Pharmacology HESI/Final Exam Review
Questions And Answers
List the criteria a medication needs to have for OTC status - ANS Low risk of A/Es
Easy to use
Treats symptoms easy to diagnose and easy to treat
High therapeutic index
Low potential for abuse
Ltd drug interactions
List disadvantages of OTC meds - ANS May delay treatment for serious illness
What's a high-alert med? Give an example. - ANS A medication that has a high risk of
harm if given inaccurately. Strategies to reduce errors, such as second nurse checks should be
followed.
What's the Beers List and how's it used? - ANS A list of meds that may be inappropriate for
the elderly. If used they require additional precautions.
What's first-pass effect? - ANS How much of an oral medication is metabolized in the liver
via portal circulation before it's made available for distribution to the tissues
What would it mean if a medication had a high first-pass effect? - ANS A drug with a high
first pass effect would require a much higher dose for any of the drug to reach the cells
Pharmacokinetics VS pharmacodynamics - ANS -kinetics: What the body does to the drug
(absorption, distribution, metabolism, excretion)
-dynamics: What the drug does to the body via receptors, enzymes, and cells
What's a prodrug? Who would it not be good for? - ANS It's not bioavailable until it's
metabolized in the liver. Wouldn't be good for a pt w/ a bad liver
Explain protein binding - ANS Drugs that bind to protein leave less circulating drug that's
available to the tissues, because the protein bound drug is held within the vascular system. A
decrease in protein levels will cause drug levels to rise and possibly be toxic. Multiple protein
bound drugs that compete for protein will result in higher blood levels of one or more of the
drugs.
, Synergistic VS additive effect - ANS Syn: Drugs work better in combination than alone
Add: Drugs with similar effects allow for less of each drug to be used to avoid A/Es
What's meant by "start low, go slow"? - ANS Used with the elderly, start medication dose at
lowest end of therapeutic range and increase slowly and in increments to reach greatest benefit
with least risk
What is medication reconciliation? - ANS A comparison of meds that the pt's taking at
home or on a previous unit w/ the list of meds the pt's ordered in the hospital to make sure meds
aren't missed and eliminated during the hospital stay (i.e. glaucoma drops, insulin) and to make
sure newly recorded meds aren't incompatible or redundant w/ meds the pt's already taking
Who does medication reconciliation and when is it done? - ANS The nurse upon
admission, transfer to a higher or lower level of care, and upon discharge. The list is compiled
by the nurse and reviewed with the provider.
When are peak and trough levels drawn? What do they tell you? - ANS PEAK: @ highest
concentration of the medicaton after giving and it tells you if you have a high enough blood level
of the drug to kill the bugs
TROUGH: Drawn immediately prior to the dose and tells you if the dose remains too high and
may lead to nephrotoxicity
In which trimester of pregnancy are meds most likely to be teratogenic? - ANS 1st
In which trimester of pregnancy is drug transfer to the fetus most likely? - ANS 3rd
Definition of half-life. How many does it take for a drug to be eliminated from the body? - ANS
The amount of time it takes for half of a drug to be considered eliminated (although there still
may be trace amounts remaining)
Takes 5 half lives
Name things that should be included in the care plan for diuretic therapy (except potassium
sparing) - ANS Monitor I/Os, daily wts, VS, electrolytes,
Use potassium supplement or potassium sparing diuretic according to lab values
Caution pts to sit before standing (orthostatic HTN)
Near bathroom w/ clear path (esp. w/ loop diuretics)
What class of meds are used as rescue drugs in the tx of acute pulmonary edema (CHF) and
give an example? - ANS Loop diuretics to induce rapid diuresis
EX: furosemide, bumetanide, torsemide
1st line diuretic med for HTN - ANS HCTZ (hydrochlorothiadize)
Questions And Answers
List the criteria a medication needs to have for OTC status - ANS Low risk of A/Es
Easy to use
Treats symptoms easy to diagnose and easy to treat
High therapeutic index
Low potential for abuse
Ltd drug interactions
List disadvantages of OTC meds - ANS May delay treatment for serious illness
What's a high-alert med? Give an example. - ANS A medication that has a high risk of
harm if given inaccurately. Strategies to reduce errors, such as second nurse checks should be
followed.
What's the Beers List and how's it used? - ANS A list of meds that may be inappropriate for
the elderly. If used they require additional precautions.
What's first-pass effect? - ANS How much of an oral medication is metabolized in the liver
via portal circulation before it's made available for distribution to the tissues
What would it mean if a medication had a high first-pass effect? - ANS A drug with a high
first pass effect would require a much higher dose for any of the drug to reach the cells
Pharmacokinetics VS pharmacodynamics - ANS -kinetics: What the body does to the drug
(absorption, distribution, metabolism, excretion)
-dynamics: What the drug does to the body via receptors, enzymes, and cells
What's a prodrug? Who would it not be good for? - ANS It's not bioavailable until it's
metabolized in the liver. Wouldn't be good for a pt w/ a bad liver
Explain protein binding - ANS Drugs that bind to protein leave less circulating drug that's
available to the tissues, because the protein bound drug is held within the vascular system. A
decrease in protein levels will cause drug levels to rise and possibly be toxic. Multiple protein
bound drugs that compete for protein will result in higher blood levels of one or more of the
drugs.
, Synergistic VS additive effect - ANS Syn: Drugs work better in combination than alone
Add: Drugs with similar effects allow for less of each drug to be used to avoid A/Es
What's meant by "start low, go slow"? - ANS Used with the elderly, start medication dose at
lowest end of therapeutic range and increase slowly and in increments to reach greatest benefit
with least risk
What is medication reconciliation? - ANS A comparison of meds that the pt's taking at
home or on a previous unit w/ the list of meds the pt's ordered in the hospital to make sure meds
aren't missed and eliminated during the hospital stay (i.e. glaucoma drops, insulin) and to make
sure newly recorded meds aren't incompatible or redundant w/ meds the pt's already taking
Who does medication reconciliation and when is it done? - ANS The nurse upon
admission, transfer to a higher or lower level of care, and upon discharge. The list is compiled
by the nurse and reviewed with the provider.
When are peak and trough levels drawn? What do they tell you? - ANS PEAK: @ highest
concentration of the medicaton after giving and it tells you if you have a high enough blood level
of the drug to kill the bugs
TROUGH: Drawn immediately prior to the dose and tells you if the dose remains too high and
may lead to nephrotoxicity
In which trimester of pregnancy are meds most likely to be teratogenic? - ANS 1st
In which trimester of pregnancy is drug transfer to the fetus most likely? - ANS 3rd
Definition of half-life. How many does it take for a drug to be eliminated from the body? - ANS
The amount of time it takes for half of a drug to be considered eliminated (although there still
may be trace amounts remaining)
Takes 5 half lives
Name things that should be included in the care plan for diuretic therapy (except potassium
sparing) - ANS Monitor I/Os, daily wts, VS, electrolytes,
Use potassium supplement or potassium sparing diuretic according to lab values
Caution pts to sit before standing (orthostatic HTN)
Near bathroom w/ clear path (esp. w/ loop diuretics)
What class of meds are used as rescue drugs in the tx of acute pulmonary edema (CHF) and
give an example? - ANS Loop diuretics to induce rapid diuresis
EX: furosemide, bumetanide, torsemide
1st line diuretic med for HTN - ANS HCTZ (hydrochlorothiadize)
