Pharm/Med Exam III Flashcards
1
Q
What are medications that are not legally available without a prescription?
A
Legend drugs
2
Q
What are legend drugs?
A
Drugs that are not legally available without a prescription.
3
Q
What are a plant components (bark, root, seeds, flowers, fruit of trees, and extract of these plants) that are valued for their savory, aromatic, or medicinal qualities?
A
Herbs
4
Q
What are herbs?
A
Plant components (bark, root, seeds, flowers, fruit of trees, and extract of these plants) that are valued for their savory, aromatic, or medicinal qualities.
5
Q
What is medicine that can be bought without a prescription (doctor’s order)?
A
Over-the-counter medication
6
Q
These represent the potential hazards of what type of medication?
- May postpone effective treatment of more chronic disease states
- May delay treatment of serious or life-threatening disorders
- May relieve symptoms of a disorder but not the cause
- Toxicity
- Interactions with current prescription medications may occur
- Abuse
A
Over-the-counter medication
7
Q
OTC medications now account for about what percent of all medications used in the United States?
A
OTC medications now account for about 60% of all medications used in the United States.
8
Q
A 56-year-old man is taking OTC antacids for relief of indigestion. He tells the nurse that he consumes at least one bottle a week and has done so for more than 1 month because “it works for me.” What is the nurse’s primary concern?
A. This self-treatment is expensive.
B. This self-treatment may be delaying treatment of a more serious problem.
C. This self-treatment may be the best treatment of his indigestion.
D. The long-term use of antacids may make the indigestion worse.
A
B - This self-treatment may be delaying treatment of a more serious problem.
9
Q
The nurse associates use of which OTC medication with the development of hepatotoxicity?
A. Acetylsalicylic acid (Aspirin)
B. Ibuprofen (Motrin)
C. Pseudoephedrine (Sudafed)
D. Acetaminophen (Tylenol)
A
D. Acetaminophen (Tylenol) is associated with the development of hepatotoxicity.
10
Q
What is the simultaneous use of both traditional and alternative medicine.
A
Complementary Medicine
11
Q
What is complementary medicine?
A
Complementary Medicine- Simultaneous use of both traditional and alternative medicine.
12
Q
What do you call herbal medicine, chiropractic, acupuncture, massage, reflexology, and any other therapies traditionally not emphasized in Western medical schools?
A
Alternative Medicine
13
Q
What is alternative medicine?
A
What do you call herbal medicine, chiropractic, acupuncture, massage, reflexology, and any other therapies traditionally not emphasized in Western medical schools?
14
Q
What is phlebitis?
A
Inflammation of a vein.
15
Q
What are the potential hazards of over-the-counter medication?
A
- May postpone effective treatment of more chronic disease states
- May delay treatment of serious or life-threatening disorders
- May relieve symptoms of a disorder but not the cause
- Toxicity
- Interactions with current prescription medications may occur
- Abuse
16
Q
What causes these symptoms near an IV site?
- Visible red “streaking” on your arm or leg
- Redness
- Swelling
- Warmth
- Tenderness
A
Phlebitis
17
Q
Your patient is saying that his IV site is tender. Upon inspection you find that it is slightly pink and swollen 1-2 inches above the insertion site and it feels warm. These findings indicate:
A. Phlebitis
B. Infiltration
C. Edema
D. Thrombus
A
A. Phlebitis
18
Q
The physician has written an order to discontinue an IV line. You obtain which of the following supplies from the supply closet to apply pressure to the site after removing the catheter.
A. Band-aid
B. Sterile 2X2 gauze
C. Alcohol swab
D. Betadine swab
A
B. Sterile 2X2 gauze
19
Q
The nurse recognizes that the client will require fluid replacement with hypotonic solution. One of the hypotonic solutions that may be ordered by the physician is:
A. 5% sodium chloride
B. 0.45% sodium chloride
C. Dextrose 5% in 0.45% normal saline
C. Dextrose 10%
A
B. 0.45% sodium chloride
20
Q
The nurse suspects a patient has fluid volume excess. What signs would the nurse expect to note if fluid volume excess is present?
A. Weight loss
B. Increase in blood pressure
C. Dry skin
D. Thirst
A
B. Increase in blood pressure
21
Q
The nurse is caring for a hospitalized adult patient after thoracic surgery. The nurse observes that the patient has decreased skin turgor, dry mucous membranes, and a weak radial pulse of 100 beats/min. The nurse determines that the patient is most likely experiencing
A. Hypervolemia
B. Interstitial-to-plasma shift
C. Hypernatremia
D. Hypovolemia
A
D. Hypovolemia
22
Q
What is it called when fluid from IV enters the subcutaneous tissue?
A
Infiltration
23
Q
What is infiltration?
A
Infiltration- fluid from IV enters the subcutaneous tissue.
24
Q
What type of antibiotic therapy is
used to prevent an infection?
A
Prophylactic
25
What are prophylactics?
Antibiotics that are used to prevent an infection.
26
What is it called when the
selection of an antibiotic is based on the possibility that it will work against the causative microorganism?
Empiric
27
What is Empiric Therapy?
When the selection of an antibiotic is based on the possibility that it will work against the causative microorganism.
28
What type of antibiotic therapy is the selection of an antibiotic when the causative organism is known?
Definitive Therapy
29
What are other names for pseudomembranous colitis?
Clostridium difficile or antibiotic-associated colitis.
30
What is pseudomembranous colitis, antibiotic-associated colitis or Clostridium difficile?
A necrotizing inflammatory bowel condition that is often associated with antibiotic therapy.
31
What is another term for C. diff overgrowth?
Pseudomembranous colitis or antibiotic-associated colitis.
32
What are the symptoms of pseudomembranous colitis?
Watery diarrhea, abdominal pain and fever.
33
Watery diarrhea, abdominal pain and fever are symptoms of what type of antibiotic induced condition?
Clostridium difficile or pseudomembranous colitis ( or antibiotic-associated colitis)
34
What antibiotic is more likely to produce Clostridium difficile than others?
Clindamycin
35
Clindamycin is more likely to cause what type of colitis?
Pseudomembranous colitis (antibiotic-associated colitis)
36
How do you treat pseudomembranous colitis (C. diff)?
More antibiotics. Especially vancomycin
37
What is it called when solutes move from area of higher concentration to one of lower concentration?
diffusion
38
What is diffusion?
When solutes move from an area of higher concentration to an area of lower concentration.
39
What is it called when a physiologic pump moves ions from an area of lower concentration to one of higher concentration?
Active transport
40
What is active transport?
When a physiologic pump is used to move ions from an area of lower concentration to one of higher concentration.
41
What is biotransformation?
Metabolism
42
What is alteration of a drug into an inactive metabolite, a more soluble compound, a more potent active metabolite called?
Metabolism or biotransformation
43
What is biotransformation?
Biochemical alteration of a drug into an inactive metabolite, a more soluble compound, a more potent active metabolite (as in the conversion of an inactive prodrug to its active form), or a less active metabolite.
44
What is this an example of: transformation of a more potent active metabolite (as in the conversion of an inactive prodrug to its active form)?
Metabolism or biotransformation
45
What is a prodrug converted to during biotransformation (metabolism)?
A more active form
46
What is required to convert a prodrug into it's more active form?
Metabolism (biotransformation)
47
What are the four results of metabolism (biotransformation)
1. An inactive metabolite
2. A less active metabolite
3. A more potent active metabolite
4. A more soluble compound
48
What is it called when a large proportion of a drug is chemically changed into inactive metabolites by the liver.
Much smaller amount will be bioavailable.
First pass effect
49
What is the first pass effect?
A large proportion of a drug is chemically changed into inactive metabolites by the liver.
Much smaller amount will be bioavailable.
50
What amount of drug is available after the first pass effect?
A much smaller amount will be bioavailable.
51
Where does first pass effect happen?
In the liver
52
Where does a physiologic process that chemically changes a large proportion of a drug is into inactive metabolites occur?
In the liver
53
What is the time required for half (50%) of a given drug to be removed from the body?
Half-life
54
What is the half-life of a drug?
The time required for half (50%) of a given drug to be removed from the body
55
After how many half-lives is a drug considered effectively removed from the body?
After approximately five half-lives.
56
What is considered effectively removed after five passes through the liver?
A drug
57
What type of medication is affected by first pass effect?
PO
58
What is PO medication?
Oral
59
What type of medications are considered PO?
A drug absorbed into the systemic circulation through the oral or gastric mucosa or the small intestine.
60
Due to what physiological process do IV medication doses need to be lower than PO doses?
Because of the first-pass effect.
61
What routes of administration are considered enteral?
Sublingual, buccal, oral, and rectal routes
62
What percentage of a drug is bioavailable via the IV route of administration?
100%
63
What is a strong physical and psychologic dependence on a drug or other psychoactive substance?
Addiction
64
What is addiction?
A strong physical or psychological dependence on a drug or other psychoactive substance.
65
What is withdrawal?
A substance specific mental disorder that follows cessation or reduction of a substance.
66
What is a substance specific mental disorder that follows cessation or reduction of a substance?
Withdrawal
67
What two types of addiction occur?
- Physical dependence: physiologic reliance on a substance
- Psychologic dependence: strong desire to obtain and use a substance
68
What is it called when the need for a greater amount of a substance is required to produce desired effect?
Tolerance
69
What is drug tolerance?
When the patient needs need a greater amount of a drug to produce the desired effect.
70
What is the use of mood or behavior altering substances in a maladaptive manner called?
Substance abuse
71
What is substance abuse?
The use of mood or behavior altering substances in a maladaptive manner.
72
What are two types of dependence?
Physical dependence and
psychologic dependence.
73
What is a physiologic reliance on a substance?
Physical dependence
74
What is a strong desire to obtain and use a substance called?
Psychologic dependence
75
What is the difference between a physical and psychologic dependence on a drug?
In a physical dependence, physical withdrawal will occur.
76
What is the study of what the drug does to the body?
Pharmacodynamics
77
What is pharmacodynamics?
The study of what the drug does to the body.
78
What is another name for the mechanism of drug actions in living tissues?
Pharmacodynamics
79
Is the therapeutic effect part of pharmacodynamics or pharmacokinetics?
Pharmacodynamics because the therapeutic effect is the result of what the body does to the drug.
80
What types of interactions occur in pharmacodynamics?
Receptor interactions
Enzyme interactions
Non-selective interactions
81
Receptor interactions, enzyme interactions and non-selective interactions occur in what?
Pharmacodynamics
82
What is the study of what the body does to the drug?
Pharmacokinetics
83
What is the study of what happens to a drug from the time it is put in the body until it has left the body?
Pharmacokinetics
84
What is pharmacokinetics?
The study of what the body does to the drug.
85
What are the steps in pharmacokinetics?
Absorption
Distribution
Metabolism
Excretion
86
What phase of pharmacokinetics is involved in how the drug gets in?
Absorption
87
What phase of pharmacokinetics is involved in where the drug will go?
Distribution
88
What phase of pharmacokinetics is involved in how is it broken down?
Metabolism
89
What phase of pharmacokinetics is involved in how the drug leaves the body?
Excretion
90
What is absorption?
Movement of drug from its site of administration into the blood stream for distribution to tissues.
91
What is movement of drug from its site of administration into the blood stream for distribution to tissues?
Absorption
92
What stage of pharmacokinetics do these factors affect?
- Route of administration
- Bioavailability
- First pass effect
Absorption
93
What is it called when a large proportion of a drug is chemically changed into inactive metabolites by the liver?
First pass effect
94
Synergistic, additive and antagonistic are types of what?
Types of drug interactions
95
What is the equation relative to synergistic effects?
1+1>2
96
What is it called when the effect of two drugs with similar actions is greater than the sum of the individual effects?
Synergistic effect
97
What is a synergistic effect?
When the effect of two drugs with similar actions is greater than the sum of the individual effects?
98
What is it called when the effect of two drugs is equal to the sum of the individual effects alone?
Additive effect
99
What is the equation relative to the additive effect?
1+1=2
100
What is it called when the combination of 2 drugs results in drug effects that are less than the sum of the effects for each drug given separately?
Antagonistic effect
101
What is the equation relative to the antagonistic effect?
1+1<2
102
What is the decreasing response to repeated drug doses?
Drug tolerance
103
What is a neurologic disorder characterized by apathy drowsiness, ataxia, nystagmus and opththalmoplegia?
Wenicke's encephalopathy
104
What is ataxia?
Poor muscle control that causes clumsy voluntary movements usually from damage to the cerebellum.
105
What is opththalmoplegia
Paralysis of the extra-ocular muscles that control the movements of the eye ( III, IV and VI CNs)
106
What results from opththalmoplegia?
Double vision
107
What is usually a cause of Wernike's encephalopathy?
Thiamine (B1) deficiency secondary to alcoholism
108
What deficiency are Wernike's encephalopathy and Korsakoff's psychosis associated with?
B vitamin deficiency
109
What is a syndrome of amnesia with confabulation associated with chronic alcohol abuse?
Korsakoff's psychosis
110
What are two conditions associated with chronic alcohol abuse?
Wernike's encehalopathy and Korsakoff's psychosis.
111
What is confabulation?
Making up stories
112
What are two conditions associated with vitamin B1 (thiamine) deficiency?
Wernike's encephalopathy and Korsakoff's psychosis.
113
What are drugs that bear a heightened risk of causing significant patient harm when they are used in error?
High alert medications
114
What are examples of high alert medications?
Insulin
Opioids and narcotics
Heparin
115
What is the most common point of medication errors?
Prescribing
Administering
Dispensing
Monitoring?
Nearly 50% of preventable errors occur at the point of prescribing. The next most common error point is administration of medications.
116
What is an understanding of the specific impact of cultural factors on patient drug response?
Ethnopharmacology
117
What is ethnopharmacology?
Understanding the specific impact of cultural factors on patient drug response.
118
What is the effect of patients age, gender, size, and body composition on pharmacokinetics called?
Drug polymorphism
119
What is drug polymorphism?
The effect of patients age, gender, size, and body composition on pharmacokinetics.
120
What is the difference between ethnopharmacology and drug polymorphism?
Ethnopharmocology regards the patient's cultural influences that affect "response" to a drug. Drug polymorphism is the list of physical parameters that can affect the way the body reacts to the drug (pharmacokinetics).
121
Are drug polymorphism or ethonopharmacology influenced by patient's age and gender?
Drug polymorphism. It is the effect of patients age, gender, size, and body composition on pharmacokinetics.
122
Is drug polymorphism or ethnopharmacology dependent on the patient's response to a drug due to cultural parameters?
Ethnopharmacology
123
What is a substance that destroys or inhibits the growth or action of microorganisms especially in or on living tissue?
Antiseptic
124
What is an antiseptic?
A substance that destroys or inhibits the growth or action of microorganisms especially in or on living tissue?
125
What is a substance that is able to kill organisms
and used in non living organisms?
Disinfectant
126
Hydrogen peroxide, isopropyl alcohol, or chlorhexidine are examples of what?
Antiseptics
127
Why are hydrogen peroxide, isopropyl alcohol, or chlorhexidine considered antiseptics?
Because they can be used on living tissue.
128
What are chlorine bleach, and
formaldehyde examples of?
Disinfectants
129
Why are chlorine bleach and formaldehyde considered disinfectants?
Because they are not used on living tissues but still kill microbes.
130
What inhibits the growth or action of microorganisms (as bacteria) especially in or on living tissue (as the skin or mucous membranes)?
Antiseptics
131
What are the principle ECF electrolytes?
Sodium cations (Na+)
Chloride anions (Cl−)
132
Sodium cations (Na+) and Chloride anions (Cl−) are the principle ECF or ICF electrolytes?
ECF
133
What is the principle ICF electrolyte?
Potassium (K+)
134
Potassium (K+) is the principle ICF or ECF electrolyte?
ICF
135
Calcium, magnesium, phosphorus are examples of what type of ions?
Electrolytes
136
What ion is the most frequently occurring extracellular cation that also
regulates fluid volume?
Sodium (Na+)
137
What is the most abundant positively charged electrolyte outside cells?
Sodium (Na+)
138
What electrolyte has a normal concentration outside cells of 135 to 145 mEq/L?
Sodium (Na+)
139
What is the normal range of Na+ in ECF?
135-145 mEq/L
140
What electrolyte is maintained through dietary intake salt, fish, meats, foods flavored or preserved with salt?
Sodium (Na+)
141
What is sodium loss or deficiency along with serum levels below 135 mEq/L?
Hyponatremia
142
What are symptoms of hyponatremia?
Lethargy, stomach cramps, hypotension, vomiting, diarrhea, seizures.
143
What can the following cause:
excessive perspiration (during hot weather or physical work), prolonged diarrhea or vomiting, or renal disorders?
Hyponatremia
144
What is the condition where there is excess and serum levels over 145 mEq/L?
Hypernatremia
145
The following are symptoms of what?
Water retention (edema), hypertension, red flushed skin; dry sticky mucous membranes; increased thirst; elevated temperature; decreased urine output.
Hypernatremia
146
What condition can the following cause?
Poor renal excretion stemming from kidney malfunction; inadequate water consumption and dehydration
Hypernatremia
147
What are four functions that sodium is responsible for?
1. Control of water distribution
2. Fluid and electrolyte balance
3. Osmotic pressure of body fluids
4. Participation in acid–base balance
148
True/False: Does sodium contribute to acid-base balance in the body?
True
149
What electrolyte is a major cation of intracellular fluid and involved in nerve transmission and excretion?
Potassium (K+)
150
What is a low potassium level called?
Hypokalemia
151
What is a high potassium level called?
Hyperkalemia
152
What is a normal serum level of potassium?
3.5-5 mEq/L
153
What is the system most effected by hyper- or hypokalemia?
Cardiac system and muscle contraction are most influenced by changes in potassium.
154
Changes in what electrolyte cause cardiac system and muscle contraction changes?
Potassium
155
What of the following are principally ECF electrolytes and which are ICF electrolytes?
Sodium
Chloride
Potassium
ECF:
Sodium
Chloride
ICF:
Potassium
156
Which electrolyte is found in fruit and fruit juices (bananas, oranges, apricots, dates, raisins, broccoli, green beans, potatoes, tomatoes), meats, fish, wheat bread, and legumes?
Potassium
157
Eliminating excess potassium from the body is contingent on what organ working efficiently?
Kidneys
158
True/False: Excess dietary potassium excreted via liver.
False. Excess dietary potassium is excreted via the kidneys.
159
True/False: Does potassium contribute to acid-base balance in the body?
True
160
Which electrolyte is involved in muscle contraction, transmission of nerve impulses, regulation of heartbeat and maintenance of acid–base balance?
Potassium
161
Which two electrolytes are involved in acid-base balance in the body?
Potassium and sodium
162
What is a condition in which the liquid portion of the blood (plasma) is too low?
Hypovolemia
163
What is a condition in which the fluid portion of the blood is too high (retention)?
Hypervolemia
164
Hypervolemia and hypovolemia are which type of conditions?
Fluid imbalance.
165
What is fluid volume deficit called?
Hypovolemia
166
What is fluid volume excess called?
Hypervolemia
167
What is the condition called where the patient experiences weight gain, fluid retention and peripheral edema?
Hypervolemia
168
What is the condition called where the patient experiences fluid output that is greater than fluid intake?
Hypovolemia or dehydration
169
Dehydration is an example of hypovolemia or hypervolemia?
Hypovolemia
170
What route of medication is absorbed into the systemic circulation through the oral or gastric mucosa or the small intestine?
Enteral
171
What is enteral medication?
Absorbed through the oral or gastric mucosa or the small intestine to get into the systemic circulation.
172
What are the four routes of medication administration that are considered enteral?
Oral
Buccal
Sublingual
Rectal
173
What type of enteral medication route is also considered to be topical?
Rectal
174
Rectal is considered to be a medication administration type that is included in what two routes?
Enteral and topical
175
What is a sublingual medication?
Absorbed under the tongue
176
What medication route is absorbed under the tongue?
Sublingual
177
What medication route is tucked between the cheek and gum?
Buccal
178
What is a buccal medication route?
Between the cheek and gum
179
The following are what types administration route?
transdermal patches
inhalers
ointment
gel
cream
eye drops
Topical
180
Is a transdermal patch considered subdermal or topical?
Topical
181
Are eye drops considered in the same administration route as nasal spray?
Yes - both topical
182
What are the four steps in replacing a transdermal patch?
- Clean area
- Ensure the area is free of hair
- Check for skin breakdown (if replacing a patch)
- Initial/time on patch
183
What are examples of parenteral routes of medication administration?
IV
IM
Subq
Intradermal
Intraarterial
Intrathecal
Interarticular
184
What do each of these routes mean?
IV
IM
Subq
Intradermal
Intraarterial
Intrathecal
Interarticular
IV - intravenous
IM - intramuscular
Subq - subcutaneous
Intradermal - within the skin
Intraarterial - in an artery
Intrathecal - In the CSF
Interarticular - In the joint
185
List these routes of administration from fastest to slowest:
Liquid
Subq
IM
Capsules
Enteric
Tablet
Powders
Buccal
IV
Suspension
IV
IM
Subq
Buccal
Liquid
Suspension
Powders
Capsules
Tablet
Enteric
186
What is bioavailability?
Rate of drug absorption
187
What is objective data?
Information gathered through the senses - seen, heard, felt or smelled
188
Can enteric medication be sprinkled on top of apple sauce?
Yes.
189
Can you crush enteric medication and why?
No, because it's designed to withstand the pH of the stomach to be absorbed in the small intestine.
190
What three dosage forms can you add to soft food?
Liquid
Powders
Capsules
191
Wha type of information does a nurse collect at an assessment that is gathered through the senses - seen, heard, felt or smelled?
Objective
192
What type of information is collected in an assessment and is shared by the patient or caregiver?
Subjective
193
Is the patient rating pain an objective or subjective finding?
Subjective
194
If the patient grimaces, is that an objective or subjective finding?
Objective
195
What is an example of palliative care?
Hospice
196
What is safer: a high therapeutic index or a low?
A high
197
In what type of therapy do you relieve symptoms because you can't correct the condition?
Palliative care
198
What is palliative care?
A therapy where you treat symptoms because you can't correct the problem.
199
What happens with acute therapy?
Administer something that immediately treats the problem.
200
When a patient presents with an infection and an antibiotic is administered that treats the problem, what type of therapy is this?
Acute therapy
201
What type of therapy is a drug administered that manages a condition but does not correct it?
Maintenance therapy.
202
What is an example of maintenance therapy?
Thyroid medication
203
Give an example of each therapy:
Acute
Palliative
Maintenance
- Acute - antibiotics
- Paillative - - Hospice
- Maintenance - Thyroid medication
