NRNP 6566 week 1 to 5
Week 1
1. Describe the cytochrome P450 system. Describe how inducers and inhibitors affect the
cytochrome system and how that affects the half-life of medications.
a. Cytochrome p450 system is a
...
NRNP 6566 week 1 to 5
Week 1
1. Describe the cytochrome P450 system. Describe how inducers and inhibitors affect the
cytochrome system and how that affects the half-life of medications.
a. Cytochrome p450 system is a series of enzymes used to metabolize medications.
b. Drugs that cause CYP450 metabolic drug interactions are referred to as either inhibitors
or inducers. Inducers increase CYP450 enzyme activity by increasing enzyme
synthesis
c. Inhibitors block the metabolic activity of one or more CYP450 enzymes
2. Describe the affect on low and high albumin levels on active drug levels especially for drugs
that are highly protein bound.
a. Albumin is the plasma protein with the greatest capacity for binding drugs.
i. Binding to plasma proteins affects drug distribution into tissues, because only
drug that is not bound is available to penetrate tissues, bind to receptors, and
exert activity. As free drug leaves the bloodstream, more bound drug is released
from binding sites.
b. Highly protein bound drugs, low albumin levels (w/ malnutrition, or chronic illness) may
lead to toxicity because there are fewer than the normal sites for the drug to bind
3. Describe ways to lessen the hepatic first pass effect: metabolism during first pass through the
liver
a. Alternative routes (suppository, intravenous, intramuscular, inhalational aerosol,
transdermal, and sublingual) avoid the first-pass effect allow drugs to be absorbed
directly into the systemic circulation
4. Be able to calculate creatinine clearance using the Cockgraft Gault equiation:
a. Male = ([140-age] × weight in kg)/(serum creatinine × 72)
b. Female = CrCl (male) × 0.85
5. Describe what determines the frequency of drug administration:
a. Drug half-life, plasma concentration
6. Be familiar with the Beers criteria and how t
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