615 Exam 1 Review
NP Prescriptive authority is regulated by: - Answer-Board of Nursing for each state
Factors associated with clinical judgement when prescribing medications - Answer-o Best therapy
Least invasive
Least expensive
Least likely to cause adverse reactions
o Clinical judgement in prescribing includes factoring in the cost to the patient of the medication
prescribed
Criteria for choosing an effective drug for a disorder include - Answer-consulting nationally recognized
guidelines for disease management
o Consider special populations and that adjustments may need to be made for this special population
How does Hypoalbeminemia affects the process of prescribing - Answer-o Low albumin = more free
drug = increased adverse effects
o When albumin is low, instead of the drug getting to target tissues, it is floating around leading to
toxicity or different effects
o This affects distribution of drugs to target tissue
, Describe First-pass metabolism - Answer-o Drugs with a high first-pass metabolism are rapidly
metabolized by the liver and may have little if any desired action
o It is the fraction of a drug lost through the process of absorption
o Concentration of a drug is greatly reduced before it reaches the systemic circulation
o Greatly reduces the bioavailability of a drug
o Sublingual administration can bypass this first pass metabolism leading to rapid absorption (faster
than oral and rectal administration)
o Nitro is given SL or topical to avoid the first-pass metabolism
Describe half life - Answer-o How long it takes for the drug to be increased or decreased by 50%
Important with meds, especially new meds, because it takes 4-5 half-lives to reach a steady state
o The amount of time it takes for an administered drug to be halfway cleared from the system
o Digoxin has a half-life of 23-36 hours, because of this, a dose change could take almost a week to take
effect
o Drugs with long half-life are started with a loading dose to achieve their desired clinical effect more
quickly
Examples: amiodarone and azithromycin
• Azithromycin requires the first day's dose to be twice those of the other four days of the prescription,
otherwise known as a loading dose, in order to rapidly achieve drug levels in the therapeutic range
Cephalexin is given every 8 hours due to its biological half-life
o You must use the drug half-life to determine the length of need required between dosage
administrations
Define Onset of action - Answer-the point in time on the drug concentration curve that indicates the
first sign of a therapeutic effect
o It is not the best therapeutic effect
Define Peak of action - Answer-the time between drug administration and the maximum concentration
of a drug in the blood stream
NP Prescriptive authority is regulated by: - Answer-Board of Nursing for each state
Factors associated with clinical judgement when prescribing medications - Answer-o Best therapy
Least invasive
Least expensive
Least likely to cause adverse reactions
o Clinical judgement in prescribing includes factoring in the cost to the patient of the medication
prescribed
Criteria for choosing an effective drug for a disorder include - Answer-consulting nationally recognized
guidelines for disease management
o Consider special populations and that adjustments may need to be made for this special population
How does Hypoalbeminemia affects the process of prescribing - Answer-o Low albumin = more free
drug = increased adverse effects
o When albumin is low, instead of the drug getting to target tissues, it is floating around leading to
toxicity or different effects
o This affects distribution of drugs to target tissue
, Describe First-pass metabolism - Answer-o Drugs with a high first-pass metabolism are rapidly
metabolized by the liver and may have little if any desired action
o It is the fraction of a drug lost through the process of absorption
o Concentration of a drug is greatly reduced before it reaches the systemic circulation
o Greatly reduces the bioavailability of a drug
o Sublingual administration can bypass this first pass metabolism leading to rapid absorption (faster
than oral and rectal administration)
o Nitro is given SL or topical to avoid the first-pass metabolism
Describe half life - Answer-o How long it takes for the drug to be increased or decreased by 50%
Important with meds, especially new meds, because it takes 4-5 half-lives to reach a steady state
o The amount of time it takes for an administered drug to be halfway cleared from the system
o Digoxin has a half-life of 23-36 hours, because of this, a dose change could take almost a week to take
effect
o Drugs with long half-life are started with a loading dose to achieve their desired clinical effect more
quickly
Examples: amiodarone and azithromycin
• Azithromycin requires the first day's dose to be twice those of the other four days of the prescription,
otherwise known as a loading dose, in order to rapidly achieve drug levels in the therapeutic range
Cephalexin is given every 8 hours due to its biological half-life
o You must use the drug half-life to determine the length of need required between dosage
administrations
Define Onset of action - Answer-the point in time on the drug concentration curve that indicates the
first sign of a therapeutic effect
o It is not the best therapeutic effect
Define Peak of action - Answer-the time between drug administration and the maximum concentration
of a drug in the blood stream
