PHARMACOLOGY EXAM Qs

drugs only have one of these, convey a clear and concise meaning about the nature of a drug

chemical names

the second stage of drug testing in a clinical investigation, involves testing of a new drug in selected patients

clinical phase trials

drugs with more than one active ingredient

combination drugs

The conditions whereby the drug should be avoided

contraindications

in the US, a drug whose use is restricted by the Comprehensive Drug Abuse Prevention and Control Act

controlled substances

a powerful physiological or psychological need for a substance

dependence

the movement of a chemical from an area of higher concentration to an area of lower concentration

diffusion

the transport of drugs throughout the body after they are absorbed

distribution

any substance that is taken to prevent, cure, or reduce symptoms of a medical condition

drug

formed when a drug that binds reversibly to a plasma protein, particularly albumin, that makes the drug unavailable for distribution to its site of action

drug-protein complex

administration of drugs orally or through nasogastric or gastrostomy tubes

enteral route

tablets designed to dissolved in the alkaline environment of the small intestine because the agents will irritate the stomach mucosa if dissolved in the stomach

enteric-coated

recycling of drugs and other substances by the circulation of bile through the intestine and liver

enterohepatic recirculation

increase metabolic activity in the liver

enzyme induction

during this period, competing companies are not allowed to market generic versions of the product

exclusivity

drugs removed from the body

excretion

tablets or capsules are designed to dissolve slowly, resulting in a longer duration of action for the medication

extended release

special anatomic barrier that inhibits many chemicals and drugs from entering the fetus

fetal-placental barrier

some drugs can be completely metabolized to an inactive form on their first trip through the liver before they even reach the general circulation

first pass effect

list of drug and drug recipes commonly used by pharmacies

formulary

named assigned by the United States Adopted Name council

generic name

metabolizes drugs as well as nutrients and other endogenous substances

hepatic microsomal enzyme system

the conditions for which a drug is approved

indications

multiple, similar from of an enzyme that perform slightly different metabolic functions

isozymes

relatively large dose of a drug given at the beginning of treatment to rapidly obtain a therapeutic response

loading dose

amount of drug that keeps the plasma drug concentration in the therapeutic range

maintenance dose

Description of how a drug works on its target organs and cells

mechanism of action

the process used by the body to chemically change a drug molecule; AKA biotransformation

metabolism

amount of drug required to produce a therapeutic effect

minimum effective concentration

medications that are truly unique and structurally different from existing drugs

new molecular entities

serious, though rare, disease that affects less than 200,000 people in the US

orphan disease

in early America before drug regulation, products that contained an easily identified name that claimed to cute just about any symptom or disease

patent medicines

the study of drug movement throughout the body

pharmacokinetics

describes how the drug acts

pharmacologic classification

expansive subject, ranging from understanding how drugs are administered, to where they travel in the body, to the actual responses

pharmacology

a medical reference summarizing standards of drug purity, strength, and directions for synthesis

pharmacopeia

the application of drugs for the purpose of disease prevention and treatment of suffering

pharmacotherapy

in drug testing, an inert substance that serves as a control "non treatment" group used to compare the effectiveness of the drug

placebo

the length of time required for the plasma concentration of a drug to decrease by one half after administration

plasma half life

stage 4 of the drug approval process crying which testing is done to survey for harmful drug effects in a larger population

postmarketing surveillance

first stage of drug development that involves extensive lab testing by the pharmaceutical company on human and microbial cells

preclinical research

agents that require metabolism to produce their action

prodrugs

a single drug is selected from a class and is compared to all other medications in the class to this representative model

prototype drug

the perfect drug is

safe and effective

classified and regulated according to their potential for abuse, 5 different levels

scheduled drugs

drug that is metabolized by a CYP enzyme

substrate

what is being treated by the drug

therapeutic classification

practice of monitoring plasma levels of drugs that have low safety profiles and using the data to predict drug action or toxicity

therapeutic drug monitoring

dosage that produces the desired effects of a drug

therapeutic range

medications applied to the skin or the membranous linings of the eye, ear, nose, respiratory tract, urinary tract, vagina, and rectum

topical route

level of drug that results in serious adverse effects

toxic concentration

brand name, assigned by pharmaceutical company marketing the drug; intentionally short and easy to remember

trade name

topical delivery method that uses patches that contain a specified amount of medication that is released over a specified time period

transdermal patches

When considering various drug therapies, the nurse knows that most drug testing and approval occurs with which population? A. multiple population types and is usually safe for all clients B. Caucasian males and may not be safe for other populations C. the elderly and may be harmful to children and adolescents D. animals, which verifies the drug's effectiveness in humans

B

A client with myasthenia gravis has been receiving neostigmine, a cholingeric agonist, for the past 2 years. The nurse is ready to administer benzotropine, a cholingeric antagonist. Which would most likely occur if these drugs were combined? 1. Neostigmine will exhibit a great effect. 2. Neostigmine will exhibit a lesser effect. 3. Neostigmine will not be affected by the administration of benzotropine. 4. Neostigmine will first exhibit a greater effect followed by a lesser effect.

2

Prior to administering a liquid medication to a client, the nurse notices that the medication color looks different than usual. Based on this observation the nurse should: 1. Administer the medication 2. Consult the hospital pharmacist 3. Notify the health care provider 4. Call the poison control center

2

The nurse is caring for a client receiving a sedative-hypnotic. Which adverse effect associated with this drug therapy is the highest priority for the nurse? 1. Urinary incontinence 2. Activity intolerance 3. Risk for falls 4. Poor nutritional intake

3

A research nurse is discussing the TD50 of a drug with the other members of the investigation team. On which of the following would the discussion focus? 1. Effectiveness 2. Dose response 3. Receptor subtypes 4. Toxicity

4

An elementary school nurse is providing education to the faculty on the use of central nervous system stimulants used to treat attention deficit/hyperactivity disorder. Of the following, which is most important for the nurses to convey to the faculty? 1. Have the child bring the drug dose in a lunch bag and come to the office to take it to avoid being teased. 2. Request that the parents leave extra copy of the prescription at the school in case the dose runs out. 3. Suggest that the parents have two prescriptions filled, one for home and one to keep at school. 4. Keep the drugs in a locked drawer, clearly labeled with the client's name and only the number of doses allowed by school policy.

4

The nurse is caring for several clients who are receiving opioids for pain relief. Which client is at the highest risk of developing hypotension, respiratory depression, and mental confusion? 1. 23 year old female postoperative ruptured appendix 2. A 16 year old male post-motorcycle injury with lacerations 3. A 54 year old female post MI 4. 86 year old male postoperative femur fracture

4

While completing the health history, the nurse asks the client, "What medications do you take regularly?" which drug name should the nurse expect the client to use in providing the answer? A. chemical B. trade C. generic D. standard

B

The nurse is caring for several patients. Which patient will the nurse anticipate is most likely to experience an alteration in drug metabolism? A. A 3 day old premature infant B. A 22 year old pregnant female C. A 32 year old man with kidney stones D. A 50 year old executive with hypertension

A

The nurse knows that a drug with high therapeutic index is: A. Probably safe B. often dangerous C. frequently risky D. most likely effective

A

The nurse knows that drugs are the subject to stricter regulations are those: A. with a high potential for abuse or dependency B. that are most costly and difficult to produce C. with adverse effects and high occurrence of drug or food interactions D. that have taken years to be proven effective in the laboratory

A

When providing nursing care for the client, the nurse understands that drugs are: A. one of the many tools available to prevent and treat human suffering B. the most important part of the therapeutic plan C. primarily the concern of the health care provider and not included in nursing care D. substances that should be relied on for health and wellness

A

A nurse notes that multiple clients had a reaction to the same medication, a drug that has been available for several years. Which action should the nurse take? (SATA) A. file an Adverse Event Report with the FDA B. note the reaction in the client's chart C. notify the healthcare provider who ordered the drug D. wait until the FDA sends a notification of a drug's recall before informing the client E. compare each client's reaction to determine if its the same

A, B, C

Which client characteristic, if noted in the client's medical record, would the nurse consider important information that may affect the physiological response to various types of drug therapy? (SATA) A. 82 year old and female B. Asian and obese C. past medical history of kidney disease D. mother and sister with diabetes E. has no medical insurance

A, B, C, D

The older adult has a new prescription for cyanocobalamin (vitamin B12). Which of the following activities should the nurse preform before giving this drug? (SATA) A. identify the client by checking identification band and asking the client to state full name B. position the client in the proper position for medication administration C. evaluate the client's response to the drug D. document the medication administration on the chart E. check the chart for drug allergies and verify these with the client F. verify the medication for accuracy

A, B, E, F

The nurse is monitoring the therapeutic drug level for a patient on Vancomycin (Vancocin) and notes that the level is within the accepted range. What does this indicate to the nurse? SATA A. The drug should cause no toxicities or adverse effects. B. The drug level is appropriate to exert therapeutic effects. C. The dose will not need to be changed for the duration of treatment. D. The nurse will need to continue monitoring because each patient response to a drug is unique. 5. This drug will effectively treat the patient's condition.

B, D

The drug research participant with a particular disease is taking part in an investigative study to examine the effects of a new drug. Previously, the drug was tested using healthy volunteers. In which phase of the clinical trial investigation is the client participating? A. phase 1 B. phase 2 C. phase 3 D. phase 4

B

The nurse is teaching the patient about a newly prescribed medication. Which statement made by the patient would indicate the need for further medication education? A. "The liquid form of the drug will be absorbed faster than the tablets." B. "If I take more, I'll have a better response." C. "Taking this drug with food will decrease how much drug gets into my system." D. "I can consult my healthcare provider if I experience unexpected adverse effects."

B

The nurse knows that governmental drug legislation requires the drug manufacturer to prove that a drug is both safe and: A. free of adverse effects and potential reactions B. effective for a specific purpose C. reasonable in cost and easily accessible D. beneficial to various population groups

B

The prescriber orders Lasix 40 mg intravenous stat to a client with HF. Which of the following describes the correct response of the nurse to this medication order? A. give the medication at the next meal B. administer the medication immediately C. dispense the medication when the client requests it D. oversee the self-administration of the medication

B

When considering pharmodynamic principles for a client's drug therapy, the nurse is aware of the affinity receptor is most closely associated with a drug's 1. Potency 2. Efficacy 3. Metabolism 4. First pass effect

1

While receiving a drug manufacturer's package insert, the nurse reads the dose-response curve. The purpose of the dose-response curve is to illustrate the relationship between: 1. The amount of a drug administered and the degree of the response it produces. 2. The prevalence of toxic effects in a given population. 3. The degree of response and the total duration of action of the drug. 4. The peak serum drug level when half the dose is administered.

1

What parameters would the nurse use to determine whether the average dose of a medication is effective for a client? Select all that apply. 1. Physical examination 2. Vital signs 3. Laboratory values 4. Dosage time 5. Efficacy

1,2,3,5

Prior to administering a liquid medication to a client , the nurse notices that the medication color looks different than usual. Based on this information the nurse should A. administer the medication B. consult the hospital pharmacist C. notify the health care provider D. call the poison control center

B

The nurse is looking up a drug that has been prescribed and wants to know the therapeutic classification for the drug. Which of the following would indicate a therapeutic classification? A. beta-adrenergic antagonist B. antihypertensive C. diuretic D. calcium channel blocker

B, antihypertensive indicates the therapeutic classification of the drug by describing its usefulness in lowering blood pressure

A patient is being discharged from the hospital with a nebulizer for self-administration of inhalation medication. Which statement made by the patient indicates to the nurse that patient education has been successful? A. "Inhaled medications should only be taken in the morning." B. "Doses for inhaled medication are larger than those taken orally." C. "Medicines taken by inhalation produce a very rapid response." D. "Inhaled drugs are often rendered inactive by hepatic metabolic reactions."

C

The nurse is using a drug handbook to determine the indications for the drug furosemide (Lasix). The term "indications" is defined as the: A. way a drug works on the target organs B. amount of the drug to be administered C. conditions of which a drug is approved D. reason that the drug should not be given

C

The patient is receiving multiple medications, including one drug specifically used to stimulate gastric peristalsis. The nurse knows that this drug could have what influence on additional oral medications? A. increased absorption B. reduced excretion C. decreased absorption D. enhanced distribution

C

Cipro XR has been prescribed for a client with a gastrostomy tube. Which is the appropriate nursing action for the medication. A. crush the medication and dilute it in the tepid tap water B. instruct the client to take the medication with only sips of water C. request the hospital pharmacist to send a substitute drug D. notify the health care provider and request that another form of the drug be prescribed

D

The client is receiving a vaginal suppository. Which should the nurse include in the instructions to the client concerning the drug's administration? A. remove the suppository after 5 minutes of insertion B. cleanse the perineal area with soap and water before insertion C. insert the suppository only in the morning D. urinate before insertion of the suppository

D

The client requests that a refill prescription of a schedule II controlled substance be telephones to the drug store. When responding tot he client, the nurse would consider which factors? Refills of schedule II drugs: A. are less costly than the original prescription B. must be listened to by at lease 2 people C. are verified through the local DEA office D. are not permitted under federal law

D

The client who received a prescription for an antibiotic 2 weeks ago now presents with the same symptoms of bacterial infection. What should the nurse suspect? A. faulty and low quality medication B. toxic adverse effects of the drug C. excessive dosage of the prescription D. nonadherence to the prescribed therapy

D

The nurse is asked by a family member: "They're giving mom Motrin and she takes Advil. Hasn't the wrong drug been ordered? The nurse will respond, knowing that: A. There has been an error in the order and the nurse will contact the health care provider B. there may be a reason for the health care provider to order a different drug C. Not all health care agencies buy the same generic drugs and that may account for the difference D. Motrin and Advil are trade names for the same generic drug, ibuprofen

D

The nurse is caring for a patient with hepatitis and resulting hepatic impairment. The nurse would expect the duration of action for most medications to: A. decrease B. improve C. be unaffected D. increase

D

US agency responsible for the evaluation and approval of new drugs

FDA

application to the FDA that contains all the animal and cell testing data

Investigational New Drug (IND)

application submitted to the FDA that signals hat the pharmaceutical company is ready to sell the new drug

New Drug Application (NDA)

testing is conducted on 20-80 HEALTHY volunteers for several months to determine proper dosage and to assess for adverse effects. The focus of this phase is on safety.

Phase 1

Several hundred patients with the disease to be treated are given the drug. The primary focus of this phase is on effectiveness, although safety data continue to be recorded.

Phase 2

Large numbers of patients with the disease are given the drug to determine patient variability. Potential drug-drug interactions are examined.

Phase 3

the process by which drug molecules move from their site of administration to the blood

absorption

compliance

adherence

attraction example: bone marrow, teeth, eyes, and adipose tissue have a high attraction for certain medications

affinity

drug that activates a receptor and produces the same type of response as the endogenous substance

agonist

agent that blocked the response of another drug

antagonist

the rate and extent to which the active ingredient is absorbed from a drug product and becomes available at the site of drug action to produce its effect

bioavailability

network of capillaries in the CNS that inhibits many chemicals and drugs from gaining access to the brain

blood-brain barrier