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PM 202456NURS56533456Pharm56Study56Guide56Quiz56156Latest56Update56Bes
t56E…
2023/2024
NURS 5334 56
Pharm Study 56 56
Guide Quiz 1 56 56 56
Latest Update 56 56
Best Exam So 56 56
lution Graded 56 56
A+
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NURS 5334 PHARM 56 56
MODULE5 6 1
• What56are56the56BON56rules56and56regulations56for56prescriptive56aut
hority56for5 6 the56advance56practice56nurse?
• Texas56 is56very56restricted
• Describe56the56pharmacokinetic56processes56of56absorption,56distribu
tion,5 6 metabolism56and56elimination56and56how56differences56in56the
se56areas56affect5 6 drug56action.
• Absorption
• Drug’s56movement56from56the56site56of56administration56
into56the5 6 blood.
• Distribution
• Drug’s56movement56from56the56blood56into56the56interstiti
al56space5 6 of56tissues56and56from56there56into56cells.
• Metabolism
• Biotransformation56is56the56enzymatically56mediated56alterati
on56of5 6 drug56structure.
• Elimination
• Combination56 of56 metabolism56 and56 excretion
• Discuss56the56impact56of56food56on56drug56absorption,56drug56metabolis
m56and56on5 6 drug56toxicity56and56action—
as56well56as56the56timing56of56drug56administration.
LIFESPAN
• Hepatic56metabolism56and56GFR56increase56during56pregnancy,56dos
ages56of5 6 some56drugs56may56need56to56be56increased.
• Rate56 of56albumin56 to56water56 decreases
• Third56trimester:56Renal56blood56flow56is56doubled56a
nd56renal5 6 excretion56is56accelerated56(drugs56excrete
d56rapidly)
• Tone56 and56 mobility56 of56 bowel56 decrease
• Prolongation56 of56 drug56 effects56 Total56 (½56 life56 increases)
Understand56 stages56 of56 development56 in56 pregnancy
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t56E…
• Conception:56 through56 week56 2
• Embryonic56 period:56 week56 3-week56 8
a)5 6 Gross56 malformations56 can56 be56produced56by56 teratogens
• Fetal56 period:56 week56 9-delivery
• Understand5 6 pregnancy5 6 labeling
• 356 categories56 now
a)5 6 Pregnancy,56lactation,56male56&56female56reproductive
56 potential
• How56 do56you56 decrease56risk56 in56 the56 infant56 during56 breastfeeding?
• Take56meds56immediately56after56breastfeeding,56avoid56dru
gs56that5 6 have56long56half-
lives,56choose56drugs56that56tend56to56be56excluded5 6 from5
6milk,56avoid56drugs56that56are56known56to56be56hazardous.
• How56 do56pediatric56 patients56 differ56 in56their56 response56 to56 medications?
• Absorption
a) Oral?
• Neonates:56drug56remain56in56the56stomach56lon
ger5 6 which56increases56the56levels,56low56acidit
y56can56affect5 6 the56absorption56of56acid56labil
e56drugs
b) Parenteral?
• Reponses56are56 slow56 and56 erratic.
• Infancy:56absorption56is56more56rapid56than56in56
neonates5 6 &56adults
• Best56avoided56 in56 infants
c) Transdermal?
• Greater56skin56permeability56which56increase
s5 6 topical56drug56absorption56and56increases
56the56risk5 6 for56toxicity
• Distribution
a) Protein56 binding
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t56E…
1.5 6 Neonates:56less56protein-binding—
increased5 6 availability56of56highly56protein56bou
nd56drugs56such56as5 6 phenytoin,56diazepam,56an
d56phenobarbital.56Reduced5 6 dosages56needed56i
n56these56highly56bound56drugs.
b) Blood56 Brain56 Barrier
1.5 6 Not56fully56developed56at56birth,56drugs56
have56easy5 6 access56to56the56CNS,56doses56
should56be56reduced.
• Metabolism
a) Hepatic56 function?
1.5 6 Liver56hasn’t56reached56full56maturation—
sensitive5 6 to56drugs56eliminated56by56the56CY
P450.56Liver’s5 6 ability56to56metabolize56drugs5
6increases56about56one5 6 month56after56birth.
b) T56half56 life
1.5 6 Decreased56 by56 as56 much56 as56 48-7256hours
• Excretion
a) Renal?
1.56GFR56is56significantly56reduced56at56birth,56drug
s5 6 eliminated56by56the56kidneys56must56be56give
n56in56a5 6 reduced56dosage56and56longer56dosing
56intervals.
• What56 education56needs56 to56be56 given56 to56parents?
• What56to56 do56if56 child56spits56 out56 medication56or56 throws56it56up
• Effective56education:56dosage56size56and56timing,56route,56te
chnique5 6 of56administration,56duration56of56treatment,56how
56to56store56the5 6 drug,56nature56and56time56course56of56the5
6desired56response,56nature5 6 and56time56course56of56adverse
56reactions.
• Compare56and56contrast56pharmacokinetics56and5 6 pharmac
odynamics56of56special56populations—pediatrics,56older
about:blank 4/84
PM 202456NURS56533456Pharm56Study56Guide56Quiz56156Latest56Update56Bes
t56E…
2023/2024
NURS 5334 56
Pharm Study 56 56
Guide Quiz 1 56 56 56
Latest Update 56 56
Best Exam So 56 56
lution Graded 56 56
A+
about:blank 1/84
,12/4/23,564:4456 2562023-
PM 202456NURS56533456Pharm56Study56Guide56Quiz56156Latest56Update56Bes
t56E…
NURS 5334 PHARM 56 56
MODULE5 6 1
• What56are56the56BON56rules56and56regulations56for56prescriptive56aut
hority56for5 6 the56advance56practice56nurse?
• Texas56 is56very56restricted
• Describe56the56pharmacokinetic56processes56of56absorption,56distribu
tion,5 6 metabolism56and56elimination56and56how56differences56in56the
se56areas56affect5 6 drug56action.
• Absorption
• Drug’s56movement56from56the56site56of56administration56
into56the5 6 blood.
• Distribution
• Drug’s56movement56from56the56blood56into56the56interstiti
al56space5 6 of56tissues56and56from56there56into56cells.
• Metabolism
• Biotransformation56is56the56enzymatically56mediated56alterati
on56of5 6 drug56structure.
• Elimination
• Combination56 of56 metabolism56 and56 excretion
• Discuss56the56impact56of56food56on56drug56absorption,56drug56metabolis
m56and56on5 6 drug56toxicity56and56action—
as56well56as56the56timing56of56drug56administration.
LIFESPAN
• Hepatic56metabolism56and56GFR56increase56during56pregnancy,56dos
ages56of5 6 some56drugs56may56need56to56be56increased.
• Rate56 of56albumin56 to56water56 decreases
• Third56trimester:56Renal56blood56flow56is56doubled56a
nd56renal5 6 excretion56is56accelerated56(drugs56excrete
d56rapidly)
• Tone56 and56 mobility56 of56 bowel56 decrease
• Prolongation56 of56 drug56 effects56 Total56 (½56 life56 increases)
Understand56 stages56 of56 development56 in56 pregnancy
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,12/4/23,564:4456 2562023-
PM 202456NURS56533456Pharm56Study56Guide56Quiz56156Latest56Update56Bes
t56E…
• Conception:56 through56 week56 2
• Embryonic56 period:56 week56 3-week56 8
a)5 6 Gross56 malformations56 can56 be56produced56by56 teratogens
• Fetal56 period:56 week56 9-delivery
• Understand5 6 pregnancy5 6 labeling
• 356 categories56 now
a)5 6 Pregnancy,56lactation,56male56&56female56reproductive
56 potential
• How56 do56you56 decrease56risk56 in56 the56 infant56 during56 breastfeeding?
• Take56meds56immediately56after56breastfeeding,56avoid56dru
gs56that5 6 have56long56half-
lives,56choose56drugs56that56tend56to56be56excluded5 6 from5
6milk,56avoid56drugs56that56are56known56to56be56hazardous.
• How56 do56pediatric56 patients56 differ56 in56their56 response56 to56 medications?
• Absorption
a) Oral?
• Neonates:56drug56remain56in56the56stomach56lon
ger5 6 which56increases56the56levels,56low56acidit
y56can56affect5 6 the56absorption56of56acid56labil
e56drugs
b) Parenteral?
• Reponses56are56 slow56 and56 erratic.
• Infancy:56absorption56is56more56rapid56than56in56
neonates5 6 &56adults
• Best56avoided56 in56 infants
c) Transdermal?
• Greater56skin56permeability56which56increase
s5 6 topical56drug56absorption56and56increases
56the56risk5 6 for56toxicity
• Distribution
a) Protein56 binding
about:blank 3/84
, 12/4/23,564:4456 2562023-
PM 202456NURS56533456Pharm56Study56Guide56Quiz56156Latest56Update56Bes
t56E…
1.5 6 Neonates:56less56protein-binding—
increased5 6 availability56of56highly56protein56bou
nd56drugs56such56as5 6 phenytoin,56diazepam,56an
d56phenobarbital.56Reduced5 6 dosages56needed56i
n56these56highly56bound56drugs.
b) Blood56 Brain56 Barrier
1.5 6 Not56fully56developed56at56birth,56drugs56
have56easy5 6 access56to56the56CNS,56doses56
should56be56reduced.
• Metabolism
a) Hepatic56 function?
1.5 6 Liver56hasn’t56reached56full56maturation—
sensitive5 6 to56drugs56eliminated56by56the56CY
P450.56Liver’s5 6 ability56to56metabolize56drugs5
6increases56about56one5 6 month56after56birth.
b) T56half56 life
1.5 6 Decreased56 by56 as56 much56 as56 48-7256hours
• Excretion
a) Renal?
1.56GFR56is56significantly56reduced56at56birth,56drug
s5 6 eliminated56by56the56kidneys56must56be56give
n56in56a5 6 reduced56dosage56and56longer56dosing
56intervals.
• What56 education56needs56 to56be56 given56 to56parents?
• What56to56 do56if56 child56spits56 out56 medication56or56 throws56it56up
• Effective56education:56dosage56size56and56timing,56route,56te
chnique5 6 of56administration,56duration56of56treatment,56how
56to56store56the5 6 drug,56nature56and56time56course56of56the5
6desired56response,56nature5 6 and56time56course56of56adverse
56reactions.
• Compare56and56contrast56pharmacokinetics56and5 6 pharmac
odynamics56of56special56populations—pediatrics,56older
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