NURS 303 - Pharmacology 1, 3, 4, 5, 6

Definition of metabolism

The 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 parts

The transmission of medications from the location of administration to the bloodstream

absorption

Medications capable of binding with receptors and causing a cellular response

agonist

Buccal medications are administered

between the gum and cheek

The ability of a medication to reach its target cells and produce its effect

bioavailability

What is CNS toxicity

brain toxicity

A condition or factor that serves as a reason to withhold medications due to the harm that it would cause the patient

contraindications

The period of time needed for the medication to be reduced by 50% in the body

half life

Definition of absorption

the movement of a drug from the site of administration into the circulatory system

Transdermal drugs are applied to

the skin

The preferred and expected effect for which a medication is administered

therapeutic effect

Indicates the safety margin of medications.

therapeutic index

Sublingual medications are administered

under the tongue

Primary care providers prescribe drug dosages for children using which of the following information? (Select all that apply.) A. Body surface area B. Age C. weight D. Developmental level E. Drug properties

A, B, C, E To avoid toxicity, overdose, or under treatment, primary care providers adjust drugs fro children based on their body surface area, age, and weight, along with drug properties such as metabolism and excretion. The child's developmental level may determine the method of administration but not the appropriate dosage

A nurse is caring for a client who arrived at an emergency department following a bee sting. Which of the following findings indicates an anaphylactic reaction? (select all that apply) A. low blood pressure B. wheezing C. bradycardia D. peripheral edema E. difficulty swallowing

A. Low blood pressure is correct. *Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Immediate treatment with epinephrine and IV fluids is imperative. B. Wheezing is correct. *Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Wheezing is an indication of bronchospasm and is treated using bronchodilators. E. Difficulty swallowing is correct. *Anaphylaxis is an immediate and life-threatening allergic response, manifesting as bronchospasm, laryngeal edema, and a rapid drop in blood pressure. Difficulty swallowing is an indication of laryngeal edema and, therefore, anaphylaxis.

A nurse is preparing to teach a client how to take care of a newly created colostomy. The nurse should identify that which of the following factors can decrease the client's ability to learn? (select all that apply) A. impaired cognitive level B. language barrier C. discomfort D. repetition of teaching E. unreadiness to learn

A. impaired cognitive level B. language barrier C. discomfort E. unreadiness to learn

A nurse is reviewing drugs in a drug reference. The nurse should identify that drugs in the same class share which of the following similarities? A. they have similar mechanisms of actions B. they have the same half-life C. they are administered by the same route D. they have similar availability

A. they have similar mechanisms of actions Drugs in the same class often share similar mechanisms of action, as well as assessment guidelines, interactions, and precautions.

Definition of excretion

The removal of the drug or its metabolites through the kidneys, gastrointestinal tract, skin, or lungs

A hyper response of body tissues to a foreign substance

allergic reaction

_____ effect: A medication produces effects that are more pronounced than those produced by the first dose

cumulative effect

The length of action of a medication

duration

Same metabolic pathway metabolizes two medications, it can alter the metabolism of one or both of the medications

similar metabolic pathways

When medication intake equals medication metabolism and excretion.

steady state

What does SL mean

sublingual

Definition of distribtuion

the movement of a drug by the circulatory system to its intended site of action

Proprietary name given by the company that manufactures the medication, it is always capitalized.

trade or brand name

A nurse is caring for a client who was prescribed an antidepressant based on its ability to prevent the reuptake of neurotransmitters. The nurse should identify that which of the following terms describes why this drug was prescribed for the client? A. pharmacologic action B. chemical stability C. route D. adverse effects

A. Pharmacologic action is Correct The nurse should identify that the mechanism of action of a drug on the body to achieve the desired effect is referred to as pharmacologic action. Chemical stability The nurse should identify that knowledge of how a drug should be stored and handled to maintain maximum effectiveness is referred to as chemical stability. Route The nurse should identify that route refers to the method of administering the drug, such as oral, topical, or parenterally. Adverse effects The nurse should identify that adverse effects refer to the unintended and undesired effects that drugs have on the body, which can range from annoying to life-threatening.

A nurse is obtaining a client's health history and discovers that the client takes loratadine, an over-the-counter drug. The nurse should identify that which of the following is correct regarding the over-the-counter drugs? (select all that apply) A. they do not require the supervision of a nurse B. they can interact with other drugs C. they should be included in the client's drug history assessment D. they are less effective than prescription drugs E. they do not cause toxicity

A. They do not require the supervision of a nurse is correct. *Over-the-counter drugs do not require a prescription or the supervision of a nurse. B. They can interact with other drugs is correct. *Many over-the-counter drugs interact with other drugs. C. They should be included in the client's drug history assessment is correct. *Over-the-counter drugs are often omitted from the drug history assessment, but they should be included. Nurses should ask specific questions about over-the-counter drugs and herbal remedies.

An older client may be at risk for drug toxicity due to which of the following physiologic changes associated with aging? A. Reduced hepatic blood flow B. Increased glomerular filtration rate C. Reduced body fat D. Increased gastric motility

A. reduced hepatic blood flow Older clients may be at risk for drug toxicity due to delayed drug metabolism related to reduced hepatic blood flow and decreased liver enzyme production. Other physiologic changes in older adults are decreased blood flow to the kidneys and reduced glomerular filtration rate, increased body fat, decreased cardiac output, decreased gastric emptying, and slower peristalsis

A client with glaucoma asks you about taking oxybutynin, a muscarinin antagonist, to manage an overactive bladder. You explain that glaucoma is a contraindication for taking oxybutynin. Primary care providers should not prescribe contraindicated drugs because of their potential for which of the following? A. Serious adverse reactions B. Drug tolerance C. Drug dependence D. Interactions with other drugs

A. serious adverse effects Some drugs are unsafe for clients with certain characteristics or disorders or because they eat certain foods or take certain drugs as they have the potential to cause serious or life-threatening adverse effects. Drug tolerance is a decreased response to a drug over a period of time. Drug dependence is a physiologic or psychologic need for a drug. A drug interaction is an alteration in the expected pharmacologic action of a drug that results from an interaction with another drug

A client asks you about the difference between a generic drug and a trade- or brand-name drug. Which of the following are true regarding generic drugs? (Select all that apply.) A. Have the potential for abuse and dependence B. Have the same chemical composition as the brand-name drug C. May have several brand names D. May have several generic names E. Are usually less expensive than a brand-name drug

B, C, E Generic and trade or brand-name drugs have the same chemical composition and the same effects. Generic drugs are usually less expensive than brand-name drugs. Each drug has only one generic name. The trade name is the brand or proprietary name the manufacturer gives a drug, so various manufacturers give the same drug different brand names. Brand names also differ with the various formulations or routes the same manufacturer provides. There is no difference in abuse potential between a generic and a brand-name drug.

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the client can receive the drug? A. adverse effects B. contraindications C. implementation D. black box warning

B. Contraindications The nurse should review the contraindications section in the drug handbook to determine if a client can receive the drug. This section lists pre-existing diseases or clinical situations that could make it unsafe to administer a drug.

A nurse is obtaining a client's health history. The client reports no allergies but has experienced mild itching while taking amoxicillin in the past. Which of the following responses should the nurse make? A. "itching is an expected adverse effect of amoxicillin." B. "itching can indicate amoxicillin toxicity." C. "itching can indicate a hypersensitivity to amoxicillin." D. "itching can result from dry skin, which is often caused by amoxicillin."

C. "itching can indicate hypersensitivity to amoxicillin." Itching can be an indication of drug hypersensitivity, and a more severe allergic reaction can develop with future exposures. The client might be allergic to amoxicillin and other penicillins.

A nurse is caring for a client who has a history of renal insufficiency and is taking lithium. The nurse should monitor the client for which of the following? A. tolerance to the drug B. drug interaction C. drug toxicity D. dependence on the drug

C. Drug toxicity Drug toxicity develops when the amount of a drug that is taken is greater than its rate of excretion, and it results in the drug accumulating in the body. A client who has renal insufficiency might have delayed or impaired excretion of the drug. The drug dosage should be reduced if toxicity occurs.

You note that a primary care provider prescribed morphine sulfate, an opioid agonist, to relive a client's postoperative pain. Which of the following actions describes the action of an agonist on a receptor? A. Destroys the receptor B. Competes with the receptor C. Activates the receptor D. Blocks the receptor

C. activates the receptor Agonists bind with receptor sites on a cell and activate them to produce a response. In contrast, antagonists block drugs from receptor sites, blocking the drug's intended reaction. Antagonists that compete with an agonist for cell receptor sites are called competitive antagonists. Drugs typically do not destroy the receptor sites on cells.

A nurse is teaching a client about the adverse effects of digoxin. which of the following statements should the nurse include in the teaching? A. "adverse effects are the intended effects of the medication." B. "adverse effects indicate a severe allergy to the medication." C. "decrease your medication dose if adverse effects occur." D. "contact your provider if adverse effects occur."

D. "contact your provider if adverse effects occur."

A nurse is teaching a client about naproxen enteric-coated tablets. Which of the following statements should the nurse include in the teaching? A. "drug absorption occurs in the stomach." B. "you should expect immediate absorption of the drug." C. "you should allow the tablet to dissolve in your mouth." D. "do not crush or chew the tablet."

D. "do not crush or chew the tablet." Drugs that irritate the stomach are often covered with an enteric coating that does not dissolve until the drug enters the alkaline environment of the small intestine. Clients should not crush or chew enteric-coated drugs because this will damage the enteric coating.

_____ medications require a provider's order (signature). _____ medications can be purchased by anyone.

Prescription Over the counter (OTC)

True/False: If two drugs use the same metabolic pathway (enzyme system) are given together, the result could be a drug-drug interaction altering the metabolism of one or both of the medications

True

True/false: Toxicity could occur when two drugs that are highly protein bound are given at the same time

True

An acute allergic response to an antigen that results in severe hypotension and may cause death if untreated

anaphylactic shock

Medications that inhibit or block the responses of agonists

antagonist

PRN means

as needed

What is nephrotoxicity

damage to the kidneys by a toxic substance

What are the necessary components of a prescription? (7)

date and time signature of prescribing provider route frequency name of patient dosage name of medication

Lifespan effects of aging adult

decreased: lean body mass kidney function and glomerular filtration rate body water blood flow through cardiovascular system, liver and kidneys hepatic enzyme function GI motility increased body fat

Intravenous drugs are administered

directly into the venous system; rapid onset, immediate response

Transportation of medications to sites of action by bodily fluids

distribution

What are the rights of safe medication administration? (6)

dose patient medication route documentation time

Reduced responsiveness to a medication administered over time

drug tolerance

Accumulation of too much medication in the bloodstream

drug toxicity

What is ototoxicity?

ear toxicity

Elimination of medications from the body primarily through the kidneys

excretion

What is cardiotoxicity

heart toxicity

Enteral routes of administration

oral, sublingual, buccal

The highest concentration of a medication in the bloodstream

peak

Measures levels of medications in the bloodstream before and after a medication is administered

peak and trough

_______ medications compete for protein-binding sites within the bloodstream, primarily albumin

protein binding

The undesired effect when a medication is administered

side/adverse effect

A nurse is caring for a client who is taking diphenhydramine for insomnia and reports drowsiness. The nurse should identify that drowsiness indicates which of the following? A. therapeutic effect B. adverse reaction C. contraindication D. precaution

A. Therapeutic effect Drowsiness is a therapeutic effect of diphenhydramine for a client who is taking the drug to treat insomnia.

You are talking with a client about taking tetracycline along with an antacid. You tell the client not to take these two drugs at the same time because the antacid can reduce the absorption of tetracycline. When one drug reduces the effect of another drug, it is A. an allergic reaciton B. a synergistic effect C. an antagonistic effect D. An adverse reaction

C. An antagonistic effect When one drug reduces the effect of another drug, it is an antagonistic effect. When the client's body responds to a drug by releasing histamine and causing itching and. hives, the client is having an allergic reaction to drug. Drugs that interact, causing greatly increased or exaggerated effects, are acting synergistically. The non therapeutic, unintended effects of a drug that occur at a therapeutic dose are side or adverse effects or reactions.

You are helping a client learn how to give himself an insulin injection. Which of the following is the best method for evaluating effective learning? A. Verbally quiz a family member. B. Instruct the client to complete a written test. C. Have the client demonstrate an insulin injection. D. Ask the client several key questions about the procedure.

C. Have the client demonstrate an insulin injection.

A client who has a peanut allergy comes to the emergency department with suspected anaphylactic shock. Which of the following actions should you anticipate taking? (Select all that apply) A. Initiate oxygen therapy to support respiratory function B. Administer epinephrine to increase blood pressure C. Give diphenhydramine to stop histamine release D. Establish and maintain an open airway to ensure oxygenation E. Administer a drug agonist to neutralize the allergic reaction

A, B, C, D When a client has an anaphylactic reaction, your priority is to establish an open airway and then to administer oxygen immediately. Give epinephrine to increase blood pressure and diphenhydramine to stop the release of histamine. Do not administer a drug agonist, because it would elicit an action in the body instead of blocking an action

A nurse is teaching a client who has a prescription for a drug that has a receptor agonist effect. Which of the following information should the nurse include in the teaching? A. "This will increase the effects of normal cellular functions" B. "this prevents cells in your body from performing certain actions" C. "this prevents hormones in your body from attaching to cell receptor sites" D. "this minimizes the risk that the medications you take will become toxic"

A. "This will increase the effects of normal cellular functions" Agonist drugs bind to cell receptors in the body and are targeted to a specific type of receptor. When they attach to the receptors, they perform the same action as a hormone or chemical would, increasing the effects of that hormone or chemical. For example, pharmacological insulin is administered to clients who have little to no insulin to mimic insulin's effects in the body.

A nurse is caring for a client who has a new prescription for a drug. After receiving the first dose of the drug, the client experiences anaphylaxis. The nurse should identify that anaphylaxis represents which of the following results of the drug? A. adverse effect B. paradoxical effect C. therapeutic effect D. toxicity

A. Adverse effect is correct Adverse effects are the unintended and unexpected effects of a drug, which can range from mildly annoying to life-threatening, such as an anaphylactic reaction. Paradoxical effect Paradoxical effects are the opposite of the intended or desired effect of a drug, such as a drug intended to aid with sedation causing increased excitability in certain clients. Therapeutic effect A therapeutic effect is the intended benefit of the drug for the client. Toxicity Toxicity occurs when the client receives a drug in excessive dosages. Manifestations of toxicity differ between drugs.

A nurse is caring for a client who is taking acetaminophen and codeine for pain relief. These analgesic drugs interact with one another to cause an additive effect. The nurse should identify that which of the following are characteristics of additive drug interactions? (select all that apply) A. clients can achieve desired effects with the use of lower dosages B. taking the two drugs together can reduce the effects of one or both drugs C. taking the two drugs together can potentiate the effects of one or both drugs D. the two drugs can produce an action neither would have produced alone E. both drugs have similar actions

A. Clients can achieve desired effects with the use of lower dosages is correct. *When two or more drugs are given at the same time and have similar actions, an additive effect will occur. Clients can take some drugs together for their additive effects, so they can take lower doses of each drug. E. Both drugs have similar actions is correct. *Additive effects occur when two or more drugs with similar actions are taken at the same time.

A nurse is providing teaching for a client who has a new prescription for a drug with a high potential for toxicity. Which of the following information should the nurse include? (select all that apply) A. periodic laboratory tests are essential to measure serum drug levels B. monitoring for indications of toxicity is important C. taking the drug with an inducing agent will increase the possibility of toxicity D. taking the smallest effective dose is crucial E. increasing fluid intake is recommended to avoid toxicity

A. Periodic laboratory tests are essential for measuring serum drug levels is correct. *Clients who are taking drugs that have a high potential for toxicity should undergo regular monitoring of serum drug levels to be certain the drug level stays within the therapeutic range. B. Monitoring for indications of toxicity is important is correct. *Drugs that have a high potential for toxicity can quickly build up to toxic levels in the blood, resulting in effects that can be irreversible or life-threatening. Therefore, the nurse should monitor for manifestations of toxicity particular to the drug the client is taking. D. Taking the smallest effective dose is crucial is correct. *It is optimal to use the lowest effective dose of a drug to achieve therapeutic effects because doing so helps minimize the risk for toxicity.

A nurse is caring for a client who is postpartum and breastfeeding. The client asks the nurse about the effects that taking over-the-counter drugs will have on her newborn. Which of the following should the nurse consider when recommending a drug for the client? (select all that apply) A. the newborn's weight B. how much breast milk the newborn consumes each day C. whether or not the benefits to the client outweigh the risks to the newborn D. the properties of the drug E. the route of administration of the drug

A. The newborn's weight is correct. *The nurse should consider the weight of the newborn when recommending a drug for a client who is breastfeeding. The lower the newborn's weight, the greater the effects of the drug absorbed via breastmilk will be to the newborn. B. How much breast milk the newborn consumes each day is correct. *The nurse should consider the amount of breast milk the newborn consumes per day when recommending a drug for a client who is breastfeeding. The more breast milk the newborn consumes, the more of the drug is likely to be absorbed into the newborn's circulation. C. Whether or not the benefits to the client outweigh the risks to the newborn is correct. *The nurse should weigh the benefits against the risks when recommending a drug for a client who is breastfeeding. If the benefits will be minimal, it is generally not worth the risk to the newborn. D. The properties of the drug is correct. *The nurse should consider the properties of the drug when recommending a drug for a client who is breastfeeding. Certain drugs can transfer more easily into breast milk, depending on properties like fat solubility.

When reviewing a list of drugs in a drug handbook, a nurse can identify the generic name for a drug in which of the following ways? A. it begins with a lower-case letter B. it is listed in parentheses along with the trade name C. there are both letters and numbers in the name D. the chemical name is listed in parentheses before the generic name

A. it begins with a lower-case letter

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use? A. Adverse effects B. indications C. pharmacokinetics D. nursing implications

B. Indications is Correct The indications section provides information on conditions and diseases for which the drug is used. Adverse effects This section categorizes the adverse effects of a drug. Pharmacokinetics The pharmacokinetics section outlines how the drug is processed in the body through absorption, distribution, metabolism, and excretion, but it does not address the disease or conditions that the drug is used to treat. Nursing implications The nursing implications section explains how the nurse will apply the nursing process to the use of the drug.

A nurse is reviewing a drug handbook prior to administering a drug to a client who has kidney disease. The handbook states that the drug can be administered but identifies certain risks. Which of the following terms describes these risks? A. contraindications B. precautions C. paradoxical effects D. adverse effects

B. Precautions A precaution includes disease states, such as kidney disease, or clinical situations in which use of a drug involves particular risks or dosage modification might be necessary.

A nurse is preparing to teach a client about a newly prescribed drug. Prior to providing teaching, the nurse should review the precautions section of a drug handbook for which of the following reasons? A. to determine drug-food interactions B. to determine if dosage modification is indicated C. to determine how the drug is absorbed D. to determine availability

B. To determine if dosage modification is indicated The precautions section includes diseases or clinical situations in which drug use involves particular risks or dosage modification might be necessary, such as the presence of a client condition or restrictions due to the client's age.

A nurse is caring for a client who is having difficulty remembering to take their prescribed drug three times each day. The nurse should identify that which of the following alternate forms of the drug can help to promote adherence to the prescribed dosage? A. liquid suspension B. immediate-release capsule C. extended-release tablet D. powder form

C. Extended-release tablet Extended-release tablets release the drug over an extended period of time. Clients can take them less frequently.

A nurse is caring for a client who is receiving nitroglycerin IV and is switching to the oral form of the drug. The nurse should identify that the oral dose will be higher than the IV dose for which of the following reasons? A. the IV form crosses the blood-brain barrier B. the oral form has a decreased half-life C. the oral form has decreased bioavailability because of the first-pass effect D. the oral form has an increased rate of excretion

C. The oral form has decreased bioavailability because of the first-pass effect Oral doses are often larger than IV doses of the same drug because of the first-pass effect by the liver, which reduces the bioavailability of the drug. Enzymes in the liver metabolize drugs, making less of the drug available for use by the body.

A nurse is caring for a client who is newly admitted to the facility for chest pain. At which of the following times should the nurse begin teaching about drugs and discharge planning? A. after the client has a definitive diagnosis B. on the day of discharge C. when the client's family members are present D. as soon as possible

D. As soon as possible

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 the client's risk for which of the following? A. reduced drug absorption B. drug dependence C. altered drug distribution D. drug toxicity

D. Drug toxicity Grapefruit juice can cause increased levels of certain drugs, such as sertraline, which can lead to drug toxicity. Clients should avoid drinking grapefruit juice while taking these drugs.

A nurse is providing teaching to a pregnant client who is taking captopril, an ACE inhibitor, to treat hypertension. The nurse informs the client that captopril is a teratogenic drug. The nurse should explain that teratogenic drugs can cause which of the following? A. maternal bleeding B. maternal blood clots C. gestational diabetes mellitus D. fetal malformation

D. fetal malformation Teratogenic drugs can cause birth defects. Clients who are pregnant should not take these drugs.

Definition: ________ - when some oral medications are metabolized through the liver before reaching the bloodstream.

first pass effect

The official or nonproprietary name that is given by the United States Adopted Names Council, it is never capitalized.

generic name

When a medication that inhibits an enzyme for metabolism is administered, the medication metabolized by that enzyme will have a _____ effect

greater

Lifespan effects of peds patients

immature: kidney function blood-brain barrier liver function

Oral medications are absorbed where

in the stomach or small intestine

The medication metabolized by the increased enzyme will result in a more rapid metabolism, requiring an increase in dosage.

increase in medication-metabolizing enzymes

Intradermal medications are administered

into the dermis layer of the skin

Otic drugs are administered

into the ear

Opthalmic drugs are administered

into the eye

Subcutaneous drugs are administered

into the subcutaneous fat of the abdomen, upper hips, lateral upper arms, and thighs

Intramuscular drugs are administered

into the ventrogluteal, deltoid, or vastus lateralis muscles

What does ID mean

intradermal

Parenteral routes of administration

intradermal, subcutaneous, intramuscular, intravenous

When a medication that induces (increases) an enzyme for the metabolism is administered, the medication metabolized by that enzyme will have a _____ effect

lesser effect

What is hepatotoxicity

liver toxicity

What is pulmonary toxicity?

lung toxicity

What changes medications into less active or inactive forms by the action of enzymes primarily through the liver

metabolism

What does NPO mean

nil per os (nothing by mouth)

When a medication starts to have an effect

onset

Topical routes of administration

ophthalmic, otic, vaginal, nasal, transdermal, inhalation, rectal

Interactions between medications and target cells, body systems, and organs to produce an effect

pharmacodynamics

How medications travel through the body. It includes the processes of absorption, distribution, metabolism, and excretion

pharmacokinetics

Methods or procedures intended to prevent or avoid adverse outcomes

precautions