..
. lOMoAR cPSD| 19500986
. .
..
ATI PHARMACOLOGY
.
PROCTORED STUDY .
GUIDE EXAM QUESTION AND ANSWERS LATEST UPDATE
. . . . . .
Chapter .1: .Pharmacokinetics .and .Routes .of .Administration . .
• Absorption .
▪ Route .of .admin .affects .the .rate .and .amount .of
.absorption o.
Oral: . .
▪ GI .pH .and .emptying .time . .
▪ Presence .of .food .in .the .stomach .or .intestines . .
▪ Form .of .meds .(liquid/XR) .o .Sublingual/buccal . .
▪ Quick .absorption .systemically .through .highly .vascular
.mucous .membranes . .
o Inhalation .via .mouth/nose . .
▪ Rapid .absorption .through .alveolar .capillary .networks
.o .Intradermal, .topical . .
▪ Slow, .gradual .absorption .o .SQ/IM . .
▪ Highly .soluble .meds .have .rapid .absorption .(10-
30min), .poorly .soluble .have .slower .absorption . .
▪ Blood .perfusion .at .site .of .injection .affect .absorption .
. o .IV . .
▪ Immediate .and .complete . .
• Distribution .o .Transportation .of .meds .to .sites .of .action .by .body
.fluids . .o .Plasma .binding .protein: .meds .compete .for .protein .binding
.sites .within .bloodstream, .primarily .albumin. .The .ability .of .med .to
.bind .to .protein .can .affect .how .much .med .will .leave .and .travel .to
.target .tissues. . .
• Metabolism .
o Primarily .occurs .in .the .liver .but .can .take .place .in .the .kidney
.o .Factors .that .influence .metabolism: . .
▪ Age .(infants/older .adults .require .smaller .doses) . .
..
,..
. lOMoAR cPSD| 19500986
. .
▪ First .pass .effect: .liver .inactivates .some .meds .on .first
.pass .through .and .thus .require .sublingual .or .IV .route
.(may .need .higher .dose) . .
• Excretion: .o .Eliminated .through .the .kidneys. . .
o Kidney .dysfunction .can .result .in .elevated .levels .of
.medications. . .
• Med .Response .o .Maintain .plasma .levels .between .minimum
.effective .concentration .and .the .toxic .concentration: . .
• Therapeutic .index .(TI) .o .High .TI .has .a .wide .safety .margin. .o .Low
.TI .requires .monitoring .of .serum .levels. .o .Tough .levels: .obtain
.immediately .before .next .dose. . . .
.. Downloaded .by .John .Kabiru .() . .
,..
. lOMoAR cPSD| 19500986
. .
• Half-life: .o .Time .it .takes .a .medication .level .to .drop .in .the .body .by
.50%. .o .Short .vs .long .half-life: .long .half-life .has .greater .risk .for .med
.accumulation .in .body. . .
• Agonist: . enhance .
• Antagonist: . blocks .
• Routes .of . admin: .o .Oral/Enteral: . .
▪ 90 .degrees .upright .
▪ do .not .mix .with .large .amounts .of .food .
▪ lean .chin .in .to .help .facilitate .swallowing o.
Sublingual/buccal . .
▪ Keep .med .in .place .until .completely .dissolved o
.Transdermal . .
▪ Wash .skin .with .soap .and .water .then .dry .it .thoroughly
.before .placing .patch. .Place .patch .on .hairless .area .and .rotate
.sites .to .prevent .irritation. o .Drops: . .
▪ Place .drop .in .center .of .sac. .
▪ Avoid .placing .directly .on .cornea. .
▪ If .blink .repeat .process. .
▪ Apply .gentle .pressure .with .finger .and .a .clean .facial
.tissue .on .the .nasolacrimal .duct .for .30-60 .seconds .to .prevent
.systemic .absorption. o .Ears: . .
▪ Have .client .lay .on .unaffected .side. .
▪ Up .and .out .for .adults .
▪ Down .and .back .for .children o .Inhalation: . .
▪ MDI .
• Shake .vigorously .5-6 .times . .
• Take .a .deep .breath .and .then .exhale . .
• Slow .deep .breath .for .3-5 .seconds .from .MDI . .
• Hold .breath .for .10 .seconds .after . .
▪ .DPI .•
. DO .NOT .SHAKE .DEVICE . .
• Place .mouthpiece .between .lips .and .take .a .deep .breath . .
• Hold .breath .for .5-10 .seconds . .
o NG/Gastrostomy .tubes . .
▪ To .prevent .clogging .flush .tube .before .and .after .each .med
.with .15-30ml .of .warm .sterile .water. .o .Suppositories: . .
▪ Left .lateral .sims .position. .
..
, ..
. lOMoAR cPSD| 19500986
. .
▪ Insert .beyond .internal .sphincter .
▪ Remain .flat .or .left .lateral .for .5 .min .after .insertion. . o
. Intradermal: . .
▪ Used .for .allergy .testing .
▪ Used .for .tb .testing .
▪ Small .amount .of .solution .(no .more .than .0.1ml) .
▪ 10-15-degree .angle .bevel .up. o .Z-track: .for .iron . .
..
Chapter .2: .Safe .Med .Admin .and .Error .Reduction . .
• Types .of .Prescriptions: .o .Routine/standard: .regularly .scheduled .meds .o
.Single/one .time: .asap .or .a .specific .time . .o .Stat: .once .and .immediately .o
.PRN: .as .needed . .o .Standing: .specific .circumstances .or .specific .units: .ex:
.heparin .protocol . .
• Taking .a .phone .prescription: .o .Have .2nd .nurse .on .line .if .possible .o .Read-
back .prescription .o .Verify .and .sign .within .24 .hours . .
• Med .rec: . o .Take .place .at .admission, .transfer .of .clients, .and .discharge. . .
• RIGHTS .OF .SAFE .MED .ADMIN: .o .Right .client .o .Right .med .o .Right .dose .o
. Right .time .o .Right .route .o .Right .documentation .o .Right .client .education .o
. Right .to .refuse .o .Right .assessment .o .Right .evaluation . .
• Evaluation .o .Report .all .errors .and .implement .corrective .measures
.immediately . .
▪ .Complete .incident .report .within .time .frame .the .facility .specifies .(usually . .24
.hours) .and .it .should .include . .
• Client .id, .name .and .dose .of .med, .time .and .place .of .incident, .accurate .and
.objective .account .of .event, .who .you .notified, .what .actions .you .took, .your
.signature. . .
▪ Do .not .reference .or .include .report .in .clients .medical .record . .
▪Med .errors .relate .to .systems, .procedures, .product .design, .or .practice
.patterns. .Report .all .errors .to .help .avoid .similar .errors .in .future. . .
Chapter .3: .Dosage .Calculation .
. 1kg=1000mg .• .
1oz=30mL .
• 1L=1000mL .Chapter .4: .IV .Therapy . .
• Rapid .and .precise .
.. Downloaded .by .John .Kabiru .() . .
. lOMoAR cPSD| 19500986
. .
..
ATI PHARMACOLOGY
.
PROCTORED STUDY .
GUIDE EXAM QUESTION AND ANSWERS LATEST UPDATE
. . . . . .
Chapter .1: .Pharmacokinetics .and .Routes .of .Administration . .
• Absorption .
▪ Route .of .admin .affects .the .rate .and .amount .of
.absorption o.
Oral: . .
▪ GI .pH .and .emptying .time . .
▪ Presence .of .food .in .the .stomach .or .intestines . .
▪ Form .of .meds .(liquid/XR) .o .Sublingual/buccal . .
▪ Quick .absorption .systemically .through .highly .vascular
.mucous .membranes . .
o Inhalation .via .mouth/nose . .
▪ Rapid .absorption .through .alveolar .capillary .networks
.o .Intradermal, .topical . .
▪ Slow, .gradual .absorption .o .SQ/IM . .
▪ Highly .soluble .meds .have .rapid .absorption .(10-
30min), .poorly .soluble .have .slower .absorption . .
▪ Blood .perfusion .at .site .of .injection .affect .absorption .
. o .IV . .
▪ Immediate .and .complete . .
• Distribution .o .Transportation .of .meds .to .sites .of .action .by .body
.fluids . .o .Plasma .binding .protein: .meds .compete .for .protein .binding
.sites .within .bloodstream, .primarily .albumin. .The .ability .of .med .to
.bind .to .protein .can .affect .how .much .med .will .leave .and .travel .to
.target .tissues. . .
• Metabolism .
o Primarily .occurs .in .the .liver .but .can .take .place .in .the .kidney
.o .Factors .that .influence .metabolism: . .
▪ Age .(infants/older .adults .require .smaller .doses) . .
..
,..
. lOMoAR cPSD| 19500986
. .
▪ First .pass .effect: .liver .inactivates .some .meds .on .first
.pass .through .and .thus .require .sublingual .or .IV .route
.(may .need .higher .dose) . .
• Excretion: .o .Eliminated .through .the .kidneys. . .
o Kidney .dysfunction .can .result .in .elevated .levels .of
.medications. . .
• Med .Response .o .Maintain .plasma .levels .between .minimum
.effective .concentration .and .the .toxic .concentration: . .
• Therapeutic .index .(TI) .o .High .TI .has .a .wide .safety .margin. .o .Low
.TI .requires .monitoring .of .serum .levels. .o .Tough .levels: .obtain
.immediately .before .next .dose. . . .
.. Downloaded .by .John .Kabiru .() . .
,..
. lOMoAR cPSD| 19500986
. .
• Half-life: .o .Time .it .takes .a .medication .level .to .drop .in .the .body .by
.50%. .o .Short .vs .long .half-life: .long .half-life .has .greater .risk .for .med
.accumulation .in .body. . .
• Agonist: . enhance .
• Antagonist: . blocks .
• Routes .of . admin: .o .Oral/Enteral: . .
▪ 90 .degrees .upright .
▪ do .not .mix .with .large .amounts .of .food .
▪ lean .chin .in .to .help .facilitate .swallowing o.
Sublingual/buccal . .
▪ Keep .med .in .place .until .completely .dissolved o
.Transdermal . .
▪ Wash .skin .with .soap .and .water .then .dry .it .thoroughly
.before .placing .patch. .Place .patch .on .hairless .area .and .rotate
.sites .to .prevent .irritation. o .Drops: . .
▪ Place .drop .in .center .of .sac. .
▪ Avoid .placing .directly .on .cornea. .
▪ If .blink .repeat .process. .
▪ Apply .gentle .pressure .with .finger .and .a .clean .facial
.tissue .on .the .nasolacrimal .duct .for .30-60 .seconds .to .prevent
.systemic .absorption. o .Ears: . .
▪ Have .client .lay .on .unaffected .side. .
▪ Up .and .out .for .adults .
▪ Down .and .back .for .children o .Inhalation: . .
▪ MDI .
• Shake .vigorously .5-6 .times . .
• Take .a .deep .breath .and .then .exhale . .
• Slow .deep .breath .for .3-5 .seconds .from .MDI . .
• Hold .breath .for .10 .seconds .after . .
▪ .DPI .•
. DO .NOT .SHAKE .DEVICE . .
• Place .mouthpiece .between .lips .and .take .a .deep .breath . .
• Hold .breath .for .5-10 .seconds . .
o NG/Gastrostomy .tubes . .
▪ To .prevent .clogging .flush .tube .before .and .after .each .med
.with .15-30ml .of .warm .sterile .water. .o .Suppositories: . .
▪ Left .lateral .sims .position. .
..
, ..
. lOMoAR cPSD| 19500986
. .
▪ Insert .beyond .internal .sphincter .
▪ Remain .flat .or .left .lateral .for .5 .min .after .insertion. . o
. Intradermal: . .
▪ Used .for .allergy .testing .
▪ Used .for .tb .testing .
▪ Small .amount .of .solution .(no .more .than .0.1ml) .
▪ 10-15-degree .angle .bevel .up. o .Z-track: .for .iron . .
..
Chapter .2: .Safe .Med .Admin .and .Error .Reduction . .
• Types .of .Prescriptions: .o .Routine/standard: .regularly .scheduled .meds .o
.Single/one .time: .asap .or .a .specific .time . .o .Stat: .once .and .immediately .o
.PRN: .as .needed . .o .Standing: .specific .circumstances .or .specific .units: .ex:
.heparin .protocol . .
• Taking .a .phone .prescription: .o .Have .2nd .nurse .on .line .if .possible .o .Read-
back .prescription .o .Verify .and .sign .within .24 .hours . .
• Med .rec: . o .Take .place .at .admission, .transfer .of .clients, .and .discharge. . .
• RIGHTS .OF .SAFE .MED .ADMIN: .o .Right .client .o .Right .med .o .Right .dose .o
. Right .time .o .Right .route .o .Right .documentation .o .Right .client .education .o
. Right .to .refuse .o .Right .assessment .o .Right .evaluation . .
• Evaluation .o .Report .all .errors .and .implement .corrective .measures
.immediately . .
▪ .Complete .incident .report .within .time .frame .the .facility .specifies .(usually . .24
.hours) .and .it .should .include . .
• Client .id, .name .and .dose .of .med, .time .and .place .of .incident, .accurate .and
.objective .account .of .event, .who .you .notified, .what .actions .you .took, .your
.signature. . .
▪ Do .not .reference .or .include .report .in .clients .medical .record . .
▪Med .errors .relate .to .systems, .procedures, .product .design, .or .practice
.patterns. .Report .all .errors .to .help .avoid .similar .errors .in .future. . .
Chapter .3: .Dosage .Calculation .
. 1kg=1000mg .• .
1oz=30mL .
• 1L=1000mL .Chapter .4: .IV .Therapy . .
• Rapid .and .precise .
.. Downloaded .by .John .Kabiru .() . .
