Chapter 4 Pharmcognetics

Question 1

Study of how a patient’s genomes affect drug
response

Answer 1

Pharmacogenetics

Question 2

Patients who benefit
most from pharmacogenetics

Answer 2

taking multiple prescription
drugs, Those not responding to current therapy, Those having adverse drug reaction, black box warning

Question 4

Helps decrease drug reactions

Answer 4

Pharmacogenetics

Question 5

is the body’s physiologic response to changes in drug concentration at the site of action.

Answer 5

dose-response relationship

Question 6

is defined as the drug’s ability to produce the desired result.

Answer 6

Efficacy

Question 7

refers to the amount of drug needed to elicit a specific physiologic response to the drug.

Answer 7

Potency

Question 8

drug with high potency (e.g., morphine) produces significant therapeutic responses at

Answer 8

low concentrations

Question 9

drug with low potency (e.g., meperidine) produces _______________ at low concentration

Answer 9

minimal therapeutic responses

Question 10

Drug’s minimum effective concentration (MEC) is the plasma drug level below which therapeutic effects will

Answer 10

not occur

Question 11

Oral drugs reach peak in

Answer 11

2 to 3 hours

Question 12

Intramuscular drugs reach peak in

Answer 12

2 to 4 hours

Question 13

Intravenous drugs reach peak in

Answer 13

30 to 60 minutes

Question 14

of action is the length of time the drug exerts a therapeutic effect.

Answer 14

Duration

Question 15

When monitoring for therapeutic response in a patient prescribed a new drug, it is important for the nurse to understand it takes about___________ half-lives for a drug to reach steady state.

Answer 15

4

Question 16

Drug-binding sites are primarily on

Answer 16

proteins, glycoproteins, proteolipids, and enzymes.

Question 17

domain for drug binding is on the cell surface. The drug activates the enzyme inside the cell, and a response is initiated

Answer 17

The ligand-binding

Question 18

The three components to the G protein-coupled receptor are

Answer 18

(1) the receptor, (2) the G protein that binds with guanosine triphosphate (GTP), and (3) the effector

Question 19

found in the cell nucleus on DNA, not on the surface.

Answer 19

transcription factors

Question 20

When drugs interact with a specific receptor and maintain focus on a specific process, the action of the drug is limited because it does not affect multiple receptors.

Answer 20

selective action

Question 21

If a drug interacts with several receptors

Answer 21

nonselective

Question 22

Drugs that exert their effect across many tissues or organs. An example of this drug is atropine.

Answer 22

relatively non-selective

Question 23

Drugs that exert a singular effect on a specific target tissue or organ. An example of this is the nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin and ibuprofen.

Answer 23

relatively selective drug

Question 24

Drugs that exert their effect on a single organ or organ system. An example of a this is digoxin, which effects electrolyte channels in the heart the heart, resulting in a decrease in heart rate

Answer 24

highly selective drug

Question 25

neutralize gastric acidity by direct chemical interaction with stomach acid.

Answer 25

Antacids

Question 26

Ethyl alcohol precipitates bacterial proteins.

Answer 26

Antiseptics

Question 27

work directly on target organs.

Answer 27

Hormones

Question 28

Magnesium sulfate acts by retaining water in the intestinal lumen through an osmotic effect.

Answer 28

Saline laxatives

Question 29

These agents prevent toxicity by forming complexes with heavy metals.

Answer 29

Chelating agents

Question 30

Cell membrane channel opens, and ions flow into and out of the cells.

Answer 30

Cell membrane–embedded enzymes

Question 31

Which type of drug can mimic or block the actions of receptors?

Answer 31

Partial agonists

Question 32

When two drugs are administered in combination, occasionally the response is increased beyond what either could produce alone.

Answer 32

additive effect.

Question 33

When two or more drugs are given together, one drug can have a this on another. This means the therapeutic effect is substantially greater than that of either drug alone.

Answer 33

synergistic effect

Question 34

Some antibiotics have an enzyme inhibitor added to the drug to _________ the therapeutic effect.

Answer 34

potentiate

Question 35

When drugs with ___________________are administered together, one drug reduces or blocks the effect of the other.

Answer 35

antagonistic effects

Question 36

Which drug may cause toxicity when taken with grapefruit juice?

Answer 36

Cyclosporine

Question 37

For example, St. John's wort, an herbal medication, reduces the effectiveness of many drugs, including

Answer 37

digoxin, warfarin, and oral contraceptives.

Question 38

may result from decreased drug clearance in patients with impaired kidney or liver function or from drug-drug interactions

Answer 38

Dose-related adverse effects

Question 39

are not dose-related and usually require prior exposure.

Answer 39

Allergic adverse effects

Question 39

are unexpected adverse effects that are not dose-related or allergic. Genetically determined abnormal response to a drug

Answer 39

Idiosyncratic adverse effects

Question 40

is an effect that is opposite of the intended drug response.

Answer 40

paradoxical effect

Question 41

occurs when drug levels exceed the therapeutic range

Answer 41

Drug toxicity

Question 42

Drugs with narrow TIs require close monitoring to ensure patient safety

Answer 42

aminoglycosides, warfarin, digoxin, lithium, phenytoin

Question 43

Administering a diuretic and beta blocker for hypertension

Answer 43

Additive

Question 44

Using two cytotoxic drugs to treat cancer at lower doses than if given alone

Answer 44

Synergistic

Question 45

Adding a bacterial enzyme inhibitor to an antibiotic

Answer 45

Potentiation

Question 46

Giving naloxone to block harmful effects of morphine overdose

Answer 46

Antagonistic

Question 47

After administering lorazepam to an older adult patient with restlessness and crying, the patient becomes hostile and aggressive and has angry outbursts and psychomotor agitation. Which type of adverse drug effect is the patient experiencing?

Answer 47

Paradoxical reaction