Nursing Pharmacology

85 cards

from the introduction to administration of medications. Medications' mechanism of action, classes of medications, some anatomy and physiology. Adverse side effects, therapeutic uses, etc.


 
  
Created Feb 4, 2008
by
sdavis107

 

 
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1
State the three most important characteristics of any drug.
 
Effectiveness, safety, and selectivity
2
Is it possible to have a selective drug?
 
No, all drugs can cause side effects
3
Define pharmacokinetics:
 
how much of the drug gets to the site of action via Absorption, distribution, metabolism, and...
4
Define pharmacodynamics.
 
Determines nature and intensity of the response after binding to receptors
5
Who is the most likely member of the health care team to observe and evaluate drug responses...
 
the nurse
6
What are the three basic goals of pre administration assessment of medications
 
Collecting baseline data (therapeutic and adverse responses), identify high-risk patients,...
7
State the factors that can predispose an individual to adverse reactions from drugs
 
Pathophysiology (liver and kidney dysfunction), genetics, allergies, pregnancy, age (very young/old).
8
What are measures to reduce adverse effects of medication administration?
 
Identify high-risk patients, ensure proper administration, educate patients that might precipitate...
9
Which Amendment strengthened drug regulation after the thalidomide tragedy in Europe?
 
The Harris-Kefauver Amendments in response to a sedative that caused the birth defect phocomelia).
10
What type of research is required to assess drug therapies?
 
Randomized controlled trials
11
What is a “blinded” study?
 
People involved do not know to which group subjects have been randomized. Single: subjects...
12
What is the purpose of having a trade name for a drug?
 
Easy recall and pronunciation
13
What is the problem with trade names?
 
Clouds communication of the drug and promotes medication errors.
14
What are the limitations of the testing procedures used to bring drugs to market?
 
Testing is limited on women of childbearing age and children and the failure to detect all...
15
How much does it cost to develop a new drug in the US?
 
$800 million
16
State the four basic pharmacokinetic processes.
 
Absorption, distribution, metabolism, excretion
17
Highly lipid-soluble drugs are absorbed more (rapidly or slowly) than drugs whose lipid solubility...
 
rapidly
18
Define the term parenteral.
 
Outside of the GI tract (sub-Q, IV, IM)
19
At what rate should (intravenous) IV drugs be administered?
 
Over 1 minute or more
20
How long does it take an IV drug injected in the anti-cubital space to reach the brain?
 
15 secs
21
What are depot preparations?
 
Releases drugs slowly and steadily (EC, SR, ER)
22
What types of compounds pass freely from the maternal bloodstream into the blood of the fetus?...
 
Lipid-soluble, non-ionized
23
What kinds of compounds do not pass freely across the placenta?
 
Ionized, protein bound, highly polar compounds
24
What can occur when two highly protein bound drugs are given together?
 
Faster metabolism of one or both of the drugs
25
Give an example of a drug that is highly bound to protein.
 
Warfarin (Coumadin)
26
Drugs that are highly bound to protein may exhibit_____ levels in the blood when the patient...
 
Decreased
27
Define biotransformation.
 
metabolism
28
Where does most drug biotransformation (metabolism) occur?
 
liver
29
If two drugs are given that both utilize p450 hepatic microsomal system, the drug level in...
 
decreases
30
At what age does hepatic maturation occur?
 
1 years old
31
Drug metabolizing capacity in infants is (decreased or increased)?
 
decreased
32
How is the first-pass effect circumvented?
 
Parental administration
33
Define therapeutic range
 
Between the minimal effective concentration and toxicity
34
What aspect of pharmacokinetics primarily affects patients with kidney disease?
 
excretion
35
A drug with a narrow therapeutic range is (more or less) dangerous
 
more
36
Define drug half-life.
 
The time required for amount of drug in the body to decrease by ½
37
How many half lives does it take for a drug to reach plateau?
 
4 half-lives
38
Drugs that have a long half-life need to be administered (more or less) frequently than drugs...
 
less
39
Agonists are molecules that (prevent or activate) receptor response?
 
Activate
40
Antagonists (activate or prevent) receptor activation?
 
prevent
41
Drugs that mimic the body’s own regulatory molecules are called
 
agonist
42
Define down-regulation and give an example of a medication that may lead to this effect.
 
When a receptor has become less responsive to agonist Narcotics have that affect.
43
Define ED-50
 
average effective dose
44
What is the therapeutic index?
 
Measure of a drug’s safety, a ratio of lethal dose/effective dose averages
45
A drug with a high therapeutic index is considered (safe, or unsafe)?
 
safe
46
Laxatives (reduce or increase) absorption?
 
reduce
47
Drugs that depress peristalsis (reduce or increase) absorption?
 
morphine and atropine
48
When an inducing drug (phenobarbital) is taken with another medication, the metabolism of the...
 
increased
49
Accelerated metabolism would lead to (increased or decreased) levels of the other drug?
 
decreased
50
(More or less) of the other medication would be needed?
 
more to maintain blood levels
51
Grapefruit juice can (inhibit or induce) the metabolism of certain drugs, thereby (raising...
 
inhibit, raising
52
What are the potential consequences when calcium channel blockers are taken with grapefruit...
 
More intense effects on the blood pressure causing hypotension, tachycardia, headache, and...
53
How would you administer a drug “on an empty stomach”?
 
1 hr before or 2 hrs after a meal
54
Patients over what age account for greater than 50% of adverse drug reactions (ADRs)?
 
60
55
When do side effects usually occur?
 
Soon after onset of drug use
56
Can an allergic reaction occur without prior sensitization?
 
no
57
Define an idiosyncratic effect from a drug and give an example.
 
Uncommon response resulting from a genetic predisposition
58
Define anaphylaxis
 
A life threatening response characterized by brochospasm, laryngeal edema, and drop in blood...
59
Why is abrupt discontinuation of a medication discouraged?
 
physical dependence, and the withdrawal symptoms can be harmful if not fatal.
60
What is the potential consequence of a medication that prolongs the QT interval?
 
causing serious dysrhythmias
61
Why are women at more risk for QT prolongation?
 
Because their normal QT interval is longer than those in men.
62
What is the most common cause of acute liver failure and hepatotoxicity?
 
medications
63
Define teratogenic.
 
Drug-induced birth defect
64
Define iatrogenic
 
Disease produced by drugs
65
What are the three most common causes of fatal medication errors?
 
Human factors, miscommunication mistakes, and name confusion
66
Why are the elderly more sensitive to drugs?
 
Organ degeneration, hypersensitivity, severity of illness, polypharmacy, multiple pathologies....
67
A patient with kidney or liver disease would require (higher or lower) dosages of a medicine?...
 
lower
68
Define bioavailability
 
Ability of a drug to reach circulation from site of administration
69
Define the placebo effect.
 
Component of drug response caused by psychological facts
70
Define tachyphylaxis
 
Form of tolerance caused by repeated doses of a short time frame (Nitro patch)
71
Define tolerance
 
Decreased responsiveness to a drug, resulting from repeated drug administration.
72
A patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency that takes aspirin or a...
 
Hemolysis or destruction of red blood cells
73
During pregnancy, increased renal blood flow leads to accelerated excretion of drugs. This...
 
increase
74
What class of blood pressure medication should not be taken during pregnancy?
 
ACE-inhibitors
75
Which FDA pregnancy risk category shows risk of fetal harm in women or animals whereby the...
 
Category X
76
Which antibiotics should not be taken during pregnancy?
 
Tetracycline
77
When is the best time to take a medication if breast feeding?
 
After breastfeeding to reduce concentrations in the next feeding
78
A neonate is defined as (less than or greater than) 4 weeks of age?
 
less than
79
Protein or albumin is (higher or lower) in and infant which might lead to_____ levels of a...
 
lower, decreased
80
Hepatic metabolism and renal excretion in infants is (high or low)?
 
Low in the beginning; newborn and through mid infancy, but reaches maturation by one year....
81
Why are neonates especially sensitive to drugs that affect the CNS
 
The blood-brain-barrier is not fully developed
82
The rate of drug absorption in the elderly is (slow or accelerated)?
 
Slow because of delayed gastric emptying or reduced blood flow. (96)
83
Drugs last longer in the elderly due to (decreased or increased) liver function
 
Decreased, which causes longer ½ lives and decreased metabolism.
84
What is creatinine clearance and why is it important in the elderly?
 
It’s the proper index to assess renal function. This is important to assess because some...
85
What is the Beers criteria?
 
Not needed, has a narrow therapeutic range, slowly excreted, and exclusively excreted through...

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