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NUR 622 Advanced Pharmacology: Exam Questions and Answers, Exams of Pharmacology

A comprehensive set of questions and answers covering key concepts in advanced pharmacology, specifically focusing on beta-2 adrenergic agonists, pharmacokinetics, pharmacodynamics, and antibiotic use in surgical procedures. it's valuable for students preparing for exams in advanced pharmacology courses, offering detailed explanations and clinical applications of pharmacological principles. The questions delve into drug mechanisms, absorption, distribution, metabolism, excretion, and therapeutic implications, making it a useful study resource.

Typology: Exams

2024/2025

Available from 04/23/2025

LennieDavis
LennieDavis šŸ‡ŗšŸ‡ø

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NUR 622 ADVANCED PHARMACOLOGY
NUR 622 ADVANCED PHARMACOLOGY FINAL EXAM
2025 VERIFIED QUESTIONS AND ANSWERS GRADED
A+
What is the preferred treatment of acute asthma episodes and prevention of
exercise induced asthma?
beta 2 adrenergic agonists
How are beta 2 adrenergic agonist agents divided? (duration of action)
intermediate action (3-6 hours)
long acting (>12 hours)
What is used in COPD patients to improve air flow and exercise tolerance?
beta 2 adrenergic agonists
Why does the beta 2 adrenergic agonist, salmeterol, have such a long duration of
action?
it is highly lipophilic and has a high affinity for the beta 2 receptor because of a
side chain that binds to the beta 2 receptor
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NUR 622 ADVANCED PHARMACOLOGY FINAL EXAM

2025 VERIFIED QUESTIONS AND ANSWERS GRADED

A+

What is the preferred treatment of acute asthma episodes and prevention of exercise induced asthma?

beta 2 adrenergic agonists

How are beta 2 adrenergic agonist agents divided? (duration of action)

intermediate action (3-6 hours)

long acting (>12 hours)

What is used in COPD patients to improve air flow and exercise tolerance?

beta 2 adrenergic agonists

Why does the beta 2 adrenergic agonist, salmeterol, have such a long duration of action?

it is highly lipophilic and has a high affinity for the beta 2 receptor because of a side chain that binds to the beta 2 receptor

How can beta 2 adrenergic agonists cause tachycardia?

peripheral vasodilation and cardiac stimulation (the heart does contain some beta 2 receptors but not many. the tachycardia is mainly caused by the vasodilation and reflex tachycardia)

What is another use for beta 2 adrenergic agonists besides treatment for respiratory issues?

continuous infusions of these drugs can stop premature labor (tocolytics)

What are the routes of administration for beta 2 adrenergic agonists?

PO, inhalation, SQ, IV

inhaled is preferred due to side effects and as effective as parenteral route

What percentage of the drug dose of a beta 2 adrenergic agonist actually reaches the lungs when given via metered-dose inhaler?

12%

If given via nebulizer, how much more of a beta 2 adrenergic agonist would you need to produce the same degree of bronchodilation as with a metered-dose inhaler?

Define pharmacokinetics.

Study of how drug concentrations change as it moves through the body (what is the body doing to the drug?)

Define pharmacodynamics.

Study of how the drug is exerting its effect on the body (receptor interactions, potency, etc)

What is absorption?

process of the drug entering the systemic circulation

What is distribution?

the process of the drug being circulated/disseminated through the body

True or False. Route of administration affects drug absorption.

true

A drug moving from the vasculature to the extravascular space is part of what aspect of pharmacokinetics?

distribution

What is biotransformation performed by?

enzymes

What is occuring when molecules are added to a drug to make it more polar to enhance removal from the body?

metabolism

Define pharmacobiophysics.

The drug's concentration in the plasma and the effect site

What is concerned with the effect site concentration and clinical effect?

pharmacodynamics

What is concerned with the plasma concentration and effect site concentration?

pharmacobiophysics

liver or kidney disease

What predicts the speed of recovery when discontinuing an infusion?

context-sensitive half time

What dose is calculated by: peak concentration x Vd / bioavailability?

loading dose

What dose is calculated by: peak concentration x clearance / bioavailability?

maintenance dose (give drug at same rate is it excreted)

When giving a loading dose followed by a maintenance dose in a renal impaired patient, which dose should be changed?

maintenance should be lowered, loading stays the same

What two things does volume of distribution (Vd) assume?

the drug distributes instantly

elimination does not occur before it is distributed

True or false. The more soluble a drug is and the more it binds to peripheral tissues, the larger the Vd.

true

What are causes of a small Vd?

high protein binding and ionization

What are causes of a large Vd?

high solubility and binding in tissues other than plasma

True or False. Protein-bound drugs have an exaggerated effect.

False, they are inactive (only free drugs are active)

What is the ultimate bioavailability of a drug?

amount of drug actually used

benzodiazepines

What drugs inhibit hepatic enzymes which metabolize drugs?

antibiotics

cimetidine

If plasma concentration is increased, clearence is _____?

decreased

What part of a drug is usually active? (ionized or nonionized)

nonionized

A weak base is more or less ionized at a lower pH?

more ionized

When is steady state achieved?

after 5 half times

Clearance is indirectly proportional to what?

half life and drug concentration

Clearance is directly proportional to what?

blood flow to clearing organ and drug dose

What is zero order kinetics?

constant elimination of a drug at a set rate

What is first order kinetics?

dependent on concentration (more drug we have, the higher the elimination

What does alpha distribution describe?

drug distribution from the plasma to the tissues

When does beta distribution begin?

begins as plasma concentration falls below tissue concentration

Although most are used as racemic mixtures in clinical practice

What is the bioavailability of IV drugs?

1; all of the drug is available

If drug concentration in central compartment is increased, then clearance is?

decreased

What is minimum inhibitory concentration of antibiotics?

the lowest concentration of a given antimicrobial at which an organism's growth is inhibited.

When must prophylactic antibiotics be given? Discontinued?

within 1 hour of incision

stop within 24 hours after surgery completed

In seriously ill or immunocompromized patients, should bactericidal or bacteriostatic agents be used?

bactericidal

Why should narrow-spectrum be the first choice rather than broad-spectrum antibiotics?

to preserve normal flora

Using less than the recommended dose is only acceptable in what two conditions?

renal or hepatic dysfunction

What percentage of surgical cases are complicated by infections?

1-5%

Why are cephalosporins the choice for surgical procedures in which the skin flora and normal flora of the GI/GU tract are the most likely pathogens?

broad spectrum and low incidence of side effects

Do preop steroids for PONV effect infection rates?

no

Good glucose control decreases the incidence of deep sternal infections in CV surgery populations by how much?

50% (continuous insulin better than intermittent)

How long before surgery should smokers attempt to stop to achieve a 50% reduced risk of postop infection?

4-8 weeks

When should re-dosing occur in procedures lasting longer than 4 hours or when large blood loss occurs?

every 1-2 half lives of the antibiotic (in patients with normal renal function)

What is the most common cause of bacteremia and fungemia in the hospital?

IV catheters

How is oral absorption in the elderly altered?

decreased gastic pH

reduced GI motility

How is distribution altered in the elderly?

increased total body fat

decreased albumin

How is metabolism altered in the elderly?

decreased hepatic flow

How is excretion altered in the elderly?

decreased GFR

In elderly patients with normal serum creatinine levels, what two antibiotics need dosing adjustments, what two antibiotics do not according to the examples given?

penicillins and cephalosporins do not need adjusting due to large therapeutic index

aminoglycosides and vancomycin might need adjusting

What is the chance of a patient with a penacillin allergy having an allergic reaction to cephalosporin?

1% (however, giving cephalosporins to patients with a positive penacillin skin test is not recommended)

What replacement antibiotics should be given to patients with documented IgE- mediated anaphylactic reactions?

clindamycin and vancomycin (vanc also given when MRSA likely)

What is the drug of choice for pneumococcal, streptococcal, and meningococcal infections?

penicillins

What two agents are susceptible to beta lactamases and are ineffective against most staph aureas strains?

Penicillin G and V

Transient bacteremia is very common in what type of procedures?

dental

How much K+ does 10 million units of PCN G have?

16 mEq (this is significant in patients with renal dysfunction as neurotoxicity and hyperkalemia possible)

Instead of giving aqueous PCN G, given sodium salt of PCN G or similar drug like ampicillin

Why is intrathecal penicillin forbidden?

potent convulsant

arachnoiditis and encephalopathy

True or False. Penicillin can be mixed into an antibiotic cocktail.

False

What drug competitively inhibits renal excretion of some drugs and is used in the tx of gout?

Probenecid

How much of an IM penicillin dose is excreted within the first hour?