NRSE 2241 Exam 1 Questions With Correct Answers

properties of idea drug - Answer -effectiveness, safety, & selectivity are the 3 most important -reversible action: effects can be reversed//want drug actions to subside within an appropriate time -predictability: know with certainty how patient will respond to drug -ease of administration: simple to administer//convenient route & number of doses a day should be low -freedom from drug interaction -low cost -chemical stability: no loss in efficacy -simple generic name pharmacokinetics - Answer -impact of body on drugs -absorption, distribution, metabolism, excretion (ADME) pharmacodynamics - Answer -impact of drugs on the body -drug-receptor interaction -patient's functional state -placebo effect therapeutic objective of drug therapy - Answer provide maximum benefit with minimal harm sources of individual variations - Answer -physiologic variation: age, gender, weight -pathologic variation: especially diminished function of kidneys & liver, the major organs of drug administration) -genetic variation -drug interactions role of a nurse in administration of drugs - Answer -right patient, drug, dose, time, route, assessment, documentation, evaluation, education, & refusal -nurse is the last person who sees the drug before it enters the patient nursing process in drug administration: what is done in pre- & post-administration? - Answer pre-administration: all drug therapy begins with assessment of the patient//3 basic goals: 1. collect baseline data needed to evaluate therapeutic & adverse responses, 2. identify high-risk patients, and 3. assess patient's capacity for self-care nursing process in drug administration: what are life threatening adverse reactions? - Answer -thorough drug history -advising the patient to avoid OTC drugs that can interact with prescription -monitoring for adverse interactions known to occur between the drugs the patient is taking -being alert to the possibility of as-yet-unknown interactions chemical drug name - Answer -description of drug using nomenclature of chemistry -e.g., N-Acetyl-para-aminophenol generic drug name - Answer -assigned by U.S. Adopted Name Council -e.g., Acetaminophen brand (trade) drug name - Answer -name in drug is marketed -e.g., Tylenol phases of drug development - Answer -preclinical testing in animals -phase I: safety -phase II: effectiveness -phase III: safety & effectiveness -filing: FDA approval -phase IV: marketing surveillance what is a randomized controlled trial & its 3 distinguishing features? - Answer -RCT: most reliable way to objectively assess drug therapies 1. use of controls 2. randomization 3. blinding (single or double) 3 ways to cross a cell membrane - Answer 1. channels or pores: very few drugs use this system; channels & pores are extremely small & are specific for certain molecules 2. transport systems: carriers that can move drugs from one side of the cell membrane to the other; some require expenditure of energy while others do not; all are selective & will not carry just any drug. the P-glycoprotein is a transmembrane, multidrug transporter protein that moves a variety of drugs out of the cell 3. direct penetration of the membrane: most common; most drugs are too large to pass through channels or pores & most drugs lack transport systems to help them get across; "like dissolves like" so drugs must be lipid soluble (lipophilic) to directly cross membrane what is unique about quaternary ammonium compounds & absorption? - Answer -molecules that contain at least one atom of nitrogen & carry a positive charge at all times -result from atypical bonding to nitrogen -because of the charge, these compounds are unable to readily cross most membranes -cannot be absorbed by intestines how does pH partitioning effect movement across membranes? -P450 system -inducers -inhibitors - Answer -when the pH of the fluid on one side of a membrane differs form the other side, drug molecules will tend to accumulate on the side where the pH most favors their ionization (acids go to basic side//bases go to acidic side) -P450 system: liver has a group of enzymes that metabolize drugs by breaking them down for eventual removal -inducers speed up metabolism, gets rid of drug faster (excreted faster); no risk for toxicity of other drug -inhibitors slow metabolism down, keeps it in body longer (slower excretion); risk of toxicity what is a drug half-life? - Answer -time it take for 50% of drug to be excreted -tells us how often a medication needs to be administered -if X= amount of drug in the body, then x/2 is the half-life maximal efficacy - Answer largest effect that a drug can produce relative potency - Answer amount of drug needed to elicit an effect affinity - Answer strength of the attraction between a drug & its receptor intrinsic activity - Answer -ability of a drug to activate a receptor upon binding -drugs with high intrinsic activity have high maximal efficacy agonists - Answer molecules that activate receptor antagonists - Answer produce their effects by preventing receptor activation by endogenous regulatory molecules & drugs//virtually no effect on their own noncompetitive antagonist - Answer -irreversible -blocks receptor site no matter how much substrate is present