Patho I Final Exam (Test 4).docx - NURS 365 Pathophysiology and Pharmacology Final Exam Study GUide Comprehensive content 30 questions Pulmonary content

Patho I Final Exam (Test 4).docx - NURS 365 Pathophysiology...

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NURS 365: Pathophysiology and Pharmacology Final Exam Study GUide Comprehensive content- 30 questions + Pulmonary content- 35 questions = 65 questions Introduction to Pharmacology -2 questions Purpose of drug therapy Three MOST important properties of an ideal drug Effectiveness → has to do what it is supposed to do Safety → no completely safe drugs, side effects has to be a balance Selectivity → would produce ONLY the desired effect Pharmacokinetics Absorption movement of drug from site of administration into bloodstream Affecting factors: Rate of dissolution Absorbing surface Blood flow Stomach contents Other drugs Drug coatings/compound pH partitioning Lipid solubility of drug: lipid soluble → pass through membrane→ be absorbed Parenteral (anything but oral/not through GI tract) Intravenous (IV) → no barriers to absorption, directly in blood stream Benefits: Rapid onset Can give large amounts of fluid Dispersed and circulated quickly Problems: Cost, convenience Not reversible Infection, embolism Drugs have to be water soluble to be injected Intramuscular (IM) Absorbed through capillary wall Absorption determined by blood flow + drug solubility (~ rapid 10-30 min) Subcutaneous (SubQ) → similar to IM Blood flow not as good as IM, absorption may be slower Enteral (by mouth) Oral (PO) → via the GI tract Barriers to absorption: Epithelial cells of GI tract lining → very tightly packed Endothelial cells of capillary walls → opening between cells Factors affecting absorption: Solubility → needs to be dissolved, not ionized GI pH, gastric emptying, stomach contents, other drugs, coatings Disadvantages: Variable absorption → every person will be different
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Inactivation by food, other drugs, gastric acidity, liver Patient must be awake, alert, and needs to swallow by themselves GI upset Distribution movement of drugs through the body Affected by: blood flow, ability to exit vascular system, ability to enter cells Exit affected by: protein binding (more drug bound to protein, less available to be distributed tissues) and barriers Barriers: Blood-brain barrier → tight junctions between cells have to be lipid soluble Placental → not necessarily a barrier, not a junction Lipid soluble, nonionized drugs can pass through Metabolism alteration of the drug, enzymes Liver and kidneys Results of metabolism: Accelerated renal excretion of drugs not lipid soluble, makes more water soluble Drug inactivation (convert to inactive form) Increased therapeutic action Increased or decreased toxicity First pass effect → rapid hepatic inactivation of certain oral drugs GI tract → capillary → venous system → liver Won't get 100% of drug into the system* may need to increase dosage to account for this Excretion → drug elimination , removal of drug from the body Bile and urine Glomerular filtration → moves drugs from blood into renal tubule Passive tubular reabsorption → lipid soluble will move back into blood
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