2023/2024
NURS 5334 i
Pharm Study i i
Guide Quiz 1 L i i i
atest UpdateB i i
est Exam Solu
i i
tion Graded A i i
+
about:blank 1/83
,12/4/23,i4:44iPM 2i2023-2024iNURSi5334iPharmiStudyiGuideiQuizi1iLatestiUpdateiBestiE…
NURS 5334 PHARM i i
MODULEi 1
• Whati arei thei BONi rulesi andi regulationsi fori prescriptivei authorityi forit
heiadvanceipracticeinurse?
• Texasi isi veryi restricted
• Describei thei pharmacokinetici processesi ofi absorption,i distribution,im
etabolismi andi eliminationi andi howi differencesi ini thesei areasi affectidru
giaction.
• Absorption
• Drug’si movementi fromi thei sitei ofi administrationi intoi theib
lood.
• Distribution
• Drug’si movementi fromi thei bloodi intoi thei interstitiali spaceio
fitissuesiandifromithereiintoicells.
• Metabolism
• Biotransformationi isi thei enzymaticallyi mediatedi alterationi ofid
rugistructure.
• Elimination
• Combinationi ofi metabolismi andi excretion
• Discussi thei impacti ofi foodi oni drugi absorption,i drugi metabolismi andi onid
rugi toxicityi andi action—asi welli asi thei timingi ofi drugi administration.
LIFESPAN
• Hepatici metabolismi andi GFRi increasei duringi pregnancy,i dosagesi ofis
omeidrugsimayineeditoibeiincreased.
• Ratei ofi albumini toi wateri decreases
• Thirdi trimester:i Renali bloodi flowi isi doubledi andi renalie
xcretioniisi acceleratedi (drugsi excretedi rapidly)
• Tonei andi mobilityi ofi boweli decrease
• Prolongationi ofi drugi effectsi Totali (½i lifei increases)
Understandi stagesi ofi developmenti ini pregnancy
about:blank 2/83
,12/4/23,i4:44iPM 2i2023-2024iNURSi5334iPharmiStudyiGuideiQuizi1iLatestiUpdateiBestiE…
• Conception:i throughi weeki 2
• Embryonici period:i weeki 3-weeki 8
a) Grossi malformationsi cani bei producedi byi teratogens
• Fetali period:i weeki 9-delivery
• Understandi pregnancyi labeling
• 3i categoriesi now
a)i Pregnancy,i lactation,i malei &i femalei reproductiveipotential
• Howi doi youi decreasei riski ini thei infanti duringi breastfeeding?
• Takei medsi immediatelyi afteri breastfeeding,i avoidi drugsi thatih
avei longi half-
lives,i choosei drugsi thati tendi toi bei excludedifromi milk,iavoidi d
rugsi thati arei knowni toi bei hazardous.
• Howi doi pediatrici patientsi differi ini theiri responsei toi medications?
• Absorption
a) Oral?
• Neonates:i drugi remaini ini thei stomachilongeriwhic
hi increasesi thei levels,i lowi acidityi cani affectitheiab
sorptioniofiacidilabilei drugs
b) Parenteral?
• Reponsesi arei slowi andi erratic.
• Infancy:i absorptioni isi morei rapidi thani ini neonatesi
&iadults
• Besti avoidedi ini infants
c) Transdermal?
• Greateri skini permeabilityi whichi increasesitopi
cali drugi absorptioni andi increasesi thei riskiforito
xicity
• Distribution
a) Proteini binding
about:blank 3/83
, 12/4/23,i4:44iPM 2i2023-2024iNURSi5334iPharmiStudyiGuideiQuizi1iLatestiUpdateiBestiE…
1. Neonates:i lessi protein-binding—
increasediavailabilityi ofi highlyi proteini boundi drug
si suchi asiphenytoin,i diazepam,i andi phenobarbital.i
Reducedidosagesi needediinitheseihighlyi boundidrug
s.
b) Bloodi Braini Barrier
1. Noti fullyi developedi ati birth,i drugsi havei easyia
ccessi toi thei CNS,i dosesi shouldi bei reduced.
• Metabolism
a) Hepatici function?
1. Liverihasn’tireachedifulli maturation—
sensitiveitoidrugsieliminatedibyitheiCYP450.iLive
r’siabilityitoimetabolizeidrugsiincreasesiaboutionei
monthiafteribirth.
b) Tihalfi life
1. Decreasedi byi asi muchi asi 48-72i hours
• Excretion
a) Renal?
1. GFRiisisignificantlyireducediatibirth,idrugsielimina
tedibyitheikidneysimustibeigiveniiniaireducedi dosag
ei andi longeri dosingi intervals.
• Whati educationi needsi toi bei giveni toi parents?
• Whati toi doi ifi childi spitsi outi medicationi ori throwsi iti up
• Effectivei education:i dosagei sizei andi timing,i route,i techniqueio
fi administration,i durationi ofi treatment,i howi toi storei theidrug,i n
aturei andi timei coursei ofi thei desiredi response,i natureianditimeic
ourseiofiadversei reactions.
• Compareiandicontrastipharmacokineticsiandipharmacodyna
micsi ofi speciali populations—pediatrics,i older
about:blank 4/83