12/4/23,z4:44zPM 2z2023-
2024zNURSz5334zPharmzStudyzGuidezQuizz1zLatestzUpdatezBestzE…
2023/2024
NURS 5334 z
Pharm Study z z
Guide Quiz 1 L z z z
atest UpdateB z z
est Exam Solut
z z
ion Graded A+
z z
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,12/4/23,z4:44zPM 2z2023-
2024zNURSz5334zPharmzStudyzGuidezQuizz1zLatestzUpdatezBestzE…
NURS 5334 PHARM z z
MODULEz 1
• Whatzarez thezBONzruleszandzregulationszforzprescriptivezauthorityzfo
rzthezadvancezpracticeznurse?
• Texasz isz veryz restricted
• Describezthezpharmacokineticzprocesseszofzabsorption,zdistribution,
zmetabolismzandzeliminationzandzhowzdifferences zinzthesezareaszaffe
ctzdrugzaction.
• Absorption
• Drug’sz movementz fromz thez sitez ofz administrationz intoz th
ezblood.
• Distribution
• Drug’sz movementz fromz thez bloodz intoz thez interstitialz spac
ezofztissueszandzfromztherezintozcells.
• Metabolism
• Biotransformationz isz thez enzymaticallyz mediatedz alterationz o
fzdrugzstructure.
• Elimination
• Combinationz ofz metabolismz andz excretion
• Discusszthezimpactzofzfoodzonzdrugzabsorption,zdrugzmetabolismzandzo
nzdrugztoxicityzandzaction—
aszwellzasztheztimingzofzdrugzadministration.
LIFESPAN
• Hepaticz metabolismz andz GFRz increasez duringz pregnancy,z dosagesz o
fzsomezdrugszmayzneedztozbezincreased.
• Ratez ofz albuminz toz waterz decreases
• Thirdz trimester:z Renalz bloodz flowz isz doubledz andz rena
lzexcretionzisz acceleratedz (drugsz excretedz rapidly)
• Tonez andz mobilityz ofz bowelz decrease
• Prolongationz ofz drugz effectsz Totalz (½z lifez increases)
Understandzstageszofzdevelopmentzinzpregnancy
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2024zNURSz5334zPharmzStudyzGuidezQuizz1zLatestzUpdatezBestzE…
• Conception:z throughz weekz 2
• Embryonicz period:z weekz 3-weekz 8
a) Grossz malformationsz canz bez producedz byz teratogens
• Fetalz period:z weekz 9-delivery
• Understandzpregnancyzlabeling
• 3z categoriesz now
a)z Pregnancy,z lactation,z malez &z femalez reproductivezpotenti
al
• Howzdozyouzdecreasezriskzinzthezinfantzduringzbreastfeeding?
• Takez medsz immediatelyz afterz breastfeeding,z avoidz drugsz tha
tzhavez longz half-
lives,z choosez drugsz thatz tendz toz bez excludedzfromz milk,z avoi
dz drugszthatz arezknownztozbezhazardous.
• Howz doz pediatricz patientsz differz inz theirz responsez toz medications?
• Absorption
a) Oral?
• Neonates:z drugz remainz inzthez stomachz longerzwh
ichz increasesz thez levels,z lowz acidityz canz affectzth
ezabsorptionzofzacidzlabilez drugs
b) Parenteral?
• Reponsesz arez slowz andz erratic.
• Infancy:z absorptionz isz morez rapidz thanz inz neonate
sz&zadults
• Bestz avoidedz inz infants
c) Transdermal?
• Greaterz skinz permeabilityz whichz increaseszto
picalz drugz absorptionz andz increasesz thez riskzf
orztoxicity
• Distribution
a) Proteinz binding
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2024zNURSz5334zPharmzStudyzGuidezQuizz1zLatestzUpdatezBestzE…
1. Neonates:z lessz protein-binding—
increasedzavailabilityz ofz highlyz proteinz boundz dru
gsz suchz aszphenytoin,z diazepam,z andz phenobarbit
al.z Reducedzdosagesz neededz inz thesezhighlyz bound
z drugs.
b) Bloodz Brainz Barrier
1. Notz fullyz developedz atz birth,z drugsz havez eas
yzaccessz toz thez CNS,z dosesz shouldz bez reduce
d.
• Metabolism
a) Hepaticz function?
1. Liverzhasn’tzreachedzfullz maturation—
sensitiveztozdrugszeliminatedzbyzthezCYP450.zLi
ver’szabilityztozmetabolizezdrugszincreaseszabout
zonezmonthzafterzbirth.
b) Tzhalfz life
1. Decreasedz byz asz muchz asz 48-72z hours
• Excretion
a) Renal?
1. GFRziszsignificantlyzreducedzatzbirth,zdrugszelimi
natedzbyzthezkidneyszmustzbezgivenzinzazreducedz
dosagez andz longerz dosingz intervals.
• Whatz educationz needsz toz bez givenz toz parents?
• Whatz toz doz ifz childz spitsz outz medicationz orz throwsz itz up
• Effectivez education:z dosagez sizez andz timing,z route,z techniqu
ezofz administration,z durationz ofz treatment,zhowz toz storez thezdr
ug,z naturez andz timez coursez ofz thez desiredz response,z naturezan
dztimezcoursezofzadversez reactions.
• Comparezandzcontrastzpharmacokineticszandzpharmacodyna
micszofzspecialzpopulations—pediatrics,zolder
about:blank 4/83
2024zNURSz5334zPharmzStudyzGuidezQuizz1zLatestzUpdatezBestzE…
2023/2024
NURS 5334 z
Pharm Study z z
Guide Quiz 1 L z z z
atest UpdateB z z
est Exam Solut
z z
ion Graded A+
z z
about:blank 1/83
,12/4/23,z4:44zPM 2z2023-
2024zNURSz5334zPharmzStudyzGuidezQuizz1zLatestzUpdatezBestzE…
NURS 5334 PHARM z z
MODULEz 1
• Whatzarez thezBONzruleszandzregulationszforzprescriptivezauthorityzfo
rzthezadvancezpracticeznurse?
• Texasz isz veryz restricted
• Describezthezpharmacokineticzprocesseszofzabsorption,zdistribution,
zmetabolismzandzeliminationzandzhowzdifferences zinzthesezareaszaffe
ctzdrugzaction.
• Absorption
• Drug’sz movementz fromz thez sitez ofz administrationz intoz th
ezblood.
• Distribution
• Drug’sz movementz fromz thez bloodz intoz thez interstitialz spac
ezofztissueszandzfromztherezintozcells.
• Metabolism
• Biotransformationz isz thez enzymaticallyz mediatedz alterationz o
fzdrugzstructure.
• Elimination
• Combinationz ofz metabolismz andz excretion
• Discusszthezimpactzofzfoodzonzdrugzabsorption,zdrugzmetabolismzandzo
nzdrugztoxicityzandzaction—
aszwellzasztheztimingzofzdrugzadministration.
LIFESPAN
• Hepaticz metabolismz andz GFRz increasez duringz pregnancy,z dosagesz o
fzsomezdrugszmayzneedztozbezincreased.
• Ratez ofz albuminz toz waterz decreases
• Thirdz trimester:z Renalz bloodz flowz isz doubledz andz rena
lzexcretionzisz acceleratedz (drugsz excretedz rapidly)
• Tonez andz mobilityz ofz bowelz decrease
• Prolongationz ofz drugz effectsz Totalz (½z lifez increases)
Understandzstageszofzdevelopmentzinzpregnancy
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2024zNURSz5334zPharmzStudyzGuidezQuizz1zLatestzUpdatezBestzE…
• Conception:z throughz weekz 2
• Embryonicz period:z weekz 3-weekz 8
a) Grossz malformationsz canz bez producedz byz teratogens
• Fetalz period:z weekz 9-delivery
• Understandzpregnancyzlabeling
• 3z categoriesz now
a)z Pregnancy,z lactation,z malez &z femalez reproductivezpotenti
al
• Howzdozyouzdecreasezriskzinzthezinfantzduringzbreastfeeding?
• Takez medsz immediatelyz afterz breastfeeding,z avoidz drugsz tha
tzhavez longz half-
lives,z choosez drugsz thatz tendz toz bez excludedzfromz milk,z avoi
dz drugszthatz arezknownztozbezhazardous.
• Howz doz pediatricz patientsz differz inz theirz responsez toz medications?
• Absorption
a) Oral?
• Neonates:z drugz remainz inzthez stomachz longerzwh
ichz increasesz thez levels,z lowz acidityz canz affectzth
ezabsorptionzofzacidzlabilez drugs
b) Parenteral?
• Reponsesz arez slowz andz erratic.
• Infancy:z absorptionz isz morez rapidz thanz inz neonate
sz&zadults
• Bestz avoidedz inz infants
c) Transdermal?
• Greaterz skinz permeabilityz whichz increaseszto
picalz drugz absorptionz andz increasesz thez riskzf
orztoxicity
• Distribution
a) Proteinz binding
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2024zNURSz5334zPharmzStudyzGuidezQuizz1zLatestzUpdatezBestzE…
1. Neonates:z lessz protein-binding—
increasedzavailabilityz ofz highlyz proteinz boundz dru
gsz suchz aszphenytoin,z diazepam,z andz phenobarbit
al.z Reducedzdosagesz neededz inz thesezhighlyz bound
z drugs.
b) Bloodz Brainz Barrier
1. Notz fullyz developedz atz birth,z drugsz havez eas
yzaccessz toz thez CNS,z dosesz shouldz bez reduce
d.
• Metabolism
a) Hepaticz function?
1. Liverzhasn’tzreachedzfullz maturation—
sensitiveztozdrugszeliminatedzbyzthezCYP450.zLi
ver’szabilityztozmetabolizezdrugszincreaseszabout
zonezmonthzafterzbirth.
b) Tzhalfz life
1. Decreasedz byz asz muchz asz 48-72z hours
• Excretion
a) Renal?
1. GFRziszsignificantlyzreducedzatzbirth,zdrugszelimi
natedzbyzthezkidneyszmustzbezgivenzinzazreducedz
dosagez andz longerz dosingz intervals.
• Whatz educationz needsz toz bez givenz toz parents?
• Whatz toz doz ifz childz spitsz outz medicationz orz throwsz itz up
• Effectivez education:z dosagez sizez andz timing,z route,z techniqu
ezofz administration,z durationz ofz treatment,zhowz toz storez thezdr
ug,z naturez andz timez coursez ofz thez desiredz response,z naturezan
dztimezcoursezofzadversez reactions.
• Comparezandzcontrastzpharmacokineticszandzpharmacodyna
micszofzspecialzpopulations—pediatrics,zolder
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