Pharmacology NUR 2474 Module 10 Quiz (solved)

What can happen to the fetus if harm is done by drugs in the first trimester or through weeks 3 to 8? - Answer- Most of the major fetal harm and gross malformations can be done here to the fetus from teratogenic drugs. What can happen to the fetus if harm is done by drugs in the 2nd/ 3rd trimesters or from week 9 to delivery? - Answer- Period where teratogenic drug exposure can disrupt function rather than organ development and formation. FDA Class A pregnancy risk - Answer- Safest drugs as studies have shown that these drugs have failed to demonstrate the risk of fetal harm FDA Class B pregnancy risk - Answer- Slightly more of a risk, as human studies show no risk to the fetus during first trimester, but in animals the drug can do harm on the offspring FDA Class C pregnancy risk - Answer- Greater risk, but animal studies show risk for fetal harm but no studies have been done on humans to show fetal harm FDA Class D pregnancy risk - Answer- There is a proven risk for fetal harm, but benefits of use during pregnancy must outweigh the risks. FDA Class X pregnancy risk - Answer- There is a definite risk for fetal harm for use of the drug in pregnancy and risk for fetal harm with adverse reactions. Women should not use this drug during pregnancy. What are the effects of alcohol on the pregnant women and fetus if taken during pregnancy? - Answer- Fetal Alcohol Syndrome may occur, but studies have not be done as they are unethical to put the mom and baby through. However there may be a link for fetal abnormalities still. What should be avoided during pregnancy at all times? - Answer- Alcohol Lipid soluble drugs... - Answer- Do not require a transporter protein to cross the membrane of most cells and tissues Water soluble drugs... - Answer- Do not easily cross the membrane and need transporter proteins to be let in and out of a membrane, safer to use! What is the issue with lipid soluble membranes? - Answer- Because they cross directly, they can cross the blood brain barrier quickly, placenta quickly, and breastmilk quickly, causing potential harmful effects on the person and the fetus. Should patients with asthma and who are pregnant stop taking their asthma medications to ensure no fetal harm? - Answer- NO!- Asthma medications are needed in the pregnant women because uncontrolled asthma can cause more detrimental effects on the fetus than the medications themselves, such as stillbirths What should we always do before giving a medication to a pregnant woman? - Answer- See if the benefits of giving the medication outweigh the risks Do children receiving chemo drugs receive the same DRUGS as adults do? - Answer- YES!- They receive the same drugs as there are no specific pediatric chemo drugs Do children receiving chemo drug receive the same DOSE of medications as adults do? - Answer- NO!- They should receive a pediatric dose of the drug based on age, weight, and body surface area At what year in life will the liver be fully matured and function at an adult level? - Answer- Liver Matures by 1 year old At what year in life will the kidney's be able to be fully mature and excrete at an adult level? - Answer- Kidneys can excrete by 1 year old What is a side effect of tetracycline in children? - Answer- Staining of the baby teeth Risk factors for Older adult drug use: - Answer- Older adults are more sensitive to drugs Have multiple illness comorbidities, meaning more drugs will be used Poor adherence Slower GI absorption and delayed gastric emptying Increased body fat Decreased water concentration Declining hepatic metabolism Declining renal function and excretion causing drug accumulation Low therapeutic index drugs How can we promote medication adherence with older adults? - Answer- Through drug history including all prescriptions, OTC, vitamins, supplements, herbals, and remedies Age related changes and response Therapeutic communication needed with privacy Have to ensure they can maintain a level of independence when taking medications and completing ADLs Simple drug regimen Clear labels and instructions Reminders Support system like family member or caregiver to help with administration Adequate finances or financial assistance What is polypharmacy? - Answer- The use of many different drugs concurrently in treating a patient, who often has several health problems, such as older adults. What can we do to decrease polypharmacy in older adults? - Answer- -take a detail medication reconciliation, ask questions in a therapeutic manner, and identify all prescriptions, OTC, vitamins, supplements and herbals the patient takes. -help the patient create an individualized dosing plan and discard any medications that could interact or are old -Use easy to open containers, clear and easy instructions along with daily reminders -Involve the family in the plan of care What is garlic used for? - Answer- To help decrease CV effects, lower TG and LDL cholesterol and raise HDL cholesterol. Reduces BP, suppress platelet aggregation, increase arterial elasticity, and decrease plaque formation, prevent infection and cancer Adverse effects of garlic use? - Answer- Bad breath, body odor Implications for garlic use: - Answer- must be raw and not cooked due to enzymes that will be activated to increase results, 1-2 cloves daily, 5 out of 18 common products will have the enzymes in effective quantities Safety and manufacturing standards for supplement productions are: - Answer- not strict What are certain provisions that one must follow when producing supplements? - Answer- -Labels should be placed on supplements, but may not outline any intentions of diagnosing, treating, curing, or preventing any diseases -A product may be deemed safe until proved hazardous -Will not address impurities, adulterants, or variability. -Have to have quality control and reporting of serious drug adverse effects -Potency of products can vary based on manufacturer and standardization May destroy active compounds Ma Huang uses - Answer- Contains ephedrine that can elevate the BP, and stimulate heart and CNS. High doses can be associated with stroke, MI, and death. Why is not Ma Huang used anymore? - Answer- There are reported incidences of serious adverse reactions with the substance and because of that, the FDA has banned sales of this substance. What things should we always to when assisting the older adult either with meds or ADLs? - Answer- Therapeutic communication, allow patient to perform at their max level of independence, never force anything on the patient, give privacy, short simple easy vocabulary and sentences. Parts of a medication reconciliation - Answer- Prescription Drugs OTC medications Vitamins Supplements Herbals Any other remedites Some of the major problems with older adults and medication usage are: - Answer- Nonadherance and Polypharmacy A social factor that may inhibit the older adult from getting all their medications they need is based on what? - Answer- Finances Which people should we involve in the drug care plan for both children and older adults? - Answer- Parents, guardians, significant others,