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Pharmacology Unit 1 - Introduction to Drugs (Chapters 1-4, 6, 16-18)
Terms in this set (132)
Name the branch of pharmacology that deals with the uses of drugs to treat, prevent, and diagnose disease
Name the branch of pharmacology that involves how a drug affects the body
Name the branch of pharmacology that involves how the body handles the drug (absorption, distribution, biotransformation, and excretion
Name the category of drugs that have a high abuse potential and no accepted medical use
Name the category of drugs that have a severe dependence liability
Name the category of drugs that have a lesser abuse potential and an accepted medical use
Name the category of drugs that have low abuse potential and limited dependence liability
Studies that involves healthy human volunteers who are usually paid for their participation
Studies that involves human volunteers with the disease the drug is intended to treat
Studies that involve use of a drug in a vast clinical population in which patients are asked to record any symptoms they experience while taking the drug
What concept is considered when generic drugs are substituted for brand name drugs?
What is the amount of a drug that is needed to cause a therapeutic effect and should not differ between generic and brand name medications?
What is the phase of pharmacokinetics which involves the movement of a drug to the body's tissues and is the same in generic and brand name drugs?
A nurse is assessing the patient's home medication use. After listening to the patient list current medications, the nurse asks what priority question?
Do you take any OTC medications or herbal supplements?
Which pregnancy drug category indicates that adequate studies in pregnant women have not demonstrated a risk to the fetus in the 1st trimester or later semesters?
Which pregnancy drug category indicates that animal studies have not demonstrated a risk to the fetus but there are no adequate studies in pregnant women?
Which pregnancy drug category indicates that animal studies have shown an adverse effect on the fetus, but no adequate studies have been done in humans?
Which pregnancy drug category reveals evidence of human fetal risk, but the potential benefits from the use of the drug in pregnant women may outweigh potential risks?
Which pregnancy drug category indicates that animal and human studies demonstrate fetal abnormalities or adverse effects? (The risk of use in a pregnant woman clearly outweighs any possible benefit)
The nurse is preparing to administer a medication from a multi-dose bottle. The label is torn and soiled but the name of the medication is still readable. What is the nurse's priority action?
Discard the entire bottle/contents and obtain a new bottle
What aspect of pharmacology does a nurse study?
Impact of drugs on the body
The body's response to a drug
Adverse and anticipated drug effects
In response to the patient's question about how to know whether drugs are safe, the nurse explains that all medications undergo rigorous scientific testing controlled by what what organization?
Food and Drug Administration (FDA)
The patient asks the nurse, "Is it safe to take OTC medications with prescription medications?" What is the nurse's best response?
OTC medications can interact with prescription medications
It is important to tell your doctor all medications you take, including OTC
OTC medications could mask or hide manifestations of a disease
Before administering a prescription medication, what information does the nurse find on the drug label?
Brand name, generic name, drug concentration, and expiration date
Drugs do not metabolize the same way in all people. For what patient would a nurse expect to assess for an alteration in drug metabolism?
A 50-year old man with cirrhosis of the liver
(Note: Toxic levels could develop unless dosage is reduced)
A patient presents to the emergency department with a drug level of 50 units/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug is given. How long will it take for the blood level to reach the non-toxic range?
An important concept taught by the nurse when providing medication teaching is the need to provide a complete list of medications taken to health care providers to avoid what?
A pharmacology student asks the instructor what an accurate description of a drug agonist is. What is the instructor's best response?
A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
Some drugs react with receptor sites to block normal stimulation, producing no effect.
Some drugs react with specific receptor sites on a cell and, by reacting there, prevent the reaction of another chemical with a different receptor site on that cell
A nurse is caring for a patient who has been receiving a drug by the intramuscular route but will receive the drug orally after discharge. How does the nurse explain the increased dosage prescribed for the oral dose?
Involves drugs that are absorbed from the small intestine directly into the portal venous system, which delivers the drug molecules to the liver.
After reaching the liver, enzymes break the drug into metabolites, which may become active or may be deactivated and readily excreted from the body.
A large percentage of the oral dose is usually destroyed and never reaches tissues.
The nurse uses what term to describe the drug level required to have a therapeutic effect?
Several processes enable a drug to reach a specific concentration in the body. Together they are called dynamic equilibrium. What are these processes?
Absorption from the site of entry
Distribution to the active site
A nurse is administering digoxin to a patient. To administer medications so that the drug is as effective as possible, the nurse needs to consider what?
What factor influences drug absorption?
Route of administration (amount of food/acidity in the stomach)
What factor influences drug excretion?
Which factor influences drug metabolism?
Which factor influences drug distribution?
What does the lipid solubility of the drug influence?
The nursing students are learning about the half-life of drugs. A student asks the instructor to explain half-life. What is the instructor's best response?
Half-life of a drug is the time it takes for the amount of drug in the body to decrease to half of the peak level it previously achieved.
The student nurse asks the instructor why a patient with a central nervous system infection is receiving antibiotics that will not cross the blood-brain barrier. What is the instructor's most correct response?
A severe infection alters the bloodbrain barrier to allow the drug to cross
The patient is taking low dose aspirin daily for his heart. The nurse knows only a portion of the medication taken actually reaches the tissue due to what process?
A patient has come to the clinic and been diagnosed with Lyme disease. The physician has ordered oral tetracycline. What is important for the nurse to include in the teaching plan about tetracycline?
Do not take with foods or other drugs containing calcium
Do not take with iron supplements or with food high in iron
The nurse administers an intravenous medication with a half-life of 24 hours but recognizes what factors in this patient could extend the drug's half-life?
Kidney, liver or cardiovascular disease
When taking a medication history on a patient why should the nurse ask about the use of complementary or alternative therapies?
Many drug-alternative therapy interactions can cause serious problems
Teaching the patient/caregiver about her or his medications is an important step in reducing the risk of medication errors. What is an important teaching point about medications?
Speak up and ask questions, keep a list of your prescribed medications
When assessing a patient before starting a drug regimen, why would the nurse consider it important to assess baseline kidney function?
To determine patient's ability to excrete the drug
A nurse is caring for a 77-year-old patient. The nurse plans care for this patient based on the knowledge that the aging process impacts drug therapy in what important way?
Blood volume decreases
Which statement best describes drug efficacy/toxicity in pediatric patients?
Drug dosage is altered by age and weight in children
A 7-year-old boy fell off a wood pile while playing. He has been admitted to the intensive care unit with multiple broken bones and internal bleeding. What should the nurse know about drug therapy in this type of patient?
Pharmacodynamics may be altered
The nursing instructor is discussing drug therapy in the older adult. What would the instructor tell the students about what could affect therapeutic dosing in an older adult?
Changes in the GI system can reduce drug absorption
The nurse admits a patient to the unit and learns the patient has recently been diagnosed with chronic renal failure but has not informed the primary care provider of this diagnosis. What is the nurse's first priority?
Call the admitting physician immediately
A 32-year-old woman is admitted to the unit with a diagnosis of hypovolemia. The nurse is developing a care plan for this patient. What is an appropriate nursing diagnosis to help prevent medication errors?
Deficient fluid volume
The nurse applies the nursing process in medication therapy to ensure what?
That care is efficient and effective
A 35-year-old male patient is admitted to the hospital with pneumonia. He was originally being treated at home, but became worse when he quit taking his antibiotic prematurely. What is an appropriate nursing diagnosis for this patient?
The nurse is caring for a patient scheduled for surgery this morning who is not to be given anything orally. The nurse reviews the medication administration record and finds the patient has an important medication due but it is supposed to be given orally. What is the nurse's best action?
Call the ordering health care provider and clarify administration
The nurse is assessing a diabetic patient who has presented at the clinic reporting several hypoglycemic episodes during the past 3 weeks. The nurse questions the patient about the use of herbal or alternative therapies, suspecting what herbal remedy could cause the hypoglycemic episodes?
A 22-year-old patient calls the clinic and tells the nurse that she has been depressed and is thinking about taking St. John's wort but wants to know if it is safe first. The nurse begins by questioning what other medications the patient takes and would be concerned about a drug-alternative drug interaction if the patient is also taking what type of medication?
A patient tells the clinic nurse that he or she has been taking over-the-counter (OTC) Pepcid to relieve acid indigestion for several years. This is the first time the patient has ever reported this issue to a health care provider. As part of the teaching plan for this patient, the nurse explains what risk associated with not sharing OTC drug use with the provider?
The drug could interact with several cold medicines
The triage nurse in the emergency department sees a patient suspected of abusing amphetamines brought in by friends. While assessing this patient, what would the nurse be likely to find if steroids are being abused?
Hypertension (tachycardia, insomnia)
How has the patient's access to drug information changed the way the patient interacts with the nurse and other health care providers?
Patients are more likely to challenge the health care provider with their own research.
Today, an abundance of information is available in the health care arena for consumers, resulting in the nurse encountering patients who have a much greater use of what?
When patients do not understand the information provided with their medication, whose responsibility is it to help them sort through and comprehend the meaning?
Ipecac, formerly used as the drug of choice by parents for treatment of suspected poisoning in children, was tested by the Food and Drug Administration (FDA) in 2003. What was the finding of this testing?
Ipecac is ineffective for its intended use
What is the name of an agent that can disturb the development of the embryo or fetus, halt pregnancy, or produce a congential malformation?
What is the generic name for Lasix?
If an adverse medication effect were to occur, a form is filled out and reported to whom?
What will result in more available free drug?
To prevent accumulation of a drug in the kidneys of an older patient, the nurse should ensure the patient does what?
Stays well hydrated (oral or IV)
Elderly patients are at higher risk for drug-related complications due to?
Decline in renal function (chronic disease, multiple medications)
_____ affects liver enzymes, thus changing serum drug levels.
What is an excessive responsiveness to either the primary or secondary effects of a drug?
After the patient states that they are allergic to a particular drug, what else does the nurse need to know about the allergy?
How the patient responds after receiving the medication
Patients having an _____ reaction may present with increased heart and respiratory rates.
The prescribed drug order should include what components?
Name, dose, route and frequency
A nurse has admitted a 10-year-old child to the short-stay unit. The child has complained of chronic headaches and his or her mother reports that he or she gives him or her acetaminophen (Tylenol) at least twice a day. What will the nurse evaluate?
Hepatic function (severe hepatotoxicity can occur from overuse of acetominophen)
The nurse is discussing ethnic differences in response to medication with your nursing students. What group of people would the nurse tell the students may have a decreased sensitivity to pain-relieving effects of anti-inflammatory drugs and should be educated concerning signs and symptoms of gastrointestinal bleeding from use of these drugs?
A nurse is caring for a patient with severe rheumatoid arthritis who takes anti-inflammatory agents on a regular basis. What medication should the nurse question if ordered by the physician to be taken in addition to the anti-inflammatory agent?
Beta-blocker (NSAIDs have the potential to decrease antihypertensive effects from beta blockers is these drugs are taken at the same time)
A nurse is assessing a patient who has been taking nonsteroidal anti-inflammatory drugs (NSAID). What statement by the patient indicates to the nurse that the patient has a good understanding of the use of this therapy?
I asked my doctor to check for blood in my stool regularly (due to possible gastric mucosa irritation)
A mother has brought her 6-year-old child to the clinic. The child has a fever of 102.8ºF and is diagnosed with the flu. What medication will the nurse suggest for this child?
Acetaminophen aka Tylenol (prescribed for relief of pain and fever for influenza in children)
A mother asks the nurse how acetaminophen works. What statement best describes the therapeutic action of acetaminophen?
Acetaminophen acts directly on the hypothalamus to cause vasodilation and sweating (thereby reducing fever)
Antipyretic drugs (e.g., aspirin, ibuprofen, acetaminophen) often are used to alleviate the discomforts of fever and to protect vulnerable organs, such as the brain, from extreme elevations in body temperature. However, the use of aspirin in children is limited due to the possibility of what disease?
A nurse is caring for a patient in the early stage of rheumatoid arthritis. The nurse would expect what medication classification to be used in the treatment of this patient?
The nurse is preparing to administer a nonsteroidal anti-inflammatory drug (NSAID) to an older patient. What NSAID is associated with increased toxicity and should be avoided if possible?
The nurse teaches a patient with rheumatic disease who is being prescribed salicylate therapy to monitor himself or herself for what?
Tinnitus (ringing in the ears)
The nurse assesses laboratory results related to blood clotting when the assigned patient takes what drug regularly?
Salicylates and NSAIDs (may inhibit blood clotting)
Which of these anti-inflammatory drugs have geriatric warnings?
Naproxen (due to increased toxicity)
A patient presents at the emergency department complaining of dizziness, mental confusion, and difficulty hearing. What should the nurse suspect is wrong with the patient?
A mother brings her 3-year-old child to the emergency department telling the nurse the child has eaten a bottle of baby aspirin. The mother cannot tell the nurse how many tablets were in the bottle. What dose of salicylate would be toxic in a child?
A patient arrives at the emergency department brought by his or her friends. The friends tell the nurse that the patient has taken a whole bottle of aspirin. Blood work for salicylate toxicity is run. What does the nurse expect the results to be?
The nursing instructor is discussing COX-2 inhibitors with her nursing students. Where would the instructor tell her students that COX-2 inhibitors work?
At sites of trauma and injury (block inflammatory response)
The clinic nurse is caring for a patient who is taking a COX-2 inhibitor and knows that this patient needs to be assessed for what?
Why do COX-2 inhibitors increase the risk for cardiovascular problems?
Vasodilation is blocked
Platelet clumping is blocked
When nonsteroidal anti-inflammatory drugs (NSAIDs) are combined with loop diuretics, there is a potential for what?
Decreased diuretic effect
The nurse is caring for a patient who reports taking 800 mg of ibuprofen three times a day for relief of menstrual cramps. What lab results will the nurse find most significant in assessing this patient?
CBC or complete blood count
Ibuprofen, like all NSAIDs, can cause GI mucosa irritation and block platelet clumping, both of which may result in bleeding. Blood loss due to dysmenorrhea can exacerbate these risks so it is important to assess the _____ to monitor for excessive blood loss.
CBC or complete blood count
The patient has been diagnosed with rheumatoid arthritis. She also reports pain in various muscle groups secondary to a diagnosis of fibromyalgia and dysmenorrhea with painful cramping during menses. What drug would be most effective in treating all three of this patient's problems?
in treating muscle pain, arthritis and dysmenorrhea)
The pediatric patient has a fever and the nurse is preparing to administer an antipyretic. What drug would be the best choice for this patient?
(approved for pediatric use and has antipyretic properties)
A patient has been diagnosed with hairy cell leukemia. The patient is to begin taking interferon alfa 2b. What will the nurse include in her instructions to the patient concerning this drug?
Increase fluid intake while taking the drug
(because it is metabolized in the kidney so adequate fluid intake is needed to promote metabolism and excretion of the drug as well as to minimize common adverse effects including dry skin and dizziness)
A 30-year-old woman has been diagnosed with leukemia and will be using an immune modulator for treatment. What will be important to discuss with the patient when the nurse provides patient teaching about her treatment?
The need to use barrier contraceptives while taking the drug
A patient who is receiving an immune suppressant has been admitted to the unit. What would be a priority action by the nurse?
Protect the patient from exposure to infection
A nurse is discussing interferon alfa 2b with a patient. What will the nurse encourage the patient to do while taking this drug?
To avoid crowds
(patient needs to avoid people with infections, therefore must avoid crowds due to potential risk)
While studying for a pharmacology test, a student asks his peers about interferons. What statement about interferons is accurate?
They interfere with the ability of viruses to replicate in infected cells
How do immune suppressants work when ordered for a patient who has had an organ transplant?
Blocking normal effects of the immune system
A patient has just been told that her cancer has metastasized to her right kidney. An interferon (Aldesleukin) has been prescribed to treat this metastasis. The patient asks why this interferon is ordered. What is the nurse's best response?
Aldesleukin has been shown to inhibit tumor growth
The nurse admits a patient who was newly diagnosed with Kaposi's sarcoma to the unit. The physician has ordered an IV infusion of an interferon. What drug would be appropriate?
Interferon alfa 2b
The pharmacology instructor is talking about interferon. The instructor explains that agents, such as interferons, have more than one biologic function. What are the functions of interferons?
Antiviral, immunomodulary, antiproliferative
The pharmacology instructor is explaining interleukins to the class. What would be the best definition of interleukins?
They are chemicals used to communicate between leukocytes and stimulate immunity
While studying the T- and B-cell immune suppressors, the nursing students learn that the most commonly used immune suppressant is what?
A patient with chronic hepatitis C has been prescribed peginterferon alfa 2b (PEG-INTRON). By what route would the nurse administer this drug?
Subcutaneously (like most interferons)
The nurse, working with a nursing student, is caring for a patient who is to receive interleukins. The student nurse asks you what happens physiologically when a patient receives interleukins. What is the nurse's best response?
The patient has increases in the number of natural killer cells (and lymphocytes, cytokine activity, and number of circulating platelets)
When caring for older adults receiving immune modulators, what are the nurse's priorities of care?
Assess carefully for infection
Obtain baseline LFT and monitor follow up tests
Determine dosage based on renal and liver function
The nurse teaches the female patient receiving immune modulating drugs about the need to use barrier contraceptives. The patient says, I hate using barrier contraceptives. Why can't I just take oral contraceptives? What is the nurse's best response?
Effects of oral contraceptives may be altered by liver changes or changes in immune response
The nursing instructor is discussing immunity with her clinical group. What statement would the instructor make that would be accurate about immunity?
Passive immunity is limited, lasting only as long as the antibodies circulate
A mother brings her 18-month-old child into the clinic for a well-baby check-up. A nurse will administer measles, mumps, and rubella vaccine (MMR) to the child. What dosage will the nurse administer?
0.5 ml SQ (for adults and children older than 15 months of age)
A public health nurse is on a mission trip to Africa where she is administering Dryvax. The patient asks the purpose of this drug and the nurse explains it will prevent what?`
The mother of a newborn is learning about immunization schedules. The nurse tells this mother her child will ideally receive the immunization for measles, mumps, and rubella (MMR) on what schedule?
12-15 months and 4-6 years
A nurse is providing patient education to the mother of a child receiving a first immunization. The nurse tells the mother that after the injection, it is normal for the child to exhibit what signs and symptoms?
Pain, redness, and swelling at site of injection
When discussing vaccines in class, a student asks the nursing instructor what an antitoxin is. What is the instructor's best response?
It is a form of passive immunity
The nurse is presenting an educational event about vaccines at a local elementary school. When talking about vaccines, the nurse explains they are generally contraindicated in what situations?
In people who are immunosuppressed
The nurse is describing the schedule for vaccinations to the parents of a new baby. The nurse explains the measlesmumpsrubella (MMR) vaccine is first administered at what age?
The nursing instructor is explaining the best way to assess whether active immunity has developed from the administration of the hepatitis B series. What would the instructor cite as the best assessment method?
Serum antibody levels
A young mother asks the clinic nurse about the chickenpox vaccine. The mother states that she and her husband have both had chickenpox, but that she wants to protect her child if she can. What should the nurse tell the mother about the recommendation for the varicella vaccine?
It is recommended for all children who have not been exposed to the varicella virus
A patient has come to the clinic for an allergy shot. The patient asks the nurse what immunoglobulin (Ig) is located in the body's tissues and is thought to be responsible for allergic reactions. What is the nurse's best response?
IgE is thought to be responsible for allergic reactions
A student asks the instructor how vaccines provide active immunity. The instructor's best answer explains that active immunity is provided by stimulating production of antibodies to what?
A specific protein
The nurse at the pediatric clinic gives the mother of an infant a written record of the infant's immune sera use. The nurse encourages the mother to keep the information. What is the rationale behind keeping a written record of immune sera use?
To avoid future reactions
What occurs when the host human responds to the injected antibodies circulating through the body?
The host produces its own antibodies to the injected antibodies (results in serum sickness)
A 55-year-old patient presents at the emergency department complaining of chest tightness and difficulty breathing. The patient tells the nurse he had immune sera earlier that day at the clinic. What does the nurse suspect is happening with this patient?
An allergic reaction to the immune sera
A patient is to receive a physical examination before starting immune sera therapy. What would the nurse assess the lungs for?
Adventitious breath sounds
The mother of a preschool aged child brings her child to the clinic and asks what immunizations the child needs before starting school. What immunizations will the nurse expect this child needs if the child is healthy and has received immunizations on schedule in the past? (Select all that apply.)
Diphtheria and tetanus toxoids and acellular pertussis vaccine, assorted (DTaP),
Inactivated poliovirus vaccine (IPV)
Mealses, mumps, and rubella vaccine (MMR)
(Also need influenza and varicella for ages 4-6 years old)
The mother of a 2-month-old child tells the nurse, I've been reading about how vaccines cause autism so I have decided not to give my child any of these vaccines. What is the nurse's best response?
Extensive studies have found no link between MMR vaccine and autism
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