NUR 210 Principles of Pharmacology Mid Test Exam 2025

NUR 210 Principles of Pharmacology Mid Test Exam 2025 Selectivity - -A "selective" drug binds to a primary and predictable site, creating one desired effect. A "non-selective" drug can bind to many different and unpredictable receptor sites with potential side effects. Stage 1: the interim between consciousness and sleep - -when sleep is interrupted, what stage does the sleep cycle restart? NREM sleep - -encompasses all sleep stages except for REM sleep Insomnia - -the inability to fall asleep - affects 10-30% of Americans - more common in female patients - tx: sedative hypnotics Action of benzodiazepines - -this class of medication is used to treat sleep disorders (insomnia) and anxiety - interacts with neurotransmitter GABA to reduce neuron excitability Action of non benzodiazepines - -this class of medications inhibits neurotransmitters and causes CNS depression - the duration of action is 6-8 hours - treats insomnia short term ( less than 10 days) - older adults are given smaller doses Depression Tolerance Dependence Hypotension - -adverse reactions of benzodiazepine drugs Contraindications - -If a patient has respiratory depression or an allergy they should not take benzodiazepines. Respiratory depression and a benzodiazepine allergy are considered____________? Non pharmalogical measures first Avoid other CNS depressants, OTC sleep aids, and benzos Take at bedtime (sedative) Do not drive while medicated (sedative) NUR 210 NUR 210 Report feelings of hangover (not enough sleep) - -what teaching is needed for patient's who take non benzodiazepine medications such as Ambien? General anesthesia - -involves the total loss of body sensation and consciousness induced by anesthetic agents administered primarily by inhalation or intravenous injection Local anesthesia - -causes the loss of sensation in a limited area by injecting an anesthetic solution near that area Regional anesthesia - -Temporary interruption of nerve conduction, is produced by injecting an anesthetic solution near the nerves to be blocked - such as an epidural Balanced anesthesia - -use of several different types of drugs to achieve the quickest, most effective anesthesia with the fewest adverse effects - involves using less general anesthesia - premedication with an opioid analgesic or benzo (versed/midazolam) - with an anticholinergic (to prevent aspiration and dry secretions) - a short acting barbituate - an inhaled gas - muscle relaxant Midazolam (Versed) - -Class: Benzodiazepine Indications: the induction and maintenance of anesthesia or conscious sedation for minor surgery or procedures - patients are sedated and relaxed but responsive to commands Adverse effects: respiratory and cardiovascular depression Contraindications: cardiopulmonary disease Nursing Considerations: - assess level of sedation during and for 2-6 hours following - monitor blood pressure, pulse, respirations during IV administration - The antidote for overdose is flumazenil Spinal and epidural anesthesia - -is administered into the cerebral fluid or epidural area of the spine that corresponds with the area being treated - commonly used for caesarian sections - common side effect: headache - adverse reactions: hypotension and respiratory distress Monitory safety Observe urine output Monitor vital signs - -what are the nursing interventions for anesthetics Topical anesthetics - -block sensation of pain by numbing the skin layers and mucous membranes NUR 210 NUR 210 - benzocaine - lidocaine Contraindications of non benzodiazepines - -if a patient has an allergy to benzodiazepines, respiratory depression, severe renal or liver disease, a child, or an older adult, they should not take Ambien. The following are contraindications of what medicaiton class? Lethargy Drowsiness Confusion (older adults) Memory impairment - -side effects of benzodiazepines Drowsiness Lethargy Dizziness Memory impairment - -side effects of non benzodiazepines Non pharmalogical sleep management - -the following are classified as ______________ sleep management techniques - arise at a specific time every morning - limit day time naps - avoid caffeine, alcohol, and nicotine 6hrs before bed - avoid heavy meals, large amounts of fluids, loud noise, and strenuous exercise before bed - take warm baths - drink warm milk - decrease loud noises (listen to white noise or silence) REM sleep - -a stage of sleep characterized by rapid eye movements and a high level of brain activity Factors that affect absorption - -the following are factors that affect which stage of pharmokinetics? - blood circulation - pain, stress, exercise - food texture, fat content, temperature - serum ph - route of administration - interactions with other drugs 3.5 - 5 g/dl - -what is the normal range for albumin levels? Amount of protein - -what do albumin levels indicate? Protein binding - -the ability of certain drugs to bind to plasma protein NUR 210 NUR 210 Highly bound - -these drugs attract a greater amount of protein Absorption First pass metabolism Drug form (oral, IV, IM) - -what factors affect bioavailability? <100% - -what is the bioavailability percentage of orally consumed drugs? 100% - -what is the bioavailability percentage of drugs administered by IV? Half life - -length of time required for half of the amount of drug taken to be reduced by half Prodrug - -a drug that is metabolized into an active substance, such as codeine - -how are drug eliminated in the body? Primary effect - -the desired response to a drug Secondary effect - -desirable or undesirable affect of a drug Pharmacodynamics - -The study of what the drug does to the body Drug onset - -the time it takes for drugs to reach minimum effective concentration 2-4 hours post administration - -what is the peak time for IM administered medications Absorption is slower, due to a slower GI tract - -what is a geriatric consideration when determining how well older patients absorb medications Change in behavior or function from baseline - -what is the first sign that an older patient is experiencing an adverse drug event? Two identifiers, first and last name + DOB - -how many identifiers are needed before administering a medication? What are they? - perform hand hygiene - wear gloves - gently pull down the skin below the eye to expose the conjunctival sac - apply drops to the middle third of the sac - apply gentle pressure over the lacrimal duct after administration - do not touch the tip of the dropper to the eye - use two separate tissues for each eye - wait 2 - 5 minutes before administering another eye drop or ointment medication NUR 210 NUR 210 - remove gloves and perform hand hygiene - -how do you properly administer eye drops? - squeeze a 1/4 inch wide strip of ointment into the conjunctival sac - all other steps used for eye drops - -how to properly administer eye ointment - check placement for gastric residual - place patient in high fowlers or elevate head of bed at least 30 degrees - make sure drug is curable or in liquid form - -how to properly administer medications via nasogastric and gastrostomy Pull auricle upward and outward - -how to administer ear drops to adults and children age 3 and older Straighten the external ear canal by pulling the ear down and back - -how to administer ear drops for children under 3 Black Box warning - -A type of warning that appears in a drug's prescribing information and is required by the U.S. Food and Drug Administration (FDA) to alert prescribers of serious adverse events that have occurred with the given drug. Beers Criteria - -A list of medications that are generally considered inappropriate when given to elderly people - Identifies High Risk Meds to Generate Wide List of Meds That Should be Avoided - use one pharmacy - medication reconciliation at each encounter with a physician - -what are ways to reduce the risk of polypharmacy in the geriatric population Geriatric Polypharmacy - -> 5 drugs related to increased incident of adverse reactions, geriatric syndromes, and mortality - happens when patient see multiple physicians and use multiple pharmacies Decreased kidney function - -what causes drugs to be excreted differently in older adults Older adults have decreased liver function - -what causes drugs to be metabolized