QUESTIONS AND CORRECT ANSWERS
▶ Schedule IV? Answer:Lower + Lower + Lower. Benzodiazepines (such
as alprazolam, diazepam, midazolam, temazepam), long-acting
barbituates, meprobamate, pentazocine, and zolpidem. Used
therapeutically with prescription; five refills allowed in a 6 month period.
▶ Schedule V? Answer:Lowest + Lowest + Lowest. Over-the-counter
(OTC) cough medicines with codeine, antidiarrheal medicines with small
amounts of opioids. In some cases, these may be dispensed by a
pharmacist in small amounts without prescription.
▶ Nursing process? Answer:• Assessment- Consists of gathering
subjective data, which includes what the patient says or perceives, and
objective data gathered through physical assessment, laboratory values,
diagnostic tests, and other measurable sources.
• Diagnosis- Assessment data are used to develop a list of problems that
address the patients responses to health and life processes. These
problems, or nursing diagnosis, are used to set goals and plan and direct
care.
• Planning- includes developing appropriate goals and outcomes and
determining nursing interventions that will help the patient achieve these.
• Implementing- when the nurse applies the knowledge, skills, and
principles of nursing care to help move the patient toward the desired goal
and optimum wellness. When applied to pharmacology this involves
administering the drug, monitoring effects, carrying out the interventions
developed in the planning phase to maximize therapeutic response and
prevent adverse events, and teaching the patient or family to administer the
medication at home if necessary and about the monitoring required for the
drug used.
• Evaluation- Considers the effectiveness of the plan of care and
interventions in meeting the established goals and outcomes. If patient has
met goals then the problem is resolved, but if the patient has not met the
goals the nurse reviews and rewrites the care plan.
,▶ Pharmacotherapy and the pregnant patient? Answer:o Physiological
changes during pregnancy can alter normal pharmacokinetic responses.
o During pregnancy increased levels of progesterone cause a delay in
gastric emptying and GI motility. This causes the drugs to remain in the GI
tract longer leading to higher drug absorption of oral drugs.
o Distribution of drugs during pregnancy is affected by changes in total
body water, which may increase by over 50%. This creates greater dilution
of plasma proteins causing more free drugs in the plasma due to lack of
binding sites. This then results in more drug molecules being available for
transfer across the placenta or to be secreted in breast milk.
o Metabolism is least affected by pregnancy.
o Excretion can cause doses of medications to be adjusted due to
enhanced renal plasma flow which can increase 50% to 70% during the
first two trimesters.
▶ Risk Category A? Answer:Adequate, well-controlled studies in pregnant
women have not shown an increased risk of fetal abnormalities to the fetus
in any trimester of pregnancy.Prenatal multivitamins, insulin, thyroxine, folic
acid
▶ Risk Category B? Answer:Animal studies have revealed no evidence of
harm to the fetus; however, there are no adequate and well-controlled
studies in pregnant women. OR Animal studies have shown an adverse
effect, but adequate and well-controlled studies in pregnant women have
failed to demonstrate risk to the fetus in any trimester. Penicillins,
cephalosporins, azithromycin, acetaminophen, ibuprofen in the first and
second trimesters.
▶ Risk Category C? Answer:Animal studies have shown an adverse effect
and there are no adequate and well-controlled studies in pregnant women.
OR No animal studies have been conducted and there are no adequate
Most prescription medicines; antimicrobials such as clarithromycin,
fluoroquinolones, and Bactrim; selective serotonin reuptake inhibitors
(SSRIs); corticosteroids; and most antihypertensives
▶ Risk Category D? Answer:Adequate well-controlled or observational
studies in pregnant women have demonstrated a risk to the fetus.
However, the benefits of therapy may outweigh the potential risk. For
example, the drug my be acceptable if needed in a life-threatening situation
or serious disease for which safer drugs cannont be used or are
, ineffective.ACE inhibitors, alcohol, alprazolam, angiotensin rececptor
blockers in the second and third trimesters, carbamazepine,
cyclophosphamide, gentamicin, lithium carbonate, methimazole, mitomycin,
nicotine, NSAIDS
▶ Risk Category X? Answer:Adequate well-controlled or observational
studies in animals or pregnant women have demonstrated positive
evidence of fetal abnormalities or risks. The use of the product is
contraindicated in women who are or may become pregnant. There is no
indication for use in pregnancy. Clomiphene, fluorouracil, isotretinoin,
leuprolide, menotropins, methotrexate, misoprostol, nafarelin, oral
contaceptivves, raloxiphene, ribavirim, statins, temazepam, testosterone,
thalidomide, and warfarin.
▶ Pharmacotherapy and the older adult? Answer:o Normal aging
processes can alter pharmacokinetic and pharmacodynamics responses to
drugs.
o Overall, absorption of nutrients and drugs tend to slow with aging.
o Age related increases in fat storage cause lipid soluble drugs to be stored
in the body for extended periods, leading to lower plasma levels and
increased drug concentrations in the tissues.
o Age related changes in the liver include reduced hepatic function,
decreased liver mass, diminished blood flow, and alteration in the activity of
hepatic enzymes.
o Frequency of administration should be decreased to avoid toxicity due to
drug accumulation.
o Pharmacodynamic changes are usually associated with drug receptors.
Evidence suggests that older adults have a decreased number of
receptors.
▶Drug? Answer:Any substance that is taken to cure, or reduce symptoms
of a medical condition.
▶ Pharmacology? Answer:The study of medicine.
▶ Pharmacotherapy/Pharmacotherapeutics? Answer:Application of drugs
for the purpose of disease prevention and treatment of suffering.