Exam 1

Question 1

The most important properties of an idea drug are ___, ____, and ___.

Answer 1

Effectiveness, safety, and selectivity

Question 2

Should a drug be used if it is not effective?

Answer 2

No

Question 3

What is the objective of drug therapy?

Answer 3

To provide maximum benefit with minimum harm

Question 4

Drug therapy should be tailored based on what?

Answer 4

A client’s individual needs

Question 5

If something is wrong with a prescribed drug, who is the patient’s last line of defense?

Answer 5

Nurse

Question 6

What are the three goals of pre-administration assessment in regards to collection of data?

Answer 6

1. Evaluation of therapeutic and adverse effect
2. Identification of high-risk patients
3. Assessment of the patient’s capacity for self-care

Question 7

At what three levels are the analysis and diagnosis phase of treatment directed?

Answer 7

1. Judging the appropriateness of the prescribed therapy
2. Identifying potential health problems treatment might cause
3. Characterizing the patient’s capacity for self-care

Question 8

At what three levels is planning directed?

Answer 8

1. Defining goals
2. Establishing priorities
3. Establishing criteria for evaluating success

Question 9

What is the objective at the evaluation stage?

Answer 9

1. Therapeutic responses
2. Adverse reactions and interactions
3. Patient adherence
4. Patient satisfaction with treatment

Question 10

What trial is the most reliable way to objectively assess drug efficacy and safety?

Answer 10

Randomized controlled trial

Question 11

Phase I (subject and tests)

Answer 11

Subject: healthy volunteers
Tests: metabolism, pharmacokinetics, and biologic effects

Question 12

Phase II (subject and tests)

Answer 12

Subject: patients
Tests: therapeutic utility and dosage range

Question 13

Phase III (subject and tests)

Answer 13

Subjects: patients
Tests: safety and effectiveness

Question 14

Phase IV (subject and tests)

Answer 14

Subject: patients
Tests: safety and effectiveness

Question 15

What two groups have been excluded from drug trials?

Answer 15

Women and children

Question 16

When working with a new drug fresh out of trial, what should you look out for?

Answer 16

Unreported adverse effects

Question 17

Which drug name can be more beneficial in using with patient? Why?

Answer 17

Generic name
Brand name may not be available internationally; can be more expensive

Question 18

What are the four basic processes of pharmacokinetics?

Answer 18

Absorption
Digestion
Metabolism
Excretion

Question 19

How do drugs pass through membranes in the body?

Answer 19

1. Pores
2. Transportation
3. Direct penetration

Question 20

Where is P-glycoprotein found?

Answer 20

Liver, kidney, placenta, intestines, and brain capillaries

Question 21

Where do P-glycoproteins transport drugs to?

Answer 21

OUT of the cell

Question 22

Which drugs can pass through the lipid bilayer of a membrane easily?

Answer 22

Lipid-soluble drugs

Question 23

In what type of media do acidic drugs ionize?

Answer 23

Basic media

Question 24

In what type of media do basic drugs ionize?

Answer 24

Acidic

Question 25

What factors can enhance the absorption process?

Answer 25

Rapid drug dissolution, high lipid solubility, large surface area, high blood flow at the site of administration

Question 26

What are the advantages of IV administration?

Answer 26

Rapid onset Precise control over the amount of drug entering the blood Suitability for use with large volumes of fluid Suitability for irritant drugs

Question 27

What are the disadvantages of IV administration?

Answer 27

High cost Difficulty Inconvenience Danger related to irreversibility Potential for fluid overload, infection, and embolism

Question 28

What are the advantages of IM and SubQ administration?

Answer 28

Suitability for insoluble drugs Suitability for depot preparations

Question 29

What are the disadvantages of IM and SubQ administration?

Answer 29

Inconvenience Potential for discomfort

Question 30

What are the advantages of oral administration?

Answer 30

Ease Convenience Low cost Safety

Question 31

What are the disadvantages of oral administration?

Answer 31

High variability Possible inactivation by stomach acid, liver enzymes, and digestive enzymes

Question 32

Which oral formulations are made to release in the small intestine?

Answer 32

Enteric-coated

Question 33

These oral formulations are designed to release their contents slowly in order to increase the time between doses. What are they?

Answer 33

Sustained-release oral formulations

Question 34

Define drug distribution.

Answer 34

Movement of drugs from the blood to the interstitial space of tissues and then into cells

Question 35

Define blood-brain barrier.

Answer 35

The presence of tight junctions between the cells that compose capillary walls in the CNS

Question 36

What substance do drugs typically bind to in the vascular system?

Answer 36

Plasma albumin

Question 37

Where do most drugs metabolize?

Answer 37

Liver

Question 38

What system of enzymes catalyze the metabolism of drugs in the liver?

Answer 38

Cytochrome P450

Question 39

What is important when metabolizing drugs in the liver?

Answer 39

Converting lipid-soluble drugs to more hydrophilic forms to ease the process of their excretion

Question 40

What are some consequences of drug metabolism?

Answer 40

Conversion to less active forms Conversion to more active forms Conversion of prodrugs to active forms Conversion of drugs to more/less toxic forms

Question 41

Define substrates.

Answer 41

Drugs that are metabolized by the P450 enzyme which can act as an inducer or inhibitor

Question 42

How are plasma levels influenced by drug metabolism?

Answer 42

Plasma levels fall as drug metabolism increases

Question 43

What is the first pass effect?

Answer 43

Some oral drugs are inactivated as they pass through the liver after being absorbed

Question 44

What is enterohepatic recirculation?

Answer 44

A detoxification process in the liver where a drug travels through fluids to the duodenum and back to the liver as free drugs are released

Question 45

What are the three steps of renal drug excretion?

Answer 45

1. Glomerular filtration 2. Passive tubular reabsorption 3. Active tubular secretion

Question 46

Why are lipid-soluble drugs less likely to be excreted by the kidneys?

Answer 46

Undergo an extensive reabsorption process into the blood where the liver works to convert them into more polar forms

Question 47

Define minimum effective concentration.

Answer 47

The lowest amount for which therapeutic effects will occur

Question 48

What is the half-life of a drug?

Answer 48

The time required for a certain amount of a drug in the body to decline by 50%

Question 49

About how many half-lives are needed to reach plateau?

Answer 49

Four

Question 50

What are some ways to reduce fluctuations in plasma drug levels?

Answer 50

1. Giving smaller doses at shorter intervals 2. Using a continuous infusion 3. Using a depot preparation

Question 51

How can plateau be reached quickly with a drug that has a long half-life?

Answer 51

Using a loading dose

Question 52

In about how many half-lives will a drug leave the body after administration has been discontinued?

Answer 52

Four

Question 53

Pharmacodynamics

Answer 53

The study of the biochemical and physiologic effects of drugs and the molecular mechanisms by which those effects are produced