PHARMACOLOGY AND THE NURSING PROCESS- (PHARMACOLOGIC PRINCIPLES) CORRECT QUESTIONS AND ANSWERS 100%

.Additive Effect - ANSWERS-drug interactions in which the effect of a combination of 2 or more drugs with similar actions is equivalent to the sum of the individual effects of the same drugs given alone (1+1=2) .Adverse Drug Event - ANSWERS-any undesirable occurrence related to administering or failing to administer a prescribed medication. .Adverse Drug Reaction - ANSWERS-any unexpected, unintended, undesired, or excessive response to a medication given at therapeutic dosages (not an overdose) .Adverse Effects - ANSWERS-a general term for any undesirable effects that are a direct response to one or more drugs .Agonist - ANSWERS-a drug that binds to and stimulates the activity of one or more receptors in the body. .Allergic Reaction - ANSWERS-an immunologic hypersensitivity reaction resulting from the unusual sensitivity of a patient to a particular medication; a type of adverse drug event. .Antagonistic Effects - ANSWERS-Drug interaction which the effect of a combination of two or more drugs is less than the sum of the individual effects of the same drug given alone (1 + 1 = less than 2); it is usually caused by an antagonizing (blocking or reducing) effect of one drug on another .Bioavailability - ANSWERS-A measure of the extent of drug absorption for a given drug and route (from 0% to 100%) .Biotransformation - ANSWERS-One or more biochemical reactions involving a parent drug. Biotransformation occurs mainly in the liver and produces a metabolite that is either inactive or active. Also known as a metabolism. .Blood-Brain Barrier - ANSWERS-The barrier system that restricts the passage of various chemicals and microscopic entities (e.g. bacteria, viruses) between the bloodstream and the central nervous system. It still allows for the passage of essential substances such as oxygen. .Chemical Name - ANSWERS-The name that describes the chemical composition and molecular structure of a drug. .Contraindication - ANSWERS-Any condition, especially one related to a disease state or other patient characteristic, including current or recent drug therapy, that renders a particular form of treatment improper or undesirable. .Cytochrome P-450 - ANSWERS-The general name for a large class of enzymes that play a significant role in drug metabolism. .Dependence - ANSWERS-A state in which there is a compulsive or chronic need, as for a drug. .Dissolution - ANSWERS-The process by which solid forms of a drug disintegrate in the gastrointestinal tract and become soluble before being absorbed into the circulation. .Drug - ANSWERS-Any chemical that affects the physiologic processes of a living organism. .Drug Actions - ANSWERS-The cellular process involved in the interaction between a drug and body cells (e.g. the action of a drug on a receptor protein); also called mechanism of action. .Drug Effects - ANSWERS-The physiologic reactions of the body to a drug. They can be therapeutic or toxic and describe how the function of the body is affected as a whole by the drug. The terms onset, peak, and duration are used to describe drug effects (most often referring to therapeutic effects) .Drug-Induced Teratogenesis - ANSWERS-The development of congenital anomalies or defects in the developing fetus caused by the toxic effects of a drug. .Drug Interaction - ANSWERS-Alteration in the pharmacologic activity of a given drug caused by the presence of one or more additional drugs; it is usually related to effects on the enzymes required for metabolism of the involved drugs. .Duration of Action - ANSWERS-The length of time the concentration of a drug in the blood or tissues is sufficient to elicit a drug response. .Enzyme - ANSWERS-Protein molecules that catalyze one or more of a variety of biochemical reactions, including those related to the body's own physiologic processes as well as those related to drug metabolism. .First-Pass Effect - ANSWERS-The initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream. .Generic Name - ANSWERS-The name given to a drug by the United States Adopted Name Council. Also called the nonpropietary name. Then generic name is much shorter and simpler than the chemical name and is not protected by the trademark. .Half-Life - ANSWERS-In pharmacokinetics, the time required for half of an administered dose of drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50% (also called elimination half-life) .Idiosyncratic Reaction - ANSWERS-An abnormal and unexpected response to a medication, other than an allergic reaction, that is peculiar to an individual patient. .Incompatibility - ANSWERS-The characteristic that causes two parental drugs or solutions to undergo a reaction when mixed or given together that results in the chemical deterioration of at least one of the drugs. .Intraarticular - ANSWERS-Within a joint (e.g. intraarticular injection). .Intrathecal - ANSWERS-Within a sheath (e.g. the theca of a spinal cord, as in an intrathecal injection into the subarachnoid space). .Medication Error - ANSWERS-Any preventable adverse drug event involving inappropriate medication use by a patient or health care professional; it may not cause patient harm. .Medication Use Process - ANSWERS-The prescribing, dispensing, and administering of medications, and the monitoring of their side effects. .Glucose-6-phosphate dehydrogenase (G6PD) deficiency - ANSWERS-a hereditary condition in which red blood cells break down when the body is exposed to certain drugs .Metabolite - ANSWERS-A chemical form of a drug that is the product of one or more biochemical (metabolic) reactions involving the parent drug. Active metabolites are those that have pharmacologic activity of their own, even if the parent drug is inactive. Inactive metabolites lack pharmacologic activity and are simply drug waste products awaiting excretion from the body. (e.g. via the urinary, gastrointestinal, or respiratory tract). .Onset of action - ANSWERS-The time required for a drug to elicit a therapeutic response after doing. .Parent Drug - ANSWERS-The chemical form of a drug that is administered before it is metabolized by the body's biochemical reactions into its active or inactive metabolites. A parent drug that is not pharmacologically active itself is called a prodrug. A prodrug is then metabolized to pharmacologically active metabolites. p.20 .P-glycoprotein - ANSWERS-a transporter protein that moves drugs out of cells and into the gut, urine, or bile. .Peak Effect - ANSWERS-The time required for a drug to reach its maximum therapeutic response in the body. .Peak Level - ANSWERS-The maximum concentration of a drug in the body after administration, usually measured in a blood sample for therapeutic drug monitoring. .Pharmaceutics - ANSWERS-The science of preparing and dispensing drugs, including dosage form design. .Pharmacodynamics - ANSWERS-The study of the biochemical and physiologic interactions of drugs at their site of activity. It examines the physicochemical properties of drugs and their pharmacologic interactions with body receptors. .Pharmacoeconomics - ANSWERS-The study of economic factors that influence the cost of drug therapy .Pharmacogenomics - ANSWERS-The study of the influence of genetic factors on drug response, including the nature of genetic aberrations that result in the absence, overabundance, or insufficiency of drug-metabolizing enzymes (also called pharmacogenetics). .Pharmacognosy - ANSWERS-The study of drugs that are obtained from natural plant and animal sources. .Pharmacokinetics - ANSWERS-The rate of drug distribution among various body compartments after a drug has entered the body. It includes the phases of absorption, distribution, metabolism, and excretion of drugs. .Pharmacology - ANSWERS-The broadest term for the study or science of drugs. .Pharmacotherapeutics - ANSWERS-The treatment of pathologic conditions through the use of drugs. .Prodrug - ANSWERS-An inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body. .Receptor - ANSWERS-A molecular structure within or on the outer surface of a cell. Receptors bind specific substances (e.g. drug molecules), and one or more corresponding cellular effects (drug actions) occurs as a result of this drug-receptor interaction. .Steady State - ANSWERS-The physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose. .Substrates - ANSWERS-Substances (e.g. drugs or natural biochemicals in the body) on which an enzyme acts. .Synergistic Effects - ANSWERS-Drug interactions in which the effect of a combination of two or more drugs with similar actions is greater than the sum of the individual effects of the same drugs given alone. For example, 1 + 1 = greater than 2 (compare with additive effects). .Therapeutic Drug Monitoring - ANSWERS-The process of measuring drug peak and trough levels to gauge the level of a patient's drug exposure and allow adjustment of dosages with the goals of maximizing therapeutic effects and minimizing toxicity. .Therapeutic Effect - ANSWERS-The desired or intended effects of a particular medicine. .Therapeutic Index - ANSWERS-The ratio between the toxic and therapeutic concentrations of a drug. .Tolerance - ANSWERS-Reduced response to a drug after prolonged use. .Toxic - ANSWERS-The quality of being poisonous (i.e. injurious to health or dangerous to life). .Toxicity - ANSWERS-The condition of producing adverse bodily effects due to poisonous qualities. .Toxicology - ANSWERS-The study of poisons, including toxic drug effects, and applicable treatments. .Trade Name - ANSWERS-The commercial name given to a drug product by its manufacturer, also called the proprietary name. .Trough Level - ANSWERS-The lowest concentration of drug reached in the body after it falls from its peak level, usually measured in a blood sample for therapeutic drug monitoring. .Sub specialties of pharmacology are - ANSWERS-Pharmaceutics, Pharmacokinetics, Pharmacodynamics, Pharmacogenomics (pharmacogenetics), Pharmacoeconomics, Pharmacotherapeutics, Pharmacognosy, and Toxicology .The three names a drug will have - ANSWERS-1. Chemical 2. Generic 3. Trade .Therapeutic equivalent - ANSWERS-A drug that has essentially the same effect in the treatment of a disease or condition as one or more other drugs. A drug that is a __________________ may or may not be chemically equivalent, bioequivalent, or generically equivalent. See also bioequivalent, chemical equivalent, generic equivalent. .Drugs can be classified to - ANSWERS-Their: Chemical structure Therapeutic effect or Physiologic effect .Only FDA-approved indications are permitted to be described in the manufacturer's written information, or labeling, for a given drug product. - ANSWERS-True .Toxic - ANSWERS-Effects are often an extension of a drug's therapeutic action. .Dosage form determines the rate at which drug _________________ (dissolving of solid dosage forms and their absorption, e.g., from gastrointestinal [GI] tract) occurs - ANSWERS-Dissolution .Oral drugs that are ___________________ (e.g., elixirs, syrups) are already dissolved and are usually absorbed more quickly than solid dosage forms - ANSWERS-Liquids .Particle size - ANSWERS-Within a tablet or capsule and can make different dosage forms of the same drug dissolve at different rates, become absorbed at different rates, and thus have different times to onset of action. .Combination dosage - ANSWERS-Forms contain multiple drugs in one dose .Extended-release dosage forms - ANSWERS-Are normally easily identified by various capital letter abbreviations attached to their names. Examples of this nomenclature are SR (slow release or sustained release), SA (sustained action), CR (controlled release), XL (extended length), and XT (extended time) .Extended or Enteric coated tablets - ANSWERS-*Drugs that cannot be crushed *Have a protective coating to protect the tablet from being dissolved by the stomach and vice versa .Capsules - ANSWERS-Can be added to soft food such as apple sauce or pudding when patient is unable or unwilling to swallow a tablet .Consultation with a pharmacist or use of other suitable source is necessary if any question exists as to whether a drug can be crushed or mixed with a specific food or beverage - ANSWERS-True .Enteral dosage form - ANSWERS-Tablets, capsules, oral soluble wafers, pills, timed-release capsules, timed-release tablets, elixirs, suspensions, syrups, emulsions, solutions, lozenges or troches, rectal suppositories, sublingual or buccal tablet .Parenteral dosage form - ANSWERS-Injectable forms, solutions, suspensions, emulsions, powders for reconstitution .Topical dosage form - ANSWERS-Aerosols, ointments, creams, pastes, powders, solutions, foams, gels, transdermal patches, inhalers, rectal and vaginal suppositories .The specific characteristics of the dosage form have a large impact on how and to what extent the drug is absorbed. For a drug to work at a specific site in the body, either it must be applied directly at the site in an active form or it must have a way of getting to that site. - ANSWERS-True .__________ applied dosage forms work directly on the surface of the skin. Once the drug is applied, it is in a form that allows it to act immediately. With other ______________ dosage forms, the skin acts as a barrier through which the drug must pass to get into the circulation; once there, the drug is then carried to its site of action (e.g., fentanyl transdermal patch for pain). - ANSWERS-Topical .The pH of injections must be very similar to that of the blood for these drugs to be administered safely. - ANSWERS-True .Parenteral dosage forms that are injected ________________ are immediately placed into solution in the bloodstream and do not have to be dissolved in the body. Therefore, 100% absorption is assumed to occur immediately upon _________________ injection. - ANSWERS-Intravenous .Absorption - ANSWERS-Is the movement of a drug from its site of administration into the bloodstream for distribution to the tissues. .A drug that is absorbed from the intestine must first pass through the liver before it reaches the systemic circulation. If a large proportion of a drug is chemically changed into inactive metabolites in the liver, then a much smaller amount of drug will pass into the circulation (i.e., will be bioavailable). - ANSWERS-True .First-pass effect reduces the bioavailability of the drug to less than 100%. Many drugs administered by mouth have a bioavailability of less than 100%, whereas drugs administered by the intravenous route are 100% bioavailable - ANSWERS-True .If two drug products have the same bioavailability and same concentration of active ingredient, they are said to be _________________ (e.g., a brand-name drug and the same generic drug). - ANSWERS-Bioequivalent .How a drug is administered, or its route of administration, affects the rate and extent of absorption of that drug. Although a number of dosage formulations are available for delivering medications, they can all be categorized into three basic routes of administration: enteral (GI tract), parenteral, and topical. - ANSWERS-True ._________________________, the drug is absorbed into the systemic circulation through the mucosa of the stomach and/or small or large intestine. - ANSWERS-Enteral Drug Administration .Orally administered drugs are absorbed from the intestinal lumen into the blood system and transported to the liver. Once the drug is in the liver, hepatic enzyme systems metabolize it, and the remaining active ingredients are passed into the general circulation - ANSWERS-True .Many factors can alter the absorption of drugs, including acid changes within the stomach, absorption changes in the intestines, and the presence or absence of food and fluid. Various factors that affect the acidity of the stomach include the time of day; the age of the patient; and the presence and types of medications, foods, or beverages. - ANSWERS-True .Enteric coating is designed to protect the stomach by having drug dissolution and absorption occur in the intestines. Taking an enteric-coated medication with a large amount food may cause it to be dissolved by acidic stomach contents and thus reduce intestinal drug absorption and negate the coating's stomach-protective properties. - ANSWERS-True .Anticholinergic drugs slow GI transit time (or the time it takes for substances in the stomach to be dissolved for transport to and absorption from the intestines). This may reduce the amount of drug absorption for acid-susceptible drugs that become broken down by stomach acids. - ANSWERS-True .Short bowel syndrome - ANSWERS-Drug absorption may be altered in patients who have had portions of the small intestine removed because of disease. This is known as