Pharmacology PPT 1-3

All drugs are processed in the body through pharmacokinetics. What is the correct order that drugs pass through the body? a) Absorption, distribution, metabolism, excretion b) Distribution, metabolism, absorption, excretion c) Biotransformation, distribution, absorption, excretion d) Excretion, distribution, absorption, metabolism

Answer: a Rationale: All drugs go through four stages after administration, which can be remembered with the acronym ADME.

Which drug schedule indicates drugs with the highest risk for abuse? a)Schedule I b)Schedule II c)Schedule III d)Schedule IV e)Schedule V

Answer: a Rationale: Schedule I drugs have the highest potential for abuse. They are not currently accepted for medical use in the United States.

Which name(s) of a drug should the nurse use when teaching a patient with a new prescription? a) Trade b) Generic and trade c) Generic and chemical d) Official

Answer: b Rationale: Drug prescriptions may be filled with a trade-name drug or a generic equivalent. If the nurse teaches only one name, it may lead to confusion for the patient when he or she receives a drug with a different name.

Due to the decreased protein-binding capacity in preterm infants, what adjustment in dosage of protein-binding drugs would need to made? a) The dosage should be decreased. b) The dosage should be increased. c) The dosage should be kept at the same level. d) Protein-binding drugs are not administered to infants.

Answer: b Rationale: Drugs that are relatively insoluble are transported in the bloodstream bound to plasma proteins (albumin and globulins). There is a decreased affinity for binding in infants, especially preterm infants. These drugs are then distributed over a wider area of the neonate's body. They will therefore require a higher dosage of these medications in order to achieve a therapeutic effect.

A patient reports postoperative pain, and the nurse administers morphine (a narcotic analgesic) intravenously to ease the pain. Fifteen minutes later, the nurse notes that the patient is very drowsy, respirations are slow and shallow, and oxygen saturation is low. The nurse administers another drug that decreases the action of the morphine. What is this effect called? a) Displacement b) Antagonistic c) Interference d) Synergistic

Answer: b Rationale: The morphine had a greater-than-desired effect on the patient. Because the drug was given intravenously, it is impossible to remove the drug from the patient's bloodstream. Therefore, the nurse does the next best thing and administers another drug that interferes with the action of the first, otherwise known as an antagonistic effect. The result is a decrease in the action of the original drug. The second drug is sometimes referred to as the antidote to the first.

Which type of topical drug is more readily absorbed by infants? a) Fat-soluble b) Water-soluble c) Emollient d) Protective

Answer: b Rationale: Topical administration with percutaneous absorption is usually quite effective in infants because the outer layer of skin is not fully developed. Because the skin is more fully hydrated at this age, water-soluble drugs are absorbed more readily.

Which patient has the greatest percentage of body water? a) Older adult b) Middle-aged person c) Infant d) Toddler

Answer: c Rationale: An infant has a total body water percentage of 74%, whereas a premature infant has an even higher percentage at 83%. As we age, our total percentage of body water decreases and our percentage of total body fat increases.

It is important to maintain therapeutic levels of drugs to avoid the complications of being over- or undermedicated. If a drug level of 0.5 to 2 ng/mL is considered therapeutic, a drug level of 0.45 ng/mL is considered to be what? a) Toxic b) Therapeutic c) Subtherapeutic d) Tolerant

Answer: c Rationale: Drugs are therapeutic when maintained within the normal range for the drug. In this example, the level is below that indicated for the drug, or subtherapeutic. A subtherapeutic level would require increasing the dose for the patient to achieve the maximum benefit of the drug.

How many years on average does it take for a drug to be brought to market from the time of its conception? a) 2 to 3 b) 4 to 7 c) 8 to 15 d) 12 to 18

Answer: c Rationale: It takes 8 to 15 years and can cost up to $1 billion to get a drug to market. This amount of time and money is necessary to adequately test the drug for safety before releasing it to the general population.

Which entity is responsible for monitoring drug safety in the United States? a)Drug Enforcement Agency (DEA) b)Department of Justice (DOJ) C)U.S. Food and Drug Administration (FDA) d)World Health Organization (WHO)

Answer: c Rationale: The FDA is responsible for overseeing drug and cosmetic manufacture and promotion to determine their safety before allowing them to be released to the public.

Which source of information is best for the nurse to obtain drug information? a) Physicians' Desk Reference (PDR) b) Nursing journals c) United States Pharmacopeia (USP) and National Formulary (NF) d) Electronic databases

Answer: d Rationale: All can be sources of drug information but keeping information current is extremely important. Reliable electronic databases can provide the most up-to-date information to health care providers, unlike printed resources that are published only periodically.

Which route of administration has the fastest rate of distribution? a) Subcutaneous b) Intramuscular c) Transcutaneous d) Intravenous

Answer: d Rationale: The IV route places the drug directly into the bloodstream and isn't slowed down by the need to first travel from the GI tract into the bloodstream.

When the nurse administers a 50-mg dose of a drug with a half-life of 6 hours, how many milligrams will remain in the body at 24 hours? a) 25 mg b) 12.5 mg c) 6.25 mg d) 3.13 mg e) 1.56 mg

Answer: d Rationale: The half-life of a drug is the time required for 50% of the drug to be eliminated from the body. In this example at 24 hours, 6.25% or 3.13 mg of the drug would remain in the body.

Which form of medication is more easily administered for a toddler who requires a course of antibiotics? a) Enteric b) Capsules c) Tablets d) Liquid

Answer: d Rationale: Very small children are not able to swallow solids such as tablets or capsules. They should receive medications carefully measured in a calibrated dropper or oral syringe.

A patient is being started on a new drug that has been used safely by many people for years. The patient has no known allergies, and the nurse administers the drug correctly. Suddenly the patient experiences cardiac arrest. What is this type of reaction called? a) Allergic b) Mutagenic c) Idiosyncratic d) Therapeutic

C Rationale: Because the drug was a known safe drug and the patient had no known reason not to receive it, the response to the drug in this case was totally unexpected, or idiosyncratic. An allergic response is typically preceded by such reactions as rash, hives, tingling, or swelling.