NMNC 1210 INTRODUCTION TO PHARMACOLOGY QUESTIONS AND ANSWERS

NMNC 1210 INTRODUCTION TO PHARMACOLOGY QUESTIONS AND ANSWERS 1. The nursing process and patient centered care includes what six elements. Concept, Assessment, Patient Problem, Planning, Implementation of Nursing Considerations and Evaluation. 2. The term concept includes health, illness, and health promotion. 3. Assessment includes objective and subjective data. 4. Nursing considerations include general patient teaching about medication side effects, self- administration, and diet. 5. In the evaluation phase the nurse determines if goals and teaching objectives have been met. 6. Define the following terms: Respect for persons: Patients should be treated as independent persons capable of making their own decisions in their own best interest. Autonomy: the right to self-determination Beneficence: the duty to protect research subjects from harm. Justice: requires that the selection of research subjects be fair Informed consent: right to be informed and that participation is voluntary, without coercion. 7. American Nurses Association Code of Ethics is a guide for carrying out nursing responsibilities in a manner consistent with quality nursing care and ethical obligations of the profession. The nurse’s responsibility in clinical research includes safety of the patient and integrity of the research protocol 8. Drug standards in the US are used by United States Pharmacopeia. 9. Controlled substances are categorized into five schedules based on their abuse potential and acceptable medical use. 10. Chemical drug names described the chemical structure. 11. Generic drug names are official nonproprietary. 12. Brand (trade) names are chosen by drug companies and are proprietary. 13. Over-the-counter (OTC) drugs have been found to be safe and appropriate for use without direct supervision of a health care provider. 14. Define the following terms: Pharmacokinetics: process of drug movement throughout the body necessary to achieve drug action Passive transport: movement of drug into bloodstream after administration Diffusion: drugs move across cell membranes from high to low concentration Facilitated diffusion: relies on a carrier protein to move from high to low concentration Bioavailability: percentage of administered drug available for activity First-pass effect: following absorption of drug from GI tract they pass into the liver thru the portal vein, some drugs are metabolized to inactive forms and excreted thus reducing pharmacological effect. Drug distribution: movement of drug from circulation to body tissues Protein binding: drugs bind with plasma proteins. Free drugs: unbound drugs able to exit circulation and reach site of action. Blood-brain barrier (BBB): cells lining blood vessels in the brain are tightly pressed and decrease the ability of drugs to cross into brain. Drug metabolism: process by which the body chemically changes drugs into a form that can be excreted. Prodrug: is a compound that is metabolized into active pharmacologic substances Cytochrome P450: drug metabolizing liver enzymes that convert drugs to excretable metabolites. Half-life: time it takes for the amount of drug in the body to be reduced by half Steady state: occurs when the amount of drug being administered is the same as the amount being eliminated. Loading dose: larger initial dose to reach steady state sooner (especially with drugs that have long half-life) Drug excretion: elimination of drugs from the body (mainly by kidneys) Pharmacodynamics: study of the effects of drugs on the body Dose response: body’s physiologic response to changes in drug concentration at the site of action Potency: amount of drug needed to elicit a specific response Maximal efficacy: point at which increasing a drug dosage no longer increases therapeutic response. Therapeutic index: relationship between therapeutic dose and toxic dose Onset: time it takes a drug to reach maximum effectiveness Peak: when a drug reaches highest concentration Duration: length of time a drug exerts effects Peak and trough: highest plasma concentration is peak, lowest plasma concentration is trough. Receptor: sites drug may activate or block on cell surface to produce a response Ligand-binding domain: site on the receptor at which drugs bind Agonist: activate a receptor and produce a desired response Antagonist: block a receptor and block a response Nonspecific: drugs that effect multiple receptor sites Nonselective: drugs that effect multiple receptors Side effects: secondary effects of drug therapy Adverse drug reactions: are unintentional unexpected reactions to drug therapy Drug toxicity: occurs when drug levels exceed therapeutic range. Pharmacogenetics: study of genetic factors that influence an individual’s response to drugs Tolerance: decreased responsiveness to a drug over the course of therapy Tachyphylaxis: acute, rapid decrease in response to a drug Placebo effect: drug response not attributed to chemical properties of a drug. Drug interactions: altered or modified action or effect of a drug as a result of interaction with one or multiple drugs Additive effect: sum effect of two drugs Synergistic effect: clinical effect of the two drugs is substantially greater than either drug alone. Antagonistic effect: two drugs given together, and one drug reduces or blocks the other Photosensitivity: drug induced skin reaction caused by sun exposure 15. Seven drug actions include stimulation, depression, irritation, replacement, cytotoxic action, antimicrobial, and modification of immune system. 16. Pharmacogenetics is the study of how a patient’s genomes affect their response to medications. 17. Clinical application of pharmacogenetics includes improve quality outcomes, customize patient plan of care, decrease adverse effects of drug therapy, predict patient response to drug therapy, save time and money by reducing prescribing trial and error, and decrease treatment failure. 18. Complementary and alternative medicine includes botanicals, nutritional products and herbal medications. 19. Define the following: Botanicals additive substances that come from plants Herbs any plant used for culinary or medicinal purposes. Phytomedicine therapeutic value of plants 20. Current Good Manufacturing Practices (CGMP) are standards that require package labels to include quality and strength of all contents as well as being free of contaminants and impurities. 21. Family centered care is essential in pediatrics to ensure safety during and after health care interventions. 22. Principles of atraumatic care is the philosophy of providing therapeutic care and interventions that minimize or eliminate psychological and physical distress. 23. Polypharmacy refers to the use of more medications than medically necessary. 24. Beers criteria aid health care providers in safe prescription and administration of medications for older adults. 25. Older adults are twice as likely to visit the ED for an adverse drug events and seven times as likely to be hospitalized. 26. Adherence may be an issue for older adults because they may fail to ask questions and may not understand or follow drug regimen. 27. Substance use disorder occurs when recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment with health or major responsibilities. 28. Reward circuit is a structure that regulates our ability to feel pleasure and other emotions. 29. Tolerance is the decreased responsiveness resulting in a need for larger doses to create the same euphoria. 30. The six rights of medication administration are right patient, right drug, right dose, right time, right route, right documentation. 31. The components of a medication order are patient name and DOB, date of order, provider signature, drug name and strength, dose and frequency, route, duration, refills, quantity, special instructions. 32. Define the following: Just culture avoid punitive approach in reporting drug errors. Root cause analysis method of problem used to identify potential workplace errors. Sentinel event unanticipated event in a health care setting resulting in death or serious harm unrelated to the patients’ natural course of illness. Drug reconciliation: process identifying the most accurate list of medications for a patient during transition of care (such as at discharge). High alert medication can cause significant harm to the patient. Look-alike and sound-alike drugs drug names that look or sound similar to other medications. 33. Creating a distraction free environment is critical to safe medication administration.