NR 293 Quiz 1 Questions and answers + rationales

Bioavailability

the rate at and the extent to which a nutrient is absorbed and used

Absorption

movement of a drug from its site of administration into the bloodstream for distribution to the tissues

Distribution

transport of a drug by the bloodstream to its site of action

Another word for metabolism?

biotransformation

Where does biotransformation occur?

Mainly occurs in the liver

Biotransformation (metabolism)

- One or more biochemical reactions involving a parent drug

What does biotransformation produce?

- metabolite that can be inactive or active

Excretion

elimination of drugs from the body

Half-Life

time required for one-half (50%) of a given drug to be removed from the body

Why can't extended release or enteric coated (EC) oral medications be crushed

- it could accelerate the release of the drug from the dosage form and possibly cause toxicity

What are the common drugs that are considered first pass drugs?

- Oral

- NG tubes

- PEG tubes

What is the fastest enteral route for absorption?

- Buccal / Sublingual tabs

What is the slowest enteral route for absorption?

- enteric coated tablets

What is the order of fastest to slowest enteral routes for absorption (list is in descended order)?

- Buccal/ Sublingual

- Liquid, Elixirs, syrups

- Tablets

- Enteric coated tablet

What enteral route absorption is faster? Liquids, elixirs, syrups or tablets?

- Liquids, elixirs, syrups

What is enteral route absorption is faster? Tablets or Enteric coated tablets

Tablets

What is the order of fastest to slowest parenteral routes for absorption? (list is in descending order)?

- IV

- IM

- SQ

What parenteral route is the fastest absorption?

- IV

What parenteral route is the slowest absorption rate?

- SubQ

What is a agonist?

A drug that binds to and stimulates the activity of one or more receptors in the body

What is a antagonist?

- Drug that binds to and inhibits the activity of one or more receptors in the body

What is another word for antagonist?

- Inhibitor

What is a Prototype Drug?

First for of a drug in a class

What is a drug nomenclature?

- Refers to the drugs name

What is a Drug classification?

- Class name of a drug

What does Pharmacotherapeutics refer to?

- Clinical use of drugs to prevent and treat disease

What does Pharmacodynamics refer to?

- The Study of what the drug does to the body

What does Metabolism refer to?

Biochemical alteration of a drug into inactive or active metabolite

When does metabolism occur?

- after distribution

What does onset of action refer to?

Time required for a drug to elicit a therapeutic response after dosing

What does Peak Level refer to?

- Maximum concentration of a drug in the body

What does Duration refer to?

- Length of time the concentration of a drug in the blood/ tissues is able to elicit a response

What does Pharmacokinetics refer to?

- The study of what the body does to the drug

What does Therapeutic effect refer to?

- The Desired or intended effect of a particular medication

What does Trough level refer to?

- The lowest concentration of medication within the body after it is reduced from the peak level

What organ is most responsible for drug metabolism?

The Liver is most responsible

What organ is most responsible for the excretion (Elimination)?

- The Kidney is most responsible

What does Hepatic metabolism refer to?

- It involves the activity of a very large class of enzymes known as Cytochrome P-450 enzyme

What is the enzyme involved in Hepatic metabolism?

- P-450 enzyme (Cytochrome P-450)

What is another term for P-450?

- Microsomal Enzymes

What does an enzyme refer to?

- The substance that catalyzes nearly every biochemical reaction in the cell

What does does a receptor refer to?

- a reactive site on the surface or inside of a cell

What are some adverse effects of antitubercular (TB) drugs?

- Peripheral neuropathy

What are some adverse affects of Rifampin?

- Turns urine, feces, saliva, skin, sputum, sweat and tears a red-orange-brown color

What excretions turn red-orange-brown coloration due to Rifampin?

- Urine

- Feces

- Saliva

- Skin

- Sputum

- Sweat

- Tears

What Excretion coloration change is associated with Rifampin?

- Red-Orange-Brown coloration

What are some nursing interventions that can be provided to patients taking Rifampin?

- Teach them to drink plenty of water

What are some contraindications of Anti-Tubercular (TB) drugs?

- Liver disease

What drug has the nickname INH?

- Isoniazid

What is the drug of choice for treating TB?

- Isoniazid (INH) is the drug of choice

What lab values should a nurse monitor with Amphotericin B given via IV?

- Blood potassium levels

- CBC (Hematocrit levels)

- Blood Creatinine (BUN levels)

What test is given as a first step to determining if a patient has TB?

- Mantoux Tests (PPD)

What is another name for the Mantoux test (PPD)?

- TB skin tests

What aspect of the nursing interventions is critical for patients w/ TB?

- Patient education

If the Mantoux skin test is positive, what is the next step to determining if a patient has TB?

- Chest x-ray should be given

IF the chest x-ray is positive, what is the next step to determining if a patient has TB?

- Culture of the Sputum or stomach secretions is necessary

What are some nursing interventions for TB regarding medication adherance?

- Teach to take medications every day at the exact same time

- emphasize the importance of strict adherence to regimen for improvement of condition or cure

What can patients not do while taking TB drugs?

- consume alcohol

- take over-the-counter medication (unless instructed by provider)

What should a nurse instruct a patient to take in order to combat peripheral neuropathy?

- take pyridoxine

What is another word for pyridoxine?

- Vitamin B6

What should a nurse monitor for while taking Isoniazid (INH)?

- Numbness / Tingling

What can cause a false positive with a Mantoux test (PPD)?

- individuals who have a BCG vaccination

Where is the primary infection site of TB?

- Lungs

Where in the brain can a TB infection occur?

- Cerebral cortex

Where in bones can a TB infection occur?

- in the growing ends

Where are some other areas of the body that TB infections can occur?

- Liver

- Kidney

- Genitourinary tract

What protection methods should be utilized with patients with TB?

- Droplet precautions

What type of airflow should be utilized with patients with TB?

- Positive airflow

What should a nurse do prior to starting anti-infective drugs?

- Obtain baseline VS

- Obtain a CBC

- Obtain Liver studies

- Obtain Renal studies

- electrocardiography

What should a nurse monitor when a patient is on anti-infective agents?

- Monitor urinary input/ output

What is the First-Pass effect?

A drug that is absorbed via the intestines must first pass through the liver

What drugs are considered to have a high-pass effect?

- A large portion of a drug is chemically changed into inactive metabolites in the liver, then such smaller amounts of drug will pass into circulation

What does acute therapy refer to?

- Implemented in the acutely ill

What does maintenance therapy refer to?

- Used for the treatment of chronic illnesses such as hyper tension

What does supplemental therapy refer to?

- Supplies the body with a substance needed to maintain normal functions

What does Palliative therapy refer to?

- Make the patient as comfortable as possible

What does Prophylactic therapy refer to?

- Therapy provided to prevent illness

What does monitoring refer to?

- Evaluate the clinical response of the patient to the treatment

What does therapeutic index refer to?

- The ratio of the drug's toxic level to the level that provides the therapeutic effect

What does Drug Concentration refer to?

- Drug reaching a certain concentration within the blood

What does Tolerance refer to?

- A decreasing response to repeated drug doses

What does Dependence refer to?

- Physiologic or psychological need for a drug

What does Drug Interaction refer to?

- Alteration of the action of one drug by another

What does Contraindications refer to?

- Any patient condition, especially a disease state, that makes the use of the given medication dangerous for the patient

What does Idiosyncratic refer to?

- An abnormal or unexpected response to a medication exhibited by a specific individual

What does Synergistic refer to?

- A combination of two or more medication's effect is more than the sum of each medication

What does additive effect mean?

- When two drugs with similar actions are given together, they can have additive effects (1 + 1 = 2)

What does synergetic effects mean?

- Occurs when two drugs administered together interact in a way that their combined effects are greater than the sum of the effects of each drug given alone (1+1 = >2)

What does an Antagonistic effect mean?

- Occur when the combination of two drugs results in a drug effect that is less than the sum of the effects of each other alone (1 + 1 = < 2)

What does incompatibility mean?

One drug is not of suitable composition to be combined with another agent or substance.

The incompatibility usually results in an undesirable reaction, including chemical alteration or destruction.