Pharmacokinetics Quiz
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Questions and Answers

A client taking a Monoamine Oxidase Inhibitor (MAOI) should be educated to avoid which of the following foods to prevent a hypertensive crisis?

  • Steamed vegetables
  • Freshly baked bread
  • Aged cheddar cheese (correct)
  • Grilled chicken
  • Which of the following assessment findings would indicate lithium toxicity in a client prescribed lithium for bipolar disorder?

  • Increased thirst and frequent urination
  • Fine hand tremors and mild nausea
  • Dry mouth and constipation
  • Ataxia, coarse tremors, and confusion (correct)
  • A client is prescribed lamotrigine. What serious adverse effect should the nurse immediately educate the client about?

  • Persistent cough
  • Metallic taste in the mouth
  • Increased appetite
  • Development of a rash (correct)
  • When initiating a client on clozapine therapy, which laboratory value is most important for the nurse to monitor regularly?

    <p>Complete blood count (CBC) (D)</p> Signup and view all the answers

    A client is prescribed buspirone for anxiety. Which of the following instructions should the nurse include in the client's education?

    <p>&quot;It may take 2–4 weeks to experience the full therapeutic effect of this medication.&quot; (A)</p> Signup and view all the answers

    Which route of administration bypasses the first-pass effect?

    <p>Buccal (B), Sublingual (C)</p> Signup and view all the answers

    A drug with a high therapeutic index indicates what?

    <p>Is relatively safe. (A)</p> Signup and view all the answers

    What physiological change would most significantly affect drug distribution?

    <p>Decreased plasma protein levels (B)</p> Signup and view all the answers

    Which of the following would indicate impaired drug excretion?

    <p>Elevated BUN and creatinine (D)</p> Signup and view all the answers

    What is most likely to occur in an elderly patient with reduced kidney function?

    <p>Prolonged drug half-life (B)</p> Signup and view all the answers

    What is the primary difference between an agonist and an antagonist?

    <p>Agonists activate receptors, while antagonists block them. (C)</p> Signup and view all the answers

    A medication order written as 'Morphine 2mg IV q4h PRN pain' is what type of order?

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

    Which of the following is the most reliable method to verify the right client before administering medication?

    <p>Verifying the client's name and date of birth on their wristband. (B)</p> Signup and view all the answers

    Which medication carries the highest risk of bacterial infection during administration?

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

    A patient receiving ketamine reports experiencing vivid hallucinations post-procedure. Which nursing intervention is most appropriate?

    <p>Reassure the patient that these effects are temporary and monitor vital signs. (B)</p> Signup and view all the answers

    Why should Selective Serotonin Reuptake Inhibitors (SSRIs) not be stopped abruptly?

    <p>To prevent withdrawal symptoms. (C)</p> Signup and view all the answers

    A patient taking sertraline reports experiencing persistent nausea and diarrhea since starting the medication. What is the most appropriate initial nursing intervention?

    <p>Inform the patient that these side effects typically subside within a few weeks. (A)</p> Signup and view all the answers

    What potentially life-threatening adverse effect should the nurse closely monitor for in a patient taking an SSRI?

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

    A client is prescribed fluoxetine for depression. What critical information should the nurse include in the patient education?

    <p>The medication may increase suicidal thoughts, especially in young adults. (B)</p> Signup and view all the answers

    A patient is prescribed lorazepam as an IV non-opioid anesthetic. What vitals are most important for the nurse to continually monitor during the procedure?

    <p>Respiratory rate and blood pressure (B)</p> Signup and view all the answers

    Which combination of medications requires careful monitoring due to the increased risk of serotonin syndrome?

    <p>Paroxetine and St. John's Wort (C)</p> Signup and view all the answers

    Following an uneventful surgery, a patient who received midazolam intravenously is now awake but confused and disoriented. Which action should the nurse take FIRST?

    <p>Assess the patient's oxygen saturation and respiratory effort. (B)</p> Signup and view all the answers

    Which of the uses listed is NOT an indicated use for SSRIs?

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

    When is medication reconciliation performed to ensure patient safety?

    <p>At admission, transfer, and discharge. (B)</p> Signup and view all the answers

    Which of the following incidents requires immediate documentation after medication administration?

    <p>Immediately after administration. (D)</p> Signup and view all the answers

    A patient refuses to take their scheduled medication after the nurse provides education about its purpose and effects. What is the priority action for the nurse?

    <p>Document the refusal and inform the healthcare provider. (D)</p> Signup and view all the answers

    What is the appropriate time frame to administer a scheduled medication to adhere to the principle of 'right time'?

    <p>Within 30 minutes of the scheduled time. (D)</p> Signup and view all the answers

    A nurse notes swelling, pallor, and coolness at the IV insertion site. Which IV complication is most likely occurring?

    <p>Infiltration. (B)</p> Signup and view all the answers

    What is the primary mechanism of action for benzodiazepines in treating anxiety disorders?

    <p>Enhancing GABA inhibitory effects in the CNS. (C)</p> Signup and view all the answers

    Which of the following medications is classified as a nonbenzodiazepine sedative-hypnotic?

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

    Which of the following intravenous administration methods involves the rapid injection of a medication?

    <p>IV bolus. (D)</p> Signup and view all the answers

    Which of the following medications requires extra caution and a triple-check of the label before administration?

    <p>High-alert medications. (C)</p> Signup and view all the answers

    Which of the following assessment findings indicates phlebitis at an intravenous (IV) site?

    <p>Redness and warmth. (B)</p> Signup and view all the answers

    What is a common use for Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)?

    <p>Diabetic Neuropathy Pain (D)</p> Signup and view all the answers

    Which side effect is more commonly associated with SNRIs than with SSRIs?

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

    What symptom is NOT part of the 'Tri-Cs' mnemonic for Tricyclic Antidepressants (TCAs)?

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

    What is the recommended action when discontinuing Tricyclic Antidepressants?

    <p>Gradually taper off (A)</p> Signup and view all the answers

    Which medication is a commonly prescribed Serotonin-Norepinephrine Reuptake Inhibitor?

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

    What serious risk is associated with SNRIs when combined with certain medications?

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

    What is a potential effect of Tricyclic Antidepressants on the heart?

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

    Which of the following is NOT a side effect of Tricyclic Antidepressants?

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

    Which statement about the onset of action for Tricyclic Antidepressants is true?

    <p>They require 2-3 weeks for full effect (A)</p> Signup and view all the answers

    What is an important nursing consideration when administering SNRIs?

    <p>Monitor for hypertension (C)</p> Signup and view all the answers

    Which of the following interventions is MOST critical when a patient on tranylcypromine (Parnate) reports experiencing a severe headache?

    <p>Immediately obtaining the patient’s blood pressure and assessing for hypertensive crisis. (A)</p> Signup and view all the answers

    A patient taking lithium presents with new-onset hand tremors, nausea, and mild confusion. Their current lithium level is 1.4 mEq/L. Which of the following factors would MOST likely contribute to these findings?

    <p>Dehydration from inadequate fluid intake and warm weather exposure. (A)</p> Signup and view all the answers

    A patient stabilized on valproate (Depakote) for bipolar disorder is planning to start a family. What is the MOST critical counseling point to emphasize?

    <p>Valproate is associated with a high risk of neural tube defects and should be avoided during pregnancy. (B)</p> Signup and view all the answers

    A patient is being transitioned from fluoxetine to phenelzine for treatment-resistant depression. Following the recommended washout period, which assessment finding necessitates IMMEDIATE intervention?

    <p>Muscle rigidity and elevated temperature. (C)</p> Signup and view all the answers

    A client on clozapine complains of a sore throat and presents with a fever of 101.5°F (38.6°C). The nurse's immediate action should be to?

    <p>Obtain a complete blood count (CBC) to assess absolute neutrophil count (ANC). (B)</p> Signup and view all the answers

    Which of the following non-opioid anesthetics carries the highest risk of bacterial infection?

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

    A patient is prescribed escitalopram. The nurse recognizes that this medication works by:

    <p>Inhibiting serotonin reuptake, increasing serotonin levels in the brain. (D)</p> Signup and view all the answers

    A patient taking fluoxetine reports experiencing hyperthermia, muscle rigidity, and tachycardia. The nurse should suspect:

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

    Which instruction is most important for a nurse to provide to a patient who is starting sertraline for depression?

    <p>The full effect of the medication may take 4-6 weeks to be realized. (C)</p> Signup and view all the answers

    Which of the following combinations is most likely to increase the risk of serotonin syndrome?

    <p>Citalopram and St. John's Wort (C)</p> Signup and view all the answers

    A young adult patient is prescribed fluvoxamine for OCD. What is the most important consideration for the nurse regarding a black box warning for this medication?

    <p>Increased risk of suicidal thoughts and behaviors (B)</p> Signup and view all the answers

    Besides depression, which of the following conditions is an appropriate use for paroxetine?

    <p>Generalized Anxiety Disorder (B)</p> Signup and view all the answers

    Which of the following may occur if a patient abruptly stops taking citalopram?

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

    A patient receiving ketamine as a non-opioid anesthetic is undergoing a procedure. Which potential side effect requires the closest monitoring during recovery?

    <p>Hallucinations and mental confusion (D)</p> Signup and view all the answers

    The healthcare provider prescribed an SSRI to a patient with Bulimia Nervosa. Which medication is indicated for this patient?

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

    Which factor would most significantly impede drug distribution to a specific tissue?

    <p>Compromised blood flow and perfusion to the tissue. (B)</p> Signup and view all the answers

    In a patient with hepatic impairment, which pharmacokinetic process is most likely to be affected, potentially leading to altered drug responses?

    <p>Metabolism of drugs, particularly those subject to the first-pass effect. (D)</p> Signup and view all the answers

    A drug with a narrow therapeutic index requires careful monitoring because:

    <p>Small increases in dose can lead to toxic effects. (D)</p> Signup and view all the answers

    A medication order reads: 'Administer 50 mg of Drug X intravenously immediately.' This type of order is best described as:

    <p>STAT order. (C)</p> Signup and view all the answers

    Which of the following routes of administration would be most suitable for a medication that is significantly affected by the first-pass effect?

    <p>Intravenous (IV). (A)</p> Signup and view all the answers

    How does compromised kidney function alter drug excretion?

    <p>It reduces the elimination of drugs, potentially causing accumulation and toxicity. (D)</p> Signup and view all the answers

    Which method of drug administration is characterized by having the most variable absorption rate due to factors such as gastric pH, food presence, and motility?

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

    What is the primary role of plasma proteins, such as albumin, in drug distribution throughout the body?

    <p>To bind to drugs and form a complex that is too large to cross cell membranes, limiting distribution. (D)</p> Signup and view all the answers

    Which of the following best explains why blood pressure should be monitored in patients taking Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)?

    <p>SNRIs can increase norepinephrine levels, potentially leading to hypertension. (C)</p> Signup and view all the answers

    A patient taking a Tricyclic Antidepressant (TCA) is also prescribed an SSRI by a covering physician without realizing the patient is on a TCA. Which potential consequence is of greatest concern?

    <p>Increased risk of serotonin syndrome due to combined serotonergic activity. (D)</p> Signup and view all the answers

    Which of the following instructions should be prioritized when educating a patient who is starting on amitriptyline?

    <p>Avoid driving or operating heavy machinery until you know how the medication affects you. (C)</p> Signup and view all the answers

    Why are patients advised to gradually taper off SNRIs instead of abruptly stopping the medication?

    <p>Abrupt cessation can cause a withdrawal syndrome, including flu-like symptoms, anxiety, and insomnia. (A)</p> Signup and view all the answers

    A 68-year-old patient with a history of benign prostatic hyperplasia (BPH) is prescribed a tricyclic antidepressant (TCA). Which side effect should the nurse monitor for most closely?

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

    A patient taking venlafaxine reports experiencing increased sweating and dizziness since starting the medication. What is the most appropriate initial nursing action?

    <p>Assess the patient's blood pressure and hydration status. (D)</p> Signup and view all the answers

    A patient who has been taking imipramine for depression tells the nurse, “I accidentally took two doses this morning. I feel fine, but should I be concerned?” What is the nurse's best response?

    <p>“You should immediately go to the nearest emergency room due to the risk of cardiotoxicity and overdose.” (D)</p> Signup and view all the answers

    A patient is prescribed desvenlafaxine for major depressive disorder. Which of the following pre-existing conditions would warrant extra caution when initiating this medication?

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

    A nurse is caring for a patient who is taking clomipramine for obsessive-compulsive disorder. The patient reports experiencing frequent constipation. Which nursing intervention is most appropriate to recommend?

    <p>Increase fluid and fiber intake. (C)</p> Signup and view all the answers

    A patient is taking duloxetine and reports experiencing sexual dysfunction. Which of the following actions should the nurse take first?

    <p>Assess the patient's overall medication regimen and discuss the concern with the healthcare provider. (C)</p> Signup and view all the answers

    A patient receiving IV fluids exhibits edema, crackles in the lungs, and elevated blood pressure. Which complication is most likely indicated by these findings?

    <p>Fluid overload (B)</p> Signup and view all the answers

    When administering medications via IV bolus, what critical action is most important for the nurse to perform to ensure patient safety?

    <p>Ensure the IV site is patent and free of infiltration <em>before</em> administration (C)</p> Signup and view all the answers

    A patient is prescribed both buspirone and bupropion. What action should the nurse take to ensure patient safety?

    <p>Educate the patient about potential interactions and monitor for adverse effects. (A)</p> Signup and view all the answers

    A nurse is preparing to administer clonazepam to a patient but accidentally selects clonidine from the medication drawer. After realizing the error prior to administering the medication, what is the nurse's most appropriate action?

    <p>Immediately report the error to the prescribing provider and the nursing supervisor. (A)</p> Signup and view all the answers

    A patient is receiving lorazepam for anxiety. Which assessment finding would warrant immediate intervention by the nurse?

    <p>Respiratory rate of 8 breaths per minute and decreased level of consciousness (D)</p> Signup and view all the answers

    A patient is newly prescribed paroxetine for generalized anxiety disorder. What education should the nurse include regarding the expected time frame for therapeutic effects?

    <p>It may take 2-4 weeks to experience the full therapeutic effects of the medication. (B)</p> Signup and view all the answers

    A patient who is prescribed warfarin is also prescribed an IV medication. Which of the following 'rights' of medication administration is most critical to verify in this scenario?

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

    A patient is prescribed alprazolam for panic disorder. What instruction should the nurse prioritize when educating the patient about this medication?

    <p>Avoid driving or operating machinery due to the risk of sedation. (C)</p> Signup and view all the answers

    The nurse is preparing to administer medications to a patient. Which action exemplifies the 'right documentation' of medication administration?

    <p>Recording the medication name, dose, route, and time of administration immediately <em>after</em> administration. (B)</p> Signup and view all the answers

    A patient with a history of alcohol abuse is admitted and prescribed chlordiazepoxide. What is the primary purpose of this medication in this context?

    <p>To prevent seizures and manage alcohol withdrawal symptoms. (D)</p> Signup and view all the answers

    Flashcards

    Absorption

    Movement of drugs from the site of administration into the bloodstream.

    Intravenous (IV) Absorption

    Route with no barriers and immediate effect.

    Distribution

    Transport of drugs to target tissues via the bloodstream.

    Metabolism

    Drug breakdown, primarily occurring in the liver.

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    Excretion

    Elimination of drugs, mainly via kidneys in urine.

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    Therapeutic Index (TI)

    Measure of drug safety; high TI is safe while low TI is risky.

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    Agonists

    Substances that activate receptors, mimicking natural substances.

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    The 'Rights' of Medication Administration

    Guidelines including verifying the right client.

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    Right Medication

    Verify the medication label before administration.

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    Right Dose

    Use the correct measuring devices for dosage.

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    Right Time

    Administer medication within 30 minutes of scheduled time.

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    Right Route

    Confirm the prescribed method of medication delivery.

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    High-Alert Medications

    Medications like insulin, opioids, and warfarin require extra caution.

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    Confused Medications

    Look-alike/sound-alike medications can cause mix-ups.

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    Medication Reconciliation

    Compare current medications with new prescriptions.

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    Sedative Hypnotic Anxiolytics

    Benzodiazepines that enhance GABA effects for anxiety.

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    SSRIs for Anxiety Disorders

    Selective serotonin reuptake inhibitors used for anxiety treatments.

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    IV Medication Administration

    Methods of delivering medications directly into the bloodstream.

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    Methohexital Sodium

    A barbiturate used as an anesthetic.

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    Midazolam

    A benzodiazepine used for sedation and anxiety relief.

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    Respiratory Depression

    A serious complication that can occur with IV anesthetics.

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    Monoamine Oxidase Inhibitors (MAOIs)

    Medications that inhibit monoamine oxidase, increasing serotonin, dopamine, and norepinephrine levels in the brain.

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    Common MAOIs

    Commonly used MAOIs include Nardil, Parnate, Marb Plan, and Selegiline.

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    Cardiovascular Depression

    Reduction in heart function or blood pressure due to anesthetics.

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    Major Side Effect of MAOIs

    Hypertensive crisis can occur if MAOIs are taken with tyramine-rich foods like aged cheese and wine.

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    Propofol Risks

    High risk of bacterial infection when used intravenously.

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    Ketamine Risks

    Can cause hallucinations and mental confusion post-administration.

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    Lithium Toxicity Signs

    Symptoms of lithium toxicity include nausea, ataxia, and confusion. Check sodium levels.

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    Selective Serotonin Reuptake Inhibitors (SSRIs)

    Antidepressants that increase serotonin levels in the brain.

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    2nd Generation Antipsychotics

    Atypical antipsychotics like Clozapine and Risperidone have fewer EPS but more metabolic side effects.

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    Black Box Warning

    A warning indicating a significant risk of serious side effects, especially suicide risk with SSRIs.

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    Serotonin Syndrome

    A potentially life-threatening condition caused by increased serotonin levels.

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    Nursing Considerations for SSRIs

    Monitor for withdrawal symptoms and signs of serotonin syndrome.

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    SNRIs

    Serotonin-Norepinephrine Reuptake Inhibitors, which increase serotonin and norepinephrine levels in the brain.

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    Common SNRIs

    Common medications include Duloxetine, Venlafaxine, Desvenlafaxine.

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    Mechanism of SNRIs

    Inhibit the reuptake of serotonin and norepinephrine neurotransmitters.

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    Uses of SNRIs

    Used to treat Major Depressive Disorder, Generalized Anxiety Disorder, Diabetic Neuropathy Pain, and Fibromyalgia.

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    SNRIs Side Effects

    Similar to SSRIs but include more hypertension, tachycardia, sweating, dizziness, and sexual dysfunction.

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    Serotonin Syndrome Risk

    Risk occurs when SNRIs combine with SSRIs, MAOIs, or St. John's Wort.

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    TCAs

    Tricyclic Antidepressants that also inhibit serotonin and norepinephrine reuptake.

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    Common TCAs

    Amitriptyline, Nortriptyline, Imipramine, Doxepin, Clomipramine are common TCAs.

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    TCAs Side Effects

    Side effects include convulsions, cardiotoxicity, coma, and anticholinergic effects.

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    Withdrawal Symptoms

    Gradually taper off SNRIs and TCAs to avoid withdrawal symptoms.

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    Factors Affecting Absorption

    Elements that influence how well a drug enters the bloodstream.

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    First-Pass Effect

    The metabolism of a drug in the liver before it reaches systemic circulation.

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    Blood-Brain Barrier

    A selective barrier that prevents certain substances from entering the brain.

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    Half-Life (t½)

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

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    Agonists vs Antagonists

    Agonists activate receptors while antagonists block them.

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    Plasma Protein Binding

    The degree to which drugs bind to proteins in the blood, affecting distribution.

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    PRN Orders

    Medication orders given as needed based on patient condition.

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    Right Client Verification

    Ensuring the correct patient receives the medication.

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    Right Documentation

    Recording medication administration immediately after giving it.

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    Peripheral IV

    A short-term intravenous access used for medication administration.

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    GABA

    A neurotransmitter that inhibits activity in the brain, often targeted by anxiolytics.

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    Nonbenzodiazepines

    Medications like Zolpidem that enhance GABA for short-term insomnia treatment.

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    Administration Methods

    Includes continuous infusion, IV bolus, and piggyback setups for IV therapy.

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    Barbiturates

    Medications like Methohexital Sodium used for anesthesia.

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    Benzodiazepines

    Sedatives including Midazolam, Diazepam, and Lorazepam.

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    Serotonin Reuptake Inhibitors

    Antidepressants that increase serotonin in the brain.

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    Continuous Monitoring

    Essential practice during procedures involving anesthetics.

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    MAOIs

    Medications that inhibit monoamine oxidase, increasing levels of serotonin, dopamine, and norepinephrine.

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    Hypertensive Crisis

    A severe increase in blood pressure that can occur with MAOIs if tyramine foods are consumed.

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    Steven-Johnson Syndrome

    A severe skin reaction that can occur with certain medications, like Lamotrigine.

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    Study Notes

    Pharmacokinetics & Routes of Administration

    • Absorption: Movement of drugs from administration site to bloodstream
      • Factors affecting absorption:
        • Route of administration (IV fastest, oral slowest)
        • Drug solubility (lipid-soluble better)
        • Gastric pH and motility
        • Blood flow at administration site
      • Absorption by route:
        • Oral (PO): Variable absorption rate due to gastric pH, food, and motility
        • Intramuscular/Subcutaneous: Rapid absorption if water-soluble, slow if poorly soluble
        • Intravenous (IV): Immediate effect

    Distribution

    • Distribution: Transport of drugs to target tissues via bloodstream.
      • Factors affecting distribution:
        • Blood flow/perfusion
        • Plasma protein binding (albumin)
        • Blood-brain barrier and placenta permeability

    Metabolism

    • Metabolism: Drug breakdown, mainly in the liver.
      • Factors affecting metabolism:
        • First-pass effect: Liver inactivates oral drugs
        • Age: Infants and elderly have slower metabolism
        • Hepatic enzyme induction/inhibition

    Excretion

    • Excretion: Elimination of drugs, mainly via kidneys (urine).
      • Monitoring: Assess BUN and creatinine for kidney function

    Key Pharmacokinetic Concepts

    • Therapeutic Index (TI): High TI = Safe, less monitoring required; Low TI = Risky, requires blood level monitoring.
    • Half-Life (t½): Short t½ = Frequent dosing; Long t½ = Higher risk of toxicity

    Safe Medication Administration & Error Reduction

    • Medication Orders: Routine (standing), Single (one-time), Stat, PRN (as needed)
    • Rights of Medication Administration:
      • Right Client
      • Right Medication
      • Right Dose
      • Right Time
      • Right Route
      • Right Documentation
      • Right Education
      • Right to Refuse

    High-Alert & Confused Medications

    • High-Alert Medications: Insulin, Heparin, Opioids, Warfarin
    • Confused Medications (Look-Alike/Sound-Alike): Buspirone vs. Bupropion, Clonidine vs. Clonazepam, Prednisone vs. Prednisolone

    Medication Reconciliation

    • Occurs at admission, transfer, and discharge
    • Compare current meds with new prescriptions
    • Resolve discrepancies before administering

    Intravenous (IV) Therapy

    • IV Medication Administration: Peripheral IV (short-term), Central IV (long-term), Continuous Infusion, IV Bolus, Piggyback
    • Safe IV Medication Administration: Monitor for complications (infiltration, extravasation, phlebitis, fluid overload)
    • Sedative-Hypnotic Anxiolytics (Benzodiazepines): Prototype: Alprazolam, Other: Diazepam, Lorazepam, Clonazepam, Chlordiazepoxide, Clorazepate, Oxazepam
      • Purpose: Enhances GABA inhibitory effects
      • Uses: GAD, Panic Disorder, Seizures, Insomnia, Alcohol Withdrawal
    • Nonbenzodiazepines (Zolpidem, Eszopiclone): Purpose: Enhances GABA, Short-term use for insomnia
    • SSRIs for Anxiety Disorders: Prototype: Paroxetine, Other: Sertraline, Escitalopram, Fluoxetine, Fluvoxamine

    Sedative-Hypnotics & Intravenous Anesthetics

    • IV Non-Opioid Anesthetics: Barbiturates (Methohexital Sodium), Benzodiazepines (Midazolam, Diazepam, Lorazepam), Other (Propofol, Ketamine)
    • Complications: Respiratory and cardiovascular depression, Propofol: High risk for bacterial infection, Ketamine: Risk of hallucinations, mental confusion

    Nursing Considerations

    • Continuous monitoring of vitals during procedures
    • Maintain mechanical ventilation if needed

    Medications

    • Psychotropic & CNS Drug Study Guide: Mechanism of action, uses, side effects, nursing considerations
    • Selective Serotonin Reuptake Inhibitors (SSRIs): Escitalopram, Fluoxetine, Sertraline, Paroxetine, Citalopram, Fluvoxamine
      • Mechanism of Action: Inhibits serotonin reuptake
      • Uses: Depression, Anxiety disorders, Bulimia Nervosa, Premenstrual Dysphoric Disorder (PMDD)
      • Side Effects/S/S: Serotonin Syndrome, Sexual dysfunction, weight gain, etc
    • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Duloxetine, Venlafaxine, Desvenlafaxine
    • Tricyclic Antidepressants (TCAs): Amitriptyline, Nortriptyline, Imipramine, Doxepin
    • Monoamine Oxidase Inhibitors (MAOIs): Nardil, Parnate, Marplan, Selegiline
      • Mechanism of Action: Inhibits monoamine oxidase, increasing serotonin, dopamine, and norepinephrine
      • Uses: Treatment-resistant Depression, Atypical Depression, Panic Disorder
      • Side Effects (S/S): HYPERTENSIVE CRISIS, Serotonin Syndrome
    • Mood Stabilizers: Lithium, Valproate, Carbamazepine, Lamotrigine
      • Lithium: Therapeutic range: 0.6-1.2 mEq/L; Toxicity S/S: N/V, Ataxia, Coarse Tremors, Confusion, Seizures
      • Valproate (Depakote): Black Box Warning: Hepatotoxicity, Pancreatitis, Teratogenic Risk
      • Carbamazepine: Risk for Agranulocytosis (monitor CBC), Steven-Johnson Syndrome
      • Lamotrigine: STOP if Rash Develops (Steven-Johnson Syndrome)

    Antipsychotics

    • First Generation (Typical Antipsychotics): Haloperidol, Chlorpromazine, Side Effects: EPS (Tardive Dyskinesia, Parkinsonism, Akathisia, Dystonia, Neuroleptic Malignant Syndrome)
    • Second Generation (Atypical Antipsychotics): Clozapine, Risperidone, Olanzapine, Quetiapine, Less EPS, but more metabolic effects (weight gain, diabetes, hyperlipidemia)

    Anxiolytics

    • Benzodiazepines: Alprazolam, Lorazepam, Clonazepam, Diazepam (short term)
    • Buspirone: Non-sedating, slow onset (2-4 weeks), NOT for PRN use
    • Non-benzos (Z-drugs): Zolpidem, Eszopiclone (less addictive, short term)

    CNS Stimulants

    • Methylphenidate, Amphetamine (Adderall)

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    Description

    Test your understanding of pharmacokinetics and the routes of drug administration. This quiz covers key concepts including absorption, distribution, and metabolism of drugs. Determine how various factors influence these processes and their implications in medication administration.

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