NURS 615 PHARM EXAM 1 MARYVILLE
What factors are associated with clinical judgment when prescribing medications? -
ANS-Prescribing a drug is based on a thorough assessment of the patient and the
patient's environment. The determination of potential medical and nursing diagnoses, a
review of the potential alternative therapies, specific knowledge about the drug chosen,
and the disease process it is going to treat, known as patient centered care. The best
therapy is usually the least invasive, least expensive, and the least likely to cause
adverse reactions
What are the criteria for choosing an effective drug? - ANS-Multiple drugs may be able
to treat a specific condition. You must consult nationally recognized guidelines for
disease management to determine the most effective drug.
How does hypoalbuminemia affect the process of prescribing? - ANS-Many drugs that
carry an electric charge are bound to albumin in the blood. The distribution of the drug
to target tissues may be affected if hypoalbuminemia is present.
What is the drug's half-life? - ANS-In clinical practice it takes about four to five times the
half-life for a drugs concentration to read steady state after a drug is started, stopped or
changed. Hal life is the amount of time for a drug to be half cleared.
What is meant by the onset of action, peak of action, duration of action of medications?
- ANS-The onset of action is the time between the drug administration and the time that
you see the drugs minimum effect. Onset is the first sign of a drugs therapeutic effect.
Peak of action is the time of the maximum concentration of the drug in the blood.
Duration of action is the onset of action and the metabolism of the drug below the dose
needed for an effect.
Explain first pass metabolism. - ANS-This occurs when the concentration of the drug is
greatly reduced before it reaches the systemic circulation. It is the portion of the drug
lost during absorption. Generally, occurs in the liver or gut wall. After a drug is
swallowed it is absorbed by the digestive system and enters the hepatic system. It is
then carried by the portal vein to the liver before it reaches the rest of the body. The liver
metabolizes many drugs to such an extent that only a small portion of the drug reaches
the rest of the body. bioavailability of the drug thus is greatly reduced by the liver.
Sublingual administration can bypass the first pass system plus it is also faster than oral
route.
, What is a steady state? - ANS-The overall intake of a drug is fairly and dynamic
equilibrium with its elimination. Steady state is reached when the time of four to five
times the half-life is reached since the drug had been started.
What factors affect the drug's absorption? - ANS-Absorption involves several steps.
First the drug must be introduced via route of administration and the form of medication
like tablet or capsule. In IV or IM administration the absorption is less variable and
bioavailability is near 100%. IV administration is considered to lose no portion of the
drug. The fastest route of absorption is inhalation. Drugs must pass through the
epithelial cells of the GI tract to be absorbed by the circulatory system. Cell membranes
may affect the absorption of some drugs because they are made of lipid bilayers that
are semi permeable. This means only small uncharged solutes can pass through the
membrane. Whether or not a molecule is ionized affects the absorption, since ionic
molecules are charged. Solubility favors charged species. Permeability favors neutral
species. Some molecules have special channels to facilitate movement from the lumen
into the circulation. The Henderson Hasselbeck equation offers a way to determine the
portion that is ionized in a given pH. Weak acids will be present in their nonionic form in
the stomach because of the acidic pH and bases will be in their ionic form. Nonionic
species diffuse easier through cell membranes. Weak acids have a higher absorption
rate in the stomach. The opposite is true in the basic environment of the stomach.
Identify drug metabolism and the role of the isoenzymes of the P450 system. -
ANS-CYPs are the major enzymes in drug metabolism. Must drugs undergo
deactivation by CYPs are directly facilitated secretion from the body. Many substances
are bioactivated by CYPs to form their active compound. Many drugs increase or
decrease the activity of CYPs isoenzymes either by inducing biosynthesis of an
isozyme, which is enzyme induction or by directly inhibiting the activity of CYP which is
enzyme inhibition. This is a major source of adverse drug reactions since changes in
CYPs activity may affect the metabolism and clearance of certain drugs. When two
drugs are both metabolized by the CYP450 system the drugs should be administered at
separate times to prevent toxic effects.
What is the efficacy of the drug? - ANS-Efficacy is the maximum response achievable
from a drug. Intrinsic activity is a term used to describe the efficacy of a drug relative to
a drugs highest observed efficacy. Effectiveness refers to the ability of a drug to produce
the wanted effect.
On the drug concentration curve what is the first sign of a therapeutic effect? - ANS-The
onset of action.
What factors are associated with clinical judgment when prescribing medications? -
ANS-Prescribing a drug is based on a thorough assessment of the patient and the
patient's environment. The determination of potential medical and nursing diagnoses, a
review of the potential alternative therapies, specific knowledge about the drug chosen,
and the disease process it is going to treat, known as patient centered care. The best
therapy is usually the least invasive, least expensive, and the least likely to cause
adverse reactions
What are the criteria for choosing an effective drug? - ANS-Multiple drugs may be able
to treat a specific condition. You must consult nationally recognized guidelines for
disease management to determine the most effective drug.
How does hypoalbuminemia affect the process of prescribing? - ANS-Many drugs that
carry an electric charge are bound to albumin in the blood. The distribution of the drug
to target tissues may be affected if hypoalbuminemia is present.
What is the drug's half-life? - ANS-In clinical practice it takes about four to five times the
half-life for a drugs concentration to read steady state after a drug is started, stopped or
changed. Hal life is the amount of time for a drug to be half cleared.
What is meant by the onset of action, peak of action, duration of action of medications?
- ANS-The onset of action is the time between the drug administration and the time that
you see the drugs minimum effect. Onset is the first sign of a drugs therapeutic effect.
Peak of action is the time of the maximum concentration of the drug in the blood.
Duration of action is the onset of action and the metabolism of the drug below the dose
needed for an effect.
Explain first pass metabolism. - ANS-This occurs when the concentration of the drug is
greatly reduced before it reaches the systemic circulation. It is the portion of the drug
lost during absorption. Generally, occurs in the liver or gut wall. After a drug is
swallowed it is absorbed by the digestive system and enters the hepatic system. It is
then carried by the portal vein to the liver before it reaches the rest of the body. The liver
metabolizes many drugs to such an extent that only a small portion of the drug reaches
the rest of the body. bioavailability of the drug thus is greatly reduced by the liver.
Sublingual administration can bypass the first pass system plus it is also faster than oral
route.
, What is a steady state? - ANS-The overall intake of a drug is fairly and dynamic
equilibrium with its elimination. Steady state is reached when the time of four to five
times the half-life is reached since the drug had been started.
What factors affect the drug's absorption? - ANS-Absorption involves several steps.
First the drug must be introduced via route of administration and the form of medication
like tablet or capsule. In IV or IM administration the absorption is less variable and
bioavailability is near 100%. IV administration is considered to lose no portion of the
drug. The fastest route of absorption is inhalation. Drugs must pass through the
epithelial cells of the GI tract to be absorbed by the circulatory system. Cell membranes
may affect the absorption of some drugs because they are made of lipid bilayers that
are semi permeable. This means only small uncharged solutes can pass through the
membrane. Whether or not a molecule is ionized affects the absorption, since ionic
molecules are charged. Solubility favors charged species. Permeability favors neutral
species. Some molecules have special channels to facilitate movement from the lumen
into the circulation. The Henderson Hasselbeck equation offers a way to determine the
portion that is ionized in a given pH. Weak acids will be present in their nonionic form in
the stomach because of the acidic pH and bases will be in their ionic form. Nonionic
species diffuse easier through cell membranes. Weak acids have a higher absorption
rate in the stomach. The opposite is true in the basic environment of the stomach.
Identify drug metabolism and the role of the isoenzymes of the P450 system. -
ANS-CYPs are the major enzymes in drug metabolism. Must drugs undergo
deactivation by CYPs are directly facilitated secretion from the body. Many substances
are bioactivated by CYPs to form their active compound. Many drugs increase or
decrease the activity of CYPs isoenzymes either by inducing biosynthesis of an
isozyme, which is enzyme induction or by directly inhibiting the activity of CYP which is
enzyme inhibition. This is a major source of adverse drug reactions since changes in
CYPs activity may affect the metabolism and clearance of certain drugs. When two
drugs are both metabolized by the CYP450 system the drugs should be administered at
separate times to prevent toxic effects.
What is the efficacy of the drug? - ANS-Efficacy is the maximum response achievable
from a drug. Intrinsic activity is a term used to describe the efficacy of a drug relative to
a drugs highest observed efficacy. Effectiveness refers to the ability of a drug to produce
the wanted effect.
On the drug concentration curve what is the first sign of a therapeutic effect? - ANS-The
onset of action.
