PC707 Module 1 Study Guide | 100% Correct Answers | Verified | Latest 2024 Version

What is prescriptive authority? - Legal right to prescribe drugs Is the Physicians Desk Reference a reliable source to use when prescribing drugs? - No--it is not evidence-based and it is not updated What is the sunshine act? - -part of the affordable care act -limits providers on accepting gifts from pharmaceutical companies -reduces bias What is pharmacology? - -study of the drugs and their actions and effects on living things -legal drugs, illegal drugs, prescription drugs, OTC drugs How does the FDA define drugs that they approve? - -chemicals that have been proved for safety and efficacy What must providers consider when prescribing? - -the dose -the route of administration -indications -side effects of consequence -adverse effects -contraindications -significant drug-drug interactions -appropriate monitoring -treatment of side effects if necessary What is pharmacokinetics? - -how drugs move in the body and what the body does with it How does pharmacokinetics influence prescribing? - -the route -the dosage needed -dosing intervals What are the 4 aspects of pharmacokinetics? - -absorption -distribution -metabolism -excretion What affects bioavailability the most? - PO administration What is a pro-drug? - -a drug that needs to be metabolized to become "activated" What is the major organ of metabolism? - -Liver -Uses enzymes called "CYPs" -these enzymes can induce or inhibit metabolism What is protein-binding? - -drugs that have a high affinity for proteins will bind with them and therefore become unable to bind to receptor sites -in order to activate receptors they must be free circulating molecules What is the half-life of a drug? - -how long it takes for a drug at its original amount to be reduced by 50% Why is it important to know the half-life of a drug? - -to help determine dosing intervals to maintain therapeutic levels What is the first-pass effect? - -alteration of the drug dose by metabolism before it reaches systemic circulation -only happens with PO medications What are the genetic variances of metabolism? - -poor metabolizers (certain enzymes are little to none) -intermediate metabolizers -extensive metabolizers (NORMAL) -ultra-rapid metabolizers (duplicate genes to make extra enzymes) What is the primary organ of excretion? - kidneys What are other methods of excretion? - -saliva -sweat -breastmilk -skin -lungs Why would the elderly have a smaller first-pass effect? Why is this important to know? - -decreased liver mass -decreased enzymes --this is important because with a smaller first pass effect higher drugs levels will reach circulation What does the rate of excretion depend primarily on? - -renal blood flow -glomerular filtration rate Can side effects be negative AND positive? - Yes What is an adverse effect? - -negative side effect -undesirable -unintended What are contraindications? - -do not give -the risks outweigh the benefits What are relative contraindications? - -the consideration that there are rare exceptions to the rule -the risk of NOT taking the medication potentially is greater than the risk of taking it What are precautions? - -"warnings" -clinically significant -providers must weight the risks vs benefits What is a black box warning? - -a potential adverse effect is serious enough that the risk must be thoughtfully considered OR -a potential adverse effect that can be reduced or eliminated by appropriate use OR -FDA has approved with restrictions to assure safe use If a drug has a high protein affinity--the protein binding sites must saturated in order for what to happen? - -free drug to be able to circulate and activate receptors When taking two different drugs that are both highly protein bound, how does stopping or starting a drug affect the levels of the other drug? - -if one drug is suddenly stopped it opens up protein binding sites for the other drug to bind to--reducing plasma drug levels -if a new drug is started--it will replace some of the protein binding sites--which then increases the plasma drug levels of the drug that was already present What sources should providers use when prescribing? - -whenever possible you must utilize the highest levels of evidence -OR trusted experts in the field (ACOG, CDC, American Cancer Society, etc.) What is an enzyme inhibitor? - -inhibits the enzyme action causing decreased metabolism -this can increase the drug levels -it can affect all drugs that utilize the same metabolic pathway What is an enzyme inducer? - -increases the enzymes that induces metabolism -this decreases drug levels -it can affect all drugs that utilize the same metabolic pathway What is an agonist? - -a drug that binds to AND activates a receptor What is a partial agonist? - A drug that binds to and activates a receptor but produces a smaller effect at full dosage than a full agonist What is an antagonist? - -A molecule that binds to a receptor but does NOT activate it--it blocks the activating drug from binding to the receptor When is a drug-drug interaction risk the greatest? - -when a patient is taking multiple medications (poly-pharmacy) What is the most common cause of ER visits from an adverse drug reaction? - -bleeding from anticoagulants Why must a person limit or discontinue use of grapefruit juice when taking certain drugs? - -it inhibits metabolism -this can increase drug levels--potentially to dangerous levels -one cup of juice can inhibit metabolism for up to 72 hours! Rule of safe prescribing? - AVOID M pneumonic--Ask and Consider