MSN 571 Exam With Complete Solution

Prescriptive authority - legal authority granted to advanced practice nurses to prescribe medication; DETERMINED BY STATE LAW Rational Drug Selection - based on individual patient and addresses disease specific information: ONLY A GUIDELINE Drug Selection - includes analysis of cost, guidelines, avaibalbility, interactions, side effects, allergies, hepatic and renal function, need for monitoring, special precautions i.e elderly medication education basic components - medication name purpose dosing regimen administration adverse effects any storage needs associated labs testing food & drug interactions duration of therapy medication adherence - barriers to adherence= forgetfulness lack of planning cost dissatisfaction altered dosing Phamacokinetics - study of drug movement throughout body principles of pharmacokinetics - absorption distribution metabolism excretion Passage of drugs across membranes - - channels and pores - transport systems (P-glycoprotein) - direct penetration of the membrane Absorption of drugs - Transfer of drugs from site of administration across cell membrane into the blood stream factors that affect absorption of drugs - rate of dissolution- how easy dissolves surface area- surface area moves faster blood flow- blood flow moves faster lipid solubility - lipid easily cross membrane ph partitioning - Distribution of drugs - movement of drugs from systemic circulation to site of drug action factors that determine drug flow - blood flow to tissues ability to exit vascular system ability to enter cell Drug ability to exit vascular system - capillary bed- typical blood brain barreier placenta drug transfer protein binding - albumin drug ability to enter cell - binds with receptors on external surface of cell membrane drug metabolism - the enzymatic biotransformation of a drug structure most occur in liver by P450 system first pass effect - rapid hepatic inactivation of drug on its first pass through liver drug excretion - elimination of a drug from the body Drug Excretion Routes - renal breast milk bile lungs sweat saliva therapeutic drug range - range of drug between minimum effective dose and toxic dose. larger index - safer dose smaller index- harmful dose drug half life - the time required for the amount of drug in the body to decrease by 50% Phamacodynamics - biochemical and physiological effects of drugs on body dose-response relationship - the relationship between the size of an administered dose and the intensity it produces Drug selectivity - drug is effective in intended use w/out harmful effects but causes undesired effects (BP but nausea)