NUR-641E Advanced Pathophysiology and Pharmacology for the Nurse
Educator QUESTIOS AND ANSWERS
Terms in this set (207)
Involves ADME (absorption, distribution, metabolism and
elimination).
Absorption: absorption from the administration site
either directly or indirectly into the blood/plasma.
Pharmacokinetics
Distribution: reversibly or irreversibly move from the
bloodstream into the interstitial and intracellular fluid.
Metabolism: bio-transformed via hepatic metabolism or
by other tissues. Elimination: lastly, the drug & its
metabolites are eliminated from the body
The route of administration Intravenous; putting entire dose into a patient's vein
with the highest bio- and bypassing absorption. Intravenous route avoids
availability is first-pass metabolism in the liver.
rectal administration variable and erratic absorption
disadvantages
Steady state (SS) is usually reached within 4-5 half-lives of a drug
The half-life of a drug is how long it takes for half the drug to be excreted from the body
defined as
Determines how frequently the drug
must be administered Predicts how
Half-life of a drug
long toxic effects can last
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Half-life is constant with first-order pharmacokinetics of a drug
Zero-order (nonlinear) pharmacokinetics means a drug
is metabolized at a constant rate per unit time.
CYP3A4 substrate drugs May have enhanced activity if any CYP3A4 inducer drugs are
used along with it.
Discovery: laboratory research to
develop the new drug Pre-clinical
research with animal testing for safety
Drug development steps
(Phase I)
(according to the FDA)
Clinical research on human subjects for medication safety (Phase
II)
Clinical research in humans comparing the new drug to
accepted medications or placebo depending on the
study (Phase III)
FDA review of the results to determine approval
Post-marketing study to identify adverse effects not
found in earlier clinical studies (Phase IV)
The Institute for Safe Medication
Practices (ISMP) The Institute
of Medicine (IOM)
Medication safety
organizations
The Joint Commission
The National Coordinating Council for Medication Error
Reporting and Prevention (NCCMERP)
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Food and Drug Administration (FDA) Safe Use Initiative
Two basic type of ADRs: pharmacological
and idiosyncratic. 85% to 90% of ADRs
are pharmacological.
Adverse Drug Reactions Adverse drug reactions are usually preventable,
(ADRs) frequently occur in a hospital or nursing home setting,
and include medication errors, adverse drug effects,
allergic and idiosyncratic type reactions.
ADRs are not commonly reported; the FDA does not
mandate that ADRs be reported.
Polypharmacy involves using multiple healthcare
providers for care, using multiple medications, and
using several pharmacies for prescription filling.
Lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril;
*ACEIs reduce blood pressure by suppressing the
Cardiovascular-Angiotensin
release of angiotensin-converting enzyme.
converting enzyme inhibitors
*Important side effects of ACE inhibitors include cough
(ACEIs):
and angioedema; discontinue the ACEI if
angioedema occurs.
Candesartan (Atacand), eprosartan (Teveten),
Angiotensin II receptor
irbesartan (Avapro), losartan (Cozaar), telmisartan
blocking agents (ARBs):
(Micardis) and valsartan (Diovan).
ARBs reduce blood pressure by blocking angiotensin II
receptors.
Cardiovascular-Essential Accounts for 90% of cases; secondary hypertension
(primary) hypertension may be caused by chronic renal failure.
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