NURS 5334 PHARM
MODULE 1
• What are the BON rules and regulations for prescriptive authority for the advance practice nurse?
• Texas is very restricted
• Describe the pharmacokinetic processes of absorption, distribution, metabolism and elimination and how differences in these areas aff...
2023/2024 NURS 5334
Pharm Study
Guide Quiz 1
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Solution Graded A+ NURS 5334 PHARM
MODULE 1
•What are the BON rules and regulations for prescriptive authority for
the advance practice nurse?
•Texas is very restricted
•Describe the pharmacokinetic processes of absorption, distribution, metabolism and elimination and how differences in these areas affect
drug action.
•Absorption
•Drug’s movement from the site of administration into the
blood.
•Distribution
•Drug’s movement from the blood into the interstitial space
of tissues and from there into cells.
•Metabolism
•Biotransformation is the enzymatically mediated alteration of
drug structure.
•Elimination
•Combination of metabolism and excretion
•Discuss the impact of food on drug absorption, drug metabolism and on
drug toxicity and action—as well as the timing of drug administration.
LIFESPAN
•Hepatic metabolism and GFR increase during pregnancy, dosages of
some drugs may need to be increased.
•Rate of albumin to water decreases
•Third trimester: Renal blood flow is doubled and renal
excretion is accelerated (drugs excreted rapidly)
•Tone and mobility of bowel decrease
•Prolongation of drug effects Total (½ life increases)
Understand stages of development in pregnancy •Conception: through week 2
•Embryonic period: week 3-week 8
a)Gross malformations can be produced by teratogens
•Fetal period: week 9-delivery
•Understand pregnancy labeling
•3 categories now
a) Pregnancy, lactation, male & female reproductive potential
•How do you decrease risk in the infant during breastfeeding?
•Take meds immediately after breastfeeding, avoid drugs that
have long half-lives, choose drugs that tend to be excluded from milk, avoid drugs that are known to be hazardous.
•How do pediatric patients differ in their response to medications?
•Absorption
a)Oral?
•Neonates: drug remain in the stomach longer which increases the levels, low acidity can affect
the absorption of acid labile drugs
b)Parenteral?
•Reponses are slow and erratic.
•Infancy: absorption is more rapid than in neonates
& adults
•Best avoided in infants
c)Transdermal?
•Greater skin permeability which increases topical drug absorption and increases the risk
for toxicity
•Distribution
a)Protein binding 1.Neonates: less protein-binding—increased availability of highly protein bound drugs such as
phenytoin, diazepam, and phenobarbital. Reduced
dosages needed in these highly bound drugs.
b)Blood Brain Barrier
1.Not fully developed at birth, drugs have easy
access to the CNS, doses should be reduced.
•Metabolism
a)Hepatic function?
1.Liver hasn’t reached full maturation—sensitive
to drugs eliminated by the CYP450. Liver’s
ability to metabolize drugs increases about one
month after birth.
b)T half life
1.Decreased by as much as 48-72 hours
•Excretion
a)Renal?
1.GFR is significantly reduced at birth, drugs
eliminated by the kidneys must be given in a
reduced dosage and longer dosing intervals.
•What education needs to be given to parents?
•What to do if child spits out medication or throws it up
•Effective education: dosage size and timing, route, technique
of administration, duration of treatment, how to store the drug, nature and time course of the desired response, nature and time course of adverse reactions.
•Compare and contrast pharmacokinetics and pharmacodynamics of special populations—pediatrics, older
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