NURS 3210 Module 1 ALG

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Questions and Answers

What is the potential consequence of two highly protein-bound medications competing for binding sites on albumin molecules?

An increase in free or unbound drug, leading to unpredictable drug responses or drug-drug interactions.

Describe the role of blood flow in the distribution stage of pharmacokinetics and provide two examples of how it can affect drug distribution.

Blood flow plays a crucial role in the distribution stage of pharmacokinetics as it determines the rate at which a drug is delivered to different organs. Areas with high blood flow such as the liver, heart, and kidneys receive the drug quickly, whereas areas with low blood flow like skin and fat receive it slowly.

What is the primary focus of pharmacokinetics in the study of drug interactions?

The absorption, distribution, metabolism, and excretion of a drug in the body.

Explain how the presence of food in the gastrointestinal (GI) tract can influence the absorption of drugs and provide one example of a circumstance where this may occur.

The presence of food in the GI tract can slow down or accelerate the absorption of drugs, depending on the type of food and drug. For example, taking a drug with a fatty meal can enhance its absorption by increasing the solubility of the drug. Signup and view all the answers

How do receptors influence the therapeutic effects of drugs?

Receptors provide specific binding sites for drugs, and the drug's molecular structure determines its interaction with these sites. Signup and view all the answers

What is the term for the study of the biochemical and physiological interactions of drugs at their sites of activity?

Pharmacodynamics. Signup and view all the answers

Describe the role of enzymes in the metabolism stage of pharmacokinetics and explain how enzyme inducers and inhibitors can impact drug metabolism.

Enzymes play a crucial role in the metabolism stage of pharmacokinetics by breaking down the drug molecule. Enzyme inducers increase the activity of enzymes, leading to faster drug metabolism, while enzyme inhibitors decrease enzyme activity, resulting in slower drug metabolism. Signup and view all the answers

Explain how liver function can affect the excretion stage of pharmacokinetics and provide one example of a circumstance where this may occur.

Liver function plays a critical role in the excretion stage of pharmacokinetics as it is responsible for metabolizing and eliminating drugs. Impaired liver function can lead to decreased drug excretion, resulting in increased drug concentrations in the body. Signup and view all the answers

What is the term for the phenomenon where the presence of one drug affects the actions of another drug administered concurrently?

A drug-drug interaction. Signup and view all the answers

Compare and contrast the distribution of drugs to rapid and slow distribution areas in the body.

Drugs are distributed rapidly to areas with high blood flow such as the liver, heart, and kidneys, whereas distribution to areas with low blood flow like skin and fat is slower. This is due to the variation in blood flow rates and vascular permeability in different organs. Signup and view all the answers

What is a primary concern when administering medications to patients under 12 years old?

Avoiding toxicity by adjusting dosages based on weight rather than age. Signup and view all the answers

What is a significant issue in the elderly population when it comes to pharmacokinetics?

Polypharmacy, or the practice of prescribing multiple medications, leading to potential adverse effects. Signup and view all the answers

How does the GI tract emptying/motility affect drug absorption in pediatric patients?

Increased GI tract emptying/motility impacts the rate/extent of drug absorption. Signup and view all the answers

What is a reliable source for drug information?

Reliable nursing drug guides, pharmacists, or scholarly/peer-reviewed apps or websites. Signup and view all the answers

What is the primary pharmacokinetic issue in the very young?

Alterations in pharmacokinetic processes due to continuing development of body systems in the first decade of life. Signup and view all the answers

How does the slow acetylation of certain drugs affect their metabolism and what might be the consequence on drug dosage?

Slow acetylation results in elevated drug concentrations, which may warrant lower drug dosages to prevent adverse effects. Signup and view all the answers

What might be the pharmacogenetic profile of a patient who reports that Codeine, a prodrug, has never worked for them?

The patient may be a poor metabolizer, unable to convert the prodrug into its active form. Signup and view all the answers

How does the CYP450 enzyme system affect the ability to metabolize drugs and what is the impact on drug response?

The CYP450 enzyme system affects the ability to metabolize drugs, which can impact plasma drug levels and the intensity of drug response, leading to varying drug responses at different doses. Signup and view all the answers

What might be the consequence of being a rapid acetylator on drug metabolism and dosage?

Rapid acetylators may metabolize drugs more quickly, leading to subtherapeutic drug concentrations and potentially requiring higher drug dosages. Signup and view all the answers

How does the study of pharmacogenomics relate to the response of individuals to different drugs?

Pharmacogenomics is the study of genetics in drug response, which aims to understand how genetic variations affect an individual's response to different drugs. Signup and view all the answers

What is the primary pharmacokinetic process studied in relation to pharmacogenetics, and why is it significant in understanding individual variations in drug response?

Metabolism. It is significant because genetic factors can affect the metabolism of drugs, leading to variations in drug response and efficacy. Signup and view all the answers

How do genetic factors influence the response to antihypertensive drugs in different ethnic groups, and what implications does this have for clinical trials and drug development?

Genetic factors can affect the response to antihypertensive drugs, with some individuals, such as Black patients, responding differently to these drugs compared to White patients. This highlights the importance of including diverse ethnic groups in clinical trials to ensure that drugs are effective and safe for all populations. Signup and view all the answers

What is the significance of polymorphism in pharmacogenetics, and how does it impact drug development and response?

Polymorphism refers to the variation in response to a drug due to individual differences in age, sex, size, and/or body composition. This variation can impact drug development and response, as it may affect the efficacy and safety of drugs in different populations. Signup and view all the answers

How do slow acetylators, such as individuals of European and African descent, affect the development and response of drugs, particularly in clinical trials?

Slow acetylators may require different dosages or experience adverse reactions due to their genetic variation. This highlights the importance of including diverse populations in clinical trials to ensure that drugs are effective and safe for all individuals. Signup and view all the answers

What is the role of pharmacogenomics in understanding the relationship between genetic factors and drug response, and how does it impact clinical trials and drug development?

Pharmacogenomics is the study of genetics in drug response. It helps to identify genetic variations that affect drug response, ensuring that drugs are developed to be effective and safe for all populations. This understanding can impact clinical trials and drug development by identifying subgroups of patients who may require different dosages or experience adverse reactions. Signup and view all the answers

In pharmacokinetics, what is the significance of half-life, and how does it relate to the elimination of a drug from the body?

Half-life is the time required for half of an administered dose of a drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%. It is a measure of how quickly a drug is eliminated from the body. Signup and view all the answers

What is the steady state in pharmacokinetics, and how is it achieved?

The steady state is the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose. It is achieved through a regular dosing schedule, where the rate of drug administration equals the rate of drug elimination. Signup and view all the answers

How do hydrophilic and lipophilic medications differ in terms of their volume of distribution and blood concentrations?

Hydrophilic medications are highly water-soluble and have a smaller volume of distribution, resulting in high blood concentrations. Lipophilic medications, on the other hand, have a larger volume of distribution and lower blood concentrations. Signup and view all the answers

What is the difference in the expected time frame for Drug A, Drug B, and Drug C to clear from the body based on their half-lives?

Drug A with a half-life of 30 minutes would take approximately 2.50 hours to clear, Drug B with a half-life of 8 hours would take approximately 1.67 days to clear, and Drug C with a half-life of 3 days would take approximately 15 days to clear. Signup and view all the answers

How much of the original dose of acetaminophen 500mg po would you expect to be circulating 4 hours later, given its half-life of 2 hours?

125mg Signup and view all the answers

What is the main consequence of a drug-drug interaction that occurs in the absorption phase, and how can it affect the therapeutic response of a medication?

Decreased absorption of the medication, leading to decreased therapeutic response. Signup and view all the answers

How do competing protein-binding sites between two medications impact the actions of the medications, and what is the potential outcome?

Competing protein-binding sites increase the levels of free (unbound) medications, potentially leading to increased actions and adverse effects. Signup and view all the answers

What is the primary focus of pharmacokinetics in the study of drug interactions, and how does it relate to drug metabolism?

Pharmacokinetics focuses on the absorption, distribution, metabolism, and excretion of drugs, which can be affected by interactions with other drugs. Signup and view all the answers

What is the term for the phenomenon where the presence of one drug affects the actions of another drug administered concurrently, and what is the potential outcome?

Drug-drug interaction, potentially leading to adverse effects or decreased therapeutic response. Signup and view all the answers

How do antacids affect the absorption of levofloxacin, and what is the potential outcome?

Antacids bind to levofloxacin, preventing adequate absorption, leading to decreased therapeutic response. Signup and view all the answers

What is the result of competition for the same hepatic enzymes between erythromycin and cyclosporine, and what is the potential outcome?

Decreased metabolism of cyclosporine, potentially leading to toxic levels. Signup and view all the answers

How does the presence of probenecid affect the excretion of amoxicillin, and what is the potential outcome?

Probenecid inhibits the secretion of amoxicillin into the kidneys, leading to elevated and prolonged plasma levels. Signup and view all the answers

What are the six primary patient rights in the nursing process, and at what phase do they most often occur?

Right Drug, Right Dose, Right Time, Right Route, Right Patient, Right Documentation, Right Reason; they most often occur during the administration phase. Signup and view all the answers

What are the essential elements of a medication order, and how do they contribute to safe and effective medication administration?

Right Drug, Right Dose, Right Time, Right Route, Right Patient, Right Documentation, Right Reason; they ensure accurate and safe medication administration. Signup and view all the answers

What is the primary focus of the video 'Pharmacology and the Nursing Process', and how does it relate to medication administration?

The video focuses on the nursing process, specifically the administration phase, and its relation to medication administration. Signup and view all the answers

Study Notes

Pharmacokinetics and Pharmacodynamics

Pharmacokinetics: the study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body
Pharmacokinetics represents the drug absorption, distribution, metabolism, and excretion from the body
Pharmacodynamics: the study of the biochemical and physiologic interactions of drugs at their sites of activity
Pharmacodynamics examines the effect of the drug on the body

Pharmacodynamic Processes

The three primary pharmacodynamic processes by which drugs exert their therapeutic effect:
- Receptor Interactions: the joining of the drug molecule with a reactive site on the surface of a cell or tissue
- Enzyme Interactions: the inhibition or activation of enzymes by drugs
- Chemical Interactions: the interaction of drugs with other chemicals in the body

Pharmacokinetic Processes

The four primary pharmacokinetic processes:
- Absorption: the process by which medications enter the body and travel from the site of administration into the body's circulation
- Distribution: the process by which medication is spread throughout the body
- Metabolism: the process by which the body breaks down a drug molecule
- Excretion: the process by which the body eliminates waste

Factors Affecting Pharmacokinetics

Route of administration
Food in the GI tract
Motility of the GI tract
Blood flow to different organs
Type of medication
Enzyme inhibitors and inducers
Liver function
Kidney function
Genetic factors

Pharmacokinetics in Pediatric and Geriatric Patients

In pediatric patients (under 12):
- Dosage is often based on weight
- Increased GI tract emptying and motility may affect absorption
- Slower metabolism may affect drug concentrations
In geriatric patients:
- Polypharmacy (taking multiple medications) is common
- Decreased GI tract emptying and motility may affect absorption
- Slower metabolism may affect drug concentrations
- Decreased liver and kidney function may affect excretion

Pharmacogenetics

The study of genetics in drug response
Variations in response to drugs due to age, sex, size, and body composition
Metabolism is the most studied pharmacokinetic process in relation to pharmacogenetics
Polymorphism: variation in response to a drug due to genetic factors

Pharmacokinetic Parameters

Half-life: the time required for half of an administered dose of drug to be eliminated by the body
Steady state: the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose
Calculating expected time to clear a drug from the body: based on the drug's half-life
Calculating expected time to reach steady state: based on the drug's half-life

Hydrophilic and Lipophilic Medications

Hydrophilic: highly water-soluble, smaller volume of distribution, and high blood concentrations
Lipophilic: highly lipid-soluble, larger volume of distribution, and lower blood concentrations
Lipophilic medications are more likely to cause toxicity due to accumulation in tissues

Drug-Drug Interactions

Occur when the presence of one drug decreases or increases the actions of another drug
Can occur in any of the pharmacokinetic processes: absorption, distribution, metabolism, and excretion
Examples of drug-drug interactions:
- Antacids with levofloxacin: decreased absorption of levofloxacin
- Warfarin with amiodarone: increased levels of free warfarin and amiodarone
- Erythromycin with cyclosporine: decreased metabolism of cyclosporine
- Amoxicillin with probenecid: increased levels of amoxicillin

Patient Rights and Medication Orders

Six primary patient rights:
- Right Drug
- Right Dose
- Right Time
- Right Route
- Right Patient
- Right Documentation
- Right Reason
These rights occur during the administration phase of the nursing process
Six essential elements of a medication order:
- Patient's name
- Medication name
- Dosage
- Route
- Time
- Frequency

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Description

Understand the 4 pharmacokinetic processes and how situational factors can impact each process. Learn about absorption, distribution, metabolism, and excretion in pharmacokinetics.