Adv. Pharm NURS 8024 Week 1 Latest Update 2024-2025 Actual Exam 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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