12/4/23,c4:44cPM 2c2023-
2024cNURSc5334cPharmcStudycGuidecQuizc1cLatestcUpdatecBestcE…
2023/2024
NURS 5334 c
Pharm Study c c
Guide Quiz 1 L c c c
atest UpdateB c c
est Exam Solut
c c
ion Graded A+
c c
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2024cNURSc5334cPharmcStudycGuidecQuizc1cLatestcUpdatecBestcE…
NURS 5334 PHARM c c
MODULEc1
• Whatcarec thecBONcrulescandcregulationscforcprescriptivecauthoritycfo
rcthecadvancecpracticecnurse?
• Texasc isc veryc restricted
• Describecthecpharmacokineticcprocessescofcabsorption,cdistribution,
cmetabolismcandceliminationcandchowcdifferences cincthesecareascaffe
ctcdrugcaction.
• Absorption
• Drug’sc movementc fromc thec sitec ofc administrationc intoc th
ecblood.
• Distribution
• Drug’sc movementc fromc thec bloodc intoc thec interstitialc spac
ecofctissuescandcfromctherecintoccells.
• Metabolism
• Biotransformationc isc thec enzymaticallyc mediatedc alterationc o
fcdrugcstructure.
• Elimination
• Combinationc ofc metabolismc andc excretion
• Discusscthecimpactcofcfoodconcdrugcabsorption,cdrugcmetabolismcandco
ncdrugctoxicitycandcaction—
ascwellcascthectimingcofcdrugcadministration.
LIFESPAN
• Hepaticc metabolismc andc GFRc increasec duringc pregnancy,c dosagesc o
fcsomecdrugscmaycneedctocbecincreased.
• Ratec ofc albuminc toc waterc decreases
• Thirdc trimester:c Renalc bloodc flowc isc doubledc andc rena
lcexcretionciscacceleratedc(drugsc excretedcrapidly)
• Tonec andc mobilityc ofc bowelc decrease
• Prolongationc ofc drugc effectsc Totalc (½c lifec increases)
Understandcstagescofcdevelopmentcincpregnancy
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• Conception:c throughc weekc 2
• Embryonicc period:c weekc 3-weekc 8
a) Grossc malformationsc canc bec producedc byc teratogens
• Fetalc period:c weekc 9-delivery
• Understandcpregnancyclabeling
• 3c categoriesc now
a)c Pregnancy,c lactation,c malec &c femalec reproductivecpotenti
al
• Howcdocyoucdecreasecriskcincthecinfantcduringcbreastfeeding?
• Takec medsc immediatelyc afterc breastfeeding,c avoidc drugsc tha
tchavec longc half-
lives,c choosec drugsc thatctendc toc bec excludedcfromcmilk,cavoi
dc drugscthatcarecknownctocbechazardous.
• Howc doc pediatricc patientsc differc inc theirc responsec toc medications?
• Absorption
a) Oral?
• Neonates:cdrugcremaincincthecstomachclongercwh
ichc increasesc thec levels,c lowc acidityc canc affectcth
ecabsorptioncofcacidclabilec drugs
b) Parenteral?
• Reponsesc arec slowc andc erratic.
• Infancy:c absorptionc isc morec rapidc thanc inc neonate
sc&cadults
• Bestc avoidedc inc infants
c) Transdermal?
• Greaterc skincpermeabilityc whichc increasescto
picalc drugc absorptionc andc increasesc thec riskcf
orctoxicity
• Distribution
a) Proteinc binding
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2024cNURSc5334cPharmcStudycGuidecQuizc1cLatestcUpdatecBestcE…
1. Neonates:clesscprotein-binding—
increasedcavailabilityc ofc highlyc proteinc boundc dru
gsc suchc ascphenytoin,c diazepam,c andc phenobarbit
al.c Reducedcdosagescneededcincthesechighlycbound
c drugs.
b) Bloodc Brainc Barrier
1. Notc fullyc developedc atc birth,c drugsc havec eas
ycaccessc toc thec CNS,c dosesc shouldc bec reduce
d.
• Metabolism
a) Hepaticc function?
1. Liverchasn’tcreachedcfullc maturation—
sensitivectocdrugsceliminatedcbycthecCYP450.cLi
ver’scabilityctocmetabolizecdrugscincreasescabout
conecmonthcaftercbirth.
b) Tchalfc life
1. Decreasedc byc asc muchc asc 48-72c hours
• Excretion
a) Renal?
1. GFRciscsignificantlycreducedcatcbirth,cdrugscelimi
natedcbyctheckidneyscmustcbecgivencincacreducedc
dosagecandclongercdosingc intervals.
• Whatc educationc needsc toc bec givenc toc parents?
• Whatc toc docifc childc spitsc outc medicationc orc throwsc itc up
• Effectivec education:c dosagec sizec andc timing,c route,c techniqu
ecofcadministration,cdurationcofctreatment,chowctocstorec thecdr
ug,c naturec andc timec coursec ofc thec desiredc response,c naturecan
dctimeccoursecofcadversecreactions.
• Comparecandccontrastcpharmacokineticscandcpharmacodyna
micscofcspecialcpopulations—pediatrics,colder
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2023/2024
NURS 5334 c
Pharm Study c c
Guide Quiz 1 L c c c
atest UpdateB c c
est Exam Solut
c c
ion Graded A+
c c
about:blank 1/83
,12/4/23,c4:44cPM 2c2023-
2024cNURSc5334cPharmcStudycGuidecQuizc1cLatestcUpdatecBestcE…
NURS 5334 PHARM c c
MODULEc1
• Whatcarec thecBONcrulescandcregulationscforcprescriptivecauthoritycfo
rcthecadvancecpracticecnurse?
• Texasc isc veryc restricted
• Describecthecpharmacokineticcprocessescofcabsorption,cdistribution,
cmetabolismcandceliminationcandchowcdifferences cincthesecareascaffe
ctcdrugcaction.
• Absorption
• Drug’sc movementc fromc thec sitec ofc administrationc intoc th
ecblood.
• Distribution
• Drug’sc movementc fromc thec bloodc intoc thec interstitialc spac
ecofctissuescandcfromctherecintoccells.
• Metabolism
• Biotransformationc isc thec enzymaticallyc mediatedc alterationc o
fcdrugcstructure.
• Elimination
• Combinationc ofc metabolismc andc excretion
• Discusscthecimpactcofcfoodconcdrugcabsorption,cdrugcmetabolismcandco
ncdrugctoxicitycandcaction—
ascwellcascthectimingcofcdrugcadministration.
LIFESPAN
• Hepaticc metabolismc andc GFRc increasec duringc pregnancy,c dosagesc o
fcsomecdrugscmaycneedctocbecincreased.
• Ratec ofc albuminc toc waterc decreases
• Thirdc trimester:c Renalc bloodc flowc isc doubledc andc rena
lcexcretionciscacceleratedc(drugsc excretedcrapidly)
• Tonec andc mobilityc ofc bowelc decrease
• Prolongationc ofc drugc effectsc Totalc (½c lifec increases)
Understandcstagescofcdevelopmentcincpregnancy
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2024cNURSc5334cPharmcStudycGuidecQuizc1cLatestcUpdatecBestcE…
• Conception:c throughc weekc 2
• Embryonicc period:c weekc 3-weekc 8
a) Grossc malformationsc canc bec producedc byc teratogens
• Fetalc period:c weekc 9-delivery
• Understandcpregnancyclabeling
• 3c categoriesc now
a)c Pregnancy,c lactation,c malec &c femalec reproductivecpotenti
al
• Howcdocyoucdecreasecriskcincthecinfantcduringcbreastfeeding?
• Takec medsc immediatelyc afterc breastfeeding,c avoidc drugsc tha
tchavec longc half-
lives,c choosec drugsc thatctendc toc bec excludedcfromcmilk,cavoi
dc drugscthatcarecknownctocbechazardous.
• Howc doc pediatricc patientsc differc inc theirc responsec toc medications?
• Absorption
a) Oral?
• Neonates:cdrugcremaincincthecstomachclongercwh
ichc increasesc thec levels,c lowc acidityc canc affectcth
ecabsorptioncofcacidclabilec drugs
b) Parenteral?
• Reponsesc arec slowc andc erratic.
• Infancy:c absorptionc isc morec rapidc thanc inc neonate
sc&cadults
• Bestc avoidedc inc infants
c) Transdermal?
• Greaterc skincpermeabilityc whichc increasescto
picalc drugc absorptionc andc increasesc thec riskcf
orctoxicity
• Distribution
a) Proteinc binding
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2024cNURSc5334cPharmcStudycGuidecQuizc1cLatestcUpdatecBestcE…
1. Neonates:clesscprotein-binding—
increasedcavailabilityc ofc highlyc proteinc boundc dru
gsc suchc ascphenytoin,c diazepam,c andc phenobarbit
al.c Reducedcdosagescneededcincthesechighlycbound
c drugs.
b) Bloodc Brainc Barrier
1. Notc fullyc developedc atc birth,c drugsc havec eas
ycaccessc toc thec CNS,c dosesc shouldc bec reduce
d.
• Metabolism
a) Hepaticc function?
1. Liverchasn’tcreachedcfullc maturation—
sensitivectocdrugsceliminatedcbycthecCYP450.cLi
ver’scabilityctocmetabolizecdrugscincreasescabout
conecmonthcaftercbirth.
b) Tchalfc life
1. Decreasedc byc asc muchc asc 48-72c hours
• Excretion
a) Renal?
1. GFRciscsignificantlycreducedcatcbirth,cdrugscelimi
natedcbyctheckidneyscmustcbecgivencincacreducedc
dosagecandclongercdosingc intervals.
• Whatc educationc needsc toc bec givenc toc parents?
• Whatc toc docifc childc spitsc outc medicationc orc throwsc itc up
• Effectivec education:c dosagec sizec andc timing,c route,c techniqu
ecofcadministration,cdurationcofctreatment,chowctocstorec thecdr
ug,c naturec andc timec coursec ofc thec desiredc response,c naturecan
dctimeccoursecofcadversecreactions.
• Comparecandccontrastcpharmacokineticscandcpharmacodyna
micscofcspecialcpopulations—pediatrics,colder
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