Chapter 8 Objective Questions including Knappier's Notes

Question 1

The higher the concentration, the more _________ a drug response will be.

Answer 1

Intense

Question 2

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 __________).

Answer 2

Adiposity

Question 3

Body fat can change drug ___________

Answer 3

Distribution

Question 4

Which 2 age groups are more sensitive to drugs?

Answer 4

Infants

Elderly

Question 5

How does kidney disease alter drug responses?

Answer 5

Kidney disease reduces drug excretion which causes drugs to accumulate in the body

Question 6

Hoes does Liver disease alter drug responses?

Answer 6

If liver function declines, the rate of metabolism will decline, which will cause drug levels to accumulate in the body.

Question 7

To prevent accumulation to toxic levels, dosage of drugs eliminated via hepatic metabolism must be _________ or ________ if liver disease develops.

Answer 7

Reduced

Discontinued

Question 8

How do acid base imbalances alter drug responses?

Answer 8

By altering pH partitioning.

Question 9

What is pH partitioning?

Answer 9

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.

Question 10

What are the most important electrolytes in cell physiology?

Answer 10

K, Na, C, N, P

Question 11

Tissues that are especially sensitive to alterations in electrolyte alterations are excitable tissues like ______ and ______.

Answer 11

Muscle

Nerve

Question 12

How often do electrolyte changes have a significant impact on drug responses?

Answer 12

Rarely

Question 13

Word for the familiar type of tolerance associated with long-term administration of drugs, such a morphine and heroin.?

Answer 13

Pharmacodynamic tolerance

Question 14

If a patient is experiencing pharmacodynamic tolerance, increased drug levels are required to produce an effective response. __________ _________ ________ (MEC) of a drug becomes abnormally high.

Answer 14

Minimum Effective Concentration

Question 15

Tolerance resulting from accelerated drug metabolism is called?

Answer 15

Metabolic Tolerance

Question 16

How is metabolic tolerance brought about?

Answer 16

By certain drugs that induce synthesis of hepatic drug metabolizing enzymes.

Question 17

What do hepatic drug metabolizing enzymes increase?

Answer 17

Metabolism

Question 18

Does metabolic tolerance affect the MEC?

Answer 18

No

Question 19

A reduction in drug responsiveness brought on by repeated dosing over a short time is called:

Answer 19

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. )

Question 20

Is tachyphylaxis a common mechanism of drug tolerance?

Answer 20

No

Question 21

How can nurses make use of the placebo effect?

Answer 21

Present the patient with an optimistic (but realistic) assessment of the effects that placebo therapy is likely to produce.

Question 22

What is the most common mechanism by which genetic variants modify drug responses?

Answer 22

Drug Metabolism

Question 23

How can genetic variations alter receptor sensitivity?

Answer 23

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.

Question 24

How can genetic variations alter immune response to drugs?

Answer 24

Some people have genetic variations that cause their immune system to be confused and overreact to a drug.

Question 25

The study of how genetic variations can affect individual responses to a drug:

Answer 25

pharmacogenetics

Question 26

In the distant future, pharmacogenetic analysis of each patient may allow us to pick a drug and dosage that best fits his or her __________.

Answer 26

genotype

Question 27

Why is race not very helpful as a basis for predicting individual variation in drug responses?

Answer 27

Race is nearly impossible to define

Question 28

Instead of race, what we are more interested in is the specific ________ and ____________ factors-shared by many members of an ethnic group-that influence drug responses.

Answer 28

Genetic

Psychosocial