NR 293 - Exam 1 QUESTIONS AND ANSWERS| GRADED A

NR 293 - Exam 1 Pharmaceutics ANS: the dosage form that determines the rate of drug dissolution Pharmacodynamics ANS: - what the drug does to the body - therapeutic effects Selective Enzyme Interaction ANS: when the drug binds to an enzyme molecule and inhibits (blocks) or stimulates the enzyme action with the normal target cell Pharmacokinetics ANS: - what the body does to the drug - study of movement of drugs throughout the body Absorption ANS: being absorbed or used by the tissues Fastest to Slowest Absorption Routes by Mouth ANS: - Sublingual - Liquid Suspension - Capsule - Tablet - Enteric Coated Tablet - Extended Release Tablet First Pass Effect ANS: oral doses of drugs are absorbed into the GI tract and metabolized by the liver, resulting in a reduced amount of bioavailability or active drug in the circulatory system. *Oral doses are generally higher to allow for this effect* Drugs that are Effected by First Pass Effect ANS: - Elixir - Tablets - Capsules *enteral drugs* What drugs aren't effected by First Pass Effect? ANS: - IV - Sublingual - Transdermal Patch - Suppository *parenteral drugs* Half Life ANS: - the time t takes for 1/2 of the drug dose to be eliminated from the body -drugs with a long half life enables them to be taken less frequently EX: ibuprofen has a half life of 2 hours, after 1 half life 200 mg will turn into 100 mg Plasma ANS: yellow fluid part of blood that holds the cells Interstitial Fluid ANS: fluid within the cells Transcellular Fluid ANS: part of extracellular fluid Areas of Fast Distribution ANS: - Heart - Liver Areas of Slow Distribution ANS: - Muscle - Fat - Skin Protein Binding Complications ANS: if a person has a low protein , or albumin level, free drug will be circulating and can cause toxicity of the drug. EX: a person with normal albumin levels is prescribed more than one drug that is highly protein binding. the prescriber will likely decrease the dose of both drugs to avoid drug toxicity Normal Albumin Level ANS: 3.5-5.5 g/dL Metabolism ANS: use and transformation of drugs so that they can be excreted from the body Where are most drugs metabolized/excreted? ANS: - Liver - Kidney Neonates/Infants: Drug Metabolism ANS: have immature liver and kidneys causing them to have decreased or poor metabolism and excretion of drugs Cytochrome P-450 ANS: when drugs are bio-transformed through an enzyme to form fat-soluble metabolites that are easy to eliminate Liver Failure: Drug Metabolism ANS: have difficulty metabolizing certain drugs Fast/Slow Acetylators ANS: genetic conditions that affect how the liver metabolizes drugs Excretion ANS: drugs excreted through liver, kidneys (urine), hair, skin, breath, saliva, perspiration, feces, milk and bile Six Rights of Medication Administration ANS: - Right Patient - Right Drug - Right Route - Right Dose - Right Time - Right Documentation What should you do if part of the order is missing? ANS: NOTIFY THE PRESCRIBER EX: give mr. jones bactrim PO every 6 hours for UTI (no dose is given) Assessment ANS: - always assess the patient before, during and after drug adminitrations - nurses are legally bound as assessment is one of the roles of the RN - failure to assess is a legal liability Diagnosis ANS: Nursing diagnoses Planning ANS: Plan of Care Implementation ANS: Interventions aimed at reaching desired outcome Evaluation ANS: always evaluate the therapeutic response of a medication Definitive Therapy ANS: administering antibiotics based on culture and sensitivity results (preferred method) Drug Dosages ANS: likely need to be decreased in patients with chronic renal failure, liver failure, concurrent use of medications metabolized by the same pathway. Drug Interactions ANS: Altered effects of drug as a result of interaction with other drugs or herbal supplements Drug Routes ANS: - IV - Transdermal Patch - Sublingual - Subcutaneous - Intramuscular - Buccal - Oral - Suppositories Empiric Therapy ANS: administering antibiotics prior to getting culture and sensitivity results, based on experience/knowledge Peak ANS: highest concentration of drug in the systemic circulations (generally drawn 1 hour after drug is infused via IV) Trough ANS: lowest concentration of drug in the systemic circulations