NUR 641E final Questions And Answers(Guaranteed Success)100%PASS!!! A+Graded

NUR 641E final Questions And Answers(Guaranteed Success)100%PASS!!! A+Graded Pharmacokinetics involves - correct answer...absorption, distribution, metabolism and elimination). Absorption: - correct answer...absorption from the administration site either directly or indirectly into the blood/plasma. Distribution: - correct answer...reversibly or irreversibly move from the bloodstream into the interstitial and intracellular Metabolism: - correct answer...biotransformed via hepatic metabolism or by other tissues. Elimination: - correct answer...tissues. lastly, the drug and its metabolites are eliminated from the body. route of administration with the highest bioavailability - correct answer...intravenous; putting entire dose into a patient's vein and bypassing absorption. avoids first-pass metabolism - correct answer...Intravenous route administration has variable and erratic absorption. n - correct answer...Rectal administration 4. Steady state (SS) - correct answer...absorption. n is usually reached within 4-5 half-lives of drug. Half-life of a drug is - correct answer...how long it takes for half the drug to be excreted from the body. Determines how frequently the drug must be administered. Predicts how long toxic effects can constant with first-order pharmacokinetics of a drug. Zero-order (nonlinear) pharmacokinetics - correct answer...means a drug is metabolized at a constant rate per unit time. CYP3A4 substrate drugs - correct answer...may have enhanced activity if any CYP3A4 inducer drugs are used along with it. Drug development process involves these steps according to the FDA: - correct answer...Discovery: laboratory research to develop the new drug. Preclinical research with animal testing for safety (Phase I). Clinical research on human subjects for medication safety (Phase II). Clinical research in humans comparing the new drug to accepted medications placebo depending on the study (Phase III). FDA review of the results to determine approval. Post marketing study to identify adverse effects not found in earlier clinical studies (Phase IV) 2. Medication safety organizations - correct answer...The Institute for Safe Medication Practices (ISMP) The Institute of Medicine (IOM) The Joint Commission The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) Food and Drug Administration (FDA) Safe Use Initiative Two basic type of ADRS: - correct answer...pharmacological and idiosyncratic. 85% to 90% of ADRS - correct answer...are pharmacological. Adverse drug reactions are usually preventable, - correct answer...frequently occur in a hospital or nursing home setting, and include medication errors, adverse drug effects, and allergic idiosyncratic type reactions. ADRS are not commonly reported; - correct answer...the FDA does not mandate that ADRS be reported. Polypharmacy - correct answer...involves using multiple health care providers for care, using multiple medications, and using several pharmacies prescription filling. Angiotensin converting enzyme inhibitors (ACEIS): - correct answer...lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril. ACEIS reduce blood pressure enzyme. - correct answer...by suppressing the release of angiotensin-converting enzyme. Important side effects of ACE inhibitors - correct answer...Important include cough and angioedema; discontinue the ACEI if angioedema occurs. Angiotensin II receptor blocking agents (ARBS): - correct answer...Icandesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), telmisartan (Micardis) and valsartan (Diovan). ARBS reduce blood pressure - correct answer...by blocking angiotensin II receptors. Essential (primary) hypertension - correct answer...Essential (primary) accounts for 90% of cases; secondary hypertension may caused by chronic renal failure. Nitroglycerin - correct answer...Nitroglycerin is a nitrate drug that can be administered IV, SL, a topical ointment and as a transdermal patch. Nitrates are contraindicated - correct answer...with PDE-5 inhibitors (e.g., sildenafil and vardenafil) Amiodarone is the antiarrhythmic - correct answer...Of choice when there is coexisting heart failure; can cause thyroid and pulmonary toxicity. Alpha-1 adrenergic stimulation - correct answer...results in vasoconstriction and increased blood pressure. Alpha-1 adrenergic blockade - correct answer...results in vasodilation and reduced blood pressure. Beta-1 adrenergic stimulation - correct answer...by beta agonists (e.g., isoproterenol) results in increased heart rate, increased blood pressure, and increased cardiac output. Beta-1 adrenergic blockade results - correct answer...in reduced heart rate, reduced blood pressure, and reduced cardiac output. Left heart failure - correct answer...causes reduced delivery of oxygenated blood to the body tissues. Right heart failure - correct answer...is associated with pulmonary disease and increased pulmonary vascular resistance. drug that relieves heart failure symptoms but does not reduce mortality - correct answer...furosemide. Loop diuretics like furosemide - correct answer...are potent diuretics, can cause diuretic resistance and hypokalemia, and work on receptors in the thick ascending renal loop of Henle. Loop diuretics inhibit - correct answer...reabsorption of sodium and chloride at this site in the kidney. Potassium-sparing diuretics: - correct answer...spironolactone, triamterene. Milrinone - correct answer...phosphodiesterase inhibitor used for acute heart failure. Children diagnosed with the tetralogy of Fallot can stop hypoxic spells - correct answer...by squatting down compensatory mechanism). Patent ductus arteriosus (PDA) - correct answer...is a congenital heart defect with a continuous machine- like murmur heard over the left upper sternal border in both systole and diastole, a bounding pulse and a thrill on palpation. PDA can be effectively treated - correct answer...IV NSAIDS such as indomethacin. Raynaud's disease - correct answer...vasospastic disorder typically seen during cold weather. Raynaud's involves - correct answer...the small arteries and arterioles in the fingers; occasionally, the toes are also involved. Raynaud's is treated - correct answer...with dihydropyridine-type calcium channel blockers (e.g., nifedipine) because they cause peripheral vasodilation. Asthma - correct answer...is an obstructive airway disease associated with airflow obstruction, mucus production, hyperreactivity of the bronchial tissue, and inflammation. Mild persistent asthma - correct answer...is best treated with a short-acting beta-2 agonist (SABA) plus an inhaled corticosteroid. . Moderate persistent asthma - correct answer...is best treated with an inhaled low-dose corticosteroid and a long-acting bronchodilator. Severe persistent asthma - correct answer...is best treated with a long-acting beta-2 agonist (LABA), plus a high-potency inhaled corticosteroid, plus an oral corticosteroid drug. Inhaled short-acting beta-2 agonists (SABA) - correct answer...are indicated only for PRN use. Long-acting beta-2 agonists (LABA, e.g., salmeterol) - correct answer...should never be used in an acute asthma exacerbation; use a short-acting beta-2 agonist (SABA, e.g., albuterol). short-acting Short-acting beta-2 agonists (SABA) - correct answer...are used in acute asthmatic attacks, but can increase heart rate, tremors, nervousness, and reduce serum potassium levels. , Instruct a patient on any inhaled corticosteroid - correct answer...rinse the mouth after each use