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Prescribing basics - ANSWER---Prescribing is regulated by state BON
Proper RX - ANSWER---Providers name and address, Telephone
DEA
Pt name/DOB/Addres
Name of Drug, strength, SIG(directions) with indication/Route and frequency, Quantity and
signature.
Drug Schedules: Most addictive to least - ANSWER---1: Heroin,LSD, MJ
2: hydrocodone, cocaine, Methamphetamine, methadone, oxycodone, meperidine, fentanyl,
adderall, ritalin
3: codeine, ketamine, testosterone
4: xanax, valium, soma, ambient, tramadol
5: antidiarrheal, antitussives, lomotil, lyrica
Pharmicodyamics - ANSWER---The effects of drug on the body. Receptors are large molecules
usually proteins, that interact and mediate the action of drugs
agonist - ANSWER---produce receptor stimulation and a conformational change every time
they bind. Do not need all available receptors to produce a maximum response
Partial agonist - ANSWER---drugs that have properties in b/w those of full agonist and
antagonist. They bind to receptors but when they occupy the receptor sites, they stimulate
only some of the receptors.
antagonist - ANSWER---drugs with affinity for a receptor but with no intrinsic activity. Affinity
allows the antagonist to bind to receptors, but lack of intrinsic activity prevents the bound
antagonist from causing receptor activation. The block action of drugs (ex. Narcan)
, NURS 5334 FINAL QUESTIONS AND ANSWERS
100% CORRECT 2024 LATEST UPDATE
Bioavailabity - ANSWER---% of administered dosage of the drug that survives the first pass
through the liver and reaches the blood stream
half life - ANSWER---Time required for the amount of a drug in the body to decline by 50%,
drugs with shorter half lives must be administer frequently. 4.5-5.5 times the half life to get
steady state and to be limited from the body
what the body does to the drug - ANSWER---absorption, distribution, metabolism, excretion
Distribution - ANSWER---movement of absorbed drug in bodily fluids throughout the body to
target tissue. Properties affecting: lipid/water solubility, PH affects ionization of drug, protein
binding, size of molecule (smaller molecules are more able to diffuse)
Tissue: fat, bone, blood/brain barrier (only lipid soluble will pass), placental barrier (many
drugs can pass)
Protein binding - ANSWER---unbound drug is free which is active, crosses membrane. Low
plasma proteins result in more free drug. Competition: when 2 highly bound drugs are given it
increases the level of both drugs
Metabolism - ANSWER---take place in the liver mostly. Chemical change of a drug structure
to:
Enhance excretion, inactivate the drug, increase therapeutic action, active a prodrug (inactive
until metabolized in the body into the active compound, ex: levodopa), increase or decrease
toxicity
CYP450 - ANSWER---enzymes constitutes the most important of the phase I metabolizing
enzymes (account for about 75% of drug metabolism in the liver)
Phase 2: conjugation reaction occur leading to large increases in hydrophilicity of the
substrates rendering them more readily excretable
, NURS 5334 FINAL QUESTIONS AND ANSWERS
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Substrate - ANSWER---an agent that is metabolized by an enzyme into a metabolite and
product and eventually excreted
Inhibitors - ANSWER---compete with other drugs for a particular enzyme affecting the
metabolism (decreased) of the substrate and decreases the excretion of the substrate and
increasing the circulating drug
inducer - ANSWER---competes with other drugs for a particular enzyme affecting metabolism
of the substrate (increases) decreasing the efficacy of the drug
excretion - ANSWER---renal: passive glomerular filtration, active tubular secretion, tubular
reabsorption, gi tract, lung, sweat and salivary, mammary
genomics - ANSWER---study of the complete set of genetic information present in a cell, an
organism, or species
pharmacogenetics - ANSWER---the study of the influence of hereditary factors on the
response of individual organisms to drugs, and the study of variations of DNA and RNA
characteristics as related to drug response
Pharmacogenetics tests - ANSWER---Mentioned on drug labels can be classified as "test
required," "test recommended," and "information only." Currently, four drugs are required to
have pharmacogenetics testing performed before they are prescribed: cetuximab,
trastuzumab, maraviroc and dasatinib
wafarin, carbamazepine, valproic acid and abacavir are recommended to tests prior to initial
dosing
, NURS 5334 FINAL QUESTIONS AND ANSWERS
100% CORRECT 2024 LATEST UPDATE
Carbamazepine and Asisans - ANSWER---Initiating carbamazepine therapy in these patients
(allele HLA-B*1502) are at high risk for developing Steven Johnson syndrome or toxic
epidermal necrolysis (TEN)
The ability of the anesthetic to penetrate the axon membrane is determined by 3 properties.
What are they? - ANSWER---Molecular size, Lipid solubility, degree of ionization at tissue pH
Why is epinephrine given with local anesthetics? - ANSWER---Decreases local blood flow
(decreased risk of bleeding)
Delays systemic absorption of the anesthetic
prolongs anesthesia
reduces the risk of toxicity
What is the most widely used local anesthetic? - ANSWER---Lidocaine
What is a possible fatal reaction to benzocaine - ANSWER---Methemoglobinemia
What is included in application guidelines for topical anesthetics - ANSWER---avoid wrapping
the site and heating the site, avoid application to open skin
Which medication will not cause rebound headaches from overuse? - ANSWER---propranolol
(preventative)
What is the best option for menstural migraine? - ANSWER---low dose estrogen about 3 days
prior to menses
What food can trigger migraines? - ANSWER---Hot dog d/t nitrates
What medication is a Seratonin 1B1D receptor agonist? - ANSWER---Sumatriptan