NURS 1060: EXAM #2 QUESTIONS AND VERIFIED
ANSWERS LATEST UPDATE
Pharmacokinetics: Four basic processes
Absorption, distribution, metabolism, excretion
Clinical Decision Making
A process used to examine and determine the best actions to meet desired goals;
requires anticipating, recognizing and organizing patient problems to respond with
urgency and/or importance in a preferential order to avoid or minimize adverse changes
in a patients condition
Acid-Base Balance
The physiological mechanisms that maintain blood pH critical to homeostasis and
optimal cell function
Distribution
Movement of the drug from the blood to the site of action or storage area
Drug distribution is determined by three factors
Blood flow to tissues, exiting the vascular system, & entering cells
Blood flow to tissues
Drugs are carried by the blood to tissues and organs of the body, blood flow determines
the rate of delivery, & abscesses and tumors
Abscesses and Tumors
-Low regional blood flow impacts therapy
-Pus-filled pockets, not internal blood vessels
,-Solid tumors have limited blood supply
(This is one reason treatment of abscesses and tumors can be difficult- the amount of
drug to the site is reduced)
Blood flow to Tissues: High blood flow regions-
Heart, liver, kidney, brain
Blood flow to Tissues: Slower blood flow regions-
Muscle, bone, skin
Exiting the Vascular System
Capillary walls: ionized drugs pass between capillary cells.
-Non-ionized or lipid soluble drugs pass between and also directly through the lipid
membrane of cells of the capillary wall
Protein Binding
Drugs can form reversible bonds with protein, plasma albumin is the most important
protein drugs bind with, albumin is a LARGE molecule that always remains in the
bloodstream
Protein Binding (Pt. 2)
Protein binding maintains a consistent level of drug in the blood and prolongs drug
action and constantly maintains drug levels
Protein Binding: Bound Drug
Drugs attached to protein/albumin in the blood
Protein Binding: Free Drug
Drug not attached to protein/albumin in the blood
Protein Binding (Pt. 3)
, -Only free drug can travel to the site of action or a cell
-Bound drug stays in the blood stream
-Competing for protein binding sites will occur when the client is taking two drugs that
are protein bound. Both drugs have an increase in the amount of free drug and a
decrease in the amount of bound drug. Adverse reaction of toxicity can occur
Protein Binding (Pt. 4)
-Albumin is the most prevalent protein in plasma and the most important of the proteins
to which drugs bind
-Only unbound (free) drug molecules can leave the vascular system. Bound molecules
are too large to fit through the pores in the capillary wall
Drugs can enter cells to:
-Reach the site of action
-Undergo metabolism and excretion
Many drugs produce their effects by:
Binding with receptors on the external surface of the cell membrane
-Key and Lock fit
-Do not need to cross the cell membrane to act
Plasma Drug Levels: Clinical Significance
Promote patient safety of maximum benefit with minimum harm
-Individualize dosage for this patient
Two Plasma Drug Levels
Minimum effective concentration (MEC) and Toxic concentration
Minimum Effective Concentration (MEC)
ANSWERS LATEST UPDATE
Pharmacokinetics: Four basic processes
Absorption, distribution, metabolism, excretion
Clinical Decision Making
A process used to examine and determine the best actions to meet desired goals;
requires anticipating, recognizing and organizing patient problems to respond with
urgency and/or importance in a preferential order to avoid or minimize adverse changes
in a patients condition
Acid-Base Balance
The physiological mechanisms that maintain blood pH critical to homeostasis and
optimal cell function
Distribution
Movement of the drug from the blood to the site of action or storage area
Drug distribution is determined by three factors
Blood flow to tissues, exiting the vascular system, & entering cells
Blood flow to tissues
Drugs are carried by the blood to tissues and organs of the body, blood flow determines
the rate of delivery, & abscesses and tumors
Abscesses and Tumors
-Low regional blood flow impacts therapy
-Pus-filled pockets, not internal blood vessels
,-Solid tumors have limited blood supply
(This is one reason treatment of abscesses and tumors can be difficult- the amount of
drug to the site is reduced)
Blood flow to Tissues: High blood flow regions-
Heart, liver, kidney, brain
Blood flow to Tissues: Slower blood flow regions-
Muscle, bone, skin
Exiting the Vascular System
Capillary walls: ionized drugs pass between capillary cells.
-Non-ionized or lipid soluble drugs pass between and also directly through the lipid
membrane of cells of the capillary wall
Protein Binding
Drugs can form reversible bonds with protein, plasma albumin is the most important
protein drugs bind with, albumin is a LARGE molecule that always remains in the
bloodstream
Protein Binding (Pt. 2)
Protein binding maintains a consistent level of drug in the blood and prolongs drug
action and constantly maintains drug levels
Protein Binding: Bound Drug
Drugs attached to protein/albumin in the blood
Protein Binding: Free Drug
Drug not attached to protein/albumin in the blood
Protein Binding (Pt. 3)
, -Only free drug can travel to the site of action or a cell
-Bound drug stays in the blood stream
-Competing for protein binding sites will occur when the client is taking two drugs that
are protein bound. Both drugs have an increase in the amount of free drug and a
decrease in the amount of bound drug. Adverse reaction of toxicity can occur
Protein Binding (Pt. 4)
-Albumin is the most prevalent protein in plasma and the most important of the proteins
to which drugs bind
-Only unbound (free) drug molecules can leave the vascular system. Bound molecules
are too large to fit through the pores in the capillary wall
Drugs can enter cells to:
-Reach the site of action
-Undergo metabolism and excretion
Many drugs produce their effects by:
Binding with receptors on the external surface of the cell membrane
-Key and Lock fit
-Do not need to cross the cell membrane to act
Plasma Drug Levels: Clinical Significance
Promote patient safety of maximum benefit with minimum harm
-Individualize dosage for this patient
Two Plasma Drug Levels
Minimum effective concentration (MEC) and Toxic concentration
Minimum Effective Concentration (MEC)
