,Chapter2012-2Introduction2to2Drugs
A2nurse2working2in2radiology2administers2iodine2to2a2patient2who2is2having2a2computed2tomography2(CT
)2scan.2The2nurse2working2on2the2oncology2unit2administers2chemotherapy 2to2patients2who2have2c
ancer.2At2the2Public2Health2Department,2a2nurse2administers2a2measles-mumps-
rubella2(MMR)2vaccine2to2a214-month-
old2child2as2a2routine2immunization.2Which2branch2of2pharmacology 2best2describes2the2actions2of
2all2three2nurses?
Pharmacoeconomics2
Pharmacotherapeutics
2Pharmacodynamics2P
harmacokinetics2 Ans:
B
Response:
Pharmacology 2is2the2study2of2the2biologic2effects2of2chemicals.2Nurses2 are2involved 2with2clinical2pha
rmacology2or2pharmacotherapeutics,2which2is2a2branch2of2pharmacology 2that2deals2with2the2uses2of2d
rugs2to2treat,2prevent,2and2diagnose2disease.2The2radiology2nurse2is2administering2a2drug2to2help2diag
nose2a2disease.2The2oncology 2nurse2is2administering2a2drug2to2help2treat2a2disease.
Pharmacoeconomics2includes2any2costs2involved2in2drug2therapy.2Pharmacodynamics2involves2how2a
2drug2affects2the2body 2and 2pharmacokinetics2is2how2the2body 2acts2on 2the2body.
A2physician 2has2ordered2intramuscular2(IM)2injections2of2morphine,2a2narcotic,2every242hours2as2needed2f
or2pain2in2a2motor2vehicle2accident2victim.2The2nurse2is2aware2this2drug2has2a2high2abuse2potential
.
Under2what2category2would2morphine2be2classified?
Schedule2I2S
chedule2II2S
chedule2III2
Schedule2IV
2Ans: B
Response:
Narcotics2with2a2high2abuse2potential2are2classified2as2Schedule2II2drugs2because2of2severe2dependence
, liability.2Schedule2I2drugs2have2high2abuse2potential2and2no2accepted2medical2use.2Schedule2III2dr
ugs2have2a2lesser2abuse2potential2than2II2and2an2accepted2medical2use.2Schedule2IV2drugs2have2lo
w2abuse2potential2and2limited2dependence2liability.
When2involved2in2phase2III2drug2evaluation2studies,2what2responsibilities2would2the2nurse2have
? 2Working2with2animals2who2are2given2experimental2drugs
Choosing2appropriate2patients2to2be2involved2in2the2drug2study2Mon
itoring2and2observing2patients2closely2for2adverse2effects2Conductin
g2research2to2determine2effectiveness2of2the2drug2Ans:2C
Response:
Phase2III2studies2involve2use2of2a2drug2in2a2vast2clinical2population2in2which2patients2are2asked2to2rec
ord2any2symptoms2they2experience2while2taking2the2drugs.2Nurses2may2be2responsible2for2helping2co
llect2and2analyze2the2information 2to2be2shared2with2the2Food2and2Drug2Administration 2(FDA)2but2wo
uld2not2conduct2research2independently 2because2nurses2do2not2prescribe2medications.2Use2of2animals2
in2drug2testing2is2done2in2the2preclinical2trials.2Select2patients2who2are2involved2in2phase2II2studies2to
2participate2in 2studies2where2the2participants2have2the2disease2the2drug2is2intended 2to 2treat.2These2pati
ents2are2monitored 2closely2for2drug2action2and2adverse2effects.2Phase2I2studies2involve2healthy2human
2volunteers2who 2are2usually 2paid 2for2their2participation.2Nurses2may 2observe2for2adverse2effects2and 2t
oxicity.
What2concept2is2considered 2when2generic2drugs2are2substituted 2for2brand2name2drugs? 2Bioavail
ability
Critical2concentration
2Distribution
Half-
life2 Ans: A
Response:
Bioavailability 2is2the2portion2of2a2dose2of2a2drug2that2reaches2the2systemic2circulation2and2is2availa
ble2to2act2on2body2cells.2Binders2used2in2a2generic2drug2may2not2be2the2same2as2those2used2in2the2
brand2name2drug.2Therefore,2the2way2the2body2breaks2down2and2uses2the2drug2may2differ,2which2
may2eliminate2a2generic2drug2substitution.2Critical2concentration 2is2the2amount2of2a2drug2that2is2ne
eded2to2cause2a2therapeutic2effect2and2should2not2differ2between2generic2and2brand2name2medicatio
ns.
Distribution2is2the2phase2of2pharmacokinetics,2which2involves2the2movement2of2a2drug2to2the2bod
y’s2tissues2and2is2the
, same2in2generic2and2brand2name2drugs.2A2drug’s2half-
life2is2the2time2it2takes2for2the2amount2of2drug2to2decrease2to2half2the2peak2level,2which2should2not2c
hange2when2substituting2a2generic2medication.
A2nurse2is2assessing2the2patient’s2home2medication2use.2After2listening2to2the2patient2list2current2medicat
ions,2the2nurse2asks2what2priority2question?
Do2you2take2any2generic2medications?
Are2any2of2these2medications2orphan2drugs?
Are2these2medications2safe2to2take2during2pregnancy? 2
Do2you2take2any2over-the-counter2medications?
Ans: D
Response:
It2is2important2for2the2nurse2to2specifically 2question2use2of2over-the-
counter2medications2because2patients2may2not2consider2them2important.2The2patient2is2unlikely2to2kn
ow2the2meaning2of2orphan2drugs2unless2they2too2are2health2care2providers.2Safety2during2pregnancy,
2use2of2a2generic2medication,2or2classification 2of2orphan 2drugs2are2things2the2patient2would 2be2unabl
e2to2answer2but2could2be2found2in2reference2books2if2the2nurse2wishes2to2research2them.
After2completing2a2course2on2pharmacology 2for2nurses,2what2will2the2nurse2know? 2Every
thing2necessary2for2safe2and2effective2medication 2administration
Current2pharmacologic2therapy;2the2nurse2will2not2require2ongoing2education2for252years.
2General2drug2information;2the2nurse2can 2consult2a2drug2guide2for2specific2drug2informati
on.2The2drug2actions2that2are2associated2with2each2classification 2of2medication2Ans: C
Response:
After2completing2a2pharmacology 2course2nurses2will2have2general2drug2information 2needed2for2safe2a
nd2effective2medication2administration 2but2will2need2to2consult2a2drug2guide2for2specific2drug2inform
ation2before2administering2any2medication.2Pharmacology 2is2constantly 2changing,2with2new2drugs2ent
ering2 the2market2and2new2uses2for2existing2drugs2identified.2Continuing2education 2in2pharmacology 2i
s2essential2to2safe2practice.2Nurses2tend2to2become2familiar2with2the2medications2they2administer2mos
t2often,2but2there2will2always2be2a2need2to2research2new2drugs2and2also2those2the2nurse2is2not2familiar
2with 2because2no 2nurse2knows2all2medications.
A2nurse2working2in2radiology2administers2iodine2to2a2patient2who2is2having2a2computed2tomography2(CT
)2scan.2The2nurse2working2on2the2oncology2unit2administers2chemotherapy 2to2patients2who2have2c
ancer.2At2the2Public2Health2Department,2a2nurse2administers2a2measles-mumps-
rubella2(MMR)2vaccine2to2a214-month-
old2child2as2a2routine2immunization.2Which2branch2of2pharmacology 2best2describes2the2actions2of
2all2three2nurses?
Pharmacoeconomics2
Pharmacotherapeutics
2Pharmacodynamics2P
harmacokinetics2 Ans:
B
Response:
Pharmacology 2is2the2study2of2the2biologic2effects2of2chemicals.2Nurses2 are2involved 2with2clinical2pha
rmacology2or2pharmacotherapeutics,2which2is2a2branch2of2pharmacology 2that2deals2with2the2uses2of2d
rugs2to2treat,2prevent,2and2diagnose2disease.2The2radiology2nurse2is2administering2a2drug2to2help2diag
nose2a2disease.2The2oncology 2nurse2is2administering2a2drug2to2help2treat2a2disease.
Pharmacoeconomics2includes2any2costs2involved2in2drug2therapy.2Pharmacodynamics2involves2how2a
2drug2affects2the2body 2and 2pharmacokinetics2is2how2the2body 2acts2on 2the2body.
A2physician 2has2ordered2intramuscular2(IM)2injections2of2morphine,2a2narcotic,2every242hours2as2needed2f
or2pain2in2a2motor2vehicle2accident2victim.2The2nurse2is2aware2this2drug2has2a2high2abuse2potential
.
Under2what2category2would2morphine2be2classified?
Schedule2I2S
chedule2II2S
chedule2III2
Schedule2IV
2Ans: B
Response:
Narcotics2with2a2high2abuse2potential2are2classified2as2Schedule2II2drugs2because2of2severe2dependence
, liability.2Schedule2I2drugs2have2high2abuse2potential2and2no2accepted2medical2use.2Schedule2III2dr
ugs2have2a2lesser2abuse2potential2than2II2and2an2accepted2medical2use.2Schedule2IV2drugs2have2lo
w2abuse2potential2and2limited2dependence2liability.
When2involved2in2phase2III2drug2evaluation2studies,2what2responsibilities2would2the2nurse2have
? 2Working2with2animals2who2are2given2experimental2drugs
Choosing2appropriate2patients2to2be2involved2in2the2drug2study2Mon
itoring2and2observing2patients2closely2for2adverse2effects2Conductin
g2research2to2determine2effectiveness2of2the2drug2Ans:2C
Response:
Phase2III2studies2involve2use2of2a2drug2in2a2vast2clinical2population2in2which2patients2are2asked2to2rec
ord2any2symptoms2they2experience2while2taking2the2drugs.2Nurses2may2be2responsible2for2helping2co
llect2and2analyze2the2information 2to2be2shared2with2the2Food2and2Drug2Administration 2(FDA)2but2wo
uld2not2conduct2research2independently 2because2nurses2do2not2prescribe2medications.2Use2of2animals2
in2drug2testing2is2done2in2the2preclinical2trials.2Select2patients2who2are2involved2in2phase2II2studies2to
2participate2in 2studies2where2the2participants2have2the2disease2the2drug2is2intended 2to 2treat.2These2pati
ents2are2monitored 2closely2for2drug2action2and2adverse2effects.2Phase2I2studies2involve2healthy2human
2volunteers2who 2are2usually 2paid 2for2their2participation.2Nurses2may 2observe2for2adverse2effects2and 2t
oxicity.
What2concept2is2considered 2when2generic2drugs2are2substituted 2for2brand2name2drugs? 2Bioavail
ability
Critical2concentration
2Distribution
Half-
life2 Ans: A
Response:
Bioavailability 2is2the2portion2of2a2dose2of2a2drug2that2reaches2the2systemic2circulation2and2is2availa
ble2to2act2on2body2cells.2Binders2used2in2a2generic2drug2may2not2be2the2same2as2those2used2in2the2
brand2name2drug.2Therefore,2the2way2the2body2breaks2down2and2uses2the2drug2may2differ,2which2
may2eliminate2a2generic2drug2substitution.2Critical2concentration 2is2the2amount2of2a2drug2that2is2ne
eded2to2cause2a2therapeutic2effect2and2should2not2differ2between2generic2and2brand2name2medicatio
ns.
Distribution2is2the2phase2of2pharmacokinetics,2which2involves2the2movement2of2a2drug2to2the2bod
y’s2tissues2and2is2the
, same2in2generic2and2brand2name2drugs.2A2drug’s2half-
life2is2the2time2it2takes2for2the2amount2of2drug2to2decrease2to2half2the2peak2level,2which2should2not2c
hange2when2substituting2a2generic2medication.
A2nurse2is2assessing2the2patient’s2home2medication2use.2After2listening2to2the2patient2list2current2medicat
ions,2the2nurse2asks2what2priority2question?
Do2you2take2any2generic2medications?
Are2any2of2these2medications2orphan2drugs?
Are2these2medications2safe2to2take2during2pregnancy? 2
Do2you2take2any2over-the-counter2medications?
Ans: D
Response:
It2is2important2for2the2nurse2to2specifically 2question2use2of2over-the-
counter2medications2because2patients2may2not2consider2them2important.2The2patient2is2unlikely2to2kn
ow2the2meaning2of2orphan2drugs2unless2they2too2are2health2care2providers.2Safety2during2pregnancy,
2use2of2a2generic2medication,2or2classification 2of2orphan 2drugs2are2things2the2patient2would 2be2unabl
e2to2answer2but2could2be2found2in2reference2books2if2the2nurse2wishes2to2research2them.
After2completing2a2course2on2pharmacology 2for2nurses,2what2will2the2nurse2know? 2Every
thing2necessary2for2safe2and2effective2medication 2administration
Current2pharmacologic2therapy;2the2nurse2will2not2require2ongoing2education2for252years.
2General2drug2information;2the2nurse2can 2consult2a2drug2guide2for2specific2drug2informati
on.2The2drug2actions2that2are2associated2with2each2classification 2of2medication2Ans: C
Response:
After2completing2a2pharmacology 2course2nurses2will2have2general2drug2information 2needed2for2safe2a
nd2effective2medication2administration 2but2will2need2to2consult2a2drug2guide2for2specific2drug2inform
ation2before2administering2any2medication.2Pharmacology 2is2constantly 2changing,2with2new2drugs2ent
ering2 the2market2and2new2uses2for2existing2drugs2identified.2Continuing2education 2in2pharmacology 2i
s2essential2to2safe2practice.2Nurses2tend2to2become2familiar2with2the2medications2they2administer2mos
t2often,2but2there2will2always2be2a2need2to2research2new2drugs2and2also2those2the2nurse2is2not2familiar
2with 2because2no 2nurse2knows2all2medications.