Pharmacology Quiz: Drug Concentration and Effects
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Questions and Answers

What is the term for the highest concentration of a drug in the blood?

  • Peak (correct)
  • Duration
  • Therapeutic range
  • Onset

    • What is the primary effect of Diphenhydramine (Benadryl)?

  • Sedation
  • Antihistamine (correct)
  • Pain relief
  • Anti-inflammatory

    • What is the therapeutic range of a drug?

  • The concentration at which a drug reaches its maximum effect
  • The time a drug exerts its therapeutic effect
  • The time it takes for a drug to reach its minimum effective concentration
  • The range of doses that produce a therapeutic effect without causing significant adverse effects (correct)

    • Which of the following describes an agonist?

    <p>A drug that binds to a receptor and produces a desired response (B)</p> Signup and view all the answers

    What is the purpose of measuring trough drug levels?

    <p>To determine the rate of elimination of the drug (D)</p> Signup and view all the answers

    Which of the following is NOT considered a type of drug receptor?

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

    Which of the following routes of drug administration would not be subject to the first pass effect?

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

    What is the term for the time it takes for a drug to reach its minimum effective concentration?

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

    Which of the following is a characteristic of a partial agonist?

    <p>It elicits moderate activity when binding to receptors (D)</p> Signup and view all the answers

    What is the primary reason why a loading dose of a drug is often administered?

    <p>To quickly achieve therapeutic levels (B)</p> Signup and view all the answers

    What is the term used to describe the percentage of administered drug that reaches systemic circulation?

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

    Which of the following factors influences the distribution of a drug within the body?

    <p>All of the above (D)</p> Signup and view all the answers

    What happens when two highly protein-bound drugs are administered concurrently?

    <p>The drugs compete for binding sites, increasing the amount of free drug in circulation. (B)</p> Signup and view all the answers

    Which of the following is NOT a factor that affects bioavailability?

    <p>Patient's height (A)</p> Signup and view all the answers

    Identify the primary route of drug excretion.

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

    What is the term for a drug that is designed to be inactive until it is metabolized by the body?

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

    Which of the following responses is consistent with the activation of the cholinergic receptor site in the heart?

    <p>Decrease in heart rate (C)</p> Signup and view all the answers

    What is the mechanism of action of epinephrine on the bronchus?

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

    Which of the following is an example of a drug-nutrient interaction?

    <p>A patient taking a blood thinner experiences a decrease in effectiveness due to high vitamin K intake in their diet (B)</p> Signup and view all the answers

    Which of the following statements correctly describes the interaction between two drugs with a synergistic effect?

    <p>One drug enhances the effect of the other drug (D)</p> Signup and view all the answers

    Which of the following is NOT listed as a potential mechanism of drug action?

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

    Which of the following is an example of an adverse reaction to a drug?

    <p>A patient experiences an allergic reaction after taking penicillin (D)</p> Signup and view all the answers

    Which of the following statements accurately describes the effects of epinephrine on the cardiovascular system?

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

    Based on the information provided, which of the following is a likely effect of a drug that acts by stimulating cholinergic receptors in the stomach?

    <p>Increased gastric secretion (D)</p> Signup and view all the answers

    Which of these factors slows gastric emptying time, leading to a decreased rate of absorption?

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

    Which of these does not directly influence the absorption of a drug?

    <p>Dosage of the drug (A)</p> Signup and view all the answers

    Which of the following most accurately describes the process of dissolution in drug absorption?

    <p>Combining drug particles with liquid to form a solution (B)</p> Signup and view all the answers

    Which method of drug administration bypasses the gastrointestinal tract?

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

    Which of the following transport mechanisms requires energy to move drugs across cell membranes?

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

    Which of the following types of drugs most readily pass through mucous membranes?

    <p>Lipid-soluble (D)</p> Signup and view all the answers

    What is the primary function of excipients in drug formulation?

    <p>To facilitate the disintegration and dissolution of the drug (D)</p> Signup and view all the answers

    Which of the following routes of drug administration generally leads to the fastest absorption?

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

    Which of the following is NOT a factor that influences drug distribution?

    <p>Patient's perception of the drug (A)</p> Signup and view all the answers

    What is the primary physiological reason why fluid overload can impact drug distribution?

    <p>Increased blood flow due to excess fluid (D)</p> Signup and view all the answers

    What nursing action reflects the principle of monitoring the therapeutic index of a drug?

    <p>Observing for signs of drug toxicity (B)</p> Signup and view all the answers

    Why is monitoring serum peak and trough levels particularly important for drugs with a narrow therapeutic index?

    <p>These drugs have a small difference between therapeutic and toxic doses. (D)</p> Signup and view all the answers

    If a patient is experiencing signs of drug toxicity, what is the most appropriate initial nursing action?

    <p>Monitor the patient's vital signs closely and notify the physician. (B)</p> Signup and view all the answers

    What is the main reason why drug-laboratory interactions are a concern for nurses?

    <p>They can lead to inaccurate test results, affecting patient care. (D)</p> Signup and view all the answers

    Which of the following nursing interventions would be most appropriate for a patient who is at risk for drug-induced photosensitivity?

    <p>Encouraging the patient to wear protective clothing and sunscreen. (D)</p> Signup and view all the answers

    Which of the following is NOT a component of the nursing process when managing pharmacologic therapies?

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

    A patient is prescribed a medication with a narrow therapeutic range. What is the nurse's priority action when administering this medication?

    <p>Monitoring the patient closely for signs of toxicity. (A)</p> Signup and view all the answers

    Which of the following patients would be MOST likely to require a dosage adjustment for a medication due to altered pharmacokinetic considerations?

    <p>A 65-year-old patient with chronic kidney disease. (B)</p> Signup and view all the answers

    A nurse is educating a patient about a new medication. Which of the following statements made by the nurse BEST demonstrates an understanding of pharmacodynamics?

    <p>This medication will bind to specific receptors in your body, causing the desired effect. (D)</p> Signup and view all the answers

    Which of the following medications is MOST likely to have a prolonged half-life in a patient with liver disease?

    <p>A medication that is metabolized primarily by the liver. (D)</p> Signup and view all the answers

    A nurse is caring for a patient who is taking a medication that has a high potential for drug interactions. Which of the following is the MOST important nursing intervention to prevent adverse effects?

    <p>Obtaining a complete medication history from the patient. (A)</p> Signup and view all the answers

    Flashcards

    Pharmacodynamics

    The study of how drugs affect the body.

    Primary effect

    The desirable response produced by a drug.

    Secondary effect

    A desirable or undesirable response from a drug aside from the primary effect.

    Dose-Response Relationship

    The body's response to varying concentrations of a drug.

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    Therapeutic range

    The range of drug doses that are effective without harmful effects.

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    Agonist

    A drug that activates a receptor to produce a desired response.

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    Antagonist

    A drug that prevents receptor activation thereby blocking the response.

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    Receptor Theory

    Drugs bind to receptors to activate or block them for a response.

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    First Pass Effect

    Process where a drug is metabolized to an inactive form before reaching systemic circulation.

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    Bioavailability

    Percentage of an administered drug that reaches systemic circulation for action.

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    Factors Affecting Bioavailability

    Includes absorption, first pass metabolism, drug form, route of administration, and more.

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    Drug Distribution

    Movement of drug from circulation to body tissues based on several influencing factors.

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    Protein Binding

    Many drugs bind to plasma proteins, affecting the amount of free drug available.

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    Blood-Brain Barrier

    Protective barrier that limits drug access to the brain, blocking 98% of drugs.

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    Half-life

    Time required for the concentration of a drug in the body to reduce by half.

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    Prodrug

    A medication designed to improve its bioavailability by requiring metabolic conversion.

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    Pharmacokinetics

    The process of drug movement through the body, including absorption, distribution, metabolism, and excretion.

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    Absorption

    The movement of a drug from the GI tract into the bloodstream.

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    Passive Transport

    A method where drugs move across cell membranes without energy, usually from higher to lower concentration.

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    Active Transport

    A method requiring energy where drugs move against a concentration gradient with the help of carriers.

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    Factors Affecting Absorption

    Various elements such as blood flow, pH, and food that influence how drugs are absorbed.

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    Rate of Dissolution

    The time required for a drug to break down and dissolve for absorption.

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    Enteric-coated Drugs

    Drugs designed to resist disintegration in stomach acid and dissolve in the small intestine.

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    Dissolution Process

    The combining of small drug particles with liquid to form a solution for absorption.

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    Drug Distribution Factors

    Influences include blood flow, tissue affinity, and protein binding.

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    Low Therapeutic Index

    A measure indicating a small margin between effective and toxic drug doses.

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    Serum Peak Level

    The highest concentration of a drug in the bloodstream at a specific time.

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    Serum Trough Level

    The lowest concentration of a drug before the next dose is given.

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    Primary Site of Metabolism

    Most drugs are primarily metabolized in the liver.

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    Drug-laboratory interactions

    Interactions where drugs can alter test results, leading to misinterpretation.

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    Drug-induced photosensitivity

    Skin reaction caused by drugs when exposed to sunlight.

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    Patient Problems

    Common concerns like anxiety or need for teaching during care.

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    Nursing Interventions

    Actions nurses take to support patient care and safety.

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    Assessment phase

    Evaluating patient for possible drug interactions and current medications.

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    Creatinine clearance

    Test measuring kidney function by assessing creatinine levels.

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    Burns and fluid shift

    Significant burns can cause fluid overload, impacting drug distribution.

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    Distribution phase

    Process where a drug spreads throughout the body's fluids and tissues.

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    Bethanechol Effects

    Drug that activates cholinergic receptors in various sites causing multiple physiological responses.

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    Epinephrine Receptor Types

    Epinephrine acts on alpha, beta 1, and beta 2 receptors, impacting blood pressure and heart rate.

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    Cholinergic Responses

    Responses to cholinergic receptor stimulation include pupil constriction, decreased heart rate, and increased secretion.

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    Physiological Effects of Epinephrine

    Epinephrine increases blood pressure and heart rate and relaxes bronchioles via receptor stimulation.

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    Additive Drug Interactions

    The sum of effects when two drugs are combined, leading to a total effect equal to their individual effects.

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    Synergistic Drug Interaction

    The combined effect of two drugs is significantly greater than the sum of their individual effects.

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    Antagonistic Drug Effect

    When one drug inhibits or blocks the effects of another drug, undermining its action.

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    Drug-Nutrient Interaction

    Food can affect drug absorption and action, changing the drug's response in the body.

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    Study Notes

    Pharmacokinetics Phase

    • The process of drug movement through the body.
    • It's a four-part process:
      • Absorption
      • Distribution
      • Metabolism
      • Excretion

    Pharmacodynamic Phase

    • Receptor binding
    • Postreceptor effects
    • Chemical reactions

    Pharmacokinetics: Absorption

    • Eyedrops, eardrops, nasal sprays, respiratory inhalants, transdermal drugs, sublingual drugs, and parenteral drugs do not travel through the gastrointestinal tract.
    • Excipients allow drugs to be taken in a particular size and shape or enhance drug dissolution.
    • The rate of dissolution is the time it takes for a drug to disintegrate and dissolve to become available for absorption.
    • Enteric-coated drugs resist disintegration in gastric acid, allowing them to pass through the acidic stomach environment. They dissolve in the alkaline environment of the small intestines.

    Absorption Methods

    • Passive transport: Diffusion and facilitated diffusion.
    • Active transport: requires energy to move the drug against a concentration gradient.
    • Diffusion: Movement of drugs across a cell membrane from an area of higher concentration to an area of lower concentration.
    • Facilitated Diffusion: Relies on a protein carrier, moving from areas of higher to lower concentration.
    • Lipid-soluble drugs pass rapidly through mucous membranes; water-soluble drugs need an enzyme or protein carrier.
    • Pinocytosis: Cell carries drug across membrane by engulfing the drug particles.

    Factors Affecting Absorption

    • Poor circulation to the stomach decreases absorption.
    • Pain, stress, solid foods, hot foods, high-fat foods decrease gastric emptying, keeping drugs in the stomach longer.
    • IM drugs are absorbed faster in muscles with increased blood flow (e.g., deltoid) compared to those with decreased flow (e.g., gluteus maximus).
    • SQ drugs have slower absorption but are more predictable than oral drugs.
    • Rectal drugs are absorbed more slowly than oral due to a smaller surface area.

    Drug Movement From GI Tract to Liver

    • Drugs are carried via the portal vein to the liver, then enter the bloodstream.
    • First-pass effect: Some drugs are metabolized to an inactive form and excreted, decreasing the amount of active drug available.
    • Drugs administered via IV, IM, SQ, nasal, sublingual, and buccal routes bypass the liver and portal circulation.
    • Bioavailability is the percentage of administered drug available for activity. For oral medications, bioavailability is always less than 100% due to absorption and first-pass effects.

    Factors Affecting Bioavailability

    • Absorption
    • First-pass metabolism
    • Drug form
    • Route of administration
    • Gastric mucosa and motility
    • Administration with food or other drugs
    • Changes in liver metabolism

    Drug Distribution

    • Movement of drugs from circulation to body tissues.
    • Influencing factors:
      • Protein binding
      • Free drugs
      • Volume of drug distribution (Vd)
    • Distribution Influencing Factors:
      • Vascular permeability and permeability of cell membranes
      • Regional blood flow and pH
      • Cardiac output
      • Tissue perfusion
    • Protein Binding: Many drugs bind to plasma proteins, leaving a portion of the drug unbound (free drug).
    • Blood-Brain Barrier: Protects the brain from foreign substances; 98% of drugs are excluded.

    Drug Metabolism

    • Liver is the primary site of metabolism.
    • Liver diseases affect metabolism.
    • Prodrugs: Often designed to improve bioavailability.
    • Half-life (t½): The time it takes for the amount of drug in the body to reduce by half.
    • Steady state: Occurs when the amount of drug being administered is the same as the amount being eliminated.
    • Loading dose: Large initial dose to quickly reach therapeutic levels—often used for drugs with long half-lives (e.g., heparin, phenytoin).

    Drug Excretion

    • Main route is through the kidneys (e.g., filtering free drugs, water-soluble drugs, and unchanged drugs).
    • Other routes: liver (bile), lungs, saliva, sweat, breast milk.
    • Renal or kidney function tests (e.g., BUN, creatinine) can indicate potential excretion problems.

    Pharmacodynamics

    • Study of how drugs affect the body.
    • Primary effect: Desired response.
    • Secondary effect: Desirable or undesirable response.
    • Drugs mimic the actions of body's chemical messengers.
    • Example: Diphenhydramine (Benadryl): primary effect = antihistamine, secondary effect = drowsiness.

    Dose-Response Relationship

    • Body's physiological response to changes in drug concentration.
    • Therapeutic range: Doses producing therapeutic response without significant adverse effects.

    Important Pharmacodynamics Terms

    • Onset: Time to reach minimum effective concentration.
    • Peak: Highest concentration in the blood.
    • Duration: Length of time drug exerts a therapeutic effect.

    Therapeutic Drug Monitoring (TDM)

    • Peak drug level: Highest plasma concentration of a drug in a specific time.
    • Trough drug level: Lowest plasma concentration; measures rate of elimination.
    • Drawn before the next dose.
    • Important to monitor for drugs with a narrow therapeutic index

    Receptor Theory

    • Drugs act by binding to receptors.
    • Different receptor types: cell membrane-imbedded enzymes, ligand-gated ion channels, G protein-coupled receptors, transcription factors.
    • Drug fits in receptor; better fit means more active drug.

    Pharmacodynamics: Agonists, Partial Agonists, Antagonists

    • Agonist: Produces a desired response
    • Partial agonist: Moderate activity. Also prevents receptor activation by other drugs.
    • Antagonist: Prevents receptor activation; blocks response.

    Nonspecific Drug Effects

    • Drug effects on various sites when stimulated.
    • Example: Bethanechol, epinephrine

    Mechanisms of Drug Action

    • Stimulation
    • Depression
    • Irritation
    • Replacement
    • Cytotoxic action
    • Antimicrobial action
    • Modification of immune status

    Pharmacodynamics Continued

    • Side Effects: Secondary drug effects, mild to severe adverse reactions, unintentional undesirable effects.
    • Drug Toxicity: Drug levels exceed therapeutic range.
    • Drug Interactions: Altered drug effect due to interaction with another drug.

    Pharmacodynamic Interactions

    • Additive: Sum of effects of two drugs.
    • Synergistic: Effect of two drugs is greater than the effects of either drug alone.
    • Antagonistic: One drug reduces or blocks the effect of another.

    Drug-Nutrient Interactions

    • Food can increase, decrease, or delay drug response.
    • Drugs can cause misinterpretation of test results.
    • Drug-induced photosensitivity: Skin reaction to sunlight.

    Nursing Process: Pharmacokinetics and Pharmacodynamics

    • Assessment: Identify potential drug interactions, patient's current drugs, problems (anxiety, need for teaching).
    • Planning: Rationale for therapeutic regimen, nursing interventions (e.g., avoiding high-fat foods before enteric-coated tablets, monitoring narrow therapeutic index drugs).
    • Evaluation: Evaluate patient's response.

    Quiz

    • Increase in drug half-life in patients with impaired liver/kidney function.
    • Decreased creatinine clearance in older adults and those with renal dysfunction.
    • Distribution impacted in patients with significant fluid shifts, like burns.
    • Monitoring serum peak and trough levels essential for low therapeutic index medications.
    • Liver is the primary site of drug metabolism.

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    Pharmacokinetics and Pharmacodynamics Notes PDF

    Description

    Test your knowledge in pharmacology with this quiz focused on drug concentrations, effects, and interactions. Questions cover key concepts like therapeutic ranges, drug administration routes, and agonist characteristics. Perfect for students in pharmacology or healthcare programs.

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