Intro to Pharmacology
A nurse is teaching a client about naproxen enteric-coated tablets. What statement should be included in the teaching?
"Do not crush or chew the tablet."
Which of the following circumstances will increase the rate of drug absorption for a subcutaneous injection? a. Low blood flow b. Large muscle mass c. Large surface area d. Lipid Solubility
Large muscle mass
Precaution
noted prior to administering a drug and indicate a need to implement closer monitoring after administration or the need to give a reduced dose
Trough level
point when drug is at lowest level in body
Excretion
removal of the drug or its metabolites through the kidneys, GI tract, skin, or lungs
Generic drug name characteristics
safest way to refer to a drug not capitalized name given by the company that developed the drug
A nurse is teaching a client about the adverse effects of digoxin. What statement should the nurse include in the teaching?
"Contact your provider is adverse effects occur."
A nurse is obtaining a health history. Client reports no allergies but has experienced mild itching while taking amoxicillin in the past. What response should the nurse make?
"Itching can indicate a hypersensitivity to amoxicillin."
A nurse is teaching a client with a prescription for a drug that has a receptor agonist effect. What statement should the nurse include while teaching?
"This will increase the effects of normal cellular functions."
A nurse is caring for a patient with a new prescription, but after receiving the first dose, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents what result of the drug?
Adverse effect
An unintended effect of the drug is known as a(n): a. Adverse effect b. Toxic reaction c. Allergic reaction d. Side effect
Adverse effect
Distribution
movement of a drug by the circulatory system to its intended site of action
A provider prescribed morphine sulfate, an opioid agonist, to relieve a client's pain. What action describes the action of an agonist on a receptor?
Activates the receptor
When two drugs given together have an effect equal to the sum of their respective effects, the interaction is known as: a. Antagonized b. Agonist c. Additive d. Potentiated
Additive
When a drug binds to a receptor to produce a pharmacologic effect, the drug may be called a(n): a. Agonist b. Antagonist c. Accelerator d. Blocker
Agonist
When performing an assessment to determine which medications can be used, which of the following elements is most important? a. Presence of illness b. Allergies c. Physical examination d. Weight
Allergies
You tell a client not to take tetracycline with an antacid because the antacid can reduce the absorption of tetracycline. When one drug reduces the effect of another drug, it is...?
An antagonistic effect
Absorption
movement of a drug from the site of administration into the circulatory system
A nurse is caring for a client newly admitted for chest pain. When should the nurse begin teaching about drugs and discharge planning?
As soon as possible
Providers prescribe drug dosages for children using what information?
Body surface area Age Weight Drug properties (such as metabolism and excretion)
A nurse is caring for a client taking acetaminophen and codeine for pain relief. These analgesic drugs interact with one another to cause an additive effect. What are the characteristics of additive drug reactions?
Clients can achieve desired effects with the use of lower dosages Both drugs have similar actions
A nurse is preparing to administer a drug to a client. Which section of the drug handbook should the nurse consult to determine if the client can receive the drug?
Contraindications
A nurse is preparing to teach a client about a newly prescribed drug. Prior to teaching, the nurse should review the precautions section of the handbook to...?
Determine if dosage modification is indicated
A nurse is speaking to a client who is taking sertraline and reports drinking grapefruit juice. The nurse explains that grapefruit juice inhibits an enzyme in the liver that is used to metabolize sertraline. The nurse should recognize that the client is at risk for...?
Drug toxicity
A nurse is caring for a client with a history of renal insufficiency and is taking lithium. What should the client be monitored for?
Drug toxicity (b/c administration and excretion rates may differ, leading to buildup of the drug in the body)
Client with a peanut allergy comes into the ER with suspected anaphylactic shock. Which actions should be taken? (4)
Establish and maintain an open airway Give epinephrine to increase BP Give diphenhydramine to stop histamine release Initiate oxygen therapy to support respiratory function
A nurse is caring for a client who is having difficulty remembering to take their prescribed medications three times each day. What alternate form of the drug can help to promote adherence to the prescribed dosage?
Extended-release tablets (b/c clients can take them less frequently)
When reviewing a list of drugs in the handbook, a nurse can identify the generic name for a drug in what way?
It begins with a lower-case letter
A nurse is teaching a pregnant client who is taking captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. Teratogenic drugs cause...?
Fetal malformation
You are helping a client learn how to give himself an insulin injection. What is the best method to evaluating effective learning?
Have the client demonstrate an insulin injection
To achieve the most rapid onset of action, which route should be used?
IV
A nurse is preparing to teach a client how to take care of a newly created colostomy. What factors can decrease the client's ability to learn?
Impaired cognitive level Language barrier Discomfort Unreadiness to learn
A nurse is preparing to administer a drug to a client. Which section of a drug handbook should the nurse look to determine if the drug has more than one use?
Indications (provides info on conditions and diseases that the drug is used for)
Which organ does drug metabolism usually occur in? a. Brain b. Stomach c. Liver d. Heart
Liver
A nurse is caring for a client who arrived at the ER following a bee sting. What indicates an anaphylactic reaction?
Low blood pressure Wheezing Difficulty swallowing
The peak is the amount of time the drug: a. Needs to produce an initial response b. Needs to change into active metabolites c. Needs to reach its highest effective concentration d. Is in the therapeutic range
Needs to reach its highest effective concentration
A nurse is caring for a client who is postpartum and breastfeeding. Client asks the nurse about the effects that taking over-the-counter drugs will have on her newborn. What should the nurse consider when recommending a drug for the client?
Newborn's weight How much breast milk the newborn consumes each day Whether or not the benefits of the client outweigh the risks to the newborn The properties of the drug
A nurse is caring for a client who is receiving nitroglycerin IV and is switching to the oral form of the drug. Why will the oral dose be higher than the IV dose?
Oral form has decreased bioavailability because of the first-pass effect
A nurse is teaching a client about their new prescription for a drug with a high potential for toxicity. What information should the nurse include?
Periodic lab tests are essential to measure serum drug levels Monitoring for indications of toxicity is important Taking the smallest effective dose is crucial
A nurse is caring for a client prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that the term to describe why this drug was prescribed is...?
Pharmacologic action
A nurse is reviewing a drug handbook prior to medication administration to a client with kidney disease. The handbook states that the drug can be administered, but identifies certain risks. What term describes these risks?
Precautions (includes disease states or clinical situations in which use involves particular risks or dosage modifications that might be necessary)
An older client may be at risk for drug toxicity due to what physiologic change associated with aging?
Reduced hepatic blood flow
Contraindication
a reason that a drug is withheld for a client due to the risk for causing harm. Are usually related to pre-existing conditions such as allergies, diseases, or organ failure
What is true regarding generic drugs? (3)
Same chemical composition as the brand-name drug May have several brand names Are usually less expensive than a brand-name drug
Client with glaucoma asks about taking oxybutynin, a muscarinic antagonist, to manage an overactive bladder. You explain glaucoma is a contraindication for taking oxybutynin. Providers shouldn't prescribe contraindicated drugs because of their potential for...?
Serious adverse reactions
A patient taking SMZ/TMP asks the nurse what the name means. The nurse replies sulfamethoxazole is combined with trimethoprim in SMZ/TMP to help the drug effectiveness. How does this work? a. Sulfamethoxazole has a synergistic effect with trimethoprim against gram-positive and gram-negative organisms. b. Sulfamethoxazole is highly protein bound and displaces the trimethoprim c. Sulfamethoxazole increases the excretion of trimethoprim, thereby increasing the response in the bladder d. Sulfamethoxazole acts along with trimethoprim as an anesthetic.
Sulfamethoxazole has a synergistic effect with trimethoprim against gram-positive and gram-negative organisms.
A patient requires a high dose of a new antihypertensive medication because the new medication has a significant first-pass effect. What does this mean? a. The medication is extensively metabolized in the patient's liver b. The medication must pass through the patient's bloodstream several times to generate a therapeutic effect. c. The medication passes through the renal tubules and is excreted in large amounts. d. The medication is ineffective following the first dose and increasingly effective with each subsequent dose.
The medication is extensively metabolized in the patient's liver
A nurse is caring for a client who is taking diphenhydramine for insomnia and reports drowsiness. The nurse should identify that drowsiness indicates...?
Therapeutic effect
What is the ratio btw. a drug's therapeutic effects and toxic effects called?
Therapeutic level
A nurse is obtaining a history and discovers the client takes loratadine, an over-the-counter drug. What is correct about over-the-counter medications?
They do not require the supervision of a nurse They can interact with other drugs They should be included in the client's drug history assessment
A nurse is reviewing drugs in a reference book. They should identify that drugs in the same class share what similarity?
They have similar mechanisms of actions
Adverse reaction
an unexpected or dangerous result of using a drug
Metabolism
change of a drug into a more or less potent or more soluble form after it passes through the liver, kidneys, intestinal mucosa, or other body part
Brand/Trade drug name characteristics
commercial name capitalized
Duration of action
length of time the drug's effect lasts
Peak level
time it takes a drug to demonstrate its full effect
Onset of action
time it takes for drug to demonstrate a response