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Questions and Answers
What effect does pilocarpine primarily have on the body?
Which of the following is a primary clinical manifestation of muscarinic stimulation?
What is the primary concern with atropine overdose?
Which neurotransmitter is primarily involved in parasympathetic nervous system activity?
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What effect does oxybutynin have on the bladder?
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What is the first step that should be taken if a nurse is uncertain about a drug calculation?
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Which of the following is NOT one of the 10 rights in drug administration?
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For patients who have difficulty swallowing, what is the recommended method for taking enteric coated tablets?
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When administering otic medications to an adult, which position should the nurse instruct the patient to be in?
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What should a nurse monitor when a patient is prescribed a new medication?
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What is the primary advantage of parenteral medication compared to oral medication?
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Which of the following is NOT a part of the correct identification of a patient before administering medication?
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What is the purpose of rechecking medication preparation with another nurse?
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What does drug affinity refer to?
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Which of the following statements is true regarding drug potency?
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What is the significance of the therapeutic index (TI) in pharmacodynamics?
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An agonist in pharmacodynamics is defined as a drug that:
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Which term describes the time from drug administration to the first observable effect?
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Maximal efficacy of a drug occurs when:
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The potency of Drug A compared to Drug B indicates that:
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If a drug has a small therapeutic index, what does that imply?
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Which of the following occurs at peak time?
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What represents the duration of action of a drug?
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What physiological responses are stimulated by the sympathetic nervous system under stress?
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Which receptor is primarily responsible for vasoconstriction among the alpha receptors?
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What is the main action of beta 2 receptor agonists?
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Which medication is an example of a selective Alpha 1 antagonist?
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What class of medications should not be given to patients with asthma due to the risk of bronchoconstriction?
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Which neurotransmitter is primarily associated with the fight or flight response?
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What effect do alpha 2 receptor agonists have on blood pressure?
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Which drug should be held if a patient presents with dysrhythmias?
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The action of phenylephrine primarily involves which physiological effect?
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How do non-selective alpha antagonists affect blood pressure?
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What is the main difference between primary and secondary drug responses?
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Which type of drug interaction results in a combined effect greater than the sum of their individual effects?
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What calculation method would be used to determine the child's dose if the child weighs 7 kg and the adult dose is 80 mg?
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In Fried’s Rule, the formula for calculating a child's dose involves which age measurement?
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Which of the following statements correctly defines drug toxicity?
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What is the result of an idiosyncratic reaction to a drug?
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What peak response time occurs for a drug administered at 8:00 AM?
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If a child weighs 26 pounds, what would be the appropriate dosage of Amoxicillin if the average adult dose is 500 mg every 8 hours according to Young's Rule?
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What happens when two drugs produce an antagonistic effect?
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Study Notes
Drug Administration Principles
- Repeated drug administration may lead to decreased effectiveness; higher doses are often required.
- Nurses should double-check calculations if uncertain and avoid allowing others to administer prepared medications.
- Medication labels must be checked thoroughly against written orders and patient records.
- Patient identification is crucial; confirm with ID band and patient information.
- Follow the "10 Rights" for medication administration: Right Medication, Dose, Time, Route, Client, Education, Documentation, Right to Refuse, Assessment, and Evaluation.
Safe Drug Administration Practices
- Oral Medications: Most convenient but not suitable for vomiting patients.
- Avoid crushing enteric-coated or sustained-release medications; advise using water for swallowing.
- Parenteral Medications: Provide a quicker response than oral routes.
Patient Education on New Medications
- Include information on desired effects, dietary considerations, storage, and administration instructions.
Otic Medications
- Instillation techniques differ: for children, pull the ear backwards and downwards; for adults, backwards and upwards.
Pharmacokinetics Overview
- Pharmaceutic Phase: The initial phase focusing on oral drug preparation and dissolution.
Pharmacodynamics Overview
- Drug Affinity: The strength of a drug’s binding to its receptor.
- Drug Efficacy: The drug’s ability to activate the receptor upon binding.
- Agonists vs. Antagonists: Agonists facilitate activation; antagonists inhibit it.
- Maximal Efficacy: The point where increased dosage yields no further therapeutic response.
- Maximum Effective Concentration: The plasma concentration above which toxicity occurs.
- Potency: The dosage amount needed for a specific effect; higher potency requires a lower dose.
Therapeutic Index and Drug Actions
- The therapeutic index (TI) = TD50 (toxic dose) / ED50 (therapeutic dose).
- A larger TI indicates a safer drug; a smaller TI requires close monitoring due to the proximity of toxic effects.
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Parameters of Drug Action:
- Onset: Time until the first effect is observed.
- Peak: Time of highest concentration and effectiveness of the drug.
- Duration of Action: Time the drug remains effective.
Drug Response Types
- Primary Effects: Desired/physiological effects (e.g., antihistamines for allergies).
- Secondary Effects: Can be desirable or undesirable (e.g., drowsiness from antihistamines).
Drug-Drug Interactions
- Additive Effect: Combined effect equals the sum of individual effects.
- Synergistic Effect: Combined effect is greater than the sum of individual effects.
- Potentiation: One drug enhances the effect of another.
- Antagonistic Effect: Combined effect is less than the sum of individual medications.
Idiosyncratic Reactions and Drug Toxicity
- Idiosyncratic reactions occur due to genetic differences in drug metabolism.
- Drug toxicity: Evaluates the poison potential of a drug, focusing on overdose or excessive accumulation.
Pediatric Dosage Calculations
- Clark’s Rule: Child’s dose = (Adult dose x weight in pounds) / 150.
- Young's Rule: Child’s dose = (Adult dose x age in years) / (age + 12).
- Fried’s Rule: Child’s dose = (Adult dose x age in months) / 150.
Autonomic Nervous System Agents
- Divisions: Central Nervous System and Peripheral Nervous System, which includes Somatic and Autonomic Systems.
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Sympathetic Nervous System: Triggers "fight or flight" response; neurotransmitters: epinephrine/adrenaline.
- Increases heart rate, blood pressure; dilates pupils.
- Agonists for alpha and beta receptors activate responses.
Sympathetic Receptor Actions
- Alpha 1: Vasoconstriction, increased heart rate and blood pressure.
- Alpha 2: Vasodilation, decreased blood pressure.
- Beta 1: Increased heart contractility; monitor for dysrhythmia.
- Beta 2: Bronchodilation; example includes Albuterol.
Parasympathetic Nervous System Actions
- Effects: Decreased heart rate/blood pressure; increases GI activity and promotes urination.
- Acetylcholine is the key neurotransmitter; receptors include Nicotinic and Muscarinic.
- Muscarinic agonists stimulate secretions; Nicotinic receptors target skeletal muscles.
Drug Management
- Look out for excessive perspiration as a sign of extreme muscarinic stimulation.
- Antimuscarinic Agents: Used for urinary incontinence; examples include Oxybutynin and Atropine.
- Neuromuscular blockers enable muscle relaxation; observe for side effects like bradycardia and hypotension.
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Description
This quiz covers essential principles and safe practices for medication administration. It includes the importance of patient identification, the '10 Rights' of medication administration, and guidelines for oral and parenteral medications. Test your knowledge on proper drug handling and patient education for new medications.
