Chapter 2 - Pharmacokinetics, Pharmacodynamics, and Pharmacogenetics

Question 1

drugs administered ________ there is no disintegration process, which occurs when a drug becomes a solution that can cross the illogic membrane

Answer 1

parenterally

Question 2

which drugs are already in solution, which is the form necessary for absorption in the gastrointestinal tract

Answer 2

liquid suspension

Question 3

these tablets resist disintegration in the acidic environment of the stomach and disintegrate when they reach the small intestine

Answer 3

enteric coated

Question 4

Will acidic drugs enhance the absorption of enteric coated tablets? What slows the absorption rate?

Answer 4

No. high fat food.

Question 5

what must be given parentally because they re destroy in the small intestine by digestive enzymes?

Answer 5

Insulin, growth hormones, and other protein based drugs

Question 6

this types of tissue has fewer blood vessels, so absorption is slower

Answer 6

subcutaneous

Question 7

Why is insulin injected subcutaneously

Answer 7

because it is desirable to have it absorb slowly

Question 8

what do water soluble drugs require to pass through the GI membrane

Answer 8

carrier enzyme or protein

Question 9

high fat foods are useful for that that are?

Answer 9

lipid soluble

Question 10

food can stimulate the production of gastric acid, so medications requiring an acidic environment would be given with?

Answer 10

a meal

Question 11

drugs given ________ absorb faster in muscles that the more blood vessels such as the deltoid

Answer 11

IM

Question 12

Drugs that undergo ______________ are absorbed into the portal vein from the intestinal lumen and go through the liver where they are either unchanged or are metabolized to an inactive or a more active form

Answer 12

first-pass metabolism

Question 13

what kind of drugs have less bioavailability because a lower percentage of the drug reaches the systemic circulation?

Answer 13

Oral

Question 14

refers to the process by which cells carry a solute across a membrane

Answer 14

Pinocytosis

Question 15

describes a rapid decrease in response to drugs that occurs when tolerance develops quickly

Answer 15

Tachyphylaxis

Question 16

Drugs that are highly _______ bind with albumin and other proteins, leaving less free drug in circulation

Answer 16

protein bound

Question 17

If a patient is low in _________, the drug is not bound, and there is more free drug to cause drug effects. There would be increased absorption, increased interactions with other drugs, and increased toxicity

Answer 17

albumin

Question 18

Two drugs that are highly ______ will compete for protein binding sites, leaving more free drug in circulation and an increased risk of adverse effects as well as increased bioavalibility, inquired drug effects, and increased drug interactions.

Answer 18

protein bound

Question 19

LIver diseases such as cirrhosis and hepatitis alter drug?

Answer 19

metabolism

Question 20

When the drug metabolism rate is decreased what happens

Answer 20

excess drug accumulation can occur and lead to toxicity

Question 21

Steady state levels occur at how many half lives?

Answer 21

3-5

Question 22

A druge with a longer half life should be given at longer___________ to avoid drug toxicity

Answer 22

intervals

Question 23

What alkalizes the urine

Answer 23

sodium bicarbonate

Question 24

Why is aspirin more readily excreted in alkaline urine?

Answer 24

It is a weak acid

Question 25

Increased creatinine and BUN indicate

Answer 25

Decreased renal function

Question 26

If you have decreased renal function the drug that is eliminated in the kidneys can become?

Answer 26

toxic

Question 27

The nurse understand that the length of time need for a drug to reach the mini effective concentration (MEC) is the?

Answer 27

onset of action

Question 28

what is the length of time a drug has a pharmacologic effect?

Answer 28

duration of action

Question 29

occurs when the drug reaches its highest blood level

Answer 29

Peak action

Question 30

and __________ is one that stimulates a certain type of cell to produce a response

Answer 30

agonist medication

Question 31

Why do non specific drugs have so many side effects?

Answer 31

They can act of one type of receptor but in different body tissues, or a variety of receptor types, or act on hormones to produce effects. Non specific drugs can affect a variety of receptor types in similar body tissues

Question 32

Which drugs require loading doses

Answer 32

Medications with long half lives. Eg. Dogoxin and phenytoin

Question 33

Occurs when a patient experiences a response with an inactive drug

Answer 33

placebo effect

Question 34

______ to a drug effects can occur with narcotics, requiring increased doses in order to achieve adequate drug effects

Answer 34

tolerance

Question 35

an altered or modified action or effect of a drug as a result of interaction with one or more other drugs

Answer 35

drug interactions

Question 36

this can occur with one or more drugs and has effects ranging from mild to severe

Answer 36

adverse drug reaction

Question 37

chemical reaction of two or more drugs that occurs in vitro

Answer 37

drug incompatibility

Question 38

the development of reduced response to a medication over time

Answer 38

drug tolerance

Question 39

drugs that are ___________ cannot be mixed together in solution and cannot be mixed in a syringe, I bag, or other artificial environment

Answer 39

incompatible

Question 40

symptoms occurring from drug effects

Answer 40

adverse reactions

Question 41

when one drug causes an enhanced response in another drug

Answer 41

potentiation

Question 42

dairy products, multivitamins, and antacids should be avoided 1 hour after and 2 hours before taking because it prevents absorption

Answer 42

Products that contain calcium, magnesium, or iron are ingested with fluoroquinolone antibiotics such as ciprofloxacin.

Question 43

what drugs slow gastric emptying

Answer 43

opioids

Question 44

the renal loss of potassium can result in __________ which can enhance the action of digoxin and lead to toxicity

Answer 44

hypokalemia

Question 45

A patient who takes the anticoagulant warfarin will begin taking the anticonvulsant drug carbamazepine. The nurse reviews the drug information for these drugs and learns that carbamazepine is a hepatic enzyme inducer. The nurse anticipates that the provider will make which dosage adjustment

Answer 45

Carbamazepine is a hepatic enzyme inducer, which can increase drug metabolism. Patients taking both drugs usually need a larger dose of warfarin

Question 46

what interaction are changes that occur in the absorption, distribution, metabolism and excretion of one or more drugs

Answer 46

pharmacokinetic

Question 47

drugs that promote induction of enzymes are called

Answer 47

enzyme inducers

Question 48

examples of drugs that are enzyme inducers

Answer 48

phenobarbital increases the metabolism of most antipsychotics. Methylxanthine, phenobarbital, carbamazepine, and rifampin increase the metabolism of warfarin.

Question 49

care must beg take when enzyme inducers are discontinued because?

Answer 49

less drug is eliminated by hepatic metabolism and toxicity can result

Question 50

hypokalemia

Answer 50

blood potassium levels are too low

Question 51

the sum of the effects of two drugs

Answer 51

additive effect

Question 52

When two drugs are administered in combination and the response is increased beyond what either could produce along, the drug interaction is called an

Answer 52

additive effect

Question 53

when a diuretic and beta locker are administered for treatment of hypertension, in combination these two drugs use different mechanisms to have more pronounced

Answer 53

BP lowering effect

Question 54

Aspirin and ? can be used together to produce a great effect on pain

Answer 54

codeine

Question 55

if aspirin and alcohol are taken together

Answer 55

can prolong bleeding time and result in gastric bleeding

Question 56

When two or more drugs are given together ONE drug can have a clinical effect substantially greater than that of either drug alone

Answer 56

synergistic effect

Question 57

The provider has ordered amoxicillin with clavulanate (Augmenting) for a child who has optic media. The child's parent ask why this drug is necessary when amoxicillin is less expensive. The nurse will explain that clavulanate is added to amoxicillin because

Answer 57

clavulanate is a bacterial enzyme inhibitor, specifically beta lactamase, which inactivates amoxicillin. When added to amoxicillin, it broadens the antibacterial spectrum