Study Guide 1

Question 1

scope of practice for APRN prescribing

Answer 1

2 components

1. right to prescribe independently
2. right to prescribe w/o limitation

Question 2

med adherence

Answer 2

extent to which pts take their meds as prescribed by LIP and agreed to by pt

Question 3

medication hx and factors to consider when prescribing

Answer 3

1. cost
2. disease guidelines
3. interactions (drugs and polypharmacy)
4. s/e
5. allergies
6. liver and renal fx
7. need for monitoring
8. special populations

Question 4

teratogen

Answer 4

substance which will cause permanent abnormalitiy, growth retardation, or death if fetus exposed

Question 5

renal function when prescribing

Answer 5

look at creatinine clearnace

Question 6

e- prescribing

Answer 6

trend bc less likely to have errors

cannot e-prescribe scheduled meds or narcs

Question 7

pharmacokinetics

Answer 7

study of drug movement throughout the body

Question 8

first pass effect

Answer 8

o Refers to the rapid heaptic inactivation of certain PO drugs. when drugs are absorbed from the GI tract, they are carried direcly to the liver through the hepatic portal vein before they enter the systemic circulation. If the capacity of the liver to metabolize a drug is extremely high, that drug can be completely inacticated on its first pass through the liver. As a result, no therapeutic effects can occur. To circumvent the first pass effect, a drug that undergoes rapid hepatic metabolism is often administered parenterally.

Question 9

steady level aka plateau

Answer 9

Administering repeated doses will cause a drug to build up in the body until a plateau (steady level) has been achieved.

Question 10

time to plateau

Answer 10

approximately 4 half lives with constant dose

Question 11

decline from plateau

Answer 11

 When drug administration id dc’ed, most (94%) of drug in the body will be eliminated over an interval equal to about 4 half lives.

Question 12

excretion

Answer 12

removal of drugs from the body

Question 13

most common organ for drug excretion

Answer 13

renal

Question 14

absorption

Answer 14

movement of drug from site of admin into systemic circulation

Question 15

factors affecting drug absorption

Answer 15

	Rate of dissolution
	Surface area
	Blood flow
	Lipid solubility
	Ph partitioning

Question 16

half life

Answer 16

time required for the amount of drug in the body to decrease by 50%

Question 17

passage of drugs across membranes

Answer 17

ADME

Question 18

3 ways to cross cell membrane

Answer 18

1. passage through channels or pores
2. passage with aid of transport system
3. direct penetration of membrane

Question 19

polar molecules

Answer 19

molecules that have no net charge and uneven distribution of electrical charge

Question 20

ions

Answer 20

molecules that have net electrical charge- positive or negative

unable to cross membranes

Question 21

ion trapping/og oartutuibubg

Answer 21

• Bc of ionization of drugs is Ph depdendent, when the ph of the fluid on 1 side of a membrane differs from the ph of the fluid on the other side, drug molecules tend to accumulate on the side where the ph most favors their ionization. Accordingly, bc acidic drugs tend to ionize in basic meida, and bc basic drugs tend to ionie in acidic media, when there is a ph gradient between 2 sides of a membrane, the following occurs
o Acidc drugs accumulate on the alkaline side
o Basic drugs accumulate on the acidic side
• The process whereby a drug accumulates on 1 side of a membrane where the ph most favors its ionization is referred to as ion trapping or ph partitioning

Question 22

metabolism

Answer 22

aka biotransformation

enzymatic alteration of drug structure

takes place in liver

Question 23

p450 system

Answer 23

o Metabolism that takes place in the liver is perfroemd by hepatic microsomal enzyme system, known as P450 system. The term P450 refers to cytochrome P450, a key component of this enzyme system.

Question 24

therapeutic consequences of drug metabolism

Answer 24

	Accelaterated renal excretion of drugs
	Drug inactivation
	Increased therapeutic action
	Activation of prodrugs
	Increased toxicity
	Decreased toxicity

Question 25

special considerations in drug metabolism

Answer 25

```  Age  Induction and inhibition of drug-metabolisng enzymes  First-pass effect  Nutrition status  Competion between drugs ```

Question 26

protein binding

Answer 26

o Drugs can form reversible bonds with various proteins in the body. Of all the proteins with which drugs can bind, plasma albumin is the most important. Like other proteins, albumin is a large molecule. Bc of its size, albumin is too large to leave the bloodstream.

Question 27

pharmacodynamics

Answer 27

o Study of biochemical and physiologic effects of drugs on the body and the molecular mechanisms by which those effects are produced

Question 28

TI

Answer 28

o The measure of a drug’s safety

Question 29

AGNOIST

Answer 29

 Molecules that activate receptors  Bc neurotransmitters, hormones, and other endogenous regulators activate the receptors to which they bind, all of these compounds are considered agonists. When drugs act as agonists, they simply bind to receptors and mimic the actions of the body’s own regulatory molecules.

Question 30

antagonist

Answer 30

 Produce their effects by preventing receptor activation by endogenous regulatory molecules and drugs. antagonists have virtually no effects on their own receptor function

Question 31

maximal efficacy

Answer 31

largest effect that a drug can produce

Question 32

potency

Answer 32

amount of drug we must give to elicit a response

Question 33

pediatrics BBB

Answer 33

o Not fully developed at birth Drugs and other chemicals have relatively easy access to the central nervous system (CNS) o Infants especially sensitive to drugs that affect CNS function o Dosage should also be reduced for drugs used for actions outside the CNS if those drugs are capable of producing CNS toxicity as a side effect

Question 34

requirements when writing prescriptions

Answer 34

 Prescriber name, license #, contact info  DEA # (if applicable, only when prescribing controlled substances)  Patient name and DOB  Name of medication  Strength of medication  Number of tablets/capsules to dispense  Number of refills