Chapter 8 Objective Questions including Knappier's Notes Flashcards
The higher the concentration, the more _________ a drug response will be.
Intense
Sometimes the prescriber will base the dose on SURFACE AREA rather than weight because surface area determines not only the patient’s weight but also the patients relative amount of body __________).
Adiposity
Body fat can change drug ___________
Distribution
Which 2 age groups are more sensitive to drugs?
Infants
Elderly
How does kidney disease alter drug responses?
Kidney disease reduces drug excretion which causes drugs to accumulate in the body
Hoes does Liver disease alter drug responses?
If liver function declines, the rate of metabolism will decline, which will cause drug levels to accumulate in the body.
To prevent accumulation to toxic levels, dosage of drugs eliminated via hepatic metabolism must be _________ or ________ if liver disease develops.
Reduced
Discontinued
How do acid base imbalances alter drug responses?
By altering pH partitioning.
What is pH partitioning?
If there is a difference in pH on two sides of a membrane, a drug will accumulate on the side where the pH MOST FAVORS its ionization.
Ex: Basic drugs on acidic side.
Acidic drugs on basic side.
What are the most important electrolytes in cell physiology?
K, Na, C, N, P
Tissues that are especially sensitive to alterations in electrolyte alterations are excitable tissues like ______ and ______.
Muscle
Nerve
How often do electrolyte changes have a significant impact on drug responses?
Rarely
Word for the familiar type of tolerance associated with long-term administration of drugs, such a morphine and heroin.?
Pharmacodynamic tolerance
If a patient is experiencing pharmacodynamic tolerance, increased drug levels are required to produce an effective response. __________ _________ ________ (MEC) of a drug becomes abnormally high.
Minimum Effective Concentration
Tolerance resulting from accelerated drug metabolism is called?
Metabolic Tolerance
How is metabolic tolerance brought about?
By certain drugs that induce synthesis of hepatic drug metabolizing enzymes.
What do hepatic drug metabolizing enzymes increase?
Metabolism
Does metabolic tolerance affect the MEC?
No
A reduction in drug responsiveness brought on by repeated dosing over a short time is called:
Tachyphylaxis
(The book gives the example of a drug patch. If you leave the patch on in one place 24 hours straight, effects are lost. If you have an intermittent schedule for the patch, rather than continuously, the cofactor for the drug released from the patch can be replenished between doses and no loss of effects will occur. )
Is tachyphylaxis a common mechanism of drug tolerance?
No
How can nurses make use of the placebo effect?
Present the patient with an optimistic (but realistic) assessment of the effects that placebo therapy is likely to produce.
What is the most common mechanism by which genetic variants modify drug responses?
Drug Metabolism
How can genetic variations alter receptor sensitivity?
Someone’s receptor for a drug might be extra sensitive to a drug or not very sensitive at all. Or maybe they have different number of receptors.
How can genetic variations alter immune response to drugs?
Some people have genetic variations that cause their immune system to be confused and overreact to a drug.
