MSN 571 Nursing Exam
Prescriptive authority - ANSWERlegal authority granted to advanced practice nurses to prescribe medication; DETERMINED BY STATE
... [Show More] LAW
Rational Drug Selection - ANSWERbased on individual patient and addresses disease specific information: ONLY A GUIDELINE
Drug Selection - ANSWERincludes analysis of cost, guidelines, avaibalbility, interactions, side effects, allergies, hepatic and renal function, need for monitoring, special precautions i.e elderly
medication education basic components - ANSWERmedication name purpose
dosing regimen administration adverse effects any storage needs
associated labs testing food & drug interactions duration of therapy
medication adherence - ANSWERbarriers to adherence= forgetfulness
lack of planning cost dissatisfaction altered dosing
Phamacokinetics - ANSWERstudy of drug movement throughout body
principles of pharmacokinetics - ANSWERabsorption distribution
metabolism excretion
Passage of drugs across membranes - ANSWER- channels and pores
- transport systems (P-glycoprotein)
- direct penetration of the membrane
Absorption of drugs - ANSWERTransfer of drugs from site of administration across cell membrane into the blood stream
factors that affect absorption of drugs - ANSWERrate 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 - ANSWERmovement of drugs from systemic circulation to site of drug action
factors that determine drug flow - ANSWERblood flow to tissues ability to exit vascular system
ability to enter cell
Drug ability to exit vascular system - ANSWERcapillary bed- typical
blood brain barreier placenta drug transfer protein binding - albumin
drug ability to enter cell - ANSWERbinds with receptors on external surface of cell membrane
drug metabolism - ANSWERthe enzymatic biotransformation of a drug structure most occur in liver by P450 system
first pass effect - ANSWERrapid hepatic inactivation of drug on its first pass through liver
drug excretion - ANSWERelimination of a drug from the body
Drug Excretion Routes - ANSWERrenal breast milk
bile lungs sweat saliva
therapeutic drug range - ANSWERrange of drug between minimum effective dose and toxic dose. larger index - safer dose smaller index- harmful dose
drug half life - ANSWERthe time required for the amount of drug in the body to decrease by 50%
Phamacodynamics - ANSWERbiochemical and physiological effects of drugs on body
dose-response relationship - ANSWERthe relationship between the size of an administered dose and the intensity it produces
Drug selectivity - ANSWERdrug is effective in intended use w/out harmful effects but causes undesired effects ( nausea)
ease of administration - ANSWERincreases convenience and adherence and decreases administration efforts
Drug affinity - ANSWERstrength of attraction between a drug and its receptor
Drug intrinsic activity - ANSWERability of drug to activate receptor upon binding.
Agonist - ANSWEReverts effects by activating receptor sites ; can make process so faster or slower
Antagonist - ANSWERproduce effects by preventing receptor activation
partial agonist - ANSWERhas only moderate intrinsic activity can act as agonist or antagonist
Drugs that do not require receptor - ANSWERantacids saline laxatives
cheating agents antiseptics
drug therapeutic index - ANSWERmeasure of drug safety
drug-drug interactions - ANSWERwhen 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 - ANSWERoccur when a drug reacts with a food; grapefruit juice major interaction
adverse drug reaction - ANSWERany unexpected, unintended, undesired, or excessive response to a medication given at therapeutic dosages (as opposed to overdose)
adverse drug reaction examples - ANSWERallergic reaction, carcinogenic, teratogenic, hepatotoxic, affect QT interval
ways to avoid adverse drug reactions - ANSWERmonitor liver and kidney function monitor serum and creating clearance
beers criteria black box warning REM's guideline
black box warning - ANSWERstrongest safety warning drug can have.
placental drug transfer - ANSWER-all drugs can cross the placenta
-some can cross more easily than others lipid soluble-easy
others -not easy
Teratogenesis and Stage of Development - ANSWERweeks 3-8 gross malformation - first trimester most dangerous
weeks 9-38 function disruption
Drug therapy and breast feeding - ANSWERtake meds after breasfeeding take drugs with short half life
Drug Therapy in Pediatric Patients - ANSWERPediatrics includes all patients under age 16
absorption oral drug- pediatric - ANSWERdelayed gastric emptying births to (6-8m) decease acidity from birth to 2 years
absorption IM drug - pediatric - ANSWERslow and erratic b/c of low blood flow
absorption Transdermal drug - pediatric - ANSWERrapid and complete bc striatum corner of infant skin is very thin,
distribution - pediatric - ANSWERdrug easily assess blood brain barrier protein binding - amount of albumin is low
metabolism - pediatric - ANSWERhepatic 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 - ANSWERrenal excretion low at birth, reaches adult levels by 1 year.
adverse drug reaction-reaction-pediatric - ANSWERglucocorticoids- growth supression tetracyclines - discolored teet
pediatric dose determination - ANSWERchild BSA X adult dosage / 1.73m2
Drug Therapy in Geriatric Patients - ANSWERabsorption - 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 - ANSWERa list of drugs with high likelihood of causing adverse effects in older adults
opioid receptors - ANSWERMu, kappa, delta
Mu and kappa are most important opioid receptors [Show Less]