MSN 611 - Pharm Final Exam Information ()
Questions and Verified Answers, 100% Guarantee Pass
Nursing Fundamentals
IV route is the fastest
Pharmacokinetics
ADME
1. Absorption: how medication gains access to the body
2. Distribution
3. Metabolism
4. Excretion
1st pass effect
When a drug is metabolized at a specific point in the body, resulting in a lower
concentration of the active substance.
This phenomenon is termed the first-pass effect and is most often described in the
context of absorption of chemicals following ingestion. In general, the first-pass
effect after oral absorption is the result of efficient uptake and metabolism of
compounds by the liver.
Generic vs Brand
A medication only has ONE generic name but can have MULTIPLE brand names
(ex: ibuprofen; MOTRIN/ADVIL)
When should a patient be assessed before administering a medication?
The patient should be assessed right before administration of a drug (ex: assess BP
prior to administering a BP med)
What assessment in a patient needs immediate intervention?
Oliguria or anuria
,NSAIDS
Nephrotoxic & Hepatotoxic
COX-1/COX-2 inhibitors with the exception of Celecoxib
#1 Adverse Effect: GI bleeding (fecal occult blood test)
Acetaminophen
Hepatotoxic
Not an antiinflammatory
Corticosteroids
Different routes--> inhaled, intranasal, IM, topical
Major systemic adverse effects: hyperglycemia, HTN, depressed immune function,
decreased bone density (for these reasons we do NOT like to administer steroids
systemically)
What reasons are steroids used?
Asthma, cancer, nausea, etc.
Serotonin 5-HT Receptor Agonists (-triptans)
Work to treat migraines
Migraines are most common in females
These medications are TERATOGENIC
Contraindicated in patients with cardiac disease, HTN, or taking other medications
such as SSRIs/SNRIs
Opioids
Patients should not be on more than one opioid medication
Can cause bradypnea and hypotension
Long-term side effect: constipation
, *Naloxone is used to reverse OD
What other uses do opioids have?
Cough (codeine)
Diarrhea
SSRIs
Increase overall serotonin in the body
1st line medication for depression and anxiety
Sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), escitalopram (Lexapro),
and citalopram (Celexa)
Can increase risk for suicide (black box warning) --> ask the patient if they have
any thoughts of suicide
SE: weight gain and sexual dysfunction
Can cause insomnia so this should be taken in the morning
Risk for serotonin syndrome
TCAs/SNRIs
Work to block the body getting rid of NE and serotonin
TCA Examples: Amitriptyline, Doxepin, Amoxapine
SNRI Examples: Desvenlafaxine (Pristiq), Duloxetine (Cymbalta), Venlafaxine
(Effexor)
Secondary options for depression and anxiety
SNRIs are also used for neuropathic pain
MAOIs
Do not mix with tyramine containing food (aged cheeses, cured meats,
pickled/fermented foods, alcohol)
Questions and Verified Answers, 100% Guarantee Pass
Nursing Fundamentals
IV route is the fastest
Pharmacokinetics
ADME
1. Absorption: how medication gains access to the body
2. Distribution
3. Metabolism
4. Excretion
1st pass effect
When a drug is metabolized at a specific point in the body, resulting in a lower
concentration of the active substance.
This phenomenon is termed the first-pass effect and is most often described in the
context of absorption of chemicals following ingestion. In general, the first-pass
effect after oral absorption is the result of efficient uptake and metabolism of
compounds by the liver.
Generic vs Brand
A medication only has ONE generic name but can have MULTIPLE brand names
(ex: ibuprofen; MOTRIN/ADVIL)
When should a patient be assessed before administering a medication?
The patient should be assessed right before administration of a drug (ex: assess BP
prior to administering a BP med)
What assessment in a patient needs immediate intervention?
Oliguria or anuria
,NSAIDS
Nephrotoxic & Hepatotoxic
COX-1/COX-2 inhibitors with the exception of Celecoxib
#1 Adverse Effect: GI bleeding (fecal occult blood test)
Acetaminophen
Hepatotoxic
Not an antiinflammatory
Corticosteroids
Different routes--> inhaled, intranasal, IM, topical
Major systemic adverse effects: hyperglycemia, HTN, depressed immune function,
decreased bone density (for these reasons we do NOT like to administer steroids
systemically)
What reasons are steroids used?
Asthma, cancer, nausea, etc.
Serotonin 5-HT Receptor Agonists (-triptans)
Work to treat migraines
Migraines are most common in females
These medications are TERATOGENIC
Contraindicated in patients with cardiac disease, HTN, or taking other medications
such as SSRIs/SNRIs
Opioids
Patients should not be on more than one opioid medication
Can cause bradypnea and hypotension
Long-term side effect: constipation
, *Naloxone is used to reverse OD
What other uses do opioids have?
Cough (codeine)
Diarrhea
SSRIs
Increase overall serotonin in the body
1st line medication for depression and anxiety
Sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), escitalopram (Lexapro),
and citalopram (Celexa)
Can increase risk for suicide (black box warning) --> ask the patient if they have
any thoughts of suicide
SE: weight gain and sexual dysfunction
Can cause insomnia so this should be taken in the morning
Risk for serotonin syndrome
TCAs/SNRIs
Work to block the body getting rid of NE and serotonin
TCA Examples: Amitriptyline, Doxepin, Amoxapine
SNRI Examples: Desvenlafaxine (Pristiq), Duloxetine (Cymbalta), Venlafaxine
(Effexor)
Secondary options for depression and anxiety
SNRIs are also used for neuropathic pain
MAOIs
Do not mix with tyramine containing food (aged cheeses, cured meats,
pickled/fermented foods, alcohol)
