Pharm Notes

Question 1

How many schedules of controlled substances?

Answer 1

5

Question 2

Drugs that have no accepted medical use, lack accepted safety, and have high abuse potentials: heroin, lysergic acid diethylamide (LSD), 3,4-methylenedioxy methamphetamine (MDMA or ecstasy), mescaline, and peyote.

Answer 2

Schedule I

Question 3

Drugs that are used medically and have high abuse potentials: opioid analgesics (e.g., codeine, hydromorphone, methadone, meperidine, morphine, oxycodone), central nervous system (CNS) stimulants (e.g., cocaine, methamphetamine), and barbiturate sedative–hypnotics (e.g., pentobarbital).

Answer 3

Schedule II

Question 4

Drugs with less potential for abuse than those in Schedules I and II, but abuse of which may lead to psychological or physical dependence: androgens and anabolic steroids, some depressants (e.g., ketamine, pentobarbital), some CNS stimulants (e.g., methylphenidate), and mixtures containing small amounts of controlled substances (e.g., codeine, barbiturates not listed in other schedules). These drugs and substances have an accepted medical use in the United States.

Answer 4

Schedule III

Question 5

Drugs with an accepted medical use in the United States but with some potential for abuse: benzodiazepines (e.g., diazepam, lorazepam), other sedative–hypnotics (e.g., phenobarbital, chloral hydrate), and some prescription appetite suppressants (e.g., phentermine).

Answer 5

Schedule IV

Question 6

Products containing moderate amounts of controlled substances. The pharmacist may dispense them without a physician’s prescription but with some restrictions regarding the amount, record keeping, and other safeguards. Included are cough suppressants containing small amounts of codeine and antidiarrheal drugs, such as diphenoxylate and atropine (Lomotil).

Answer 6

Schedule V

Question 7

Negligence

Answer 7

Misfeasance

Question 8

Omission

Answer 8

Nonfeasance

Question 9

Giving the correct drug via the wrong route

Answer 9

Malfeasance

Question 10

What are the specific processes involved in pharmacokinetics?

Answer 10

Absorption
Distribution
Metabolism
Excretion

Question 11

+Onset of drug action is determined by the rate of absorption.
+Factors that affect the rate and extent of drug absorption;
-Dosage form, route of administration
-Administration site blood flow, GI function
-The presence of food or other drugs

Answer 11

Absorption process

Question 12

+Drugs are carried by blood and tissue fluids to; Action sites, Metabolism sites, Excretion sites
+Depends on adequacy of blood circulation

Answer 12

Distribution process

Question 13

The distribution process affected by

Answer 13

+Protein binding
+Blood–brain barrier
+Pregnancy
+Lactation

Question 14

+The method by which drugs are inactivated or biotransformed by the body
+Drugs changed to; Inactive metabolites, Active metabolites, Prodrugs

Answer 14

Metabolic process

Question 15

Drug-metabolizing enzymes are located within

Answer 15

+Kidneys
+Liver
+Red blood cells, plasma
+Lungs
+Gastrointestinal mucosa

Question 16

Factors that affect drug metabolism

Answer 16

+Enzyme induction
+Enzyme inhibition

Question 17

+elimination of a medication from the body
+Requires adequate function of; Circulatory system. Kidneys, bowel, Lungs, Skin

Answer 17

Excretion

Question 18

Serum drug level?

Answer 18

+a laboratory measurement of the amount of a drug in the blood at a particular time

+Minimum effective concentration (MEC) must be present for efficacy.
+Toxic concentration: excessive level of medication in the bloodstream; caused by
-Single large dose
-Repeated small doses
-Slow metabolism of medication

Question 19

Serum drug level reflects?

Answer 19

+Dosage, absorption
+Bioavailability, half-life
+Rates of metabolism, excretion

Question 20

Receptor Theory of Drug Action

Answer 20

+Drugs exert their effects by chemically binding with receptor cells through
-Activation, inactivation, or alteration of intracellular enzymes
-Changes in the permeability of cell membranes to one or more ions
-Modification of the synthesis, release, or inactivation of neurohormones
-Agonists and antagonist drugs

Question 21

What are Nonreceptor Drug Actions?

Answer 21

+Relatively few drugs do not act on receptor sites. These few drugs include
-Antacids
-Osmotic diuretics
-Several anticancer drugs
-Metal chelating agents

Question 22

Drug-Related Variables

Answer 22

+Dosage
-Frequency, size, number of doses
+Route of administration
-Influences absorption and distribution
+Drug–diet interactions
+Drug–drug interactions

+Interactions that can increase therapeutic or adverse effects include
-Additive effects
-Synergism
-Interference
-Displacement

+Interactions in which drug effects are decreased include
-Antidote medication
-Decreased intestinal absorption of drugs
-Increased metabolism rate of drugs

Question 23

+Main goals of treatment
-Starting treatment soon
after ingestion
-Supporting and stabilizing
vital function
-Preventing further damage
by
-Reducing absorption
-Increasing elimination
-Administering antidotes
whenever possible

Answer 23

Toxicology

Question 24

6 Rights of Medication Administration

Answer 24

Right Patient
Right Drug
Right Dose
Right Route
Right Time
Right Documentation

Question 25

what is a Black Box Warning

Answer 25

warning that the FDA can give prescription drug groups and individual drugs that may cause serious or life-threatening adverse effects

Question 26

What information must be on a Medication Order

Answer 26

+The patient’s full name
+Name of the medication (brand, generic)
+Dose
+Route
+Frequency of administration
+Date
+Time
+Signature of the prescriber

Question 27

Medication Delivery Systems “PO”

Answer 27

+By mouth (PO)
-Tablets
-Capsules
-Sublingual

Question 28

Medication Delivery Systems “Controlled Release”

Answer 28

+Controlled release
-Enteric coated (to prevent
stomach upset)
-Maintains more consistent
serum drug levels
-Allows less frequent
administration
-More convenient for
patients
+Tablets, capsules
-Contain high amount of drug
-Intended to be absorbed
slowly over prolonged period
of time
-Should never be broken,
open, crushed, chewed

Question 29

Medication Delivery Systems “Transdermal”

Answer 29

Systemic absorption through skin

Question 30

Medication Delivery Systems “Pump delivery systems”

Answer 30

+External or implanted
+Refillable or long-acting
without refills
-Insulin, opioid analgesics,
anticancer medications

Question 31

Medication Delivery Systems “Topical”

Answer 31

+Solutions
+Creams
+Suppositories
+Frequently used for local
treatment

Question 32

Injection Sites: Sub-Q common sites

Answer 32

Upper arms, abdomen, back, thighs

Question 33

Injection Sites: IM common sites

Answer 33

Ventrogluteal, deltoid, vastus lateralis muscles

Question 34

Injection Sites: IV common sites

Answer 34

Back of hands, forearms

Question 35

Drug Sources

Answer 35

(1) Plants
(2) Animals
(3) Minerals
(4) Synthetic compounds

Question 36

Synthetic compounds - Synthetic drugs

Answer 36

are more standardized in their chemical characteristics, more consistent in their effects, and less likely to produce allergic reactions.

Question 37

Semisynthetic drugs

Answer 37

(e.g., many antibiotics) are naturally occurring substances that have been chemically modified.

Question 38

Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for the patient’s preferences, values, and needs.

Answer 38

Patient-Centered Care

Question 39

Function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality patient care.

Answer 39

Teamwork and Collaboration

Question 40

Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.

Answer 40

Evidence-Based Practice (known as EBP)

Question 41

Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to improve the quality and safety of healthcare systems continuously.

Answer 41

Quality Improvement

Question 42

Minimizes risk of harm to patients and providers through both system effectiveness and individual performance

Answer 42

Safety

Question 43

Use information and technology to communicate, manage knowledge, mitigate error, and support decision-making.

Answer 43

Informatics

Question 44

Beers Criteria for Potentially Inappropriate Medications Used in Older Adults

Answer 44

The American Geriatrics Society Beers Criteria, a list of medications that are generally considered best avoided in older adults and specifically in those with certain diseases, confirms that toxic medication effects and drug-related problems affect the safety of older adults.

Question 45

Drugs that do not act on receptor sites

Answer 45

(1) Antacids, which act chemically to neutralize the hydrochloric acid produced by gastric parietal cells and thereby raise the pH of gastric fluid
(2) Osmotic diuretics (e.g., mannitol), which increase the osmolarity of plasma and pull water out of tissues into the bloodstream
(3) Drugs structurally similar to nutrients body cells require (e.g., purines, pyrimidines) can be incorporated into cellular constituents, such as nucleic acids, which interfere with normal cell functioning. Several anticancer drugs act by this mechanism.
(4) Metal chelating agents, which combine with toxic metals to form a complex that can be more readily excreted

Question 46

Decreased intestinal absorption of drugs

Answer 46

which occurs when drugs combine to produce nonabsorbable compounds. For example, drugs containing aluminum, calcium, or magnesium bind with oral tetracycline (if taken at the same time) to decrease its absorption and therefore its antibiotic effect.

Question 47

Increased metabolism rate of drugs

Answer 47

Activation of drug-metabolizing enzymes in the liver, therefore decreasing the drug’s effects.

Question 48

Newly developed drugs have been extensively tested using a five-phase process before being marketed for general use.

Answer 48

In phase 0, drug testing occurs in animals and small groups of humans.

In Phase 1, a few doses are given to a certain number of healthy volunteers.

In Phase 2, a few doses are given to a certain number of subjects with the disease or symptom for which the drug is being studied. In

In phase 3, the drug is given to different populations and different dosages by using the drug in combination with other drugs. in a double-blind, placebo-controlled design, half of the subjects receive the new drug and half receive a placebo.

In Phase 4, the FDA allows the drug to be marketed and requires manufacturers to continue post-marketing monitoring and electronic report submission of the drug’s safety and effectiveness.

Question 49

are more standardized in their chemical characteristics, more consistent in their effects, and less likely to produce allergic reactions.

Answer 49

Synthetic compounds