Pharmacology Final Exam Blueprint
Spring 2021
There will be 65-75 multiple choice questions and select all that apply questions.
Know the following principles from the chapters listed:
Chapter 1: Differentiate between OTC/Brand name/Generic drugs
o Brand name drug
Name given to the drug by the company that developed it
Time-limited patent-when patent runs out-other companies can manufacture the
drug
A drug sold by a drug company under a specific name or trademark and that is
protected by a patent. Brand name drugs may be available by prescription or over
the counter.
Found in stores
o Generic drug
Drugs produced by companies that were only involved in the manufacturing
process-not the research to develop the drug or advertising
Lowercase & official name of drug
Lower cost version of brand name drug
Brand (Benadryl) Generic (diphenhydramine)
o OTC drugs
Available without a prescription
Some originally started out as a prescription drug (e.g., Zyrtec)
Some grandfathered in
Safe if taken as directed
Nursing Considerations
When taking a drug history-specifically ask about use of OTC
medications
Use with prescription medications could cause interactions
Not taking medications as directed could result in serious overdoses
Chapter 2: Principles of Pharmacokinetics & Factors Influencing Drug Effects
o Absorption
Process that occurs to a drug from when it is introduced into the body until it
reaches the bloodstream and tissues.
Routes of Administration: Oral, IV, IM, subcutaneous, rectal, mucous
membranes, topical, inhalation
The route of administration impacts how fast the medication will take effect and
the amount of drug that is absorbed.
o Distribution – movement of a drug to the body tissues
Perfusion
Rich vs non-rich blood supply
Vasoconstriction - constriction of blood vessels, which increases blood
pressure
Disease processes that cause changes to the vasculature
Ability to cross cell membrane
Water or lipid soluble
Binding to plasma proteins
Blood-Brain Barrier
Placenta & Breast Milk
1
, Pharmacology Final Exam Blueprint
Spring 2021
o Metabolism
Biotransformation – process of the biochemical alteration of a drug
First-pass effect for oral drugs
Hepatic Enzymes work to transform drugs
Cytochrome P450 enzymes
Factors that influence metabolism
Age/weight/gender/tolerance/accumulation/interactions
Physiological/pathological/immunological/psychological factors
Environmental factors
Genetics
Disease states
Concurrent use of other medications
If the liver is not functioning effectively, drugs will not be metabolized in the
same manner and toxic levels of a drug could occur.
Oral meds have a higher dose from direct contact unlike IV via bloodstream.
o Excretion – removing drug from the body
Mostly done via kidneys in urine
Other routes: Skin, saliva, lungs, bile, feces
Kidney dysfunction can lead to toxic drug levels if the drug cannot be excreted
First pass effect – a phenomenon in which drugs given orally are carried directly to the liver
after absorption, where they may be largely inactivated by liver enzymes before they can enter the
general circulation; oral drugs frequently are given in higher doses than drugs given by other
routes because of this early breakdown (p. 24)
Half life – the time it takes for the amount of drug in the body to decrease to one half of the peak
level it previously achieved (p. 25)
Loading dose – higher dose than usually used for treatment; reach critical concentrations
Chapter 18: Active & passive immunity, differences between vaccines & immune sera
Active Immunity
The body recognizes a foreign protein and begins producing antibodies to react with it
Can occur through exposure to the disease or vaccination
It is long lasting/sometimes life-long
Passive Immunity
Occurs when preformed antibodies are injected into the system and react with a specific
antigen
Limited immunity/lasts only as long as the circulating antibodies/body does not produce
its own antibodies
Vaccines
Immunizations that contain weakened or altered protein antigens that stimulate the
formation of antibodies
Immune Sera
Provide passive immunity to specific antigen which could be a pathogen, venom or toxin
Chapter 29: Autonomic Nervous System
2
, Pharmacology Final Exam Blueprint
Spring 2021
Portion of the central & peripheral nervous systems that, with the endocrine system, functions to maintain
internal homeostasis.
A control system that acts largely unconsciously and regulates bodily functions, such as the heart rate,
digestion, respiratory rate, pupillary response, urination, and sexual arousal. This system is the primary
mechanism in control of the fight-or-flight response.
Breakdown:
Innervates
Cardiac muscle, Smooth muscle & Glands
Regulates
Blood pressure/heart rate/respirations/body temperature
Water balance/urinary excretion
Digestive functions
Salivation/perspiration/pupillary changes/reproduction/metabolic & endocrine physiology
Sympathetic Nervous System
Fight or flight
Cells that originate impulses are in the thoracic & lumbar regions of spinal cord
(thoracolumbar)
Parasympathetic Nervous System
Rest and digest
Cells originate in the brain stem & sacral spinal cord (craniosacral)
Norepinephrine/epinephrine stimulates adrenergic receptors (Sympathetic NS)
Adrenergic receptors (alpha or beta)
Alpha1 (blood vessels/iris/urinary bladder)
Vasoconstriction/increased blood pressure
Contraction of piloerection muscles/pupil dilatation
Thickened salivary secretions/closure bladder sphincter
Alpha2 (presynaptic nerve membranes/beta cells pancreas)
Prevents overstimulation from norepinephrine
Moderate insulin release
Beta1 (primarily cardiac tissue)
Increased myocardial contraction
Increased heart rate/increased conduction through AV node
Beta2 (smooth muscle blood vessels/bronchi/periphery/uterine muscle)
Vasodilation
Bronchodilation
Increased muscle & liver breakdown glycogen
Increased release of glucagon from pancreas
Relaxed uterine smooth muscle
Acetylcholine stimulates cholinergic receptors (Parasympathetic)
Cholinergic receptors (muscarinic or nicotinic)
Muscarinic
Located in: GI tract/bladder/heart/sweat glands/vascular smooth muscle
Stimulation causes:
3
Spring 2021
There will be 65-75 multiple choice questions and select all that apply questions.
Know the following principles from the chapters listed:
Chapter 1: Differentiate between OTC/Brand name/Generic drugs
o Brand name drug
Name given to the drug by the company that developed it
Time-limited patent-when patent runs out-other companies can manufacture the
drug
A drug sold by a drug company under a specific name or trademark and that is
protected by a patent. Brand name drugs may be available by prescription or over
the counter.
Found in stores
o Generic drug
Drugs produced by companies that were only involved in the manufacturing
process-not the research to develop the drug or advertising
Lowercase & official name of drug
Lower cost version of brand name drug
Brand (Benadryl) Generic (diphenhydramine)
o OTC drugs
Available without a prescription
Some originally started out as a prescription drug (e.g., Zyrtec)
Some grandfathered in
Safe if taken as directed
Nursing Considerations
When taking a drug history-specifically ask about use of OTC
medications
Use with prescription medications could cause interactions
Not taking medications as directed could result in serious overdoses
Chapter 2: Principles of Pharmacokinetics & Factors Influencing Drug Effects
o Absorption
Process that occurs to a drug from when it is introduced into the body until it
reaches the bloodstream and tissues.
Routes of Administration: Oral, IV, IM, subcutaneous, rectal, mucous
membranes, topical, inhalation
The route of administration impacts how fast the medication will take effect and
the amount of drug that is absorbed.
o Distribution – movement of a drug to the body tissues
Perfusion
Rich vs non-rich blood supply
Vasoconstriction - constriction of blood vessels, which increases blood
pressure
Disease processes that cause changes to the vasculature
Ability to cross cell membrane
Water or lipid soluble
Binding to plasma proteins
Blood-Brain Barrier
Placenta & Breast Milk
1
, Pharmacology Final Exam Blueprint
Spring 2021
o Metabolism
Biotransformation – process of the biochemical alteration of a drug
First-pass effect for oral drugs
Hepatic Enzymes work to transform drugs
Cytochrome P450 enzymes
Factors that influence metabolism
Age/weight/gender/tolerance/accumulation/interactions
Physiological/pathological/immunological/psychological factors
Environmental factors
Genetics
Disease states
Concurrent use of other medications
If the liver is not functioning effectively, drugs will not be metabolized in the
same manner and toxic levels of a drug could occur.
Oral meds have a higher dose from direct contact unlike IV via bloodstream.
o Excretion – removing drug from the body
Mostly done via kidneys in urine
Other routes: Skin, saliva, lungs, bile, feces
Kidney dysfunction can lead to toxic drug levels if the drug cannot be excreted
First pass effect – a phenomenon in which drugs given orally are carried directly to the liver
after absorption, where they may be largely inactivated by liver enzymes before they can enter the
general circulation; oral drugs frequently are given in higher doses than drugs given by other
routes because of this early breakdown (p. 24)
Half life – the time it takes for the amount of drug in the body to decrease to one half of the peak
level it previously achieved (p. 25)
Loading dose – higher dose than usually used for treatment; reach critical concentrations
Chapter 18: Active & passive immunity, differences between vaccines & immune sera
Active Immunity
The body recognizes a foreign protein and begins producing antibodies to react with it
Can occur through exposure to the disease or vaccination
It is long lasting/sometimes life-long
Passive Immunity
Occurs when preformed antibodies are injected into the system and react with a specific
antigen
Limited immunity/lasts only as long as the circulating antibodies/body does not produce
its own antibodies
Vaccines
Immunizations that contain weakened or altered protein antigens that stimulate the
formation of antibodies
Immune Sera
Provide passive immunity to specific antigen which could be a pathogen, venom or toxin
Chapter 29: Autonomic Nervous System
2
, Pharmacology Final Exam Blueprint
Spring 2021
Portion of the central & peripheral nervous systems that, with the endocrine system, functions to maintain
internal homeostasis.
A control system that acts largely unconsciously and regulates bodily functions, such as the heart rate,
digestion, respiratory rate, pupillary response, urination, and sexual arousal. This system is the primary
mechanism in control of the fight-or-flight response.
Breakdown:
Innervates
Cardiac muscle, Smooth muscle & Glands
Regulates
Blood pressure/heart rate/respirations/body temperature
Water balance/urinary excretion
Digestive functions
Salivation/perspiration/pupillary changes/reproduction/metabolic & endocrine physiology
Sympathetic Nervous System
Fight or flight
Cells that originate impulses are in the thoracic & lumbar regions of spinal cord
(thoracolumbar)
Parasympathetic Nervous System
Rest and digest
Cells originate in the brain stem & sacral spinal cord (craniosacral)
Norepinephrine/epinephrine stimulates adrenergic receptors (Sympathetic NS)
Adrenergic receptors (alpha or beta)
Alpha1 (blood vessels/iris/urinary bladder)
Vasoconstriction/increased blood pressure
Contraction of piloerection muscles/pupil dilatation
Thickened salivary secretions/closure bladder sphincter
Alpha2 (presynaptic nerve membranes/beta cells pancreas)
Prevents overstimulation from norepinephrine
Moderate insulin release
Beta1 (primarily cardiac tissue)
Increased myocardial contraction
Increased heart rate/increased conduction through AV node
Beta2 (smooth muscle blood vessels/bronchi/periphery/uterine muscle)
Vasodilation
Bronchodilation
Increased muscle & liver breakdown glycogen
Increased release of glucagon from pancreas
Relaxed uterine smooth muscle
Acetylcholine stimulates cholinergic receptors (Parasympathetic)
Cholinergic receptors (muscarinic or nicotinic)
Muscarinic
Located in: GI tract/bladder/heart/sweat glands/vascular smooth muscle
Stimulation causes:
3
