Test 1- LP 1
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| What drug form is most rapidly absorbed from the GI tract? | Suspension
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| Enteric coated tablets are absorbed from | Intestines
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| What effect does food usually have on dissolution and absorption? | Interferes with
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| What is the sequence of the four pharmacological processes? | Absorption, distribution, metabolism, excretion
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| Drugs that pass through the GI membrane include: (2) | Lipid soluble and non-ionized drugs
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| What four factors most commonly affect drug action? | Poor circulation, hunger, stress and BMI
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| What is the major site of drug metabolism? | The liver
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| What route of absorption has the greatest bioavailability? | Intravenous
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| The serum half-life of a drug is the time required | After absorption for half of the drug to be eliminated
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| Drugs with a half-life of 24-30 hours would probably be administered on a dose schedule of | Once a day
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| For elimination through the kidneys to be possible a drug must be | Water soluble
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| The biological activity of a drug is determined by the | Fit of the drug at the receptor site
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| Drugs that prevent or inhibit a response are known as | Antagonists
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| A receptor located in different parts of the body may initiate a variety of responses depending on anatomic site. The receptor is considered | Non selective
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| The valid indicator that measures the margin of safety of the drug is called | Therapeutic index
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| After drug administration, the highest plasma/serum concentration of a drug at a particular time is called | Peak level
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| What are the five rights of drug administration? | Patient, drug, dose, route, time
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| When you calculate the dosage for a client, you note that the dose is a “large dose”. What would be the best action? | Call the health care provider
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| The preferred way to correct a charting error is to | Draw a single line through the incorrect information and initial it
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| If you client is not wearing an ID band, what would be your first nursing action? | Report your finding and have a new ID band put on client
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| Should you administer drugs poured by others? | No
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| Should you administer drugs that clients states are different from usual | No. First verify that it is indeed same drug.
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| Should you administer drugs that were transferred from one container | No
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| What three factors affect a client’s compliance with med prescriptions? | Beliefs, living conditions, cultural values
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| Physiological effects not related to the desired effect that can be predictable or associated with the use of drug are called | Side effects
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| When an immediate drug response is desired, a large initial dose is given rapidly to achieve an MEC in the plasma. This is called the | Loading dose
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| The study of drugs (chemicals) that alters functions of living organisms. | Pharmacology
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| Use of drugs to prevent, diagnose, or treat signs, symptoms and disease processes. | Pharmacotherapy
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| Effects: act mainly at site of application | Local
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| Effects: taken into the body to sites of action in various body tissues | Systemic
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| The study of drug actions on target cells and the resulting reaction in the body. | Pharmacodynamics
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| The study of the movement of the drug through the body absorption, distribution, biotransformation, and excretion of drugs | Pharmacokinetics
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| What are the two pharmaceutic phases? | Disintegration and dissolution
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| How fast disintegraton and dissolution limits the rate at which drug can be absorbed is called | Rate limiting
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| Dissoution and disintegration happen faster in what type of environment? | Acidic stomach environment
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| What is the purpose of an enteric coated medication? | Used for medications tha cause stomach upset, these disolve in the small intestine instead of stomach. Should not be crushed or chewed.
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| What process determines how much of an administered dose will reach its sites of action? | Pharmacokinetic processes
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| What are the four major processes of pharmokinetics? | Absorption, Distribution, Metabolism, Excretion
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| Pharmokinectics is what the ____ does to the _____. | Body, drug
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| The movement of a drug from its site of administration into the bloodstream to be circulated. | Absorption
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| What determines how soon the effects of a drug will begin? | Rate of absorption
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| What four factors influence the rate at which a drug is absorbed? | Physical and chemical properties of the drug and by physiologic and anatomic factors at the site of absorption.
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| What determines bow intense the effects will be? | The amount of absorption
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| Before absorption can occur with an oral drug, what must occur? (3) | Must be swallowed, dissolved and delivered to small intestine before absorption occurs
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| IM drugs are absorbed more rapidly due to | Muscle tissue abundant blood supply
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| Do IV meds need to be absorbed, why or why not? | No, they are injected into the bloodstream
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| What five factors affect absorption? | Rate of dissolution, surface area, blood flow, presence of food, lipid solubility
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| Drugs that have a faster dissolution will have a faster/slower onset. | Faster
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| The larger the surface area the faster/slower the drug is absorbed. | Faster
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| PO drugs are usually absorbed in the ___. | Small intestine
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| Is the surface area of the stomach considered large or small? | Small
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| Drugs are absorbed more rapidly from sites where blood flow is | High
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| Food usually ____absorption of a drug and can lead to ______. | Slows, incomplete absorption
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| Highly lipid-soluble drugs are absorbed more ____ than drugs whose lipid solubility is low because _______. | Rapidly, they can readily cross the membranes that separate them from the blood, whereas drugs of low lipid solubility cannot.
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| The movement of drugs throughout the body | Distribution
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| What three factors determine distribution | Blood flow, affinity to tissue and protein binding effects
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| As drugs are distributed in plasma, many are bound to ____ usually ____. | Protein, Albumin
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| The part of a drug that is ___ or ___ can cause a pharmacological response. | Free, active
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| The portion of drug that is bound to protein is ___ because ___, | Inactive, it’s not available to receptors
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| Can a drug that is protein bound leave the bloodstream? | No
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| Can a drug that is bound be a source of drug interactions? | Yes
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| What is the consequence on the distribution of drugs for a patient who has a low serum albumin? | It would be a concern as more drug can be available then intended
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| Metabolism is also referred to as | Biotransformation
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| The enzymatic alteration of drug structure | Metabolism
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| Where does most metabolism take place? | The liver
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| Metabolism is a major mechanisms for stopping drug ____ and eliminating _____ from the body. | Actions, drug molecules
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| Apart from the liver, what are four other sites of metabolism? | GI tract, lungs, kidney, skin
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| Initial hepatic metabolism of a drug that is absorbed from the GI tract, before it reaches systemic circulation | First Pass Effect
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| If a drug is inactivated in the liver, what becomes of it? | Nothing, it is rendered useless
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| This drug is initially inactive and exerts no pharmacologic effects until metabolized by the liver. | Prodrugs
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| Drug metabolizing enzymes in liver | Microsomal enzymes
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| “Bring out” microsomal enzymes and will influence metabolism of a second drug. | Enzyme inducers
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| What happens when drugs compete for the same metabolic pathway in the liver? | Toxic effect
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| The removal of drugs | Excretion
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| What accounts for the majority of drug excretion? | Kidneys
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| When healthy, kidneys serve to ___the duration of action of many drugs. If renal failure occurs, both the ___ and ___ of drug responses may be ___. | Limit, duration, intensity , increased
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| What are examples of non-renal routes of excretion? | Breast milk, bile, lungs, sweat, saliva
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| Drugs that are ____ will have ready access to breast milk. | Lipid soluble
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| Will drugs that are polar, ionized or protein bound enter breast milk? | No
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| Drugs entering the intestine in bile may undergo ___ into the portal blood. Can ___ a drug’s time in the body | Reabsorption, prolong
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| Through what route are volatile anesthetics excreted? | Lungs
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| The plasma drug level below which therapeutic effects will not occur. | Minimum effective concentration (MEC
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| The drug level at which toxicity begins to occur. | Minimum toxic concentration (MTC)
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| Occurs when plasma drug levels climb too high | Toxic concentration
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| The range in which a medication can be given to produce a desired effect | Therapeutic range
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| The objective of drug dosing is to maintain plasma drug levels within the | Therapeutic range
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| Defined as the time it takes for a drug to elicit a therapeutic effect (sometimes called the minimum effective concentration or MEC). | Onset of action
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| Defined as the time when the drug reaches its highest blood or plasma concentration and maximum therapeutic response. | Peak action
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| Defined as the length of time the drug has a pharmacological effect | Duration of action
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| This is defined as the maintaining of a steady concentration in the blood. It takes 4 to 5 half-lives to achieve. It results in a constant amount of medication in the body and a consistent therapeutic effect. | Plateau or steady-state concentration
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| High & low concentrations of medications in the body | Peak & Trough
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| The margin of safety of a drug | Index
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| The concentration of the drug in plasma needed for obtaining the desired drug action and having few, if any, toxic effects. | Window
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| A large initial dose of a medication given to achieve a rapid minimum effective concentration. | Loading Dose
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| The time required for the amount of drug in the body to decrease by 50%. Tells us that no matter how much drug is given, 50% will leave during a specified time | Serum Half-life
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| When drug administration is discontinued, most of the drug in the body will be eliminated over an interval equal to __ half-lives. | Five
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| When a drug is started, ___ half-lives elapse before the drug reaches a steady state. | Three to five
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| If a client has kidney or liver dysfunction, half-life is ____: therefore more chance for ____. Client either needs to take the drug ___, or take ___ of the drug. | Prolonged, toxicity, less often, less
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| Defined as the study of the biochemical and physiologic effects of drugs and the molecular mechanisms by which those effects are produced. | Pharmacodynamics
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| Pharmodynamics is the study of what ____ do to the ____ and how they ____. | Drugs, body, do it
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| The special chemicals in the body that drugs interact with to produce effects. | Receptors
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| Many___ components are considered drug receptors but receptor usually means the body’s ___ & _____. | Cellular, neurotransmitters, hormones
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| Receptors are turned on by interaction with other______. | Molecules
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| When a drug binds to a receptor, it ____ or _____ actions. | Mimics or blocks
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| By binding to a receptor, the drug either ___ or ____ the rate of the physiologic activity normally controlled by that receptor | Increases, decreases
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| What are three examples of neurotransmitter receptors? | Norepinephrine, dopamine, acetylcholine
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| What are three examples of hormone receptors? | Progesterone, insulin, thyrotropin)
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| Molecules that activate receptors | Agonists
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| _____ and ______ are considered agonists. | Neurotransmitters hormones
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| When is a drug considered an agonist? | When they bind to receptors & mimic the action of these neurotransmitters or hormones
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| What is the difference between a strong and weak agonist? | The drug agonist that has an exact fit is a strong agonist and is more biologically active than the weak agonist
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| Inhibit cell function by occupying receptor sites | Antagonist
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| How do antagonists produce their effects? | By preventing receptor activation
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| Undesirable effects that are expected or anticipated to occur in a predictable percentage of people who receive the drug | Side effect
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| Any unexpected, unintended, undesired, or excessive response to a medication. | Adverse drug reaction
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| Occur when the drug exceeds therapeutic range, and causes potentially harmful effects. | Toxic effects
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| Given to drugs that may cause serious or life-threatening adverse effects. | Black Box Warning (BBW)
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| Manufacturer required to have special labeling describing these possible adverse effects. Strongest warning from the FDA. | Black Box Warning (BBW)
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| A BBW contains what two types of information? | Prescribing and monitor information
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| What are two types of drugs that have a BBW? | Antidepressants, nonopiods
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| The body mounts an immune defense to drug; this defense usually requires more than one exposure | Drug allergies
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| What are three typical allergies from drugs? | Rash, hives, itching
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| What is a severe allergic reaction with airway obstruction and circulatory collapse? Common example? | Anaphylaxis, penicillin allergy
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| An uncommon, unexpected reaction to the drug by an individual | Idiosyncratic reactions to drugs
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| What are idiosyncratic reactions to drugs attributed to? | Genetic characteristics of that person
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| A sedating drug makes a client feel “wired”; or does nothing at all. This is an example of | Idiosyncratic reactions to drugs
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| Term used to describe harmful, deforming effects of drugs on the fetus. | Teratogenic
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| What is an example of a teratogenic drug? | thalidomide from 1960’s
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| What has the FDA done to combat teratogenic effects of drugs? | Food and Drug Administration assigns pregnancy categories to drugs, A, B, C, D, X, with A the safest, X the least safe
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| _____ name is what drug starts out with in research: often long, a combination of letters and numbers | Chemical
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| ____name when first developed by manufacturer | Trade/brand
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| What is one way to differentiate between a trade and generic name? | Trade capitalized, generic not
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| Is the trade name protected by patent for a number of years? | Yes
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| ______ name is assigned when drug goes to market. Independent of the manufacturer | Generic, or non-proprietary
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| Drugs that can only be obtained by prescription are known as | Legend drugs
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| Generic drugs are more/less costly for consumer | Less
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| Do healthcare agencies buy from generic manufacturers? | Yes
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| “OTC” = | Over the counter
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| What was the result of the 1972 review by the FDA for safety or efficacy? | many drugs removed or reformulated
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| Are some legend drugs allowed over the counter after review? | Yes some are original prescription strength; some reduced
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| Do not use abbreviation ___ for unit | U
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| Do not use abbreviation ____ for international unit. | IU
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| QD and _____ are often mistaken for each other | QOD
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| “cc” is often mistaken for | Units
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| Does each facility have their own detailed list of abbreviations to avoid? | Yes
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| Resource which describe groups of drugs in relation to therapeutic uses. | Texts
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| Resource available in hospitals | AHFS Drug Information (American Society of Hospital Pharmacists
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| Resource published annually, generic and brand names as well as pictures available, not as objective | PDR
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| Where can you read about a new drug that is not yet in a published resource? | Package inserts from manufacturer
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| A non–governmental, official public standards–setting authority for prescription and over–the–counter medicines and other healthcare products manufactured or sold in the United States | United States Pharmacopoeia
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| Electronic resource | Internet-based files for PDA or handheld
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| What are examples of nurse friendly resources on drugs? (4) | Nurses drug handbooks, Micromedex, ADU, pharmacist
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| A client’s response to meds may vary based on what five things? | Age, gender, body weight, surface area, metabolic rate.
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| How does age impact the response of meds? Infants carry more______, the amount of albumin ____ as we age, women and _____ have more fat. | water, decreases, elderly
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| Hoe does gender impact the response of meds? | Different ratio of fat to muscle
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| What is a consideration for someone who is pregnant and taking drugs? | Drugs cross the placenta and may harm the fetus
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| What is a consideration for a child up to age 1? | organ system not fully functioning
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| What is a consideration for ages 1-12? | drugs are more rapidly metabolized and eliminated
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| When do you dose according to body weight? | Typically a larger dose is given. A heavier person needs a larger dose.
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| Explain the geriatric consideration in relation to the GI tract. | They have decreased gastric activity, blood flow and motility but these factors have little effect on absorption
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| Explain the geriatric consideration in relation to liver function. | Blood flow and metabolic enzymes are decreased, drugs take longer to act and stay n body longer
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| Explain the geriatric consideration in relation to cardiovascular function. | Cardiac output is decreased so distriution, metabolism and excretion is slowed
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| Explain the geriatric consideration in relation to acute and chronic illness. | If patient is using multiple drugs there is a greater chance for drug interctions and diseased organs mutiply
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| The perceived effect a placebo has on ones belief about their condition. | Placebo effect
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| Time of ______can be critical to response. | Administration
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| A person's reaction to a drug decreases so an increased dose is needed to achieve the same effect. | Tolerance
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| What three things should we teach clients about the specific drug they have been prescribed? | Actions, side effects precautions
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