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Questions and Answers

What is the primary site of drug metabolism in the body?

  • Lungs
  • Liver (correct)
  • Stomach
  • Kidneys

Which enzyme is primarily involved in hepatic metabolism?

  • Cytochrome P-450 (correct)
  • Lipase
  • Amylase
  • Lactase

What does the term 'half-life' refer to in pharmacology?

  • The time needed for a drug to be eliminated from the body completely
  • The time it takes for the body to metabolize a drug
  • The amount of time required for the drug concentration to decrease by half (correct)
  • The total duration a drug remains active in the body

How is pharmacokinetics primarily defined?

<p>What the body does to the drug (D)</p> Signup and view all the answers

What is the main organ responsible for the excretion of drugs?

<p>Kidneys (A)</p> Signup and view all the answers

What is the definition of the First-Pass Effect?

<p>The initial metabolism of a drug in the liver before it reaches systemic circulation (A)</p> Signup and view all the answers

Which route of administration is considered the fastest for drug absorption?

<p>Parenteral (C)</p> Signup and view all the answers

Intravenous (IV) administration bypasses which of the following?

<p>Hepatic metabolism (C)</p> Signup and view all the answers

What type of gloves must be worn when administering topical medications?

<p>STERILE gloves for open skin lesions (C)</p> Signup and view all the answers

What is the purpose of punctal occlusion during medication administration?

<p>To reduce systemic absorption of the drug (D)</p> Signup and view all the answers

What is an important consideration when applying drug drops into the conjunctival sac?

<p>Dropping prescribed number of drops into the conjunctival sac (C)</p> Signup and view all the answers

How should ocular ointments be administered?

<p>With long, smooth strokes towards the inner canthus (A)</p> Signup and view all the answers

What should be done to the patient's nasolacrimal duct after administering ocular medication?

<p>Gentle pressure should be applied for 30-60 seconds (C)</p> Signup and view all the answers

Why should residuals on the patient's skin be removed before applying topical medications?

<p>To ensure the skin is clean, dry, and irritation-free (C)</p> Signup and view all the answers

What defines supplemental therapy?

<p>Treatment that provides necessary substances the body lacks (A)</p> Signup and view all the answers

Which of the following is NOT one of the rights of medication administration?

<p>Right Insurance (B)</p> Signup and view all the answers

What is the primary action of the parasympathetic nervous system neurotransmitter?

<p>Promote digestion and decrease heart rate (C)</p> Signup and view all the answers

Which receptors are activated by acetylcholine to produce rest and digest effects?

<p>Muscarinic receptors (B)</p> Signup and view all the answers

What is a possible adverse effect of taking antipsychotic drugs?

<p>Weight gain (A)</p> Signup and view all the answers

What is the role of atropine sulfate?

<p>Act as an antidote for cholinergic toxicity (A)</p> Signup and view all the answers

Which receptor type is primarily associated with increasing heart rate?

<p>Beta 1 receptors (B)</p> Signup and view all the answers

Which condition is a contraindication for using antimuscarinic drugs like atropine sulfate?

<p>Angle-closure glaucoma (B)</p> Signup and view all the answers

What key syndrome might occur with the use of psychotic drugs?

<p>Serotonin Syndrome (A)</p> Signup and view all the answers

Which of the following is true regarding cholinergic drugs?

<p>They are linked to increased muscle contractions and autonomic activation (C)</p> Signup and view all the answers

Which of the following should be monitored due to its potential risks?

<p>Increased suicide ideations (C)</p> Signup and view all the answers

Which drug interaction should be considered when administering adrenergic agonists?

<p>Competition for albumin binding (A)</p> Signup and view all the answers

What effect is associated with stimulation of beta 2 receptors?

<p>Bronchodilation (D)</p> Signup and view all the answers

What is the primary purpose of medication reconciliation in a healthcare setting?

<p>To assess a patient's medication history (B)</p> Signup and view all the answers

What does positive dromotropy indicate regarding cardiac function?

<p>Increased AV conduction (A)</p> Signup and view all the answers

When should medication reconciliation occur during a patient's healthcare journey?

<p>At multiple points including entry and transfer (D)</p> Signup and view all the answers

What physiological effect may result from the activation of adrenergic agonists?

<p>Increased force of contraction (A)</p> Signup and view all the answers

What role does the liver play in medication metabolism?

<p>It metabolizes drugs through the first-pass effect (B)</p> Signup and view all the answers

What should be avoided during the use of CNS stimulants?

<p>Alcohol and beverages with caffeine (B)</p> Signup and view all the answers

What is the importance of using the SBAR format in communication?

<p>It provides structured clarity in communication among healthcare providers (D)</p> Signup and view all the answers

What is a recommendation for taking medication for maximal effect?

<p>Take medications on an empty stomach 30-45 minutes before eating (A)</p> Signup and view all the answers

What monitoring is important for patients following spinal anesthesia?

<p>Strict bed rest as ordered by the doctor (B)</p> Signup and view all the answers

What is one critical aspect of preparing a surgical site?

<p>Checking the patient’s positioning (A)</p> Signup and view all the answers

What is the primary use of an EpiPen?

<p>Responding to anaphylactic reactions (A)</p> Signup and view all the answers

Which adrenergic agonist is commonly used to reverse vasoconstriction caused by catecholamines?

<p>Phentolamine (A)</p> Signup and view all the answers

What is a common adverse effect of adrenergic antagonists?

<p>Abnormal ejaculation (A)</p> Signup and view all the answers

Which beta blocker is known for its dual action on both beta and alpha receptors?

<p>Carvedilol (C)</p> Signup and view all the answers

Which of the following medications is indicated to treat benign prostatic hyperplasia (BPH)?

<p>Tamsulosin (A)</p> Signup and view all the answers

What is the recommended way to administer adrenergic agonists to minimize cardiovascular complications?

<p>Use an infusion pump and infuse slowly (D)</p> Signup and view all the answers

What are sympatholytics known to inhibit?

<p>Effects of the sympathetic nervous system (C)</p> Signup and view all the answers

Concurrent use of which type of medication is contraindicated with adrenergic agonists like epinephrine?

<p>Erectile dysfunction medications (A)</p> Signup and view all the answers

Flashcards

Topical Medication Application

Applying medication directly onto the skin or mucous membranes.

Sterile Gloves

Gloves that are free of microorganisms used when applying drugs to open skin lesions.

Ophthalmic Eye Drops

Eye drops containing medication, applied into the conjunctival sac.

Punctal Occlusion

Blocking the tear ducts to prevent medication from entering the bloodstream.

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Ophthalmic Ointment

Ointment applied to the eye that comes packaged in a tube, applied gently to inner canthus to outer canthus.

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Clean, Dry Skin

Essential for effective topical medication absorption; irritation-free.

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Supplemental Therapy

Treatment providing necessary nutrients or substances when the body lacks them.

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Right Drug

Ensuring the correct medication is administered.

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Drug Metabolism

The process of chemically altering a drug in the body, often making it inactive or more soluble for excretion. The liver is the primary site for this process.

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Cytochrome P-450

A group of enzymes found in the liver that play a crucial role in drug metabolism. They help break down medications into inactive forms.

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P-Glycoprotein

A transport protein found in cell membranes that helps pump drugs out of the bloodstream and into other areas of the body. Can affect drug movement.

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Drug Excretion

The elimination of drugs from the body, primarily through the kidneys.

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Half-Life

The time it takes for the concentration of a drug in the bloodstream to reduce by half.

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Pharmacokinetics

The study of how the body absorbs, distributes, metabolizes, and excretes drugs.

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Pharmacodynamics

The study of how drugs interact with the body to produce a therapeutic effect.

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Parenteral Administration

The delivery of medication directly into the bloodstream, bypassing the first-pass effect. Examples include IV, IM, SubQ, and others.

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MAOI

Monoamine oxidase inhibitor, a type of medication that can interact dangerously with antipsychotic drugs.

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Bupropion (BuSpar)

An antidepressant that can interact with antipsychotic medications, causing potential adverse effects.

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Serotonin Syndrome

A potentially life-threatening condition caused by elevated serotonin levels, often triggered by combined use of certain drugs.

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Beta 1 Receptors

These receptors are mainly found in the heart and regulate heart rate, contractility, and renin release.

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Beta 2 Receptors

These receptors are found in various locations including the lungs and blood vessels, leading to relaxation of smooth muscles and dilation.

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Positive Inotropy

Increase in the force of heart muscle contraction.

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Positive Chronotropy

Increase in heart rate.

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Positive Dromotropy

Increase in the speed of electrical conduction through the heart.

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Medication Reconciliation

The process of reviewing a patient's medication history at key points in their care, including admission, transfer, and discharge. It ensures accurate and complete medication information is available for safe and effective care.

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What are the key areas of focus for medication reconciliation?

  1. Admission: Review past medications and identify any discrepancies. 2. Transfer: Ensure smooth medication transitions between different care settings. 3. Discharge: Provide clear instructions for home medications to avoid errors.
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What is the Liver's role in medication?

The liver is responsible for metabolizing (breaking down) drugs, a process known as the 'first-pass effect'. It converts the medication into forms that the body can use or eliminate.

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Why is communication clarity vital with medications?

Clear and accurate communication between healthcare providers is essential for safe and effective medication management. This helps prevent errors and ensures patients receive the right medications.

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What is SBAR?

A structured communication tool that helps standardize communication between healthcare providers. It stands for: Situation, Background, Assessment, and Recommendation.

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How does Spinal Anesthesia impact a patient?

Spinal anesthesia delivers medication to the spinal fluid, providing pain relief in the lower body. It requires strict bed rest for a specific duration, as determined by the physician.

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What are the key considerations for CNS Stimulants?

These medications can have various interactions and precautions. Patients should avoid alcohol, caffeine, and sudden withdrawal. It's crucial to monitor for potential side effects.

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How do anorexiant drugs affect a patient?

Anorexiant drugs suppress appetite. They are often taken on an empty stomach 30-45 minutes before meals to maximize their effect. A gradual weaning process is recommended under supervision during drug discontinuation.

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What are sympatholytics?

Drugs that block the effects of the sympathetic nervous system. They reduce the activity of the 'fight or flight' response.

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What are other names for sympatholytics?

They are also known as adrenergic antagonists, alpha/beta blockers, and alpha-beta blockers.

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What are some examples of catecholamines affected by adrenergic blockers?

Epinephrine, norepinephrine (NE), and dopamine are catecholamines whose actions are blocked by these drugs.

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What is phentolamine used for?

It is used to reverse vasoconstriction (narrowing of blood vessels) caused by other drugs like epinephrine, norepinephrine, and dopamine.

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What is the most common use of phentolamine?

It is primarily used to treat extravasation, which is when a drug leaks out of a vein.

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What is tamsulosin used for?

It is used to treat benign prostatic hyperplasia (BPH), a condition where the prostate gland enlarges.

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What are some adverse effects of tamsulosin?

Common side effects include headache, abnormal ejaculation, and rhinitis (runny nose).

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What is carvedilol used for?

It is used to treat heart failure, hypertension, and angina (chest pain). It helps slow the progression of heart failure.

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What is acetylcholine's (ACh) role in the PSNS?

ACh is the primary neurotransmitter of the parasympathetic nervous system (PSNS), causing effects like slowing heart rate, increasing digestive activity, and constricting pupils.

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What are muscarinic receptors?

Muscarinic receptors are found on target organs of the PSNS, such as the heart, smooth muscles, and glands. They are activated by ACh and mediate the 'rest and digest' effects of the PSNS.

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What are nicotinic receptors?

Nicotinic receptors are located on skeletal muscle cells and autonomic ganglia. They also bind ACh, leading to muscle contraction and activation of the autonomic nervous system.

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What is the mechanism of action of atropine sulfate?

Atropine sulfate is an antimuscarinic drug that blocks muscarinic acetylcholine receptors, preventing ACh from activating these receptors and causing its effects.

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What are the indications for using atropine sulfate?

Atropine sulfate is used as an antidote for anticholinesterase inhibitor toxicity and cholinergic crisis, and also preoperatively to reduce salivation and gastric secretions to decrease aspiration risks.

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Study Notes

Pharmacology Final Exam Study Guide

  • Otic Medications (Children & Adults):

    • Position patient in a side-lying position with affected ear facing up.
    • Older than 3 years: pull the pinna up and back.
    • Younger than 3 years: pull the pinna down and back.
    • Hold dropper 1 cm above ear canal.
    • Direct drops along the sides of ear canal.
    • Instruct patient to lie on affected side for 5-10 minutes.
    • May insert cotton loosely to prevent leakage.
    • If present, carefully remove cerumen or drainage without pushing it back into the ear canal.

  • Rectal Suppositories:

    • Contraindicated in pts with active rectal bleeding, diarrhea, low platelets, or untreated cardiac arrhythmias.
    • Position patient in Left Lateral Sims Position.
    • Use water-based lubricant.
    • Insert suppository at least 4 inches beyond internal sphincter.
    • Patient to remain on the left side for 15-20 minutes.

  • Vaginal Suppositories:

    • Patient to empty bladder before administration.
    • Absorption may take 4-12 hours.
    • Use water-based lubricant.
    • Position patient in Lithotomy position.
    • Remain in supine position for 5-10 minutes to allow absorption.

  • Transdermal Patches (RN Considerations):

    • Remove old patch and discard.
    • Cleanse skin area of old patch.
    • Observe for skin irritations.
    • Rotate patch application sites for new patches.
    • Apply new patch to a hairless, scratch-free area.
    • Avoid cutting patches; this releases all medication at once.
    • Ensure patch edges adhere flat to the skin.
    • Document the new patch location.

  • Nasal Medications:

    • Explain that temporary burning/stinging may occur.
    • Evaluate patient's history of nasal surgeries/trauma.
    • Have patient blow nose to clear passages (unless contraindicated, e.g., increased ICP or recent nasal surgery).
    • Nasal Drops: Hold dropper ½ inch above desired nostril. Instill drops per order. Maintain supine position for 5 minutes at minimum. Infants (nose breathers) should receive nasal drops 20-30 minutes before feeding.
    • Nasal Spray: Patient sitting upright. Occlude one nostril with gloved finger. Point tip toward side of nose, not center. Squeezes spray as pt inhales.

  • Ophthalmic Medications:

    • Pull lower eyelid down with one hand.
    • Hold eye drops 1-2 cm above conjunctival sac.
    • Do not touch dropper tip to eye or with fingers.
    • Apply prescribed drops to the conjunctival sac.
    • Punctial occlusion (for glaucoma patients): Occlude lacrimal punctum using finger.
    • Ointment administration: Similar to drops, but gently squeeze medication from inner to outer canthus.

  • General Medication Administration (Important Considerations):

    • Wear gloves for all medication applications, especially if applying to open skin lesions.
    • Ensure medication is applied to clean, dry, irritation-free skin.
    • Allow time for medication absorption according to the specifics of the medication.
    • Apply medications appropriately following the direction of hair growth, especially for elderly patients.

Other Topics

  • Medication Errors: Report all medication errors and near misses, do not attempt to fix them.
  • Medication Rights: Understand the 10 Rights of Medication Administration( Right patient, drug, dose, route, time, documentation, indication, response, to refuse and education)
  • First-Pass Effect: Drug-metabolization at a specific location that reduces active drug concentration before reaching site of action.
  • Pharmacodynamics: The effect a drug has on the body.
  • Pharmacokinetics: What the body does to a drug.
  • Half-life: Defined as the time taken for a substance to reduce to half of its initial concentration.
  • Empiric Therapy: Treatment given before definite diagnosis based on experience.
  • Prophylactic Therapy: preventing a disease or condition.
  • Supplemental Therapy: Providing substances lacking in the body.
  • Parenteral Administration: Includes injections like IV, IM, subcutaneous (subQ), and intrathecal (intra-arterial/intra-articular).

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