Galen NUR 210 Exam 1 Modules 1-3 | Comprehensive Q&A For Certification Success. Accurate Latest Verified Exam Update. Genuine Exam with Accurate Solutions.

Galen NUR 210 Exam 1 Modules 1-3 | Comprehensive Q&A For Certification Success. Accurate Latest Verified Exam Update. Genuine Exam with Accurate Solutions. Pharmacokinetics - CORRECT ANSThe process in which medications move through the body What are the 4 phases of pharmacokinetics? - CORRECT ANSabsorption, distribution, metabolism, excretion Absorption - CORRECT ANShappens with drug movement from the GI tract into the bloodstream. Most meds are taken by mouth. Zolpidem (Ambien) - CORRECT ANSClassification: non-benzodiazepine Uses: insomnia, conscious sedation Side Effects: dizziness, drowsiness, residual sedation, headache, blurred vision Adverse Effects: hypotension, tolerance, phycological and physical dependence Contraindications: allergy to benzodiazepines, respiratory depression, renal/ liver dysfunction Interactions: other CNS depressants, alcohol, food decreases absorption Eval/Monitor/Teach: use caution in children and older adults, monitor for dependency, avoid alcohol NSAIDS in general - CORRECT ANS•Prostaglandin inhibitors pain inhibitor COX 1 and enzyme Needing for prostaglandin inhibitors to work Protects stomach lining Regulates platelets COX 2 enzymes Anti-inflammatory Pain Stiffness in joints Mildly work for fever Preferred drugs for headache and fever (mild) Salicylates - CORRECT ANSAspirin Prostaglandin inhibitor Decreases inflammatory process Antiplatelet Reduces pain by blocking COX 1 and 2 enzymes GI bleeding, ulcers (cox 1) Antiplatelet property (cox 1) Reduces pain/inflammation (cox 2) Side effects N/V Diarrhea Constipation Abdominal pain Take with food or enteric coated Hypersensitivity Tinnitus (ringing of the ear) Vertigo (spinning) Bronchospasm (throat spasm) Not given to children Reye's syndrome (brain/liver damage) Propionic Acid Derivatives - CORRECT ANSIbuprofen Aspirin like Stronger (6-8 hours) Less GI distress Highly protein bound so can interact with other drugs Avoid Warfarin Sulfonamides Cephalosporins Phenytoin Hypoglycemia can happen if taken with diabetic meds Side effects GI upset if taken without food (COX 1) Sodium and water retention Fenamates - CORRECT ANSUsed for chronic arthritis, watch GI effects Oxicams - CORRECT ANSUsed for RA, long half-life, so once a day dosing COX-2 inhibitors - CORRECT ANS•No effect on COX 1 so will not see GI distress or bleeding •Only works on pain and inflammation (COX 2) Increased risk of heart attack and stroke, so use cautiously Celecoxib - CORRECT ANS•Only COX 2 inhibitor and doesn't produce GI bleeding •Affects heart disease patients DMARDS - CORRECT ANS•Immunosuppressants •Increased risk of infection Immunomodulators •Antimalarials •Used for RA •Severe psoriasis •Crohn's disease •UC •Must assess risk of infection Antigout - CORRECT ANS•High level of uric acid in blood, causes inflammation/severe pain •Increase fluids while taking meds to flush out uric acid Colchicine - CORRECT ANSInflammation related to gout, not for other inflammatory conditions Aspirin - CORRECT ANSClassification: salicylate, NSAID Uses: pain, arthritis, inflammation, anticoagulation Action: COX 1/2 inhibitor, prostaglandin inhibitor Side Effects: dizziness, abdominal pain, drowsiness, HA Adverse Effects: tinnitus, hearing loss, GI distress/ bleeding/ ulceration, thrombocytopenia, agranulocytosis, hepatotoxicity, Reye syndrome Contraindications: GI bleeding, sensitivity to NSAIDs, flu or viral illnesses, pregnancy Interactions: anticoagulants, hypoglycemics Eval/Monitor/Teach: monitor for bleeding/ bruising, GI, no alcohol or warfarin, inform dentist before procedure, stop 7 days before surgery, watch liver function, do not give to children Ibuprofen - CORRECT ANSClassification: NSAID, propionic acid derivative Uses: arthritis pain, inflammation, mild-moderate pain Action: Inhibits COX 1/2 enzyme, prostaglandin inhibitor Side Effects: GI upset, peripheral edema, dizziness Adverse Effects: hearing loss/ tinnitus, GI bleeding/ulcers, petechiae Contraindications: cross sensitivity to other NSAIDs, hypersensitivity to aspirin, peptic ulcers Interactions: anticoagulants, lithium, herbal products Eval/Monitor/Teach: monitor for GI bleeding (severe stomach pain, black/tarry stools) Celecoxib (Celebrex) - CORRECT ANSClassification: COX-2 inhibitor, NSAID Action: Inhibits prostaglandin synthesis in COX 2, decreases inflammation/pain Uses: osteoarthritis, RA, mild-moderate pain, fever Side Effects: GI upset, dizziness, diarrhea Adverse Effects: headaches, peripheral edema, bleeding, HTN, can cause strokes Contraindications: cardiac conditions Interactions: anticoagulants, lithium, herbal products (gingko biloba) Eval/Monitor/Teach: monitor for GI bleeding (severe stomach pain, black/tarry stools), monitor VS, caution with hepatic or renal dysfunction, highly protein bound, dysrhythmias, Allopurinol - CORRECT ANSClassification: uric acid inhibitor, anti-gout Action: reduces serum uric acid levels Uses: gout, chronic gout prophylactic Side Effects: GI upset, dizziness, pruritus, HA, flushed skin Adverse Effects: blood dyscrasias, n/v, anemia, metallic taste, pruritus Contraindications: severe kidney disease Interactions: cyclosporine, anticoagulants, diuretics Eval/Monitor/Teach: monitor uric acid, increase fluids, encourage yearly eye exams, take with food, avoid high purine foods (meats, salmon, legumes, gravy, coffee), increase fluids, assess renal/liver function Acetominophen - CORRECT ANS•Analgesic, antipyretic •Not an NSAID •no anti-inflammatory properties •Little GI effects, no antiplatelet properties •Short half-life - taken q 4 •Watch liver function •no more than 4 g/24 hours •Hepatic toxicity •N/V •Diarrhea •Abdominal pain •Used for mild headache and mild fever antidote is acetylcysteine Opioid Analgesics - CORRECT ANS•Moderate to severe pain •Antitussive •Antidiarrheal •Act on PNS and CNS Pain receptor sites Respiratory depression Euphoria Sedation Constipation Orthostatic hypotension (consider safety, falls risk) N/V •In the older adult with high doses Respiratory depression Urinary retention •Morphine Acute pain Watch for constipation RR Hypotension Urinary retention Decreased cough Combination Drugs - CORRECT ANSIbuprofen and hydrocodone PCA pump - CORRECT ANS•Loading dose •Lock out prevents overdose •Patient must control transdermal - CORRECT ANS•Patch Wear gloves Clean site Opioid Antagonists - CORRECT ANS•Naloxone Monitor patient closely Might need to add analgesia afterwards Withdrawal symptoms Tachycardia N/V Sweating Migraine headaches - CORRECT ANS•Triptans •Beta blockers •Anticonvulsants •TCA Morphine - CORRECT ANSClassification: opioid analgesic Uses: moderate to severe pain, SOB Side Effects: constipation, urinary retention, rash, orthostatic hypotension Adverse Effects: respiratory depression, psychological dependence, miosis (small pupils), sedation, blurred vision, euphoria Contraindications: CNS or respiratory depression, asthma, increased ICP Interactions: CNS depressants, alcohol Eval/Monitor/Teach: avoid alcohol, may decrease respiratory rate, monitor VS, orthostatic hypotension (falls risk), confusion decreased LOC in elderly Sumatriptan (Imitrex) - CORRECT ANSClassification: selective serotonin receptor agonist Uses: migraines, cluster headaches Action: vasoconstriction of cranial arteries Side Effects: dizziness, vertigo, drowsiness Adverse Effects: suicidal ideations, hypo/hypertension, bradycardia, dysrhythmias, cardiac arrest Contraindications: cardiovascular disease, uncontrolled HTN, liver failure, pregnancy Interactions: SSRIs, MAOIs Eval/Monitor/Teach: monitor VS, administer before pain escalates, avoid MAOIs and SSRIs, stress management, avoid migraine triggers Naloxone (Narcan) - CORRECT ANSClassification: opioid antagonist Uses: opioid overdose Side Effects: sweating, flushing, agitation, dyspnea, elevated PTT, bleeding Adverse Effects: reversal of analgesia, hypo/hypertension, tachycardia Contraindications: use caution in patients with cardiac disease Interactions: opioids, topiramate Eval/Monitor/Teach: monitor VS and respiratory status, if using opioids for pain using naloxone will cause pain to return Amphetamines and amphetamine-like drugs - CORRECT ANS•CNS stimulant •Used for ADHD and narcolepsy (excessive daytime sleepiness) •Can produce euphoria (seeing things) and increased alertness •Can also cause insomnia (can't sleep), restlessness, tremors, irritability, weight loss •Can also cause cardiovascular problems (high blood pressure, tachycardia, palpitations) •Other adverse reactions: dry mouth, diarrhea, seizure •Don't take in evening •Nursing process page 200 •High potential for building up tolerance, abuse •Monitoring weight, sleep patterns, anxiety, foods (caffeine) •You can have withdrawal, tapper dosage down when trying to stop taking, make sure you eat in the morning due to not feeling hungry Methylphenidate - CORRECT ANSClassification: stimulant Uses: ADHD, narcolepsy Actions: Stimulates release of norepinephrine and dopamine Side Effects: nervousness, anorexia, restlessness, tremors, insomnia, dry mouth Adverse Effects: tachycardia, HTN, growth suppression Contraindications: HTN, hyperthyroidism, CAD, history of seizures Interactions: other stimulants, caffeine, anticoagulants, barbiturates, anticonvulsants, decrease effects of antihypertensive meds Eval/Monitor/Teach: avoid caffeine and other stimulants, monitor for changes in mood, sugarless gum/candy for dry mouth, take in am, before meals, eat good breakfast due to anorexia effects, monitor weight, report palpations (tachy) Phenytoin - CORRECT ANSClassification: anticonvulsant Action: reduces motor activity, acts on sodium/calcium channel Uses: epilepsy, seizure prevention Side Effects: HA, dizziness, drowsiness, slurred speech, gingival hyperplasia, harmless urine discoloration Adverse Effects: thrombocytopenia, leukopenia, suicidal ideation, hyperglycemia Contraindications: pregnancy, NSAIDs, anticoagulants Interactions: folic acid, anticoagulants, decrease effectiveness of oral contraceptives, Vit K, diazepam Eval/Monitor/Teach: avoid alcohol, monitor for seizure activity, monitor for bleeding, teach good oral hygiene (gingival hyperplasia), highly protein bound, therapeutic range: 10-20 Phenobarbital - CORRECT ANSClassification: barbiturate Uses: seizures Action: Stops status epilepticus Side Effects: dizziness, drowsiness, loss of appetite, nausea Adverse Effects: dependency, respiratory depression, coma Contraindications: pregnancy Interactions: anticoagulants, disulfiram, doxycycline, hormone replacement therapy Eval/Monitor/Teach: monitor therapeutic serum levels, do not stop abruptly, monitor RR Diazepam - CORRECT ANSDiazepam IV for status epilepticus along with phenytoin/phenobarbital Oral absorption - CORRECT ANSTakes awhile to get absorbed because it has to go through the GI system Usually takes 2-4 hours •Enteric coated aspirin - hard on stomach can not crush pill •Extended release absorbed in the small intestine IM absorption - CORRECT ANSAbsorbed 1-2 hours IV absorption - CORRECT ANSAbsorbed 30-60 minutes dissolution - CORRECT ANSDissolution happens when a po medication breaks down into particles, disintegrates, and dissolves to combine with liquid so absorption from the GI tract into the bloodstream occurs. Liquid medications are absorbed faster than solids. Food can interfere with the absorption of drugs. Drugs that resist dissolution - CORRECT ANSParenteral medications (SL, eyedrops, inhalants, transdermal) do not pass through the GI tract. Enteric coated medications are designed to resist disintegration until the pill reaches the small intestine. EC and sustained release meds should not be crushed. Factors that affect absorption - CORRECT ANS•Lack of muscle and increased fat changes medicine absorption •Food consumption - will change medicine potency (delayed) •Stress - Exercise, medicine goes to muscle •pH - Medicine is made for acidic environments Antacid changes absorption •Taken alone so it doesn't change the action Excipients - CORRECT ANSFillers and other substances that make up tablets as a pill is not 100% drug. Sometimes an excipient enhances the absorption of a drug such as with PCN, which is not well absorbed from the GI tract. Adding Na to PCN, which makes it penicillin sodium, will increase the absorption of PCN first pass effect - CORRECT ANS•the oral drugs go to liver via portal vein where some of the drug becomes inactive •Only happens with oral medications delayed gastric emptying - CORRECT ANSFood doesn't move like it should Distribution - CORRECT ANSrefers to the movement of the drug from the circulation to body tissues Factors affecting distribution - CORRECT ANS-blood flow to tissues -protein binding -blood brain barrier -drug's affinity to the tissue protein binding - CORRECT ANSDrugs bind with proteins in blood Some drugs are highly protein bound and other are weakly protein bound free drugs - CORRECT ANSdrugs not bound to protein Drug Toxicity - CORRECT ANS-Two highly protein bound drugs compete and one might accumulate and cause a toxicity -it is important to know if you are administering highly protein bound medications and monitor albumin levels in patients with liver or kidney disease. -Some drugs that are highly protein bound include: Warfarin Furosemide Diazepam Drug distribution and albumin - CORRECT ANS-A decrease in albumin levels decrease the protein-binding sites, which means more of the free drug is circulated. -This can be fatal with some meds. -Free drugs are those not bound to protein, which means they are active in the body and cause a pharmacologic response. -Older adults, malnourished individuals, and those with liver or kidney disease have low albumin levels. Blood Brain Barrier (BBB) - CORRECT ANS-The BBB protects the brain from most drugs. -Some meds are able to cross the BBB such as benzodiazepines. -Drugs can cross the placenta and cause spontaneous abortion or alter fetal growth and development. Metabolism - CORRECT ANS•Chemically changes drug to a form that can be excreted •Liver primary site half-life - CORRECT ANS•the time it takes for the drug in the body to be reduced by half Loading dose - CORRECT ANSuse of a higher dose than what is usually used for treatment to allow the drug to reach the critical concentration (therapeutic level) sooner •Blood thinner •Antibiotic