PHARMACOLOGY MADE EASY 4.0 INTRODUCTION TO PHARMACOLOGY Flashcards
(178 cards)
1
Q
Drugs are organized by the
A
nine body systems–
- as well as drugs for pain and inflammation and infection
2
Q
the nine body systems–
A
neurological, musculoskeletal, respiratory, cardiovascular, hematologic, gastrointestinal, reproductive and genitourinary, endocrine, and immune
3
Q
nformation for each drug will include the following information
I PACE CIA (drug information tables recap this info in quick reference format)
A
interventions precautions administration considerations, client instructions expected pharmacological action, contraindications, interactions. adverse drug reactions,
4
Q
safety alerts
A
draw your attention to important safety considerations
5
Q
The category of neurological system drugs breaks down further, into
A
central and peripheral nervous system drugs.
6
Q
In relation to central nervous system drugs, there are several categories, such as
A
depressants, stimulants, anesthetics, anticonvulsants, drugs to treat neurodegenerative disorders, psychotherapeutics
7
Q
pharmaceutics,
A
8
Q
pharmacokinetics,
A
9
Q
pharmacodynamics,
A
10
Q
expected
pharmacologic and therapeutic effects,
A
11
Q
adverse drug reactions,
A
12
Q
contraindications,
A
13
Q
precautions,
A
14
Q
interactions
A
15
Q
special drug considerations to be aware of during therapy.
A
drug-drug interations drug-food interactions, drug tolerance, cumulative effect, drug toxicity. T
16
Q
considerations must also be addressed with
special populations, such as
A
women who are pregnant,
infants
children,
older adults.
17
Q
It’s important that you know drugs by both the
A
generic name and the brand or trade name
18
Q
pharmaceutical company develops a drug
-gives it an official name that becomes the
A
generic name of the drug.
19
Q
Generic names are not capitalized.
TRUE/FALSE
A
TRUE
20
Q
The brand, or trade, name is a drug’s
A
- commercial or proprietary name,
- capitalized
- can vary according to company producing/marketing it.
21
Q
acetaminophen - generic for which brand
A
generic name of the brand Tylenol
22
Q
Generic and brand/trade name drugs have the same
A
chemical composition.
23
Q
FDA (US Food and Drug Administration)
-conducts studies to ensure
A
- new generic drug has same therapeutic equivalence as original brand-name drug.
- the generic form can then hit the market.
- on approval from client’s provider, generic drug interchangeable with brand name drug.
24
Q
Drugs that require prescriptions are
Clients cannot obtain prescription drugs without
A
“prescription drugs.”
a prescription from licensed health provider (physician, nurse practitioner, physician’s assistant)
25
“nonprescription” drugs are available
“over-the-counter.”
26
Federal government identifies prescription drugs as potentially harmful if there is
no supervision of administration by a licensed health provider, (physician, nurse practitioner, physician’s assistant).
27
Ex's of prescription drugs are
- antibiotics, - treat infections, such as ceftriaxone,(AKA Rocephin).
- antihypertensive drugs - treat high blood pressure, such as captopril (AKA Capoten)
- diuretics drugs - promote urination, such as furosemide (AKA Lasix)
- narcotic analgesics such as fentanyl, (AKA Sublimaze or Duragesic), which are opiate-based drugs for pain relief.
28
Nonprescription or over-the-counter drugs do not require
Why?
- a prescription
- have a designation from FDA - relatively safe to take without supervision.
- can purchase at drug stores, grocery stores, etc.
29
Some examples of nonprescription drugs are
- acetaminophen, (AKA Tylenol)
- ibuprofen (AKA Advil)
- diphenhydramine (AKA Benadryl)
- loratadine, (AKA Claritin)
- ranitidine, (AKA Zantac). - recalled - replaced with
- cimetidine (AKA Tagamet)
30
Pharmaceutics address how various drug forms affect the
- dissolution of a drug,
- absorption rate of a drug
- onset of action.
31
oral drugs
drugs by mouth
32
oral drug forms:
- tablet,
- capsule,
- powder,
- liquid forms.
33
Drugs that a client takes through the mouth, but inhales into the lungs, are usually in what form.
powder form
34
The form of an oral or inhaled drug influences its
rate of absorption.
35
Some oral drugs come in forms that
Ex:
-delay release of the drug.
- Ex-enteric-coated drugs,
- sometimes abbreviated as EC,
- dissolve when the drug reaches the intestine.
36
enteric-coated drugs,
- sometimes abbreviated as EC,
| - dissolve when the drug reaches the intestine.
37
Extended release drugs,
- sometimes abbreviated as ER,
| - release over a period of time.
38
Other terms for extended-release drugs include
- extended length, abbreviated as XL,
- sustained release, abbreviated as SR or XR,
- sustained action, abbreviated as SA.
39
Some oral drugs also come in an immediate-release form, which
expedites release of the drug.
40
RATES OF ABSORPTION IS DIFFERENT FOR EACH TYPE OF ORAL ADMINISTRATION FROM LONGEST TO SHORTEST
FROM LONGEST RATE TO SHORTEST RATE:
- LIQUID
- SUSPENSION
- POWDER
- CAPSULE
- TABLET
- COATED TABLET
- ENTERIC COATED TABLET
QUESTION OUT TO TEACHER ON THIS ONE??
IS THIS REVERSE
41
Parenteral (Injectable) Drugs - 3 WAYS TO ADMINSITER
- intravenously (into a vein), abbreviated as IV;
- subcutaneously (into subcutaneous tissue), commonly abbreviated as sub-Q;
- intramuscularly (into muscle tissue), commonly abbreviated as IM
42
The onset and absorption of parenteral drugs vary depending on
which method you give the drug.
43
Parenteral drugs typically come in either a
- liquid form
| - dry form that needs liquid added - called reconstitution
44
reconstitution
when a dry form of a drug needs liquid added
45
The absorption of intravenous drugs
- immediate and complete,
| - immediate onset of action.
46
absorption of subcutaneous and intramuscular drugs
-is variable.
47
what can affect the variability of absorption of subcutaneous and intramuscular drugs
- if the drug water-soluble/client has good circulatory blood flow/tissue perfusion, - absorption is rapid.
- if drug is not water-soluble/poorly water-soluble - absorption is slower
- if client has slowed/impaired circulatory blood flow/tissue perfusion - absorption is slower.
IN SHORT: Depending on solubility of drug and the client’s circulatory status - onset of action for subcutaneous/intramuscular injection varies.
48
subcutaneous drugs absorption would be rapid when
if highly water soluble and good circulatory flow
onset would vary
49
subcutaneous drugs absorption would be slow when
if poorly water soluble and/or circulatory blood flow is slow or impaired
onset would vary
50
Topical or transdermal drugs
```
-drugs applied to a client’s
skin,
eyes,
ears,
nose,
rectum,
vagina,
lungs.
```
51
Topical drugs deliver
- constant amount of drug over extended period of time,
- slower onset of action,
- longer duration of action than oral or parenterally administered drugs.
52
Pharmacokinetics describes what
- absorption,
- distribution,
- metabolism,
- excretion of drugs.
53
absorption
movement of drug from site of administration to various tissues of body
54
```
how are inhalation drugs
absorbed-
distributed-
metabolized-
eliminated-
```
absorbed-lungs
distributed-?
metabolized-?
eliminated-exhaled air
55
```
how are IV (PARENTERAL) drugs
absorbed-
distributed-
metabolized-
eliminated-
```
- absorbed - directly into a vein
- distributed - by blood to skin and kidneys
- metabolized - ??
- eliminated - urine and sweat
56
```
how are oral drugs
absorbed-
distributed-
metabolized-
eliminated-
```
- absorbed - through the intestinal wall and enter portal vein to liver
- distributed by circulation
- metabolized by liver
- eliminated by sweat/urine/feces
57
```
how are subcutaneous (parenteral) drugs
absorbed-
distributed-
metabolized-
eliminated-
```
absorbed-subcutaneous tissue
distributed-blood to skin and then enter liver kidneys
metabolized-primarily in liver
eliminated-urine and sweat
because drug enters blood before liver - the first pass effect does not happen
58
```
how are transdermal drugs
absorbed-
distributed-
metabolized-
eliminated-
```
absorbed-blood
distributed-blood to kidneys/skin
metabolized-?
eliminated-sweat/urine
59
FIRST PASS EFFECT
WHAT IS THE RESULT
- PART OF DRUG MAY DEACTIVATED WHEN PASSES THROUGH THE LIVER
| - ACTUAL AMOUNT OF DRUG AVAILABLE TO BODY IS LESS THAN CLIENT INGESTED ORALLY
60
BIOAVAILABILITY
THE AMOUNT OF THE ORAL DRUG AVAILABLE AFTER PASSING THROUGH THE LIVER
61
distribution
movement of drug by circulatory system to intended site of action
62
Drugs enter the blood after they absorb through
- the intestinal wall
- alveoli in the lungs,
- after direct or indirect injection.
63
- Areas of the body that have a rich blood supply, such as the liver, kidneys, and heart receive
- Areas of the body that do not have a rich supply of blood, such as the bones, or areas that have a natural barrier, such as the brain’s blood brain barrier
- highest level of drug.
| - won’t receive a very high level of the drug.
64
Metabolism
- change that occurs in a drug
- -into a more or less potent form of the drug
- -more soluble form of the drug,
- -inactive form of the drug.
65
what organ is responsible for most of the metabolism of drugs that occurs in the body.
the liver
66
“Biotransformation”
- when structure of drug chemically altered during metabolism.
- new, or altered, form of drug called a “metabolite.”
67
The word metabolite indicates
by-product of metabolism.
68
Most of a drug’s biotransformation occurs in
the liver.
69
Excretion
Ex's
-elimination of a drug or its metabolites
- kidneys eliminate many drugs - urine (kidneys may reabsorb some of drug-allowing it to pass through the body again before excretion actually occurs.
- gastrointestinal tract,
- skin,
- lungs.
70
Drug half life
- time it takes for a drug that enters the body to decrease in amount by half.
- reflects how quickly and efficiently a drug metabolizes and excretes.
71
You might need to administer drugs with a short half-life ....
Likewise, you might need to give drugs with a long half-life .....
- several times a day.
| - only once a day.
72
Since most drugs are metabolized in the liver and excreted in the kidneys, a decrease in functioning in either of these organs could
- affect the level of drugs in the body.
- may experience adverse and toxic effects of drugs more easily
- dosage and frequency should be adjusted if this happens
73
drug’s onset of action
-amount of time it takes for the drug to demonstrate a therapeutic response.
74
drug’s peak effect
-time it takes the drug to demonstrate its full therapeutic effect.
75
drug’s duration of action
-length of time the drug’s therapeutic effect lasts, without additional doses.
76
When you are administering drugs that you must maintain at a therapeutic level in the blood in order for it to be effective, it’s important you know about
peak and trough levels.
77
peak and trough levels.
peak level of a drug - point in time when drug is at its highest level in the body.
-trough level of a drug is the point in time when the drug is at its lowest level in the body.
78
You can determine peak and trough levels by
- taking samples of blood from a client throughout the day.
| - analyze samples to measure amount of drug in client’s blood.
79
Pharmacodynamics
-biochemical changes that occur in body as result of taking a drug.
80
Therapeutic effects
-intended effects of the drug.
81
Adverse drug reactions
-unintended effects of the drug.
82
The effects from drugs occur secondary to
- changes in cells function,
- changes in the cellular environment,
- changes in the action of enzymes in the body.
83
Changes in cellular function precipitate what
-a greater or lesser response than what typically occurs.
84
Agonists
-drugs that bind with a receptor and precipitate a greater than typical response.
?? CLARIFY THIS
-ie - binds to receptor - producing similar response to the intended chemical and receptor.
85
Antagonists
- drugs that bind with a receptor and either block a response or precipitate a less than typical response.
- ie a drug that binds to the receptor either on primary site, or on another site - all together stops the receptor from producing a response.
86
Drugs that are antagonists exert their effect in either a _______ or ________ manner.
competitive, noncompetitive
87
“competitive antagonists"
Antagonists that compete with an agonist for receptor sites
88
“noncompetitive antagonists”
Antagonists that block an agonist’s access for receptor sites are considered
89
noncompetitive antagonists - when given in high enough doses, can
completely block the typical response caused by an agonist.
90
Competitive antagonists - given in increasingly high doses will
decrease the typical response by an agonist but will rarely completely block it.
91
Changes in the cellular environment occur when
Ex:
-drugs interfere with the structure of a cell, (ex - such as cell wall or one of cell’s critical processes like replication).
Ex- penicillin-type antibiotics inhibit cell wall synthesis of certain types of bacteria - results in destruction/death of bacteria.
Ex - Sulfa-type antibiotics inhibit replication of certain types of bacteria by preventing folic acid from helping to make DNA and RNA.
So just a thought, this is why you give folic acid to pregnant moms???
92
process of “selective drug action”
-drug interacts with specific receptor sites to produce desired effects.
93
Receptors exist for
- all molecules that synchronize the body’s physiological activities, including:
- -neurotransmitters
- -hormones.
94
Drugs that are more selective
- interact with fewer receptors,
| - have a more limited effect than drugs that interact with many receptors-allowing for more widespread bodily reactions
95
Expected Pharmacologic Action
EX:
- the action a drug exerts in the body
- provider chooses drugs for a client’s treatment plan based on the expected pharmacologic actions
Ex: - antibiotics or anti-infectives have ability to kill/inhibit reproduction of bacteria, ....so they are for clients who have an infection.
96
Therapeutic Uses
EX:
-many drugs’ pharmacologic actions have more than one therapeutic use.
EX:
- diphenhydramine (Benadryl) - antihistaminic effect- primarily to treat allergies.
- also for motion sickness - antiemetic effect,
- hypnotic or sleep aid for insomnia - sedative effect,
- Parkinson’s disease - anticholinergic effect.
97
anticholinergics
-substances that block the action of the neurotransmitter called acetylcholine (ACh) at synapses in the central and peripheral nervous system.
98
Adverse Drug Reactions (ADR)
EX:
- nontherapeutic, unintended effects of a drug that occur at a therapeutic dose.
- may be predictable/well known or unpredictable.
- range from annoying to life threatening.
EX: unintended but known effects - diphenhydramine (Benadryl)
- -dry mouth
- -drowsiness.
99
serious, possibly life threatening ADRs include
- confusion,
- uncoordination,
- dizziness,
- convulsions in some older adults.
- hyperactivity and excitation in children.
100
most severe type of adverse drug reaction (ADR)
-allergic reaction.
101
ADR
Adverse Drug Reaction
102
-most severe type of adverse drug reaction
-allergic reaction.
103
-severity of an allergic drug reaction can range from
- itching and rash or hives to life-threatening anaphylactic shock.
104
anaphylactic shock
- exaggerated response of body’s immune system to a drug,
| - precipitates massive release of histamine and other chemical mediators in body.
105
Clients who experience a mild drug reaction need to avoid taking the drug again, due to
Why?
- risk of anaphylaxis.
| - previous exposure increases sensitivity to drug - may precipitate a more severe reaction upon second exposure to drug.
106
Symptoms of anaphylactic shock can occur when
-almost immediately after exposure.
107
Symptoms of anaphylactic shock include
can lead to what?
- swelling of the eyes, face, mouth and throat;
- difficulty breathing;
- wheezing;
- rapid heart rate;
- extremely low blood pressure.
- symptoms may ultimately lead to cardiac arrest. client in anaphylactic shock must be immediately taken to medical facility to receive:
- -cardiopulmomary support,
- -rescue drugs.
108
Treatment of anaphylactic shock focuses on
-re-establishment of an airway and oxygen therapy.
- epinephrine - raise blood pressure/ dilate respiratory bronchi
- diphenhydramine (Benadryl) - block additional release of histamine.
109
Drug tolerance
- body’s decreased response to a drug it receives over a period of time.
- for drug to continue to exert a therapeutic effect, -must increase dosage.
110
cumulative effects/drug sensitivity
-may occur in clients secondary to metabolic changes
Ex: impaired hepatic/renal function,
- resulting in poor excretion of drugs.
- body unable to metabolize/excrete single dose of med before another is administered.
-pay attention to interventions, (assessing clinical signs/monitoring lab results), to reduce ADR in these clients.
111
drug toxicity
- when a client receives drugs in excessive dosages,
- resulting in negative physiologic effects.
- can also happen when impaired excretion allows it to build up in body.
- toxic effects are evident.
112
Providers should prescribe the lowest effective dose possible to
Providers must be cognizant of
-achieve therapeutic effects.
- impaired metabolic/excretory functions and adjust dosages as needed.
- periodic laboratory tests to monitor serum drug levels.
113
Pharmacodynamic tolerance
-term used to describe tolerance associated with long-term use of opioid analgesics.
114
The effects of drug toxicity may be
EX:
- irreversible
- lifethreatening.
- EX: vancomycin (AKA Vancocin) - permanent damage cranial nerve number eight - decreased hearing/deafness.
- Acetaminophen, (AKA Tylenol) - temporary damage to liver, or permanent damage - liver failure.
115
Precautions
EX:
- when providers prescribe drugs w/potential to cause ADR's in certain populations,
- or in combination with other drugs/certain foods.
- when providers prescribe a drug for clients w/ chronic/multiple medical conditions.
EX: client experiences a stroke - might require anticoagulant therapy. Extra precaution includes physical assessment/laboratory monitoring to prevent gastric bleeding if client also has peptic ulcer disease.
116
Only use these drugs when necessary, and when
the benefits outweigh the risks.-
117
Other precautions might require limiting certain types of
-food or concurrent administration of specific types of drugs, rather than restricting the drug itself.
118
Contraindications
EX:
-some drugs a provider should not prescribe because they have the potential to cause serious or lifethreatening ADR'.
EX: Some drugs contraindicated for use w/certain populations/combination w/other drugs/certain foods.
-Providers should only consider use of drugs in these situations, for extremely unusual circumstances.
119
Drug-drug and drug-food interactions can radically change the
- action of a drug in the body.
- precautions may require
- -limiting certain types of food
- -or concurrent administration of certain types of drugs, rather than restricting the drug itself.
120
Grapefruit juice
EX:
- -can decrease enzymatic metabolism of certain drugs,
- increasing their potency/risk for toxicity.
EX: avoid grapefruit juice if taking antidepressant sertraline, (AKA Zoloft) / antihistamine fexofenadine (AKA Allegra) /calcium channel blocker nifedipine, (AKA Procardia)
121
Wine and processed meats that contain tyramine can cause a hypertensive crisis in clients taking
- isocarboxazid, (AKA Marplan)
| - tranylcypromine,(AKA Parnate).
122
The calcium in milk products binds to
-tetracycline, (AKA Sumycin) - reducing its absorption.
123
Eating dark green vegetables such as avocados that are high in vitamin K counteracts
- the anticoagulant effects of warfarin, (AKA Coumadin)
| - Vit K enhances action of certain clotting factors - counteracts warfarin
124
a meal high in protein decreases the absorption of
- levodopa, (AKA Dopar)
| - causing symptoms of Parkinson’s to abruptly increase.
125
Grapefruit Juice Drug - Food Interactions
- Sertraline (Zoloft)
- Fexofenadine (Allegra)
- Nifedipine (Procardia)
-Toxicity due to slowed metabolism and increased drug levels
126
Dietary tyramine (wine, processed meats) Drug - Food Interactions
- Isocarboxazid (Marplan)
- Tranylcypromine (Parnate)
-Hypertensive crisis
127
Milk Food - Drug Interactions
- Tetracycline (Sumycin)
| - Reduced therapeutic effect
128
Avocados Food - Drug Interactions
- Warfarin (Coumadin)
| - Reduced therapeutic effect
129
High-protein meals Food - Drug Interactions
- Levodopa (Dopar)
| - Sudden loss of therapeutic effect.
130
Drug to Drug Interactions
When one drug changes the way the other drug affects the body
131
Additive –
EX:
- when combined effect of two drugs together is same as each drug alone in similar doses,
- results in a 1 plus 1 equals 2 effect
EX: two drugs - central nervous system depressants, (alcohol/opioids) effects add to each other in a 1 plus 1 equals 2 manner,
-at risk for significant/possibly fatal central nervous system depression.
132
Synergistic –
EX
- effect of one drug is greater if you give it with another drug.
- results in a 1 plus 1 > 2 effect.
EX: aspirin w/ prescription blood thinner Warfarin
-effects of Warfarin intensify and severe bleeding can occur.
133
Antagonistic
EX:
- effect of one drug is decreased or blocked if you give it with another drug.
- result is a 1 plus 1 < 2 effect.
EX: drug for asthma to open the airway and another drug for its cardiovascular effects that has an ADR that constricts airways,
- effect of the second drug antagonizes/interferes with action of the first drug,
- results in 1 plus 1 = 0 effect.
134
Drug to Food Interactions
Can result in:
-When food changes the way a drug affects the body
- increased levels of drug in the body
– occurs when food increases the amount of a drug the body absorbs or rate of metabolization
135
Grapefruit juice, - inhibits what
can cause:
why?
- enzyme in the liver that facilitates drug metabolism
- can increase the amount of a drug in the body
- because it no longer breaks down in the liver.
- occurs if take a drug w/grapefruit juice,
- or take drug several hours after drinking grapefruit juice.
136
There are special considerations for certain groups of clients, such as
- women who are pregnant or breastfeeding,
- infants,
- children,
- older adults.
137
Women who are pregnant should only take drugs that
- their health care provider prescribes,
| - only after determining benefits > risks.
138
Many drugs and foods a woman ingests during pregnancy can do what?
- cross placenta into the fetus through the umbilical cord.
| - fetus at risk for birth defects from teratogenic drugs during first trimester.
139
teratogenic drugs can cause
-malformations of a developing embryo or fetus.
140
The FDA classification system that identified how safe a drug is to take during pregnancy.
-categories A, B, C, D, X.
Category D?
Category X?
D - drugs carried a possible risk to the fetus,
X - demonstrated a relationship between fetal malformations and drug therapy.
When providers considered category X drug for use during pregnancy, assess potential benefits against the risks before decision on administration.
141
The Pregnancy and Lactation Labeling Rule (PLLR) mandates what?
three sections for labeling:
- pregnancy,
- lactation,
- females and males of reproductive potential.
142
Women who are breastfeeding should know what?
- Pharmacologic effects may occur in infants when drug concentrations in the breast milk are high.
- Other factors - size of the infant/amount of breast milk consumed.
143
In neonates, infants, and children, the absorption, distribution, metabolism, and excretion of drugs is
-different from that of adults.
144
under 1 mo of age are:
if <38 weeks gestation) referred to as
neonates
premature or preterm infants
145
between 1 mo and 1 yr
infants
146
between 1 and 12 years
children
147
in relation to drug absorption - gastric emptying is slower when
until 6-8 months of age
148
when is gastric pH higher
until 2 years of age
149
less of a drug is metabolized in the liver when
on its first pass through
150
if you administer drugs in neonates intramuscularly, what is the rate of absorption?
in children:
- is delayed and erratic
| - increase in absorption
151
what effects the distribution of drugs in neonates, infants and children
higher water and lower body fat content
152
why are drugs easier to enter an infants brain
infants have less effective blood brain barrier than adults
153
how does a neonates liver effect metabolism of drugs
- neonates have fewer enzymes produced in liver until about 1 yr old
- therefore metabolization rates great increase in children 1-2 yrs old
154
when does metabolization rate of children reach that of an adult
about 12 yrs of age
155
why is excretion of drugs so greatly decreased until 1 year of age
decreased perfusion of kidney - decreases rate of filtration and tubular reabsorption
156
when administering meds to neonates, infants, children, make dosage adjustments in relation to:
- age
- weight
- body surface area
- avoid toxicity/overdose
157
physiological changes (decreased cardiac output/decreased perstalsis/increase pH in GI tract/decreased renal/hepatic function) that occur with aging affect:
- absorption
- distribution
- metabolism
- excretion of drugs
may necessitate adjustment of dosage for older adults
158
what should you do with an older adult before prescribing meds
determine liver/kidney function by lab tests
159
amount of anesthetic and recovery time from anesthetic varies related to
ability to metabolize/excrete anesthetic drugs
-dosage/frequency of analgesic - based on ability of livery/kidneys to metabolize/excrete
160
it is the nurses responsibility to instruct client on what drugs they are taking after being admitted.
information should include:
- purpose of drug
- generic/brand name
- proper method/schedule of administration
- potential ADR's
- precautions
161
client instruction is critical to what?
when preparing to provide client instruction determine (4) these
-safe administration of drugs
- cognitive/developmental level
- learning style
- native language
- readiness to learn
162
what is a common method used to provide client instruction to children
incorporating play
163
is an interpreter required for clients who do not speak English
- yes
- medical translator familiar with med terminology whenever possible
- decrease chance of misunderstanding
164
client instruction can be done in a variety of ways - such as:
- verbal
- written (pamphlets)
- videos
- demonstrations (inhalers/injections)
165
what should the nurse do after giving client instructions
how?
-evaluate client understanding
- ask specific questions
- ask to repeat information or demonstration
166
A client asks you about the difference between a generic drug and a trade- or brand-name drug. Which of the following are true regarding generic drugs? (Select all that apply.)
A Have the potential for abuse and dependence
B Have the same chemical composition as the brand name drug
C May have several brand names
D May have several generic names
E Are usually less expensive than a brand-name drug
B,C,E
167
```
Drag the pharmacokinetic process in the left column to match it with its definition in the right column.
Distribution
Absorption
Metabolism
Excretion
```
Distribution-The movement of a drug by the circulatory system to its intended site of action
Absorption- The movement of a rug from the site of administration into the
circulatory system
Metabolism-The change of a drug into a more or less potent or more soluble
form after it passes through the liver,
kidneys, intestinal mucosa, or other body
part
Excretion- The removal of the drug or its metabolites through the kidneys, gastrointestinal tract, skin, or lungs
168
A client with glaucoma asks you about taking oxybutynin, a muscarinic antagonist, to manage an overactive bladder. You explain that glaucoma is a contraindication
for taking oxybutynin. Primary care providers should not prescribe contraindicated drugs because of their
potential for which of the following
A Serious adverse reactions
B Drug tolerance
C Drug dependence
D Interactions with other drugs
A Serious adverse reactions
169
Peak drug level
The time it takes a
drug to demonstrate
its full therapeutic
effect
170
Trough drug level
The point in time when
a drug is at its lowest
level in the body
171
Duration of action
The length of time the
drug’s therapeutic
effect lasts.
172
Onset of action
The time it takes for a
drug to demonstrate a
therapeutic response
173
You note that a primary care provider prescribed morphine sulfate, an opioid agonist, to relieve a client’s
postoperative pain. Which of the following actions describes the action of an agonist on a receptor?
A Destroys the receptor
B Competes with the receptor
C Activates the receptor
D Blocks the receptor
C Activates the receptor
174
A client who has a peanut allergy comes to the emergency department with suspected anaphylactic shock. Which of the following actions should you anticipate taking? (Select all that apply.)
A Initiate oxygen therapy to support respiratory function.
B Administer epinephrine to increase blood pressure.
C Give diphenhydramine to stop histamine release.
D Establish and maintain an open airway to ensure oxygenation.
E Administer a drug agonist to neutralize the allergic
reaction
A,B,C,D
175
You are talking with a client about taking tetracycline along with an antacid. You tell the client not to take these two drugs at the same time because the antacid can reduce the absorption of tetracycline. When one
drug reduces the effect of another drug, it is
A an allergic reaction.
B a synergistic effect.
C an antagonistic effect.
D an adverse reaction.
C an antagonistic effect.
176
```
Primary care providers prescribe drug dosages for children using which of the following information? (Select all that apply.)
A Body surface area
B Age
C Weight
D Developmental level
```
A ,B,C
177
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An older client may be at risk for drug toxicity due to which of the following physiologic changes associated with aging?
A REDUCED HEPATIC BLOOD FLOW
B INCREASED GLOMERULAR FILTRATION RATE
C REDUCED BODY FAT
D INCREASED GASTRIC MOTILITY
```
A
178
YOU ARE HELPING A CLIENT LEARN HOW TO GIVE HIMSELD AN INSULIN INJECTION. WHICH OF THE FOLLOWING IS THE BEST METHOD FOR EVAULATING EFFECTIVE LEARNING?
A VERBALLU QUIZ A FAMILY MEMBER
B INSTRUCT CLIENT TO COMPLETE A WRITTEN TEST
C HAVE THE CLIENT DEMONSTRAT AN INSULIN INJECTION
D ASK THE CLIENT SEVERAL KEY QUESTIONS ABOUT THE PROCEDURE
c
