Exam 1

Question 1

Describe the 4 phases required by the FDA

Answer 1

Phase I : evaluation of drug metabolism, healthy volunteers, effects on humans (S&S)
Phase II : SMALL group, determine therapeutic effects, tested in SICK pts, safety & effectiveness (non refillable)
Phase III : LARGE group, dose ranges, side effects & effectiveness, pt safety, hundreds-thousands of ppl
Phase IV : REFINE the dosage range, new side effects may be discovered, GENERAL population, conditional approval from FDA

Question 2

What are the drug names

Answer 2

Chemical: scientific name, describes the molecular structure of a drug
Generic: “OFFICIAL” name of a drug, non-proprietary
Trade: named by pharm company that made the drug, propietary

Question 3

Define the 5 drug schedules from the Controlled Substance Act

Answer 3

Schedule I : all non-research use is forbidden, HIGHEST risk for abuse….heroin, LSD, weed
Schedule II : no phone scripts, NO refills, high risk for abuse….cocaine, oxy, fentanyl
Schedule III : script must be rewritten after 6 months, moderate risk for abuse…..tylenol w/ codeine, testosterone, ketamine
Schedule IV : differs in penalties for illegal possession, low potential for abuse….xanax, valium, tramadol
Schedule V : limited dependence, OTC…..cough syrup w/ codeine, lyrica

Question 4

What are the sources of drug info available for HCP

Answer 4

Official : National Formulary, US Pharmacopeia
Non-Official : USP Dispensing Info
Other : PDR - pharm info, Internet- FDA

Question 5

What are the rights of drug admin

Answer 5

Right drug
Right pt
Right dose
Right route
Right time
Right documentation

Question 6

Describe the methods of drug admin

Answer 6

Enteral : oral (PO)
Parenteral : IM, IV, Subcut, Intradermal
Topical : sublingual, dermal, vaginal, rectal, inhalation (drink water 10-15 mins before med admin

Question 7

Describe drug-food interactions

Answer 7

• alters rate of absorption
• inhibits drug metabolism
• increases toxicity of a drug

Question 8

Describe drug-drug interactions

Answer 8

• INcrease therapeutic effect
• INcrease ADRs
• DEcrease effectiveness
• DEcrease side effects
• toxic to same organ
• DEcrease renal perfusion

Question 9

Describe absorption in parenteral

Answer 9

• can move larger amt of med throughout the body
• circulates before reaches liver
• goes right into circulatory system

Question 10

What influences distribution

Answer 10

• First Pass effect
• blood flow to tissue
• ability of drug to exit vascular system (strong binding=slow release….weak binding=quick release

Question 11

Where does drug metabolism occur

Answer 11

liver

Question 12

Describe drug metabolism

Answer 12

• biotransformation
• converts fat soluble drugs into water soluble metabolites
• can be affected by CYP450 system

Question 13

Describe drug excretion

Answer 13

• removal of drugs from the body
• released from kidney via urine
  -released from GI tract via stool
• released from lungs via exhaled air (releases bile)

Question 14

What is the drug half life

Answer 14

time needed for the amt of drug in the bpdy to decrease by 50%

Question 15

Drug dosing is determined by what

Answer 15

half life

Question 16

If a drug has a prolonged half life what does it need

Answer 16

loading dose

Question 17

How do you calculate therapeutic index

Answer 17

LD (lethal dose of 50% of animals) divided by ED (effective dose of 50% of humans)

Question 18

Define peak

Answer 18

when the drug level is at the highest

Question 19

Define trough

Answer 19

when the drug level is at the lowest

Question 20

What is an allergic response

Answer 20

• antigen-antibody response
• stimulates immune system

Question 21

A pt has an allergic response what should the nurse do?

Answer 21

• monitor & check for “true” drug allergies
• stop med
• maintain airway
• monitor vital signs
• switch meds
• teach pt on how their body might react

Question 22

What are the 2 types of pain

Answer 22

acute & chronic

Question 23

Describe acute pain

Answer 23

• short duration
• triggers ANS
• sharp & localized
• response: grimacing & guarding

Question 24

Describe chronic pain

Answer 24

• more than 6 months persistant pain
• RAREly triggers ANS
• effects personality, lifestyle & function
• may experience depression, fatigue, & decreased level of function

Question 25

Describe Gate Control Theory

Answer 25

• acupuncture or acupressure
• low risk to help relieve pain

Question 26

Describe opioid agonists

Answer 26

• Mu & Kappa
• activate receptors
• bind to receptor

Question 27

Describe opioid antagoinst

Answer 27

• block Mu & Kappa
• blocks the opioid receptors sites

Question 28

Narcan (naloxone) therapeutic uses

Answer 28

-reverse effects of narcotic agonist
- blocks receptor sites for agonists

Question 29

Describe the “Chain of Infection”

Answer 29

1. infectious agent: fungi, bacteria, virus, parasite
2. reservoir: animals, humans, food, water, environment
3. portal of exit- where germs escape from: openings in skin, stool, urine, blood
4. mode of transmission- how agents travel: sexual contact, airborne, underprepared food, contact
5. portal of entry- how agents enter the body: openings in skin, body cavity, eating, drinking, mucous membrane
6. susceptible host- who agents travel to next: anyone, animals, close contacts, community members

Question 30

Describe the proper hand washing technique

Answer 30

• avoid touching scrubs or clothing to sink
• warm water
• keep hands lower than elbows
• apply soap & scrub for at least 20 secs
• wash at least 1” above soiled area
• rinse soap off
• pull towel & use it to shut off water

Question 31

When should you be using proper hand hygiene

Answer 31

• BEFORE entering a pt’s room
• BEFORE a clean/aseptic procedure
• AFTER exposed to bodily fluids
• AFTER touching a pt
• AFTER touching pt’s items or surroundings
• AFTER interaction w/ pt