BEST ANSWERS NRNP 6566 Midterm Exam Review 2024, 2026 EXAM WITH100 Percent VERIFIED SOLUTIONS

QUESTIONS AND ANSWERS Describe the cytochrome P4 50 system Cytochromes P450 CYPSRA super family Vinson's containing hit me as a cofactor the function as monooxygenases. In mammals, these proteins oxidize steroids, fatty acids, and xenobiotics, and are important for the clearance of various compounds, as well as for hormone synthesis and break down. Cytochrome P4 502C inhibitors Fluoxetine, sertraline, and fluVoxamin Mnemonic to remember common cytochrome P4 50 inhibitors SICK-FACES Sodium valproate ISoniazid cimetidine Ketoconazole Fluconazole Alcohol and grapefruit juice Chloramphenicol Erythromycin Describe the effect on low and high albumin levels on active drug levels especially for the drugs that are highly protein bound Some drugs have a higher affinity for protein binding and with low albumin levels that may cause toxicity. The drug with the greatest affinity for albumin will bind and it's not to disrupt in ratio afraid about drug for the second medication as a result of the second medication will be more available to distribute to the site of action and potentially cause side effects. Describe ways to lessen the hepatic first pass effect Some drugs such as propanolol undergo significant metabolism during a single passage to deliver. This is called the first pass effect. When drugs are highly susceptible to the first pass effect the oral dose needed to cause a response will be significantly higher than the intervenous dose used to cause the same response. Alternative routes administration such a suppository, Iv, IM, inhalation, transdermal, or sublingual, avoid the first pass effect because they allow drugs to be slowly absorbed into systemic circulation. Cockgraft gualt equation male (140-age) x (wt in KG) /(serum creatine x 72) Cockcroft equation of ckd for female (140-age) x (wt in kg) x 0.85 Platelet count, liver and renal function Describe appropriate labs and monitoring guidelines for Coumadin INR, PT APTT, XA Xa lab 2-2.5 INR of 2.0-3.0 2/3 2.5-3.5 Plavix 75 mg PO daily for at least 12 months. If necessary Plavix can we stopped at three months with a bare metal stent or six months with a drug release instead. Any surgical schedule procedure should be scheduled at least six weeks post or six months after drug releasing stent if possible possible Plasma concentration data collected is plotted against time and analyzed. This type of pharmacokinetic data, collected from average adults, is the basis for determining dose, dosing intervals, and limitations on the safe use of a drug. Follow ADME originally developed by a group headed by Dr. Mark H. Beers, listing of drugs that carry high risks for older adults and criteria for potentially inappropriate medication use in older adults Make sure you are familiar with this. Benzodiazepines are mentioned quite a bit. It is estimated that 1/5 of clients are prescribed medications that are not