Exam 1 Flashcards
If a drug is a Teratogenic it:
Is known to induce birth defects
The pharmacokinetic principle of absorption refers to the:
Movement of a drug from site of administration to the bloodstream
T/F: Pharmacodynamics is the process by which a drug is absorbed, distributed, metabolized, and eliminated by the body.
False
What is a desired outcome when a drug is described as easy to administer?
It enhances patient adherence to the drug regimen
A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply?
“This route is safer, less expensive, and more convenient.”
A patient is receiving intravenous gentamicin. A serum drug test reveals toxic levels. The dosing is correct and this medication has been tolerated by this patient in the past. Which could be a probable cause of the test result?
The patient is taking another medication that binds to serum albumin
What occurs when a drug binds to a receptor in the body?
It increases or decreases the activity of the receptor.
First pass effect is the:
Ability of the liver to inactivate certain oral drugs after being absorbed.
With repeated dosing of a drug, plateau or “steady state” is reached in approximately _______ half-lives.
4-5
Antagonists produce their effects by:
Preventing receptor activation by endogenous regulatory molecules and drugs.
What are considered the “Big Three” properties of an ideal drug?
Effectiveness
Safety
Selectivity
The nurse is teaching a patient how a medication works to treat an illness. To do this the nurse will rely on knowledge of which topic?
Pharmacotherapeutics
A post operative patient is being discharged how with acetaminophen/hydrocodone [Norco] for pain. The patient asks the nurse about using Tylenol for fever. Which statement by the nurse is correct?
Taking two medications together poses a risk of toxicity
The nurse is preparing to care for a patient who will be taking an antihypertensive medication. Which action by the nurse is parr of the assessment step of the nursing process?
Questioning the patient about over the counter medications
A nurse is reviewing a patient’s medical record before administering a medication. Which factors can alter the patient’s physiologic response to the drug?
Gender
Genetic factors
Age
The nurse is teaching a patient about home administration of insulin to treat diabetes mellitus. As part of the teaching the patient and nurse identify goals to maintain specific blood glucose ranges. This represents which aspect of the nursing process?
Planning
A postoperative patient has orders for morphine sulfate 1 to 2 mg IV every 1 hour PRN for several pain and acetaminophen-hydrocodone [Norco] 5 mg PO every 4 to 6 hours PRN for moderate pain. The patient reports pain at a level 8 on a scale of 1-10, with 10 being the worst pain. Which action by the nurse is appropriate?
Administer morphine sulfate 2 mig IV and evaluate the patient’s pain in 15 to 30 minutes.
An adult male patient is 1 days postoperative from a total hip replacement. On a scale of 0 to 10 with 10 being the greatest pain the patient reports a pain level of 10. Which medication would be most appropriate for the nurse to administer to this patient?
6 mg morphine sulfate intravenously
2 gm TID
200 mg three times a day
2 mg/kg dose for patient weighting 52.8 pounds
48 mg
Time spacing for BID
12 hours apart
1.7 L
1700 mL
Which two groups of people are especially sensitive to medication effects?
Older adults
Infants
Which cellular change is caused by a deduction in functional demand?
Atrophy
What process may cause columnar cells to turn into squamous cells as a method of adaptation to a persistent stressor?
Metaplasia
Which term indicates cell death associated with inflammation?
Necrosis
Which statements regarding testing a client for acromegaly is an accurate interpretation of the results?
Growth hormone should be measured as a component of a glucose tolerance test
Following ingestion of 75 g of glucose, it is normal for growth hormone levels to decrease
A patient is admitted with a diagnosis of idiopathic thrombocytopenia. The term idiopathic indicates that the etiology:
Is unknown
An increase in cell size is termed
Hypertrophy
The incubation period/stage of disease is
The time between exposure and appearance of first signs and symptoms
Liquefaction necrosis occurs most often in the:
Neurons and glial cells of the brain
Which type of necrosis is found in patients with Myocardial Infarction (MI)?
Coagulation Necrosis
A 17 year old college bound student received a vaccine against an organism that causes meningitis. This is an example of:
Primary prevention
A diabetic patient reports to the clinic with a chief complain of pain and numbness in the right foot when walking. Upon assessment, the nurse noted a red, 1 cm open ulcer on the great toe. The complaint of pain and numbness would be classified as a:
Symptom
The results of a paper smear of the cervix of a patient reveal that the cells have changed in size and organization. This type of cellular adaptation occurring in the cervix is termed:
Dysplasia
An exam of the bronchial airway of a patient who smokes reveals that stratified squamous epithelial cells have replaced the normal columnar ciliated cells. This type of cellular adaptation is called:
Metaplasia
A patient develops valve damage of the heart as an adverse effect of taking a prescription medication. The term for the etiology of this complication is:
Iatrogenic
A patient with COVID recovers from the virus, but does not regain full pulmonary function. This is an example of:
Sequela
When a nurse observes muscle stiffening occurring within 6-14 hours after death, the nurse should document this finding:
Rigor Mortis
A group of prison inmates developed tuberculosis following exposure to an infected inmate. On examination, tissues were soft and granular (like clumped cheese). What is the likely cause?
Caseouse Necrosis
When planning care for a cardiac patient the nurse knows that in response to an increased workload myocardial cells will:
Increase in size
What does occur with cell injury leading to necrosis?
Intracellular accumulation of debris and particle occur
Lack of oxygen leading to a change in cell metabolism
Hydrophobic swelling occurs due to the accumulation of water
When the etiology of a disease process is termed multifactorial. This indicates that the disease is:
Has more than one cause
Pharmacokinetics (PK)
Rate processes such as absorption, distribution, metabolism, and excretion of a drug and the multiple interrelationships affecting same, such as incomplete absorption, satiability in transport, biotransformation, or binding.
Pharmacodynamics
Drug molecular, biochemical, and physiologic effects or action
Enteral
Involving or passing through the intestine, either naturally via the mouth and esophagus, or through an artificial opening
Parentreal
Situated or occurring outside the intestine. I.e administration by intravenous, intramuscular, or subcutaneous injections.
Blood Brain Barrier
A selective semi-permeable membrane between the blood and interstitial of the brain.
Placental drug transfer
Exchange of drugs across the placenta occurs by passive diffusion, facilitated diffusion, transporter-mediated mechanisms, and vesicular transport.
Albumin
Most abundant circulating protein found in plasma. It represents half of the plasma’s total protein content in health human patients. Liver hepatocytes synthesize albumin and rapidly excrete it into the bloodstream at about 10g to 15 g per day.
CYP Enzymes
Cytochromes P450 (CYP) are a family of enzymes involved in oxidation and reduction of lipid-soluble compounds.
Grapefruit juice can block the action of intestinal CYP so instead of being metabolized, more of the drug enters the blood and stays in the body which can lead to toxic effects.
Inducers
A type of drug that increases the metabolic activity of an enzyme either by binding to the enzyme and activating it or by the expression of the gene coding for the enzyme.
Inhibitors
A substance which slows down or prevents a particular chemical reaction or other process of which reduces the activity of a particular reactant, catalyst, or enzyme.
Half life
The time it takes for the amount of a drugs active substance in your body to reduce by half
Liver function tests
AST
ALT
Kidney monitoring
BUN
Serum creatinine
GFR
Urine output
Minimum effective concentration
The minimum plasma concentration of a drug needed to achieve sufficient drug concentration at the receptors to produce the desired pharmacological response.
Toxic concentration
At which a particular substance produces a toxic effect
Drug steady state
When the quantity of drug eliminated in the unit of time equals the quantity of the drug that reaches the systemic circulation in the unit of time.
Therapeutic index
A ratio that expresses the relationship between the dose expected to elicit some adverse effect and the dose needed to elicit therapeutic effects.
Lethal dose (LD50)/Effective Dose (ED50)
Relative potency
The amount of a compound required to produce an effect when compared to another compound.
Maximal efficacy
Implies that the drug occupy all receptors and further increasing the drug concentration does not lead to an additional response.
Drug receptors
A specialized target macromolecule that binds a drug and mediates its pharmacological action
Affinity
A measure of how avidly a drug binds to a receptor.
Intrinsic activity
The maximal possible effect that can be produced by a drug.
Agonist
A substance which initiates a physiologic response when combined with a receptor.
Antagonist
A substance that stops the action or effect of another substance
Partial agonist
A drug that interacts with a receptor by produces less than the maximal effect
Noncompetitive
Noncompetitive antagonist can prevent the action of an agonist without any effect on the binding of the agonist to the receptor.
Noncompetitive
Noncompetitive antagonist can prevent the action of an agonist without any effect on the binding of the agonist to the receptor.
Competitive
A competitive antagonist binds to the same site as the agonist but does not activate it, thus blocking the agonist’s action.
Selectivity
The degree to which a drug acts on a given site relative to other sites
Pharmacodynamics tolerance
Begins when the cellular response to a substance is reduced with repeated use.
Metabolic tolerance
Results from increased clearance of a drug and/or reduced drug uptake.
Tachyphylaxis tolerance
A rapid and short-term onset of drug tolerance.
Adverse Drug reactions (Side Effects)
Unwanted undesirable effects that are possible related to a drug
Adverse Drug reaction (Toxicity)
Effects of over ingestion or too elevated blood levels or enhanced drug effects that occur durning appropriate use.
Adverse drug reaction (Allergic Reaction)
The immune system reaction to a medicine
Adverse drug reaction (Idiosyncratic effect)
An adverse reaction that does not occur in most patients treated with a drug and does not involve the therapeutic effect of the drug.
Adverse drug reaction (Iatrogenic disease)
Diseases, illnesses of reactions to medial therapy. Adverse events that can be caused by reaction to drugs.
Carcinogenic effect
Producing or tending to produce cancer
FDA pregnancy category A
No risk in human studies
FDA pregnancy categories B
No Risk in Animal studies
FDA pregnancy categories C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans
FDA pregnancy Category D
Evidence of risk
FDA pregnancy category X
Studies in humans and animals have demonstrated evidence of fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.
Bioavailability
The proportion of a drug or other substance which enters the circulation when introduced into the body and so is able to have an active effect.
Patient adherence
The degree to which a patient correctly follow medical advice
Etiology
The cause, set of causes, or manner of causation of a disease or condition
Pthogenesis
The process by which an infection leads to disease
Incubation period
The period between exposure to an infection and the appearance of the first symptoms
Prodromal period
The period after incubation and before the characteristics symptoms of infection occur
Acute phase
The host’s physiologic response to tissue injury or infection
Silent period
Temporary suppression of symptoms
Subclinical stage
Infected do not show symptoms of illness but they can effectively transmit the agent to others
Convalescence
Time spent recovering from an illness
Acute
Severe and sudden onset of symptoms
Chronic
A long-lasting (6+ months) of symptoms
Exacerbation
An acute increase in the severity of an illness
Remission
A diminution of the seriousness or intensity of disease of pain; a temporary recovery.
Sequela
A condition which is the consequence of a previous disease or injury
Epidemiology prevalence
All cases both new and preexisting in the population at the specific time
Epidemiology incidence
Limited to new cases only in the population at the specific time.
Levels of Prevention
Primordial prevention
Primary prevention
Secondary prevention
Tertiary prevention
Example of primordial prevention
Improved sanitation
Example of primary prevention
Immunizations
Example of secondary prevention
Screening programs
Example of tertiary prevention
Rehabilitation programs
Atrophy
A decrease in cell size
Hypertrophy
An increase in cell size and volume
Metaplasia
The replacement of one differentiated somatic eel type with another differentiated somatic cell type in the same tissue.
Dysplasia
Abnormal changes in cellular shape, size, and/or organization
Cerebral atrophy
Happens when an area of your Brian or your entire brain losses neurons
Cardiac Hypertrophy
A condition affecting the left ventricle, the main pumping chamber of the heart.
Necrosis
The death of body tissue
Gangrene
When blood flow to an area of tissue is cut off. Tissue break down and die.
Coagulative necrosis
Having the power to cause coagulation or the property of coagulation. Type of cell death that occurs when blood flow to cells stops or slows.
Liquefaction cellular injury
Partial or complete dissolution of dead tissue and transformation into a liquid, viscous mass.
Caseous cellular injury
A type of cell death that causes tissue to become “Cheese-like” in appearance. Commonly caused by tuberculosis
Apoptosis
The death of cells which occurs as a normal and controlled part of an organisms growth or development
Somatic death
Irreversible cessation of the vital functions of the brain, heart, and lungs,
