What is Drug tolerance? - answer>>a state of decreased sensitivity to a drug that develops as a result of
exposure to it
What is addiction? - answer>>the fact or condition of being addicted to a particular substance, thing, or
activity.
What is the impact of Cirrhosis on drug levels and dosing? - answer>>Because medications with a low
extraction ratio (e.g., warfarin, phenytoin, carbamazepine, and lorazepam) rely heavily on the metabolic
capacity of the liver for intrinsic clearance through CYP 450 enzymes, these medications will be impacted
more significantly.Nearly 30% of patients with cirrhosis suffer adverse drug reactions or hepatoxicity if
these risk factors are not considered or monitored closely. So Close monitoring of liver functions and
doses may need to be reduced due to risk of hepatoxicity.
pharmacodynamics - answer>>the study of the effects of drugs and their mechanism of action
pharmacokinetics- answer>> the study of the movement of drugs within the body
describes what the body does to the drug through absorption, distribution, metabolism, and excretion -
answer>>pharmacokinetics
describes what the drug does to the body - answer>>pharmacodynamics
What is the impact of protein binding on drug levels and dosing? - answer>>Decreased plasma protein
binding leads to an increase in free plasma fraction causing an increase in volume of distribution and a
shorter elimination half life. The increase in the apparent volume of distribution and the shorter
elimination half life cause a decrease in total plasma concentration.
what is the impact of drug interactions on drug levels and dosing? - answer>>
,What is the impact of half-life on drug levels and dosing? - answer>>For drugs with short half-life the
dosing interval must be correspondingly short. If a drug has a long half-life a long time can separate
doses without loss of benefit. The actual amount of drug lost in one half life depends on how much drug
is present the tire drug in the body, the larger the amount of drug lost in one half-life
What is the efficacy of a drug? - answer>>Efficacy is the maximum response achievable from a drug.
Effectiveness refers to the ability of the drug to produce a beneficial effect.
what is Dependence? - answer>>physiological or psychological need for a substance
what is Withdrawal? - answer>>the discomfort and distress that follow discontinuing the use of an
addictive drug
what is First pass effect? - answer>>After oral administration, many drugs are absorbed intact from the
small intestine and transported first via the portal system to the liver, where they undergo extensive
metabolism, therefore usually decreasing the bioavailability of certain oral medications.
What is Idiosyncratic response? - answer>>Idiosyncratic reactions are unpredictable and not explained
by the pharmacologic properties of the drug.
Medication Reconciliation - answer>>process of creating an accurate list of all medications a patient is
taking, including drug name, dosage, frequency, and route, and comparing the list to the physician's
admission, transfer, or discharge orders, with the goal of providing correct medications to the patient at
all transition points within the hospital
what is Polypharmacy? - answer>>regular use of at least five medications, is common in older adults and
younger at-risk populations and increases the risk of adverse medical outcomes.
Which drug classes produce withdrawal if stopped abruptly? - answer>>Central nervous system
depressants, such as alcohol, benzodiazepines, barbiturates, and opioids.
Central nervous system stimulants, including cocaine, amphetamines, and methamphetamine.
,When is withdrawal life threatening? - answer>>acohol, barbiturates, and benzodiazepines
Which drugs/meds have EPS symptoms? - answer>>anti-psychotics
Understand the appropriate use of herbal therapies - answer>>
Understand components of cultural competence - answer>>cultural competence has four components a)
an awarement of ones own cultural worldview, b) attitude towards cultural differences, c) knowledge of
different cultural practices and worldview and 4)cross-cultural skills
How can adverse drug events be minimized? - answer>>Providers need to find ways to streamline the
medical regimen, such as periodically reviewing all medications in relation to the Beers criteria and
avoiding new prescriptions to counteract adverse drug reactions. The incorporation of computerized
alerts and a multidisciplinary approach can reduce adverse drug events.
Why do drugs require clinical study and FDA approval? - answer>>to ensure that all drugs are safe and
effective and is stricter than other countries government agencies and is harder to get drugs approved
here than in Europe
Know common teaspoon, tablespoon, and milliliter conversions - answer>>1/2 tsp=2.5 ml
1 teaspoon = 5 ml
2 teaspoons= 10 ml
1/2 tablespoon= 7.5 ml
1 tablespoon=15 ml
3 teaspoons=1 tablespoon
1 Liter= 1000 ml
1 fluid ounce=30 ml
What are the special prescribing restrictions for these various classes? (DEA schedule 1-5) - answer>>
, What is the purpose of the MedWatch Program? - answer>>allows health care professionals and
consumers to report serious problems that they believe may be associated with the medical products
they prescribe, dispense or use
Medwatch receives reports from the public and when appropriate, publishes safety alerts for FDA-
regulated products
Symptoms and treatment of drug intoxication from cocaine, opioids, marijuana - answer>>
Appropriate use of reversal agents for digoxin? - answer>>
Appropriate use of reversal agents for opioids? - answer>>
Understand the implications of changing renal function on creatinine and drug dosing? - answer>>
when selecting drugs and determining doses for patients it is essential to consider what individual
patient factors that might impact pharmacokinetic and pharmacodynamic processes? -
answer>>genetics, gender, ethnicity, age, behavior (diet, nutrition, smoking, alcohol, illicit drug abuse)
and or a pathophysiological change due to disease
to counter effects of severe bleeding from Warfarin patients can be given? (ie: traumas, excessive
bleeding) - answer>>Vitamin K
Warfarin - answer>>MOA:prevents clots by lowering levels of vitamin K
USE: prescribed for DVT & PE, and A-fib
many foods modify effects of warfarin
common side effects?
S/E: bleeding, bruising
how pts. metabolize varies greatly and PT/INR levels need to be monitored closely and doses adjusted
accordingly
contraindications:
