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Questions and Answers
What is a potential outcome of a long half-life for medications in malnourished clients?
What is a potential outcome of a long half-life for medications in malnourished clients?
- Medications must be taken more frequently.
- Increased risk for medication accumulation and toxicity. (correct)
- Reduced therapeutic effects over time.
- Medications are eliminated faster.
What does pharmacodynamics primarily describe?
What does pharmacodynamics primarily describe?
- The interactions between medications and body systems. (correct)
- The method of medication storage in the body.
- The process of medication absorption.
- The elimination routes for medications.
Which of the following statements about agonists is correct?
Which of the following statements about agonists is correct?
- They primarily inhibit medication efficacy.
- They mimic endogenous compounds. (correct)
- They block receptor activity.
- They cannot activate receptors.
How do medications with a long half-life affect dosing intervals?
How do medications with a long half-life affect dosing intervals?
What is the primary pathway for the excretion of medications?
What is the primary pathway for the excretion of medications?
What effect do pro-drugs have upon activation?
What effect do pro-drugs have upon activation?
What can increase toxicity in medications?
What can increase toxicity in medications?
Which of the following describes a mechanism of action for medications?
Which of the following describes a mechanism of action for medications?
What is primarily affected by the presence of stool in the rectum during medication absorption?
What is primarily affected by the presence of stool in the rectum during medication absorption?
Which of the following describes the impact of binding to plasma proteins on medication efficacy?
Which of the following describes the impact of binding to plasma proteins on medication efficacy?
In which organ does the majority of metabolism of medications occur?
In which organ does the majority of metabolism of medications occur?
Why is it important to monitor medications with a low therapeutic index?
Why is it important to monitor medications with a low therapeutic index?
How does age impact medication metabolism in infants?
How does age impact medication metabolism in infants?
What is the significance of a medication's peak level?
What is the significance of a medication's peak level?
Which factor does NOT influence the rate of medication metabolism?
Which factor does NOT influence the rate of medication metabolism?
What can be a potential consequence of two medications competing for the same binding sites?
What can be a potential consequence of two medications competing for the same binding sites?
How does aging generally affect medication doses for older adults?
How does aging generally affect medication doses for older adults?
What is the purpose of obtaining a trough level blood sample?
What is the purpose of obtaining a trough level blood sample?
What does the term 'half-life' (t½) refer to in pharmacology?
What does the term 'half-life' (t½) refer to in pharmacology?
What is a common effect of the first-pass metabolism on medications?
What is a common effect of the first-pass metabolism on medications?
Why might older adults experience medication accumulation?
Why might older adults experience medication accumulation?
What is indicated by a short half-life in medication?
What is indicated by a short half-life in medication?
How can similar metabolic pathways affect concurrent medications?
How can similar metabolic pathways affect concurrent medications?
What typically happens to hepatic medication metabolism as individuals age?
What typically happens to hepatic medication metabolism as individuals age?
What is the appropriate position for clients after instilling ear drops?
What is the appropriate position for clients after instilling ear drops?
Which phrase correctly describes the sublingual method of administration?
Which phrase correctly describes the sublingual method of administration?
What should clients avoid doing while the sublingual tablet is in place?
What should clients avoid doing while the sublingual tablet is in place?
What technique should be employed when administering nasal medications?
What technique should be employed when administering nasal medications?
Why is a spacer used with nasal medication devices?
Why is a spacer used with nasal medication devices?
What is the correct instruction regarding breath-holding after nasal medication administration?
What is the correct instruction regarding breath-holding after nasal medication administration?
What should clients do to facilitate effective instillation of nasal drops?
What should clients do to facilitate effective instillation of nasal drops?
Which statement accurately describes buccal administration?
Which statement accurately describes buccal administration?
How many times per day is the medication expected to be administered?
How many times per day is the medication expected to be administered?
Which factor is relevant for administering lower medication dosages?
Which factor is relevant for administering lower medication dosages?
What is an appropriate action when administering eye drops?
What is an appropriate action when administering eye drops?
Which statement indicates that the client understands the use of transdermal patches?
Which statement indicates that the client understands the use of transdermal patches?
What should the nurse verify regarding the client's medication?
What should the nurse verify regarding the client's medication?
Which of the following is a barrier to medication absorption?
Which of the following is a barrier to medication absorption?
What instruction should the nurse provide regarding a metered-dose inhaler (MDI) with a spacer?
What instruction should the nurse provide regarding a metered-dose inhaler (MDI) with a spacer?
Which action is incorrect when instilling eye drops?
Which action is incorrect when instilling eye drops?
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Study Notes
Medication Metabolism
- Factors influencing the rate of medication metabolism:
- Age: Infants have limited capacity, while older adults may experience a decline in hepatic medication metabolism, potentially requiring lower doses to avoid accumulation.
- Increased medication-metabolizing enzymes: Can lead to faster metabolism, requiring higher dosages.
- First-pass effect: This occurs when the liver inactivates medications on their first pass, requiring nonenteral routes like sublingual or IV for medications with high first-pass effect.
- Similar metabolic pathways: Medications shared by the same metabolic pathway can affect each other's metabolism, potentially leading to accumulation.
Excretion
- Primarily occurs through the kidneys, but also through the liver, lungs, intestines, and exocrine glands.
Pharmacodynamics
- Explanations of medication interactions with cells, systems, and organs to produce effects.
- Medications can act as agonists (mimicking endogenous compound activity) or antagonists (blocking endogenous compound activity).
Therapeutic Index (TI)
- Medications with a high TI have a wide safety margin, making routine blood level monitoring unnecessary.
- Medications with a low TI require close monitoring of medication levels.
Half-Life (t½)
- The time it takes for the medication in the body to decrease by 50%.
- Liver and kidney function influence half-life.
- It typically takes four half-lives to achieve a steady blood concentration.
Short Half-Life
- Medications leave the body quickly, usually within 4 to 8 hours.
- Short dosing interval is required to maintain therapeutic effectiveness.
Long Half-Life
- Medications leave the body more slowly, over 24 hours.
- Increased risk of medication accumulation and toxicity.
- Medications can be administered at longer intervals.
Absorption
- Barriers to absorption: Rectal - Presence of stool; Vaginal - Infectious material.
- Absorption patterns: Sublingual - Directly to bloodstream, bypassing the liver; Buccal- Between cheek and gum, bypassing the liver
- Transdermal - Through the skin, slow and sustained release.
- Inhalation - Via the lungs
Administration
- Ear drops: Instill directly into the outermost part of the ear canal, client should remain in a side-lying position for 2-3 minutes.
- Nasal drops: Breathe through the mouth, stay in a supine position, and avoid blowing the nose for 5 minutes.
- MDI (Metered Dose Inhaler) with a spacer: Use medical aseptic technique, exhale completely, hold breath for 10 seconds, slowly exhale through pursed lips, resume normal breathing.
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