NUR343 Final Exam
Study online at https://quizlet.com/_iectkg
1. 4 Stages of Pharmacokinetics: absorption, distribution, metabolism, excretion
2. how does age (young or old) affect pharmacokinetics?: developmental changes can affect
drug absorption, binding, renal elimination, and metabolism
* ex: topical agents are more readily absorbed in children (thinner skin, large SA of skin compared to body composition)
3. gastrointestinal absorption based on age: - gastric pH does not reach adult values until age 20
to 30 months
- more orally administered drugs are absorbed in the small intestine
- infants have proportionately larger small intestinal surface area (unpredictable absorption compared to adults b/c
variation in SA)
- infants have increased intestinal motility (alters the absorption of drugs with limited water solubility)
4. distribution for infants: - newborns and infants have high percentage of body water (dehydrate faster)
- blood-brain barrier is incomplete and permeable in the newborn (puts babies more at risk - ex: benadryl makes
babies stop breathing)
- infants under 6 months have decreased plasma proteins available for drug binding (less albumin available)
5. distribution for adolescents: - the efficacy of the liver changes (30% drop in systemic cholesterol values
w puberty)
- total body fat decreases in adolescence
- lean body mass increases more in males
- fat distribution increases in females/decreases in males
**difficult to predict pharmacokinetics of some drugs during adolescence
6. metabolism based on young age: - phase 1 reactions start functioning soon after birth but takes
time to reach adult levels
- phase 2 reactions are slower to mature, sometimes not fully active until 1 year old
**enzyme maturation occurs at varying rates
7. elimination based on young age: - renal blood flow and glomerular filtration rate reaches adult levels
at age 9 months (prior to that, elimination will be slowed)** adjust dosages of medications to account for decreased
renal function
8. absorption changes for older adults: not dramatically different in older adults compared to
younger adults(possible shift in IV or IM because of fat differences)
9. distribution changes for older adults: increased fat stores, decreased total body water and serum
albumin (increase toxicity risk)
, NUR343 Final Exam
Study online at https://quizlet.com/_iectkg
10. metabolism changes for older adults: decreased hepatic blood flow, decreased CYP450 system
function (decrease liver function, decrease enzyme activity)
11. excretion changes for older adults: decreased renal mass and glomerular filtration rate and
tubular secretion; serum creatinine is an unreliable marker of renal function
** monitor these levels (they won't clear drugs as quickly as they should, could become toxic)
12. What organs are involved in the different stages of pharmacokinetics?: -
absorption: stomach and intestines
- distribution: liver and kidneys
- metabolism: liver
- excretion: kidneys
13. CYP450 metabolic system: a crucial enzyme system in the human body responsible for the metabolism
of drugs
* heavily influence on another (compete when more than one drug is given)
** metabolic CYP pathway may increase interactions with other drugs or even foods (competing drugs, declining liver
function, they won't produce enough enzymes, metabolism slows/gets worse)
14. how does the CYP450 metabolic system influence nursing delivery of care?-
: this helps nurses understand how CYP450 enzymes metabolize drugs, which can alter the drug's effectiveness and
side effects
* identify potential interactions and adjust dosages based on drug-drug interactions
15. diuretics: medications administered to increase urine secretion in order to rid the body of excess water and
salt
16. adverse effects of diuretics: - hypovolemia
- acid-base imbalance
- electrolyte imbalances
17. 4 major categories of diuretics: - loop: furosemide
- thiazide: hydrochlorothiazide
- osmotic: mannitol
- potassium-sparing: aldosterone and non-aldosterone antagonists
18. loop diuretics: furosemide (Lasix)
- blocks sodium reabsorption (sodium and water loss)
- rapid onset (PO 60 minutes; IV 5 minutes)
, NUR343 Final Exam
Study online at https://quizlet.com/_iectkg
19. therapeutic uses of loop diuretics: - pulmonary edema
- edematous states
- hypertension
20. furosemide adverse effects: - hyponatremia
- hypochloremia
- dehydration
- hypokalemia
- hypotension
** ototoxicity
- hyperglycemia
- hyperuricemia
- use in pregnancy
21. Thiazide diuretics (benzothiadiazides): effects similar to loop diuretics (increase sodium, chlo-
ride, potassium and water excretion)
** maximum diuresis is considerably lower than with loop diuretics
** not effective when urine flow is little (unlike w loop diuretics)
22. Hydrochlorothiazide (hydroDIURIL): most widely used
- peaks in 4-6 hours
23. therapeutic uses of hydrochlorothiazide: - essential hypertension
- edema
- diabetes insipidus
24. adverse effects of hydrochlorothiazide: same as loop diuretics but NOT ototoxic
25. potassium-sparing diuretics: - modest increase in urine production
- substantial decrease in potassium excretion (hangs onto potassium); increased excretion of sodium
* rarely used alone for therapy
* 2 subgroups: aldosterone and non-aldosterone antagonists
26. potassium-sparing therapeutic uses: - hypertension
- edematous states
- HF
- premenstrual syndrome
- polycystic ovary syndrome
- acne in young women
Study online at https://quizlet.com/_iectkg
1. 4 Stages of Pharmacokinetics: absorption, distribution, metabolism, excretion
2. how does age (young or old) affect pharmacokinetics?: developmental changes can affect
drug absorption, binding, renal elimination, and metabolism
* ex: topical agents are more readily absorbed in children (thinner skin, large SA of skin compared to body composition)
3. gastrointestinal absorption based on age: - gastric pH does not reach adult values until age 20
to 30 months
- more orally administered drugs are absorbed in the small intestine
- infants have proportionately larger small intestinal surface area (unpredictable absorption compared to adults b/c
variation in SA)
- infants have increased intestinal motility (alters the absorption of drugs with limited water solubility)
4. distribution for infants: - newborns and infants have high percentage of body water (dehydrate faster)
- blood-brain barrier is incomplete and permeable in the newborn (puts babies more at risk - ex: benadryl makes
babies stop breathing)
- infants under 6 months have decreased plasma proteins available for drug binding (less albumin available)
5. distribution for adolescents: - the efficacy of the liver changes (30% drop in systemic cholesterol values
w puberty)
- total body fat decreases in adolescence
- lean body mass increases more in males
- fat distribution increases in females/decreases in males
**difficult to predict pharmacokinetics of some drugs during adolescence
6. metabolism based on young age: - phase 1 reactions start functioning soon after birth but takes
time to reach adult levels
- phase 2 reactions are slower to mature, sometimes not fully active until 1 year old
**enzyme maturation occurs at varying rates
7. elimination based on young age: - renal blood flow and glomerular filtration rate reaches adult levels
at age 9 months (prior to that, elimination will be slowed)** adjust dosages of medications to account for decreased
renal function
8. absorption changes for older adults: not dramatically different in older adults compared to
younger adults(possible shift in IV or IM because of fat differences)
9. distribution changes for older adults: increased fat stores, decreased total body water and serum
albumin (increase toxicity risk)
, NUR343 Final Exam
Study online at https://quizlet.com/_iectkg
10. metabolism changes for older adults: decreased hepatic blood flow, decreased CYP450 system
function (decrease liver function, decrease enzyme activity)
11. excretion changes for older adults: decreased renal mass and glomerular filtration rate and
tubular secretion; serum creatinine is an unreliable marker of renal function
** monitor these levels (they won't clear drugs as quickly as they should, could become toxic)
12. What organs are involved in the different stages of pharmacokinetics?: -
absorption: stomach and intestines
- distribution: liver and kidneys
- metabolism: liver
- excretion: kidneys
13. CYP450 metabolic system: a crucial enzyme system in the human body responsible for the metabolism
of drugs
* heavily influence on another (compete when more than one drug is given)
** metabolic CYP pathway may increase interactions with other drugs or even foods (competing drugs, declining liver
function, they won't produce enough enzymes, metabolism slows/gets worse)
14. how does the CYP450 metabolic system influence nursing delivery of care?-
: this helps nurses understand how CYP450 enzymes metabolize drugs, which can alter the drug's effectiveness and
side effects
* identify potential interactions and adjust dosages based on drug-drug interactions
15. diuretics: medications administered to increase urine secretion in order to rid the body of excess water and
salt
16. adverse effects of diuretics: - hypovolemia
- acid-base imbalance
- electrolyte imbalances
17. 4 major categories of diuretics: - loop: furosemide
- thiazide: hydrochlorothiazide
- osmotic: mannitol
- potassium-sparing: aldosterone and non-aldosterone antagonists
18. loop diuretics: furosemide (Lasix)
- blocks sodium reabsorption (sodium and water loss)
- rapid onset (PO 60 minutes; IV 5 minutes)
, NUR343 Final Exam
Study online at https://quizlet.com/_iectkg
19. therapeutic uses of loop diuretics: - pulmonary edema
- edematous states
- hypertension
20. furosemide adverse effects: - hyponatremia
- hypochloremia
- dehydration
- hypokalemia
- hypotension
** ototoxicity
- hyperglycemia
- hyperuricemia
- use in pregnancy
21. Thiazide diuretics (benzothiadiazides): effects similar to loop diuretics (increase sodium, chlo-
ride, potassium and water excretion)
** maximum diuresis is considerably lower than with loop diuretics
** not effective when urine flow is little (unlike w loop diuretics)
22. Hydrochlorothiazide (hydroDIURIL): most widely used
- peaks in 4-6 hours
23. therapeutic uses of hydrochlorothiazide: - essential hypertension
- edema
- diabetes insipidus
24. adverse effects of hydrochlorothiazide: same as loop diuretics but NOT ototoxic
25. potassium-sparing diuretics: - modest increase in urine production
- substantial decrease in potassium excretion (hangs onto potassium); increased excretion of sodium
* rarely used alone for therapy
* 2 subgroups: aldosterone and non-aldosterone antagonists
26. potassium-sparing therapeutic uses: - hypertension
- edematous states
- HF
- premenstrual syndrome
- polycystic ovary syndrome
- acne in young women
