Exam (elaborations)
NURS 615 PHARM EXAM 1 MARYVILLE -questions and answers
- Course
- Maryville NURS 615 (NURS615)
- Institution
- Maryville College
NURS 615 PHARM EXAM 1 MARYVILLE -questions and answers
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NURS 615 PHARM EXAM 1 MARYVILLE -questions and answers
What factors are associated with clinical judgment when prescribing medications? - ** VERIFIED
ANSWERS **✔✔Prescribing a drug is based on a thorough assessment of the patient and the
patient's environment. The determination of potential medical and nursing diagnoses, a review of
the potential alternative therapies, specific knowledge about the drug chosen, and the disease
process it is going to treat, known as patient centered care. The best therapy is usually the least
invasive, least expensive, and the least likely to cause adverse reactions
What are the criteria for choosing an effective drug? - ** VERIFIED ANSWERS **✔✔Multiple drugs
may be able to treat a specific condition. You must consult nationally recognized guidelines for
disease management to determine the most effective drug.
How does hypoalbuminemia affect the process of prescribing? - ** VERIFIED ANSWERS
**✔✔Many drugs that carry an electric charge are bound to albumin in the blood. The distribution
of the drug to target tissues may be affected if hypoalbuminemia is present.
What is the drug's half-life? - ** VERIFIED ANSWERS **✔✔In clinical practice it takes about four to
five times the half-life for a drugs concentration to read steady state after a drug is started, stopped or
changed. Hal life is the amount of time for a drug to be half cleared.
What is meant by the onset of action, peak of action, duration of action of medications? - **
VERIFIED ANSWERS **✔✔The onset of action is the time between the drug administration and the
time that you see the drugs minimum effect. Onset is the first sign of a drugs therapeutic effect. Peak
of action is the time of the maximum concentration of the drug in the blood. Duration of action is
the onset of action and the metabolism of the drug below the dose needed for an effect.
Explain first pass metabolism. - ** VERIFIED ANSWERS **✔✔This occurs when the concentration
of the drug is greatly reduced before it reaches the systemic circulation. It is the portion of the drug
lost during absorption. Generally, occurs in the liver or gut wall. After a drug is swallowed it is
absorbed by the digestive system and enters the hepatic system. It is then carried by the portal vein
to the liver before it reaches the rest of the body. The liver metabolizes many drugs to such an extent
that only a small portion of the drug reaches the rest of the body. bioavailability of the drug thus is
greatly reduced by the liver. Sublingual administration can bypass the first pass system plus it is also
faster than oral route.
, What is a steady state? - ** VERIFIED ANSWERS **✔✔The overall intake of a drug is fairly and
dynamic equilibrium with its elimination. Steady state is reached when the time of four to five times
the half-life is reached since the drug had been started.
What factors affect the drug's absorption? - ** VERIFIED ANSWERS **✔✔Absorption involves
several steps. First the drug must be introduced via route of administration and the form of
medication like tablet or capsule. In IV or IM administration the absorption is less variable and
bioavailability is near 100%. IV administration is considered to lose no portion of the drug. The
fastest route of absorption is inhalation. Drugs must pass through the epithelial cells of the GI tract
to be absorbed by the circulatory system. Cell membranes may affect the absorption of some drugs
because they are made of lipid bilayers that are semi permeable. This means only small uncharged
solutes can pass through the membrane. Whether or not a molecule is ionized affects the absorption,
since ionic molecules are charged. Solubility favors charged species. Permeability favors neutral
species. Some molecules have special channels to facilitate movement from the lumen into the
circulation. The Henderson Hasselbeck equation offers a way to determine the portion that is ionized
in a given pH. Weak acids will be present in their nonionic form in the stomach because of the acidic
pH and bases will be in their ionic form. Nonionic species diffuse easier through cell membranes.
Weak acids have a higher absorption rate in the stomach. The opposite is true in the basic
environment of the stomach.
Identify drug metabolism and the role of the isoenzymes of the P450 system. - ** VERIFIED
ANSWERS **✔✔CYPs are the major enzymes in drug metabolism. Must drugs undergo deactivation
by CYPs are directly facilitated secretion from the body. Many substances are bioactivated by CYPs to
form their active compound. Many drugs increase or decrease the activity of CYPs isoenzymes either
by inducing biosynthesis of an isozyme, which is enzyme induction or by directly inhibiting the
activity of CYP which is enzyme inhibition. This is a major source of adverse drug reactions since
changes in CYPs activity may affect the metabolism and clearance of certain drugs. When two drugs
are both metabolized by the CYP450 system the drugs should be administered at separate times to
prevent toxic effects.
What is the efficacy of the drug? - ** VERIFIED ANSWERS **✔✔Efficacy is the maximum response
achievable from a drug. Intrinsic activity is a term used to describe the efficacy of a drug relative to a
drugs highest observed efficacy. Effectiveness refers to the ability of a drug to produce the wanted
effect.
On the drug concentration curve what is the first sign of a therapeutic effect? - ** VERIFIED
ANSWERS **✔✔The onset of action.
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