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Nurse 152 Intro to Pharmacology > Week 1 > Flashcards

Week 1 Flashcards

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1
Q

Differentiate between the 2 phases of drug action

A
  • Pharmacokinetics

- Pharmacodynamics

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2
Q

What is Pharmacokinetics?

A

The process of drug movement throughout the body and is composed of 4 processes

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3
Q

What are the 4 processess of Pharmacokinetics?

ADME

A
  1. Absorption
  2. Distribution
  3. Metabolism
  4. Excretion
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4
Q

What is drug absorption?

A

The movement of drugs into the blood stream and occurs as one of three main transport routes

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5
Q

What are the three main transport routes of drug absorption?

APP

A
  • Active transport
  • Passive transport
  • Pinocytosis
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6
Q

What is active transport?

A

transport that requires a carrier such as a protein to move against the concentration gradient
requires energy

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7
Q

What is Passive transport?

A

Transport that occurs by either diffusion or facilitated diffusion

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8
Q

What is diffusion?

A

When drugs move across the cell membrane to an area of lower concentration

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9
Q

What is facilitated diffusion?

A

When a drug relies on a carrier to move from an area of lower concentration

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10
Q

What is Pinocytosis?

A

A process in which the cells carry a drug across their membrane by engulfing the drug particles in a vesicle

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11
Q

Where do most oral meds become absorbed?

A

Across the mucosal lining of the small intestines

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12
Q

What is the first pass effect?

A

When the drug concentration is greatly reduced by the liver prior it the drug being absorbed into the blood stream

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13
Q

What is the Bio-availability of a drug?

A

The percentage of an administered drug available for activity

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14
Q

What two main factors effect bioavailability?

A

Absorption and First-pass effect

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15
Q

What are some factors that can affect absorption?

A

poor Circulation-can lover absorption
Hunger, Pain, Stress, Fasting, Food, pH-Can increase or decrease absorption depending on condition especially when they affect gastric emptying

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16
Q

What are factors that can alter bioavailability of a drug?

A
  • Drug form
  • Route of administration
  • Gastric and mucosal motility
  • Presence of food in stomach
  • Decreased liver functionincreases bioavail
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17
Q

What is Drug Distribution?

A

The movement of a drug from the bloodstream to the body tissues

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18
Q

What three main factors influence drug distribution?

A
  • Rate of blood flow to tissue
  • Drug affinity to tissue
  • Protein Binding
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19
Q

What are free drugs?

A

Drugs that remain unbound to proteins and cause a pharmacological response

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20
Q

What is drug metabolism?

A

The process which the body chemically changes drugs into a form that can be excreted

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21
Q

What is the main site of drug metabolism?

A

the liver

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22
Q

Why are patients with impaired liver disease at higher risk for drug toxicity?

A

Because if the liver is impaired it can not metabolize the drugs efficiency which will lead to an excess buildup of free drugs in the system leading to toxicity

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23
Q

What is Drug half life?

A

The amount of time it takes for X amount of drug to be reduced by half in the body.

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24
Q

What factors affect drug half-life?

A
  • The amount of drug initially given
  • The amount of drug remaining in the system at the next dose
  • rate of metabolism
  • rate of excretion
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25
Q

Why do drugs with long half-life’s sometimes need a loading dose?

A

Because drugs with long half-life’s tend to take longer to reach a therapeutic level in the system and if the patient needs the effect of the therapeutic action faster than the standard dose will allow, a larger loading dose is given and subsequent doses are given to maintain the level of available drugs in the system

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26
Q

What is drug excretion?

A

The elimination of the drug and its metabolites from the body

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27
Q

What is the main site of drug excretion?

A

The kidneys

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28
Q

What are the three types of conditions that can effect excretion?

A

_Pre-renal-reduced blood flow
_Intra-renal-altered GFR, secretion and reabsorption
_Post-renal- Urinary obstruction

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29
Q

What is Pharmacodynamics?

A

The study of the effects of drugs on the body

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30
Q

What are the 5 areas covered in Pharmacodynamics?

Polly Thought Owen Preferred Dudes

A
  • Potency
  • Therapeutic Index
  • Onset
  • Peak
  • Duration of Action
31
Q

What is drug potency?

A

The amount of drug needed to elicit a specific physiological response

32
Q

What is the therapeutic index?

A

The relationship between the therapeutic dose and the toxic dose of a drug

33
Q

What is Drug Onset?

A

The time it takes for a drug to reach the minimum effective concentration after administration

34
Q

What is Drug Peak?

A

The highest concentration in the blood

35
Q

What is Duration of Action?

A

The length of time a drug exerts a therapeutic effect

36
Q

What important considerations and actions are taken when a patient is required to take drugs with a narrow therapeutic index?

A

Drugs with a narrow TI need to be monitored due to the high risk of toxicity. This monitoring is done by actively checking the patients blood for free drugs. Drugs doses are than adjusted according to the results of these tests and the “Peaks and Troughs” used to visualize the drug evels

37
Q

What does a trough level indicate?

A

The rate of absorption and elimination

38
Q

What do peak levels indicate?

A

Drug absorption rates

39
Q

What is the general peak time for oral medications?

A

2-3 hours

40
Q

What is the general peak time for IV medications?

A

30-60 mintues

41
Q

What is the general peak time for IM medications?

A

2-4 hours

42
Q

Peak time depends on _______

A

The route of administration

43
Q

The two general effect categories of drug actions are _____ and _____

A

Agonists and Antagonists

44
Q

What are agonists?

A

Drugs that activate and produce a desired response

45
Q

What are antagonists?

A

Drugs that block receptor activation and block a response

46
Q

What pediatric considerations are there for absorption

A

Absorption can and will vary greatly depending on age, health, weight, and route of administration and needs to be individualized to each patient.

High bilirubin levels will block absorption and can lead to a toxic event

47
Q

What pediatric considerations need to be taken in terms of distribution?

A

As with absorption the rate and area of distribution will vary with each patient but special consideration must be given to younger children because they have an increased distribution of body fluids and may need higher doses of some medications

48
Q

What pediatric considerations need to be taken in terms of metabolism?

A

Metabolism will very greatly with the maturation level of the child.
Newborn’s will have reduced liver hepatic blood flow until age 1 so metabolism will be slower

49
Q

What pediatric considerations need to be taken in terms of excretion?

A

GFR is lower and elimination is lower

50
Q

How is dosage altered with pediatric patients?

A

Dosing is bases off of weight and/or body surface area,

Age, organ function, and route of administration are all considered as well

51
Q

Pediatric medications are usually given via what route? Why?

A

Pediatric medications are usually given via the Oral route.

  • This is done with oral syringes and often will be inserted in the side of the mouth to come in contact with the buccal mucosa to initiate sucking
  • Also crushing of medications into food is also common

Oral administration is favored Because it is least invasive

52
Q

What considerations does the nurse need to make when educating adolescents on prescription drug use?

A
  • Asses the adolescent for risk of High-risk behaviors
  • The nurse must consider that the adolescent may not understand what drug interactions are
  • Never directly ask if adolescent participates in high-risk behaviors, instead directly communicate the implications of high risk behaviors without the perception of accusations
  • Nurse should assess the adolescents ability to self-administer
  • Include Family centered collaborative care
53
Q

What is Family Collaborative care?

A

When the whole family is involved in the care of a family member.

  • Family-Patient teaching is Key
  • Developmental differences need to be considered
54
Q

What Geriatric considerations need to be considered in terms of drug absorption?

A

Generally, absorption will be decreased due to decreased gastric motility, gastric emptying, difficulty swallowing, and poor nutrition

55
Q

What Geriatric considerations need to be considered in terms of distribution?

A

-Geriatric patients will often have a greater volume of fat and this needs to be considered when giving lipid-soluble drugs. These drugs will have a greater volume of distribution and storage leading to reduced elimination and a longer duration of action

56
Q

What Geriatric considerations need to be considered in terms of metabolism?

A

-Geriatric patients can see a reduced hepatic blood flow of up to 40% as well as reduced liver size the implications of this are that drugs are metabolized less efficiently leading to longer drug half-life’s and duration of action

57
Q

What Geriatric considerations need to be considered in terms of excretion?

A

-Geriatric patients often have reduced renal function.
This altered renal function means that some drugs will need to be dosed “renally” meaning dosed based off of the functional levels of the kidneys. This is done to avoid toxic events

58
Q

Why are geriatric patients more likely to experience CNS side effects from drugs?

A

Due to the increased permeability of the blood-brain barrier and reduced blood flow to the brain

59
Q

What are extrapyramidal effects?

A

A form of CNS side effects that cause drug induced movement disorders and effects such as: spasms, tremors, slurred speech, dystonia (involuntary muscle contractions), anxiety, and paranoia

60
Q

What is polypharmacy and what are its implications for the geriatric patient.

A

Polypharmacy is a term that refers to a patient that is taking multiple drugs(Rx, OTC, or Herbal) at once.
-This increased the risk of adverse drug interactions

61
Q

What education can the nurse give to reduce the risk of adverse interactions from polypharmacy?

A

-Encourage the patient to:
-Always carry an up to date drug list
-Use the Same Pharmacy for all prescriptions
-Always communicate with every provider and pharmacist about all OTC and Herbal medications (include them on the drug list) As well as All co-morbidity’s
-

62
Q

Why is lack of adherence so dangerous for geriatric patients?

A
  • Many patients may have advanced conditions or conditions that could become advanced. as well as polypharmacy with specific dosage timing to avoid interactions.
  • Adherence is important because lack of adherence can lead to adverse effects or could cause a condition to worsen.
63
Q

What are two vital steps to help ensure adherence

E I

A

Education and Identification of possible barriers

64
Q

What are some possible barriers to effective use?

Poly Completed Most Decorations In Contest Collaboration Sites

A
  • Polypharmacy
  • Complexity of instructions
  • Memory loss
  • Decreased mobility and dexterity
  • Impairment of vision and hearing\
  • Cost of medications
  • Child proof bottles
  • Side effects
65
Q

How can the nurse educate the patient to avoid lack of adherence due to confusing Poly-pharmacy

A

Offer charts and coordination/consolidation tools

66
Q

How can the nurse educate the patient to avoid lack of adherence due to Complexity of Instructions?

A
  • Offer to re-explain instructions as much as necessary

- provide clear written instructions

67
Q

How can the nurse educate the patient to avoid lack of adherence due to Memory loss?

A

Include the family in education. Have the patient rely on them for help remembering

68
Q

How can the nurse educate the patient to avoid lack of adherence due to Decreased mobility?

A

Include the family. Teach the family how and when medications are needed and insure they are aware of importance of adherence

69
Q

How can the nurse educate the patient to avoid lack of adherence due to impairment of vision or hearing.

A

Provide resources for or provide vision and hearing exams and resources to obtain eyeglasses and hearing aids

70
Q

How can the nurse educate the patient to avoid lack of adherence due to Cost

A

Refer patient to social services where they can work to obtain financial help with costs

71
Q

How can the nurse educate the patient to avoid lack of adherence due to child proof caps

A

Inform the patient that they can and should ask their pharmacist for non-childproof caps. Also inform them that they may have to sign an agreement with their pharmacy to do so.

72
Q

How can the nurse educate the patient to avoid lack of adherence due to side effects.

A

Educate the patient/family of patient on how to properly communicate side effects and concerns.

73
Q

What are the top 6 considerations to make when providing medication education for geriatric patients?

A
  1. Insure visual and hearing aids are in place
  2. Always provide privacy and respect
  3. Offer material in large print
  4. Review all drugs
  5. Encourage client to keep a drug list
  6. simplify dosage scheduling

Nurse 152 Intro to Pharmacology (3 decks)

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