CHAMBERLAIN NR 293 PHARM EXAM 2025

Risks for injury - -know that anything can be a possible risk for patient injury 9 rights of medicine administration - -right patient, right dose, right medication, right time, right documentation, right route, right reason, right response What is a prototype - -the first drug of a class that all others are based from (ex- morphine) What is pharmacokinetics - -what the body does to the drug What is pharmacodynamics - -what the drug does to the body Bioavailability - -what portion of the drug that entered the circulation can have an effect on the body First pass effect - -a drug enters the GI tract and is filtered to the liver where some is destroyed What enzymes work in the liver - -P-450 enzymes if a patient has cirrhosis of the liver, what will happen when they take a medication? - When the medication passes through the liver for the first pass, there will be less P-450 enzymes so the bioavailability of the medication will be higher and it will circulate in the bloodstream longer. half-life - -time required for 50% of the drug to be removed from the body Pharmacotherapeutics - -treatment of conditions Enteral route - -through the GI tract Parenteral tract - -outside the GI tract How is medication absorption different for neonates and children? - -they have less gastric acid to break down medications and availability is higher Why do more drugs enter neonate and children's brains, why are meds not as easily excreted/destroyed by liver and kidneys ? - -immature BBB, liver, and kidneys Polypharmacy - -The use of multiple medications on a regular basis NR293 NR293 NR293 During which phase of the nursing process does a nurse prioritize the nursing diagnoses? - -planning The nurse recognizes that drugs given by which route will be altered by the first pass effect? a. oral b. sublingual c. subcutaneous d. IV e. rectal - -oral and rectal The nurse is reviewing a list of a patient's medications and notes one of the drugs has a low therapeutic index. What does this mean? - -the difference between a therapeutic dose and a toxic dose are very close together When drug A is an enzyme inhibitor of drug B, the nurse will anticipate what result of drug B? - -level of drug B could rise to toxicity A drug is highly protein bound, what does this mean? - -it will have a longer duration of action Do no harm is what ethical principle? - -nonmaleficence Which legal act required drug manufacturers to establish the safety and efficacy of a new drug before its approval for use? - -Kefauver-Harris, amendment of 1962 Over the counter drugs (otc) are - -nonprescription drugs that are used for short term treatment What herbal supplement is used to promote sleep and relaxation, prolonged use can cause yellow discoloration of nails, risk for liver toxicity - -kava Herbal supplement used to decrease nausea and vomiting induced by chemotherapy - ginkgo Which drug classes are used as OTC remedies ? a. NSAIDs b. cold remedies c. antibiotics ng deterrent drugs e. antihypertensive drugs f. histamine 2 (H2) blockers - -A, B,D,F What are side effects of NSAIDs? - -stroke, MI, GI ulcers, kidney dysfunction NR293 What do antibiotics do? - -fight off infection caused by bacteria Bacteriostatic - -doesn't kill bacteria, it inhibits growth Bactericidal - -kills bacteria Healthcare associated infections - -are contracted in a hospital or institution (48 hours after admin) , are more difficult to treat, and are more virulent Antiseptics - -are used for living tissue, inhibit growth of bacteria Disinfectants - -used on nonliving tissue, destroy/kill organisms What is a priority of the nurse to perform before beginning an antibiotic therapy? - obtain a culture and sensitivity specimen Prophylactic therapy - -preventative measure, antibiotics given before a procedure to ensure that an infection will not start Empiric therapy - -treatment of an infection before c+s information has been obtained or reported Definitive therapy - -treatment of a specific infection after receiving repot of c+s What two classes of antibiotics are common for causing allergic reactions? - -penicillins and sulfonamides If a person is allergic to penicillin, what other class of antibiotics should be looked into? - -cephalosporins What is the main example of sulfonamides? - -Bactrim what must Bactrim be taken with? - - mL of H20/ day what is the MOA of sulfonamides ? - -bacteriostatic Indications for sulfonamides - -broad spectrum, gram + or -; UTIs adverse effects of sulfonamides - -SJS, photosensitivity contraindications of sulfonamides - -allergy, pregnancy what are the main examples of Beta Lactams- penicillins - -amoxicillin, ampicillin penicillins MOA - -bactericidal NR293 NR293 indications of penicillins - -gram + ; strep throat adverse effects of penicillins - -pruritus, GI upset, throat swelling contraindications of penicillins - -allergy, renal failure Cephalosporins Gen 1 - -cefalexin and cefazolin (surgical prophylaxis and staph) Cephalosporins Gen 2 - -cefoxitin (abdominal surgery, colorectal) Cephalosporins Gen 3 - -cefidinir and ceftrixone (meningitis) Cephalosporins Gen 4 - -cefedime (uncomplicated UTI) cephalosporins Gen 5 - -ceftaroline (MRSA) cephalosporins MOA - -bactericidal cephalosporins indications - -1st gen: good +, poor - 2nd gen: good +, better - 3rd gen: gram - 4th gen: +, some - 5th gen: broad spectrum cephalosporins adverse effects - -SJS, rash, cross sensitivity with penicillins, GI upset cephalosporins contraindications - -allergy to penicillin cephalosporins nursing implications - -must infuse slowly what is the main example of carbapenems? - -meropenem (merrem) carbapenems MOA - -bacteriostatic carbapenems indications - -broadest spectrum; complicated body cavity infections, bone, joints, tissue carbapenems adverse effects - -drug induced seizure carbapenems contraindications - -hypersensitivity, seizures carbapenems nursing implications - -infuse over 60 minutes ketolides main example - -telithromycin (ketek) ketolides MOA - -bacteriostatic NR293 NR293 ketolides indications - -limited use, pneumonia ketolides adverse effects - -hepatotoxicity, GI upset, rash, fatigue Ketolides Contraindications - -severe liver disease main example of monobactams - -Azactam monobactams MOA - -bactericidal monobactams indications - -UTI, moderate-severe systemi