Pharmacologic Principals

Why would a medication be given parenterally vs orally

100% bioavailability Pt is unable to tolerate oral Need for faster onset

A drug that delivers 300 mg has a half-life of 4 hours. How many milligrams of drug will remain in the body after 1 half life?

150 mg

The movement of a drug from its site of administration into the bloodstream for distribution to the tissues is called....

Absorption

What 4 terms are used to describe pharmacokinetics?

Absorption Distribution Metabolism Excretion

What is the term used to express the extent of drug absorption

Bioavailability

Each statement describes a phase of pharmacokinetics. Put the statements in order, with 1 indicating the phase that occurs first and 4 indicating the phase that occurs last. a) Enzymes in the liver transform the drug into an inactive metabolite. b) Drug metabolites are secreted through passive glomerular filtration into the renal tubules. c) A drug binds to the plasma protein albumin and circulated through the body. d) Drug moves from the intestinal lumen into the mesenteric blood system.

D = 1 C = 2 A = 3 B = 4

What refers to the transport of a drug by the bloodstream to its site of action? a) Absorption b) Distribution c) Metabolism d) Excretion

Distribution

When can medication errors occur?

During prescribing, dispensing, administering, and/or monitoring.

What are the 3 routes of administration?

Enteral (GI tract) Parenteral Topical

All drugs must eventually be removed from the body by ___________.

Excretion

What factors can alter the biotransformation/metabolism of a drug?

Genetics Diseases (impaired functioning of kidney, liver, heart, etc...) Concurrent use of other medications

What is the process called where a portion of a drug is chemically changed into inactive metabolites in the liver, leaving smaller amount to pass into circulation?

Hepatic first-pass

What is the primary organ responsible for elimination of drugs?

Kidneys

What enzymes inhibit or enhances drug actions?

P-450 system

What route is the faster route for absorption?

Parenteral route

Who can administer drugs injected intraarterial, intrathecal, or intraarticular?

The Physician

The time required for 50% of a given drug to be removed from the body is called...

The half-life of the drug

A positive change in a faulty physiologic system is called the ________ effect of a drug.

Therapeutic

What term refers to the ratio of a drug's toxic level to the level that provides therapeutic benefits?

Therapeutic index (low therapeutic index means the difference between toxicity and benefits is small... requires close monitoring)

Topical route involves application of medications to various body surfaces, including...Skin, eyes, ears, nose, lungs, rectum, or vagina. True or False

True. All of said body surfaces are topical. Skin, eyes, ears, nose, lungs, rectum, or vagina

What therapy involves intensive drug treatment and is implemented in the acutely ill or even critically ill to sustain life or treat disease? a) Acute therapy b) Maintenance therapy c) Supplemental therapy d) Palliative therapy e) Supportive therapy f) prophylactic therapy

a) Acute therapy

The nurse understands that drugs exert their actions on the body by what process? (Select all that apply.) a) Altering metabolic chemical processes b) Interacting with receptors c) Making the cell perform a new function d) Inhibiting the action of a specific enzyme

a) Altering metabolic chemical processes b) Interacting with receptors d) Inhibiting the action of a specific enzyme

The nurse knows that which factors will affect the absorption of orally administered medications? (Select all that apply.) a) Form of drug preparation b) Time of day c) pH of the stomach d) Patient in high-Fowler's position e) Presence of food in the stomach

a) Form of drug preparation b) Time of day c) pH of the stomach e) Presence of food in the stomach

Which nursing action will increase the absorption of a medication administered intramuscularly (IM)? a) Massage the site after injection. b) Apply ice packs to the injection site. c) Administer the medication via the Z-track method. d) Lower the extremity below the level of the heart.

a) Massage the site after injection

A nurse reviewing a client's medical record notes a new prescription for verifying the trough levels of the client's medication. Which of the following actions should the nurse take? a) Obtain a blood specimen immediately prior to administering the next dose of medication b) Verify that the client has been taking the medication for 24 hours before obtaining a blood specimen. c) Ask the client to provide a urine specimen after the next dose of medication d) Administer the medication, and obtain a blood specimen 30 min later.

a) Obtain a blood specimen immediately prior to administering the next dose of medication

A provider prescribes phenobarbital for a client who as a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication? a) One b) Two c) Three d) Four

a) One

The time required for a drug to reach its maximum therapeutic response is called the... a) Peak effect b) Onset of action c) Trough level d) Drug effects e) Duration of action

a) Peak effect

Study that focuses on what happens to a drug from the time it enters the body until the parent drug and all metabolites are excreted? a) Pharmacokinetics b) Pharmaceutics c) Pharmacodynamics d) Pharmacotherapeutics

a) Pharmacokinetics

The nurse is reviewing the various forms of topical medications. Which of these are considered topical medications? (Select all that apply) a) Rectal ointment for hemorrhoids b) Eye drops for inflammation c) Sublingual tablet for chest pain d) Inhaled medication for asthma e) Intradermal injection for tuberculosis testing

a) Rectal ointment for hemorrhoids b) Eye drops for inflammation d) Inhaled medication for asthma

What is the term for ratio between a drug's therapeutic effects and toxic effects? a) Therapeutic index b) Cumulative effect c) Affinity d) Tolerance

a) Therapeutic index

A patient has just received a prescription for an enteric-coated stool softener. When teaching the patient, the nurse should include which statements? (Select all that apply) a) "Take the tablet with 2 to 3 ounces of orange juice." b) "Be sure to drink 6 to 8 ounces of water with the tablet." c) "Avoid taking all other medications with any enteric-coated tablets." d) "Crush the tablet before swallowing if you have problems with swallowing." e) "Be sure to swallow the tablet whole without chewing it."

b) "Be sure to drink 6 to 8 ounces of water with the tablet." e) "Be sure to swallow the tablet whole without chewing it."

A nurse is preparing to administer eye drops to a client. Which of the following actions should the nurse take? (Select all that apply) a) Have the client lie on one side b) Ask the client to look up at the ceiling c) Tell the client to blink when the drops enter the eye. d) Drop the medication into the client's conjunctival sac. e) Instruct the client to close the eye gently after instillation

b) Ask the client to look up at the ceiling. d) Drop the medication into the client's conjunctival sac. e) Instruct the client to close the eye gently after instillation

An elderly woman took a prescription medicine to help her to sleep however, she felt restless all night and did not sleep at all. The nurse recognizes that this woman has experienced which type of reaction or effect? a) Allergic reaction b) Idiosyncratic reaction c) Mutagenic effect d) Synergistic effect

b) Idiosyncratic reaction

A patient who has hypertension is now taking a daily beta blocker. Which term best describes this type of therapy? a) Palliative therapy b) Maintenance therapy c) Supportive therapy d) Supplemental therapy

b) Maintenance therapy

The time required for the drug to elicit a therapeutic response is called the... a) Peak effect b) Onset of action c) Trough level d) Drug effects e) Duration of action

b) Onset of action

The science of dosage form design is called...(dosage form determines the rate at which drug dissolution and absorption occur) a) Pharmacokinetics b) Pharmaceutics c) Pharmacodynamics d) Pharmacotherapeutics

b) Pharmaceutics

What is the study of physiochemical properties of drugs and how they influence the body called? a) Pharmacokinetics b) Pharmacodynamics c) Pharmacology d) Pharmacotherapeutics

b) Pharmacodynamics

Which statement best describes pharmacokinetics? a) Converts medication into its active chemical substance b) What the body does to the drug after it is administered c) Physiologic interaction between a drug and body cells d) Adverse effects and toxic reactions to medications

b) What the body does to the drug after it is administered

Drug's half-life is defined as the amount of time required for 50% of a drug to a) exert a response. b) be eliminated by the body. c) be absorbed by the body. d) reach a therapeutic level.

b) be eliminated by the body

What therapy does not eradicate problems the patient may already have but will prevent progression of a disease or chronic condition? a) Acute therapy b) Maintenance therapy c) Supplemental therapy d) Palliative therapy e) Supportive therapy f) prophylactic therapy

b) maintenance therapy

A drug given by which route is altered by the first-pass effect? a) Subcutaneous (subcut) b) Oral c) Intravenous (IV) d) Sublingual

b) oral

A patient asks the nurse why a lower dose of IV pain medication is being given than the previous oral dose. What is the nurse's best response to the patient? a) "Drugs administered intravenously enter the portal system before systemic distribution." b) "Medications given orally bypass the portal circulatory system." c) "Medications given intravenously are not affected by the first-pass effect." d) "A large percentage of an intravenously administered drug is metabolized into inactive metabolites in the liver."

c) "Medications given intravenously are not affected by the first-pass effect."

A nurse is teaching a client about transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands? a) "I will clean the site with an alcohol swab before I apply the patch." b) "I will rotate the application sites weekly." c) "I will apply the patch to an area of skin with no hair." d) "I will place the new patch on the site of the old patch."

c) 'I will apply the patch to an area of skin with no hair."

A nurse educator is reviewing medication metabolism at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (select all that apply) a) Increased renal excretion b) Increased medication-metabolizing enzymes c) Liver-Failure d) Peripheral vascular disease e) Concurrent use of medication the same pathway metabolizes

c) Liver-Failure e) Concurrent use of medication the same pathway metabolizes

The nurse is caring for a patient with cirrhosis or hepatitis, and recognizes that abnormalities in which phase of pharmacokinetics may occur in this patient? a) Absorption b) distribution c) Metabolism d) Excretion

c) Metabolism

What term is referred to as... biotransformation, involving biochemical alteration into an inactive metabolite, a soluble compound, a potent active metabolite, or less active metabolite? a) Absorption b) Distribution c) Metabolism d) Excretion

c) Metabolism

What relates to the mechanism of drug action in living tissues? a) Pharmacokinetics b) Pharmaceutics c) Pharmacodynamics d) Pharmacotherapeutics

c) Pharmacodynamics

What therapy supplies the body with a substance needed to maintain normal function, because it cannot be made by the body or is produced in insufficient quantity? a) Acute therapy b) Maintenance therapy c) Supplemental therapy d) Palliative therapy e) Supportive therapy f) prophylactic therapy

c) Supplemental therapy

What is the lowest blood level of a drug called? a) Peak effect b) Onset of action c) Trough level d) Drug effects e) Duration of action

c) Trough level

The nurse is giving medications to a patient in heart failure. The intravenous route is chosen instead of the intramuscular route. What physical function does the nurse recognize as the most influential when deciding to use the intravenous route of drug administration? a) Altered biliary function b) Increased glomerular filtration c) Reduced liver function d) Diminished circulation

d) Diminished circulation

The physiological reactions of the body to the drug is called the... a) Peak effect b) Onset of action c) Trough level d) Drug effects e) Duration of action

d) Drug effects

Patients with renal failure would most likely have problems with which pharmacokinetic process? a) Distribution b) Metabolism c) Absorption d) Excretion

d) Excretion

What therapy focuses on providing patients with relief from the symptoms, pain, and stress of a serious illness to improve quality of life for both the patient and family? a) Acute therapy b) Maintenance therapy c) Supplemental therapy d) Palliative therapy e) Supportive therapy f) prophylactic therapy

d) Palliative therapy

What defines the principles of drug actions - cellular processes that change in response to the presence of drug molecules? a) Pharmacokinetics b) Pharmaceutics c) Pharmacodynamics d) Pharmacotherapeutics

d) Pharmacotherapeutics

The length of time that the drug concentration is sufficient (without more doses) to elicit a therapeutic response is the.... a) Peak effect b) Onset of action c) Trough level d) Drug effects e) Duration of action

e) Duration of action

What therapy maintains integrity of body functions during illness or trauma recovery? a) Acute therapy b) Maintenance therapy c) Supplemental therapy d) Palliative therapy e) Supportive therapy f) prophylactic therapy

e) Supportive therapy

What therapy is provided to prevent illness or other undesirable outcome during planned events? a) Acute therapy b) Maintenance therapy c) Supplemental therapy d) Palliative therapy e) Supportive therapy f) prophylactic therapy

f) Prophylactic therapy