NRS 321 Pathophysiology – Pharmacology I Class Notes
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Questions and Answers

What is the primary difference between pathologic atrophy and physiologic atrophy?

  • Physiologic atrophy is reversible, while pathologic atrophy is not.
  • Pathologic atrophy occurs due to aging, while physiologic atrophy is developmental.
  • There is no difference; both terms describe the same process.
  • Pathologic atrophy results from disuse or decreased blood supply, while physiologic atrophy is due to normal growth. (correct)

    • What characterizes hyperplasia in cellular adaptation?

  • It is a decrease in cell size.
  • It is the replacement of one mature cell type with another.
  • It refers to an increase in the number of cells. (correct)
  • It involves abnormal changes in size and shape of cells.

    • Which term defines the study of disease occurrences within human populations?

  • Clinical manifestation
  • Pathogenesis
  • Etiology
  • Epidemiology (correct)

    • In the context of cellular responses to disease, what is metaplasia?

    <p>Replacement of one mature cell type with another.</p> Signup and view all the answers

    What is a characteristic sign of dysplasia?

    <p>It includes abnormal changes in size, shape, and organization of cells.</p> Signup and view all the answers

    What is the primary focus of pharmacokinetics?

    <p>The movement of drugs through the body</p> Signup and view all the answers

    Which of the following is NOT a process involved in pharmacokinetics?

    <p>Biotransformation</p> Signup and view all the answers

    What effect does the blood-brain barrier have on drug distribution?

    <p>It limits the entry of certain medications into the brain.</p> Signup and view all the answers

    Which organ is primarily responsible for drug metabolism?

    <p>Liver</p> Signup and view all the answers

    What is meant by 'therapeutic range' in pharmacology?

    <p>The concentration of a drug that achieves a desired effect without toxicity</p> Signup and view all the answers

    In pharmacodynamics, what does the term 'agonist' refer to?

    <p>A substance that produces a biological response</p> Signup and view all the answers

    Which factor can influence drug metabolism?

    <p>Age of the patient</p> Signup and view all the answers

    What is the primary route of excretion for most medications?

    <p>Renal excretion through urine</p> Signup and view all the answers

    Which of the following statements correctly describes potential drug-food interactions?

    <p>Warfarin's action may be altered by foods high in vitamin K.</p> Signup and view all the answers

    What distinguishes an adverse drug reaction from a side effect?

    <p>Adverse drug reactions are unintended effects at normal drug doses.</p> Signup and view all the answers

    Which factors contribute to a patient's susceptibility to adverse drug reactions?

    <p>Comorbidities, genetics, age, and diet.</p> Signup and view all the answers

    What is the primary purpose of medication reconciliation?

    <p>To ensure accurate medication management during patient transitions.</p> Signup and view all the answers

    Which of the following best characterizes a medication error?

    <p>Errors can arise from communication issues among healthcare providers.</p> Signup and view all the answers

    What type of drug interaction typically involves changes in how a drug is absorbed, distributed, metabolized, or excreted?

    <p>Pharmacokinetic interactions</p> Signup and view all the answers

    How does aging affect the absorption of medications?

    <p>The rate of absorption may slow with age.</p> Signup and view all the answers

    Which mechanism is primarily responsible for altered drug metabolism?

    <p>Cytochrome P450 enzymes</p> Signup and view all the answers

    What is the primary consequence of increased drug interactions when a patient is on multiple medications?

    <p>Potentially increased or reduced therapy outcomes</p> Signup and view all the answers

    What is a key reason older adults may experience increased effects from lipid-soluble drugs?

    <p>Increased body fat percentage.</p> Signup and view all the answers

    Which drug is an example of an inducing agent that can increase the rate of metabolism?

    <p>Phenobarbital</p> Signup and view all the answers

    Why is creatinine clearance preferred over serum creatinine in assessing renal function in older adults?

    <p>Lean muscle mass, which affects serum creatinine, declines with kidney function.</p> Signup and view all the answers

    What effect can grapefruit juice have on medication efficacy?

    <p>Increases absorption of many medications</p> Signup and view all the answers

    What is the most common cause of adverse drug reactions in older adults?

    <p>Reduced renal excretion leading to drug accumulation.</p> Signup and view all the answers

    What is a common method to minimize adverse drug-drug interactions?

    <p>Take a thorough drug history</p> Signup and view all the answers

    What measures can be taken to reduce adverse drug reactions in older adults?

    <p>Obtain a thorough drug history.</p> Signup and view all the answers

    How frequently should the need for continued drug therapy be reviewed in older adults?

    <p>Periodically.</p> Signup and view all the answers

    Which of the following can lead to altered absorption of drugs?

    <p>Laxatives and high fiber foods</p> Signup and view all the answers

    What increases the risk for serious drug interactions?

    <p>The number of drugs a patient is taking</p> Signup and view all the answers

    What percentage of hospital admissions in older adults is accounted for by adverse drug reactions?

    <p>16%</p> Signup and view all the answers

    What is the impact of decreased protein binding in malnourished elderly patients?

    <p>Increased levels of free drugs.</p> Signup and view all the answers

    What is the term used to describe abnormal changes in the size, shape, and organization of cells?

    <p>Dysplasia</p> Signup and view all the answers

    Which of the following describes the replacement of one mature cell type with another mature cell type?

    <p>Metaplasia</p> Signup and view all the answers

    What physiological process leads to an increase in the size of a cell?

    <p>Hypertrophy</p> Signup and view all the answers

    Which type of cellular adaptation involves a decrease in cell size?

    <p>Atrophy</p> Signup and view all the answers

    What is the primary characteristic of hyperplasia?

    <p>Increase in cell number</p> Signup and view all the answers

    Physiologic atrophy can occur due to which of the following factors?

    <p>Aging</p> Signup and view all the answers

    What distinguishes pathologic hypertrophy from physiologic hypertrophy?

    <p>Pathologic hypertrophy results from a disease condition.</p> Signup and view all the answers

    Which adaptation is considered a non-adaptive cell response?

    <p>Metaplasia</p> Signup and view all the answers

    Study Notes

    Pathophysiology and Pharmacology Overview

    • Pathophysiology studies altered health physiology.
    • Key terms include health, disease, etiology (biologic, physical, chemical, genetic, nutritional), pathogenesis, and clinical manifestations (signs vs. symptoms).
    • Epidemiology examines disease occurrence in populations.

    Cellular Physiology and Function

    • Eight major cellular functions: movement, conductivity, metabolic absorption, secretion, excretion, respiration, reproduction, communication.
    • Cell responses to disease can be physiologic or pathogenic, leading to changes like atrophy, hypertrophy, hyperplasia, metaplasia, and dysplasia.

    Cellular Adaptation

    • Atrophy (decrease in cell size) can be physiologic (thymus gland) or pathologic (muscle disuse).
    • Hypertrophy (increase in cell size) occurs in uterine growth during pregnancy or heart hypertrophy due to hypertension.
    • Hyperplasia (increase in cell number) can be physiologic (post-trauma) or pathologic (endometrial hyperplasia).

    Sources of Medication Information

    • Reliable sources: reputable publications, newsletters, Medication Administration Records (MAR), online databases, and human expertise.

    Electronic Health Records (EHR)

    • EHRs provide digital charting, focus on evidence-based practice, offer real-time data, are patient-centered, and promote improved health outcomes.

    Pharmacokinetics

    • Involves drug absorption, distribution, metabolism, and excretion.
    • Absorption: various routes include enteral (GI tract) and parenteral (IV, IM, subcutaneous), each with specific advantages.
    • Distribution: depends on factors like blood flow, drug leaving the vascular system, and the ability to cross barriers (e.g., blood-brain barrier).
    • Metabolism: primarily occurs in the liver via the P450 system; age and other factors influence metabolism rates.
    • Excretion: primarily renal; also through other routes like breast milk, bile, and lungs.

    Pharmacodynamics

    • Focuses on the biochemical and physiological effects of drugs.
    • Key concepts include agonists, antagonists, and dose-response relationships.

    Drug Interactions

    • Drug-drug interactions can intensify or reduce therapeutic effects; often occur through pharmacokinetic or pharmacodynamic mechanisms.
    • Important interactions include those affecting drug absorption (e.g., tetracycline and dairy) and metabolism (notably grapefruit juice inhibiting CYP3A4 enzymes).

    Adverse Drug Reactions (ADRs) and Medication Errors

    • Side effects are common and usually mild; adverse effects are unintended consequences at normal doses.
    • Risks for ADRs increase with comorbidities, age, and polypharmacy.
    • Common adverse reactions may include dizziness and cognitive impairment in the elderly, who are seven times more likely to experience ADRs.

    Minimizing Adverse Drug Reactions

    • Conduct thorough drug histories, monitor clinical responses, simplify regimens, and review ongoing therapy for necessity.
    • Encourage proper medication disposal to prevent outdated or unnecessary drug use.
    • Absorption: Slowed rate due to delayed gastric emptying and reduced blood flow.
    • Distribution: Increased body fat may enhance effects of lipid-soluble drugs; decreased total body water can intensify drug concentration.
    • Metabolism: Hepatic metabolism declines with age, potentially enhancing responses to certain oral drugs.
    • Excretion: Renal function diminishes, leading to drug accumulation and increased risk of ADRs; creatinine clearance is preferred over serum creatinine for assessing renal function in older adults.

    Goals of Treatment

    • Focus on reducing symptoms and improving the quality of life for patients while managing pharmacokinetic and pharmacodynamic changes due to aging.

    Medication Reconciliation

    • Critical for comparing and ensuring proper medication transition between care settings, as required by the Joint Commission.

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    Description

    Explore the foundational concepts of pathophysiology and pharmacology as they relate to nursing practice in this NRS 321 course. Learn about cellular pathophysiology, pharmacokinetics, and the impact of various factors on health and disease. This course will also cover the essentials for understanding lifespan considerations in drug therapy.

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