant or lactating
What is the hepatic microsomal (P-450 enzyme) system?
Liver metabolism predominately achieved by specific liver enzymes called cytochrome
P-450
What is pharmacogenomics?
Genotyping for allleles that alllow for abnormal metabolism of certain drugs by the P-
450 sytem
What is the process of excretion?
Elimination of a drug or its metabolites from the body, most commonly via kidneys
(urine)
Requires adequate function of:
- Circulatory system
- Kidneys, bowel
- Lungs
- Skin
What is the half-life of a drug?
The amount of time required to remove half (50%) of the blood concentration of a drug
What factors that can influence the actual effectiveness of drugs in the body?
- Type of drug
- Quantity of drug used
- Method of drug use
- Time taken to consume
- Tolerance
- Gender, size and amount of muscle
What is peptic ulcer disease?
- Lesion in stomach called gastric ulcer
- Lesion in small intestine called duodenal ulcer
- Symptoms: gnawing, burning pain, often occurring after meals
- Can occur in two different areas: gastric ulcer and duodenal ulcer
Two things to understand:
, - Mucosal lining creates a barrier to protect stomach
- Then you have gastric acid
- Inadequate mucous or poor barrier can contribute to developing an ulcer, medications
such as NSAIDs and steroids can cause ulcers
What are the adverse affects that drugs have on the GI system?
A lot of meds that can have increased GI risk
Ex. NSAIDs and steroids (prednisone)
What is helicobacter pylori?
- Primary cause of peptic ulcers
- Mutates rapidly: that's the reason you have to have a multi drug treatment
What is the #1 treatment for GERD?
Should be nonpharmacologic
- Watching what you eat
- Don't wear tight pants
- Don't lay down after eating
What causes GERD?
Caused by loosening of sphincter between esophagus and stomach
Acidic stomach contents move up into esophagus
What are the effects of drugs on GI secretions?
- Decrease GI secretory activity
- Block the action of GI secretions
- Form protective coverings on the GI lining to prevent erosion from GI secretions
- Replace missing GI enzymes (pancrelipase) that the GI tract or ancillary glands and
organs can no longer produce
Is pancrelipase used to treat GERD?
No, used for cystic fibrosis
Wha drugs are used to treat ulcers?
- Histamine-2 (H2) antagonists
- Antacids
- Proton pump inhibitors
- Antipeptic agents
- Prostaglandins
What is the mechanism of action of histamine-2 (H2) antagonists?
- Block the release of hydrochloric acid in response to gastrin
- Doesn't block it completely, but decreases
- More immediate reaction
What is the mechanism of action of antacids?
- Interact with acids at the chemical level to neutralize them
- Antacids = neutralize
What is the mechanism of action of proton pump inhibitors?
- Suppress the secretion of hydrochloric acid into the lumen of the stomach
- Suppress acid secretion much better than H2
- This is the best medication
- Takes longer to work bc it's suppressing it at the end of the gastric acid production
cycle
What is the mechanism of action of antipeptic agents?
