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...
100%(5)5 out of 5 people found this document helpful
This preview shows page 1 - 3 out of 50 pages.
NURS 365: Pathophysiology and Pharmacology Final Exam Study GUideComprehensive content- 30 questions + Pulmonary content- 35 questions = 65 questionsIntroduction to Pharmacology-2 questionsPurpose 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 fromsite of administration intobloodstream ○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
○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 throughthe 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→ alterationof 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■