MSN 571 ADVANCE PHARMA QUIZ 1 Questions and Answers Latest 2023
Prescriptive authority - Correct Answers legal authority granted to advanced practice
... [Show More] nurses to prescribe medication; DETERMINED BY STATE LAW
Rational Drug Selection - Correct Answers based on individual patient and addresses disease specific information: ONLY A GUIDELINE
Drug Selection - Correct Answers includes analysis of cost, guidelines, availability, interactions, side effects, allergies, hepatic and renal function, need for monitoring, special precautions i.e elderly
medication education basic components - Correct Answers medication name
purpose
dosing regimen
administration
adverse effects
any storage needs
associated labs testing
food & drug interactions
duration of therapy
medication adherence - Correct Answers barriers to adherence=
forgetfulness
lack of planning
cost
dissatisfaction
altered dosing
Phamacokinetics - Correct Answers study of drug movement throughout body
principles of pharmacokinetics - Correct Answersabsorption
distribution
metabolism
excretion
Passage of drugs across membranes - Correct Answers- channels and pores
- transport systems (P-glycoprotein)
- direct penetration of the membrane
Absorption of drugs - Correct AnswersTransfer of drugs from site of administration across cell membrane into the blood stream
factors that affect absorption of drugs - Correct Answersrate of dissolution- how easy dissolves
surface area- >surface area moves faster
blood flow- >blood flow moves faster
lipid solubility - lipid easily cross membrane
ph partitioning -
Distribution of drugs - Correct Answersmovement of drugs from systemic circulation to site of drug action
factors that determine drug flow - Correct Answersblood flow to tissues
ability to exit vascular system
ability to enter cell
Drug ability to exit vascular system - Correct Answerscapillary bed- typical
blood brain barreier
placenta drug transfer
protein binding - albumin
drug ability to enter cell - Correct Answersbinds with receptors on external surface of cell membrane
drug metabolism - Correct Answersthe enzymatic biotransformation of a drug structure
most occur in liver by P450 system
first pass effect - Correct Answersrapid hepatic inactivation of drug on its first pass through liver
drug excretion - Correct Answerselimination of a drug from the body
Drug Excretion Routes - Correct Answersrenal
breast milk
bile
lungs
sweat
saliva
therapeutic drug range - Correct Answersrange of drug between minimum effective dose and toxic dose. larger index - safer dose smaller index- harmful dose
drug half life - Correct Answersthe time required for the amount of drug in the body to decrease by 50%
Phamacodynamics - Correct Answersbiochemical and physiological effects of drugs on body
dose-response relationship - Correct Answersthe relationship between the size of an administered dose and the intensity it produces
Drug selectivity - Correct Answersdrug is effective in intended use w/out harmful effects but causes undesired effects ( nausea)
ease of administration - Correct Answersincreases convenience and adherence and decreases administration efforts
Drug affinity - Correct Answersstrength of attraction between a drug and its receptor
Drug intrinsic activity - Correct Answersability of drug to activate receptor upon binding.
Agonist - Correct Answerseverts effects by activating receptor sites ; can make process so faster or slower
Antagonist - Correct Answersproduce effects by preventing receptor activation
partial agonist - Correct Answershas only moderate intrinsic activity
can act as agonist or antagonist
Drugs that do not require receptor - Correct Answersantacids
saline laxatives
cheating agents
antiseptics
drug therapeutic index - Correct Answersmeasure of drug safety
drug-drug interactions - Correct Answerswhen the effect of a medication is changed, enhanced, or diminished when taken with another drug; caution w/ OTC, herbal, poly pharmacy, illicit drugs
Drug-Food Interactions - Correct Answersoccur when a drug reacts with a food; grapefruit juice major interaction
adverse drug reaction - Correct Answersany unexpected, unintended, undesired, or excessive response to a medication given at therapeutic dosages (as opposed to overdose)
adverse drug reaction examples - Correct Answersallergic reaction, carcinogenic, teratogenic, hepatotoxic, affect QT interval
ways to avoid adverse drug reactions - Correct Answersmonitor liver and kidney function
monitor serum and creating clearance
beers criteria
black box warning
REM's guideline
black box warning - Correct Answersstrongest safety warning drug can have.
placental drug transfer - Correct Answers-all drugs can cross the placenta
-some can cross more easily than others
lipid soluble-easy
others -not easy
Teratogenesis and Stage of Development - Correct Answersweeks 3-8 gross malformation - first trimester most dangerous
weeks 9-38 function disruption
Drug therapy and breast feeding - Correct Answerstake meds after breasfeeding
take drugs with short half life
Drug Therapy in Pediatric Patients - Correct AnswersPediatrics includes all patients under age 16
absorption oral drug- pediatric - Correct Answersdelayed gastric emptying births to (6-8m)
decease acidity from birth to 2 years
absorption IM drug - pediatric - Correct Answersslow and erratic b/c of low blood flow
absorption Transdermal drug - pediatric - Correct Answersrapid and complete bc striatum corner of infant skin is very thin,
distribution - pediatric - Correct Answersdrug easily assess blood brain barrier
protein binding - amount of albumin is low
metabolism - pediatric - Correct Answershepatic metabolism - begins 1 month after birth; mature by 1 year old but. metabolism elevated until 2 years
may need more frequent drug Amin
excretion- pediatric - Correct Answersrenal excretion low at birth, reaches adult levels by 1 year.
adverse drug reaction-reaction-pediatric - Correct Answersglucocorticoids- growth supression
tetracyclines - discolored teet
pediatric dose determination - Correct Answerschild BSA X adult dosage / 1.73m2
Drug Therapy in Geriatric Patients - Correct Answersabsorption - rate slowed delayed gastric emptying
distribution- affected by decrease percentage of lean body, increase body fat; belt o store more lip soluble drugs
metabolism - rate decline w/ age d/t decrease hepatic blood flow
excretion - decrease d/t decline in renal function USE CREATININE CLEARANCE NOT SERUM CREAT
Beers List - Correct Answersa list of drugs with high likelihood of causing adverse effects in older adults
opioid receptors - Correct AnswersMu, kappa, delta
Mu and kappa are most important opioid receptors
Mu opioid receptor - Correct AnswersStimulation produces analgesia, euphoria, respiratory depression and sedation
kapa opioid receptor - Correct Answersstimulation produces analgesia, and sedation
pure opiods - Correct Answersactivate both mu and papa receptor
Physician Dependence - Correct Answersa state when withdrawals will happen if drug is stopped
alcohol physiologic effects - Correct Answersincrease BP
increase risk f heart failure
Increase bone density
liver damage
gastritis
diuretic
decrease sexual function
cancer
affect fetus - pregnancy
alcohol metabolism - Correct Answersaverage approx 15 ml/hr = 1 drink per hour
alcohol drug interactions - Correct AnswersNSAIDS
CNS depressants
Tylenol
BP meds
Vivitrol (Naltrexone) - Correct Answersdecrease craving of alcohol and blocks it's high
Disulfiram - Correct AnswersWhat drug is used to prevent alcohol consumption by causing unpleasant effects
nicotine patch - pregnancy - Correct AnswersSafer than cigarette smoke
drugs to quit smoking - Correct Answersnicotine, Wellbutrin, zyban
Dextromethorphan - Correct AnswersDelsym; cough suppressant OTC ; abused by teenagers and adolescent [Show Less]