Pharmacology Ch 1-3, 12,19, 45, 29, 30 and 44
A patient comes to the clinic complaining of elbow pain after a sports injury. He states that he has been taking two pain pills, eight times a day, for the last few days. The medication bottle contains acetaminophen, 325 mg tablets. Calculate how much medication he has been taking per day. Is this a safe dose of this medication?
2 x 8=16...16 x 325=5200 No!
The half-life of morphine is two hours, how much medication is left in four hours?
25%
Which statement about drug names is correct?
A drug may have multiple proprietary names
What are contra indications for use of beta blockers? Select all that apply... A. Asthma B. DM C. Hypertension D. Tachycardia
A. Asthma B. DM
Distribution can be selective; some drugs cannot pass through what membranes? Select all that apply... A. Blood brain barrier B. Heart C. Lungs D. Placenta
A. Blood brain barrier D. Placenta
The nurse is explaining the difference between generic and brand to the group of students which should be included? Select all that apply... A. Ran name starts with a capital letter engineering with a lowercase B. They have same active ingredient C. Generics are more expensive D. You'll always have to choose brand
A. Brand name starts with capital letter engineering with lowercase Be. They have the same active ingredient
What can contribute to drug toxicity? Select all that apply... A. Drug accumulation B. Extensive consumption C. High dosing D. Chemical components of medication E. Normal metabolism
A. Drug accumulation B. Extensive consumption C. High dosing D. Chemical components of medication
What are routes for excretion? Select all that apply... A. G.I. (Feces) B. Urination C. Exhalation D. Skin E. Hair
A. G.I. B. Urination C. Exhalation D. Skin
A nurses education patient being discharged on opioid for severe pain, what patient statement indicates understanding of the teaching? Select all that apply... A. I might feel confused or disoriented B. Slowing down of breathing is a major side effect C. I can expect diarrhea D. I can expect difficulty urinating
A. I might feel confused or disoriented B. Slowing down of breathing is a major side effect D. I can expect difficulty in urinating
Metabolism is a process of an activation of drugs, most done in the liver, what could affect the metabolism and prolong medication action in the body? select all that apply... A. Liver disease B. Kidney disease C. Diseases affecting metabolism (thyroid problems) D. Heart problems
A. Liver disease C. Diseases affecting metabolism
The differences between OTC (over the counter) and prescription medication are...? Select all that apply A. OTC has a wider safety margin B. OTC does not need a prescription C. Prescription medications are always more effective D. There is never an abuse potential with any OTC E. Prescription medications are cheaper
A. OTC has a wider safety margin B. OTC does not need prescription
What statements about pain management are correct? Select all that apply... A. Pain is what patient says it is B. Educate patient to report pain before it becomes to severe C. Short term use of opioids is likely leading to addiction D. If patient is nonverbal utilized behavioral clues to assess pain
A. Pain is what the patient says it is B. Educate patient to report pain before it becomes too severe D. If patient is nonverbal utilize behavioral clues to assess pain
A patient is taking acetaminophen for arthritis, he complains that even though the pain is better, swelling has not improved what is the best response by the nurse?
Acetaminophen does not have any anti-inflammatory properties
Cholinergic drugs cause effects in the body similar to those produced by which of the following neurotransmitters?
Acetylcholine
When a person is unable to control his desire to inject drugs, it is called...?
Addiction/drug dependence
When are two drugs with similar action are taken for increased effect?
Additive effect
Drugs that interact with receptor and stimulate response are called...?
Agonist
What statements about controlled substances are true) select all that apply... A. Schedule I has no therapeutic value B. Schedule II has HIGH potential for abuse therefore requires new prescriptions if refill is needed C. Schedule III always requires new prescription for refills D. Schedule V drugs abuse potential is low
All are true
Hypersensitivity reaction in those previously exposed to a drug, most common as a rash...?
Allergic reaction
Drugs that interact with a receptor but it do not stimulate response (Block/inhibit) Are called...?
Antagonist
Which property of aspirin does acetaminophen lack?
Anti-inflammatory
A 16-year-old is seen in the ER for a head injury after playing football at school. Patient's mom is very concerned patient hasn't received any pain meds. She states "my son needs morphine; he says this is the worst headache he's ever had ". Nurses actions are...?
Ask the doctor for acetaminophen order
A nurse prepares to administer a newly prescribed medication to a 22-year-old woman. The insert in the medication package states, "category X ". Select the nurses best action.
Ask the patient, "when was your last menstrual period? "
What medication is given as a pre-operative medication to reduce elevation and increase heart rate?
Atropine
What medication forms cannot be crushed? Select all the apply... A. Time release B. Enteric coated C. Sublingual D. Sustained action
B. Enteric coated A. Time release D. Sustain the action C. Sublingual
What actions do beta- adrenergic Agents have on patients with respiratory conditions such as asthma?
Bronchodilation
A nurse is preparing to administer butorphanol (Stadol) to a newlyadmitted client who has a history of substance use a disorder. Which of the following is true regarding Butorphanol?
Butorphanol may cause abstinence syndrome in opioid dependent clients
A patient receiving morphine for postop pain is difficult to arouse, his vital signs are BP 100/60, P 70, R 8, O2 94%. What is the best action for the nurse? Select all that apply... A. Continue to monitor B. Look for other symptoms C. Notify the doctor D. Prepare to administer naloxone (Narcan) E. Hold next dose
C. Notify the doctor D. Prepare to administer naloxone (Narcan) E. Hold next dose
What labs can help monitor kidney function?
CMP (creatinine, BUN, electrolytes, Glucose, filtration rate)
A Patient Questions a new prescription for celecoxib (Celebrex) for osteoarthritis. She states "I don't understand why I had to change my medication. I have been taking aspirin for 20 years". A best response by the nurse would be...?
Celecoxib it's just as effective for your pain, but has a lesser risk for G.I. bleeding.
The law designed to improve regulation of substances with potential for abuse, divided medications into schedules of...?
Controlled substances act (the comprehensive drug abuse, prevention and control act)
Patient states "if I have asthma exacerbation I can use my albuterol rescue inhaler for a fast relief"?
Correct
Legislation that authorizes FDA to determine safety of drugs before marketing...? A. Drug enforcement administration B. Federal food, drug, and cosmetic act of 1938 C. Durham - Humphrey act (1970) D. Keufauver-Harris Drug amendment E. Controlled substances act ( The comprehensive drug abuse, prevention and control act)
D. Keufaver-Harris act
The nurse is instructing a patient about the use of alcohol with certain cephalosporins. Which adverse effects may occur with his combination of medications?
DiSpina, tachycardia and hypotension
The displacement of first drug from protein binding cited by second drug?
Displacement
Which adverse effects does the nurse assess for when monitoring a patient for a toxic reaction to an aminoglycoside?
Dizziness, tinnitus and hearing loss
Two patients, one thin and one obese, each receive a highly lipid soluble drug. Which difference in Pharmacokinetics does the nurse expect in the obese patient as compared with the thin patient?
Drug elimination will be slowed
Which governmental body was organized to gather intelligence, train, conduct research in the area of dangerous drugs and drug abuse, and enforce the controlled substances act?
Drug enforcement administration or DEA
A patient is taking an an acid concurrently with ketoconazole. The antacid inhibits the dissolution of ketoconazole. Which term accurately describes this result?
Drug interaction
A child with peanut allergy and history of asthma is experiencing acute bronchiospasm and wheezing after having a bite of his friends candy. The nurse knows that which is the best medication for this emergency situation?
Epinephrine (adrenaline)
Acetaminophen helps with inflammation.
F
Half-life of naloxone (Narcan) is longer than morphine.
F
T or F Acetaminophen is nephrotoxic.
F
T or F... Beta blockers are safe for patients with respiratory conditions?
F
T or F... If patient has shallow irregular respirations less than 12, it's OK to give opioid?
F
T or F... Ringing in the ears (tinnitus) is a common side effect.
F
T or F... antihistamines help with congestion?
F
T or F... bleeding is a sign of salicylate (aspirin) toxicity?
F
T or F...Diarrhea is a side effect of opioids?
F
Legislation that divides medications into prescription and nonprescription are...?
Federal food, drug and cosmetic act of 1938
The sympathic/adrenergic nervous system functions in actions that require quick responses during the __________ response?
Fight or flight
A patient taking aspirin is at risk for tinnitus. The nurse understands this condition is a sign of aspirin toxicity and affects:
Hearing
The nurse is teaching a patient who is on an anticholinergic agent for neurogenic bladder. What statement made by the patient will NOT help the side effects of this drug?
I will limit my fluid intake
What statement from a patient is on anticholinergic medication is the cause of concern?
I will make sure I use the sauna at the gym after working out
Unusual reaction to medication on first administration...?
Idiosyncratic reaction
Patient is discharged home on medication for iridal bowel containing atropine. What patient's statement indicates understanding of anticholinergic effectsof atropen?
If my mouth feels dry I will chew gum or suck on hard candy
The first drug inhibits the metabolism/excretion of second drug?
Interference effect
A patient takes two medications. Drug A is given once per day; drug B is taken every eight hours. Which conclusion about drug a is correct?
It has a longer half-life than drug B
The amendment providing greater control and surveillance of distribution and clinical testing of drugs is...?
Keufauver-Harris drug amendment
Excretion is a process of eliminating metabolized drugs (most commonly) What disease could contribute to accumulation of medication/metabolites in the body?
Kidney failure (disease)
A patient is taking acetaminophen daily for knee pain, he complains of nausea and anorexia. What is the likely cause for his symptoms?
Liver damage/Hepatotoxicity
Which aspects of Pharmacokinetics should the nurse be most concerned with when caring for a patient with abnormal functioning of hepatic enzymes?
Metabolism
____________ is a buy product of medication metabolism, typically inactive (depending on medication)?
Metabolite
Which medication should be avoided while taking a quinoline because it decreases the absorption?
Milk of magnesia
A nurse is planning to administer meperidine (Demerol) IV to a post operative client. Which of the following is an appropriate nursing action when administering meperidine?
Monitor for seizures and confusion with repeated doses
Which medication does the nurse holes if a patient's vital signs are BP 144/90 mm Hg, pulse 60 and respirations 10?
Morphine
Which medication would the nurse administer to a patient who is rating their pain scale at eight on a stale of 0 to 10?
Morphine (Roxanol)
A patient is found unresponsive by paramedics. An opioid overdose is suspected, what medication is likely to be administered?
Naloxone
A patient has overdosed on morphine. Which medication does the nurse anticipate will be ordered by the physician to treat the patients overdose?
Naloxone (Narcan)
Negative expectations about treatment outcome are called...?
Nocebo
A group of naturally occurring semi synthetic and synthetic substances that have the capability to stimulate the response of pain relief without the loss of consciousness is called...?
Opioid agonists
A patient with a rare cancer has exhausted his options in terms of treatment; due to his comorbidities (concurring conditions) he has not qualified for clinical trials. What is his other option?
Parallel tracking
Drugs that interact with receptor to stimulate a response but inhibit other responses (interact to stimulate plus partially inhabit)...?
Partial agonist
The nurse alerts the lab that she has just completed giving medication and patient needs strugglelevel checked. What is most likely to be drawn?
Peak
The study of interactions between drugs and their receptors (the study of what The drug does to the body) is called...?
Pharmacodynamics
The study of the mathematic relationship among ADME features of drugs over time (The study of what the body does to the drug) is...?
Pharmacokinetics
Positive expectations about treatment outcomes are called...?
Placebo
A black box warning, which indicates a very serious or life-threatening problem, is most commonly given in...?
Post market surveillance
An ophthalmologist is getting ready to administer anti-cholinergic eyedrops to dilate eyes for fundal exam. What screening needs to be done first?
Screening for glaucoma
The combination of fact of two drugs is greater than some of the effect of each drug given together?
Synergistic affect
T or F... Cough could be a symptom of an allergy?
T
T or F... Opioid partial agonists are contradicated in patients with history of opioid abuse?
T
T or F... Opioids stimulate opioid receptors and initiate a response of pain relief?
T
T or F... albuterol (Proventil) is a beta-adrenergic that Dilates Bronchi (broncochodilation)?
T
T or F... decongestants are contraindicated in patients with high blood pressure?
T
T or F... decongestants are the best choice for a nasal congestion?
T
T or F... it is best to start in histaminees before the symptoms start
T
T or F...A patient on PCA pump still needs to be monitored for adverse effects of opioids?
T
T or F...Anticholinergics are contraindicated in patients with prostate enlargement?
T
T or F...Decongestants are adrenergic agonists?
T
A nurse is discharging a patient home after same-day surgery with a new opioid prescription for pain. The patient states "I'm so glad I get to sleep in my own bed tonight, I will take my sleep gummies and sleep like a baby ". Upon requesting patient reveals that sleep vitamins contain melatonin and valerian root. What is the nurses action?
Tell the patient concurrent use is not recommended and can cause excessive sedation
Ability of drug to cause mutation/become cancerous...?
Teratogenicity
Drug/substance that causes abnormal fetal development/birth defects is called...?
Teratogenicity
Organization enforcing control substances act...?
The drug enforcement administration
Which legislation was written to require companies to determine the safety of medication before marketing?
The federal food, drug and cosmetic act of 1938
What definition is accurate for the trade name of a drug?
The proprietary name of the drug given by a manufacturer
When patient needs higher doses to produce the same effect __________ occurs?
Tolerance
The same nurse calls lab again later in the day to get the drug level before next doses is administered. What is most likely to be drawn?
Trough
A patient is prescribed ciprofloxacin (Cipro). Which instruction does the nurse include in the patient's teaching plan?
Wear sunglasses when exposed to sunlight
A patient states he is allergic to the medication the nurse is ready to administer to him. Which action should be implemented next?
Withhold the medication and notify the prescriber of the situation
