Adv. Pharm NURS 8024 Week 1 Latest Update

Adv. Pharm NURS 8024 Week 1 Latest Update -100+ Questions and 100% Verified Correct Answers Guaranteed A+

2 Major Administration Routes - CORRECT ANSWER: 1. Enteral -most common, easy,

cheap-BUT drug absorption pathways can be complicated

• Parenteral-IV, fast, more expensive, once in-cannot get back

Absorption - CORRECT ANSWER: entry of pharmacologic agent into plasma

Active Transport - CORRECT ANSWER: requires energy (ATP), Able to move drug

from LOWER to HIGHER concentration

adipose tissue - CORRECT ANSWER: can store drugs and hormones

Bioavailability - CORRECT ANSWER: Highest to Lowest

IV, IM, SC, PO, PR (Rectal), Inhalation, Transdermal

Blood Brain Barrier (BBB) - CORRECT ANSWER: --physiological barrier between the

circulatory system and the central nervous system that establishes a privileged blood supply, restricting the flow of substances into the CNS --Drugs must pass through the CNS capillaries or be actively transported -- Lipid soluble drugs penetrate the CNS by dissolving in the membrane of

ENDOTHELIAL CELLS

-- Ionized or polar drugs cannot pass due to the TIGHT KNIT CELLS WITHOUT SLIT

JUNCTIONS!

Capillary Permeability and Drug Distribution - CORRECT ANSWER: • Capillary

permeability • capillary structure & chemical nature of the drug

• Variance in capillary structure: slit junctions between

endothelial cells (liver and pancreas have this) • Allows passage of plasma proteins... and thus, drug molecules • Absent in the brain- "blood-brain barrier"

Clinical Implications of Plasma Protein Binding - CORRECT ANSWER: Drug

displacement from albumin substantial source of drug interactions.....• Class I drug - warfarin • Highly protein bound - small fraction of free drug in plasma ↓ • Class II drug given - sulfa • Displaces warfarin from albumin • Rapid rise in free drug concentration • Increased therapeutic effect- toxic effect 1 / 2

Competition for Plasma Protein Binding: Class I (most drugs) - CORRECT ANSWER: - Low dose/capacity ratio -Amount of drug < albumin binding capacity -number of binding sites > available drug

Competition for Plasma Protein Binding: Class II (minority of drugs) - CORRECT

ANSWER: -High dose/capacity ratio

-Amount of drug > albumin binding capacity -High proportion of drug in "free" state = not protein bound

Describe the 5 stages of CKD - CORRECT ANSWER: Stage 1: Kidney Damage with NL GFR >90

Stage 2: Kidney Damage with mild decrease GFR 60-89

Stage 3: Moderate decrease GFR 30-59

Stage 4: Severe decrease GFR 15-29

Stage 5: Kidney Failure GFR < 15 (or on dialysis)

Chronic Kidney Disease is either Kidney Damage or GFR < 60 for > 3 months

Distribution - CORRECT ANSWER: agent leaves the bloodstream and distributes to

interstitial and intracellular fluids

Drug Absorption - CORRECT ANSWER: Drugs are typically weak acids or weak bases

Role and size of MOLECULAR WEIGHT in drug absorption

Drug Displacement and Vd - CORRECT ANSWER: --Dependent on Vd and therapeutic

index of drug --Large Vd verses small Vd (drug is less around)

Drug Distribution--Blood Flow - CORRECT ANSWER: Wide variance r/t unequal

distribution of Cardiac Output (CO)

- Highest in orgCORRECT ANSWER: heart, brain, lungs, kidneys, liver, gut

-Lower in skeletal muscle _Still lower in adipose tissue

Drug Metabolism -- Zero Order Kinetics (minority of drugs) - CORRECT ANSWER:

ASA, Ethanol, Phenytoin Rate of metabolism is constant OVER TIME---therefore a CONSTANT AMOUNT of drug is metabolized per unit of TIME

--HAS A STRAIGHT ELIMINATION LINE ON GRAPH

Drug Metabolism-First Order Kinetics (most drugs) - CORRECT ANSWER: --Metabolic

transformation of drugs by enzymes --Rate of drug metabolism is directly proportional to the concentration of free drug--so CONSTANT FRACTION of drug per unit of time is eliminated --Linear elimination pattern: reflected by 1/2 life of the drug

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