Pharmacology Quiz: Drug Mechanisms and Effects

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Questions and Answers

What characteristic enhances a small drug molecule's ability to quickly permeate cell membranes?

Solubility in both water and lipids, with no electrical charge. (correct)

Large molecular size and low lipid solubility.

High electrical charge and water solubility.

Lipid solubility and the presence of an electrical charge.

Which process requires energy to move molecules across a cell membrane?

Filtration

Passive diffusion

Osmosis

Active transport (correct)

What factor significantly affects how quickly drugs are released into tissues?

The drug's ability to pass through the placenta

How strongly the drug is bound to proteins. (correct)

The level of tissue perfusion.

The rate of hepatic enzyme activity.

What is a key function of the blood-brain barrier (BBB)?

It prevents lipid-insoluble drugs from accessing the central nervous system. Signup and view all the answers

Why can a large percentage of an orally administered drug be rendered ineffective?

Due to biotransformation by enzymes during the first pass effect. Signup and view all the answers

What is the primary factor determining a drug's distribution throughout the body?

The drug's binding affinity to plasma proteins Signup and view all the answers

Which process describes the movement of a substance across a cell membrane against a concentration gradient?

Active transport Signup and view all the answers

What is the 'first-pass effect' primarily associated with?

Oral drug administration Signup and view all the answers

What does the term 'half-life' of a drug refer to?

The time it takes for the amount of drug in the body to decrease to half its peak level Signup and view all the answers

What is the purpose of a loading dose of a medication?

To allow the drug to reach critical concentration quickly Signup and view all the answers

A drug that mimics a missing chemical in the body is acting as a(n):

Agonist Signup and view all the answers

What does 'selective toxicity' refer to?

The ability of a drug to target specific systems found in foreign cells Signup and view all the answers

What does the therapeutic index of a drug describe?

The ratio of the toxic concentration to effective concentration Signup and view all the answers

What term describes the use of a medication for a purpose not originally approved?

Off-label use Signup and view all the answers

Which of the following options accurately describes a 'generic name' of a drug?

The original name given to a drug upon its development Signup and view all the answers

A drug is in Phase III of clinical trials. What does this indicate about the drug’s testing?

The drug is being tested on a larger sample of patients with the target disease Signup and view all the answers

What is the primary purpose of preclinical trials in drug development?

To conduct initial trials using in vitro or in vivo techniques on a chemical Signup and view all the answers

What does the term 'teratogenic' refer to when discussing medications?

Medications that have adverse effects on a developing fetus in the womb Signup and view all the answers

Which of the following is an example of a medication derived from a plant source?

Digitalis Signup and view all the answers

What is the significance of the 1938 Federal Food, Drug, and Cosmetic Act?

It required tests for drug toxicity and provided means for drug recalls Signup and view all the answers

What is the role of the Food and Drug Administration (FDA) in the context of medications?

To regulate the development and sale of drugs Signup and view all the answers

What is the primary purpose of pharmacotherapeutics?

The study of prevention, treatment, and diagnosis of disease using a drug Signup and view all the answers

Which of the following elements is used in the treatment of rheumatoid arthritis?

Gold Signup and view all the answers

According to the provided information, under what classification would hydromorphone, a drug with high abuse potential, be categorized?

Schedule II Signup and view all the answers

A nurse needs to learn more about a newly prescribed medication. Which resource would be the MOST appropriate for the nurse to consult?

Drug Facts and Comparisons Signup and view all the answers

If a nurse encounters a medication order for a drug they are unfamiliar with and their drug guide is 4 years old, what is the MOST appropriate course of action?

Verify the medication information using a more current resource before administering it. Signup and view all the answers

Which statement BEST describes a generic drug based on the provided information?

It is less expensive, usually as effective, and has the same strength of active ingredient as brand-name drugs. Signup and view all the answers

What did the Comprehensive Drug Abuse Prevention and Control Act of 1970 accomplish?

Defined drug abuse, classified drugs by potential for abuse, and controlled their distribution. Signup and view all the answers

What are orphan drugs?

Drugs that are not financially viable to produce and have not been 'adopted' by any drug company. Signup and view all the answers

How are local, state, and federal regulations related to drugs enforced?

The most restrictive regulation is the one that prevails. Signup and view all the answers

A nurse is consulting a drug guide. What would be the most appropriate action based on the information provided?

Use the guide if the drug is listed. Signup and view all the answers

What characteristic is common between both Brand name drugs and Generic drugs?

They have the same active ingredient and strength. Signup and view all the answers

A client asks a nurse if they can receive a drug that's still in the preclinical phase. What is the most appropriate response?

Preclinical drugs are only tested on animals and not available to humans. Signup and view all the answers

What is the primary purpose of a Drug Enforcement Agency (DEA) number?

It is a unique identifier for practitioners authorized to prescribe or dispense controlled substances. Signup and view all the answers

What term describes how a drug affects the body?

Pharmacodynamics Signup and view all the answers

Which term refers to the study of how genetic variations influence drug responses?

Pharmacogenomics Signup and view all the answers

Which of the following describes the process of a drug moving throughout the body?

Distribution Signup and view all the answers

The process by which a drug enters the circulating fluids of the body is known as:

Absorption Signup and view all the answers

The process by which the body chemically modifies a drug is referred to as:

Biotransformation Signup and view all the answers

Dynamic equilibrium is a vital process. What best describes it's function?

The process that determines the actual concentration of a drug in the body. Signup and view all the answers

Which of the following terms best describes the study of how medications travel through the body?

Pharmacokinetics Signup and view all the answers

In which of the following clients should a nurse prioritize assessing for altered drug metabolism?

A 50-year-old man with cirrhosis of the liver. Signup and view all the answers

A client's serum lithium level has reached the minimum concentration needed for a therapeutic effect. What term best describes this state?

Critical concentration Signup and view all the answers

When administering three medications simultaneously to a client, what should the nurse's first action be?

Identify the client by checking the armband and asking the client’s name. Signup and view all the answers

Which processes contribute to achieving dynamic equilibrium after drug administration? Select all that apply.

Excretion from the body. Signup and view all the answers

When administering medication to a client with a brain infection of bacterial etiology, what variable should the nurse prioritize?

Active infection may destroy the integrity of the blood–brain barrier. Signup and view all the answers

Study Notes

Module 1B Introductory Topics for Pharmacology

Course Instructor: Cathy Magowan, PhD, MSN, RN
University: D'Youville University
Course Number: NUR 320
Course Title: Pathophysiology/Pharmacology for Nurses
Semester: Spring 2025

Learning Objectives

Understand drug action concepts and principles
Identify developmental and cultural considerations in pharmacology
Identify developmental and cultural considerations of drug administration
Understand relevant pharmacology terminology and guidelines

Chapter 1 Introduction to Drugs

Adverse Effects (Side Effects): Undesired effects of a medication, ranging from unpleasant to dangerous.
Brand Name: The name given by the pharmaceutical company (trade name/proprietary name).
Generic Name: The original name given to a drug when developed.
Off-Label Use: Using a drug for a purpose not specified in the approved indication (labeling).
Over-the-Counter (OTC) Drugs: Medications available without a prescription.
Pharmacology: The study of the biological effects of chemicals.
Pharmacotherapeutics: The branch of pharmacology studying drugs for disease treatment, prevention & diagnosis.
Teratogenic: Medications that cause harm to a developing fetus during pregnancy.

Drug Testing Phases

Phase I (one): Pilot study with a small group. Usually healthy volunteers.
Phase II (two): Clinical study with select physicians. Conducted with patients who have the disorder the drug is intended for.
Phase III (three): Larger study with patients who have the disorder.
Phase IV (four): Continuous evaluation after release. Looking for long term data and reporting effectiveness.
Preclinical trials: Initial tests on chemicals thought to have therapeutic potential, before human trials (in vitro and in vivo).

Sources of Medications

Plant Sources:
- Ricinus communis: Castor oil, seeds.
- Digitalis purpurea: Digitalis leaf.
- Papaver somniferum: Opium, Morphine, MS Contin, Codeine.
Element Sources:
- Aluminum: Antacid, phosphate urinary stone prevention.
- Fluorine (as fluoride): Dental cavity and osteoporosis prevention.
- Gold: Rheumatoid arthritis treatment.
- Iron: Iron deficiency anemia treatment.

Legal Regulation of Drugs

Food and Drug Administration (FDA): Responsible for regulating drug development and sales.
Pure Food and Drug Act (1906): The first legislation to attempt to reduce mislabeling. Required labeling as a way to eliminate misleading or false claims.
Federal Food, Drug, and Cosmetic Act (1938): Mandated toxicity tests, procedures for introducing new drugs, and recall mechanisms for drugs.
Comprehensive Drug Abuse Prevention and Control Act (1970): Defined drug abuse, classified drugs by abuse potential and established strict controls on distribution, storage, and use.
Local & State Regulations: Exist in addition to federal regulations

Safety During Pregnancy

Category A: Appropriate human studies show no risk.
Category B: Insufficient human studies, but animal research suggests safety, or animal research shows issues, but human research shows safety.
Category C: Insufficient human studies, but animal studies show problems, or no animal studies and insufficient human studies
Category D: Human studies (with or without animal research) show fetal risks, but the drug is often vital to some women for treatment.
Category X: Fetal risks are evident; no situations where the risk/benefit justifies use.

Controlled Substances

Schedule I: High potential for abuse, no currently accepted medical use.
Schedule II: High potential for abuse, but accepted medical use.
Schedule III: Less potential for abuse than Schedule II, accepted medical use.
Schedule IV: Less potential for abuse than Schedule III, accepted medical use.
Schedule V: Less potential for abuse than Schedule IV, accepted medical use.

Other Drug Categories

Generic Drugs: Produced by companies focused on manufacturing. Must have identical strength. Often as effective as brand-name drugs, but usually less expensive.
Orphan Drugs: Not profitable for standard drug companies to make.
Over-the-Counter (OTC) Drugs: Available without prescriptions, used for self-treatment.

Learning Objectives (Chapter 2 Drugs and the Body)

Describe how body cells respond to medications.
Outline dynamic equilibrium, determining the actual concentration of a drug in the body.
List six factors that influence drug effectiveness.
Define drug interactions (drug-to-drug, drug-to-alternative therapy, drug-to-food, and drug-to-laboratory test).

Terms to Know (Pharmacology)

Pharmacodynamics: How a chemical (drug) affects the body.
Pharmacokinetics: How the body processes a drug (including absorption, distribution, metabolism, excretion.)
Pharmacogenomics: Variations in how people respond to drugs based on genetics.
Absorption: How a drug enters the bloodstream.
Distribution: How the drug is transported throughout the body.
Metabolism (Biotransformation): How the body breaks down the drug.
Excretion: How the drug leaves the body.
Critical Concentration: The level a drug needs to reach in the tissues to cause a desired effect.
First-Pass Effect: Drugs that are absorbed into the body from the gastrointestinal tract (e.g., stomach) first circulate to the liver for metabolism. Potentially reduces the amount of drug that is reaching its target areas.
Half-Life: The time it takes for the amount of a drug in the body to diminish to half of its original level.
Loading Dose: Higher initial dose to produce the therapeutic drug level sooner.
Placebo Effect: The documented effect of the mind on drug therapy.

Pharmacodynamics

Agonists: Replace or act as substitutes for missing chemicals. Example: insulin.
Selective Toxicity: A drug that is aimed at damaging only foreign cells.
Antagonists: Depressing or slowing down cellular activities. Example: antiinflammatories.
Interfering with foreign cell functioning: Example: Antibiotics.

Pharmacokinetics (Again, for clarity)

Critical Concentration: The drug level where it is effective within the body.
Therapeutic Index: The ratio of a drug's toxic concentration to its therapeutic concentration.
Loading Dose: Administering a higher initial dose to quickly achieve a therapeutic concentration.

Absorption (cont.)

Routes of Administration & Factors Influencing Absorption:
- Intravenous (IV): Immediate bloodstream entry.
- Intramuscular (IM): Absorption into muscles.
- Subcutaneous: Absorption into tissues beneath the skin.
- Oral (PO): Absorption from the gastrointestinal tract.
- Rectal (PR)/Vaginal: Absorption via membranes.
- Mucous Membranes (SL, buccal): Absorption through the layers of the mouth.
- Topical/Intradermal (skin): Absorption through the skin.
- Inhalation: Absorption through the lungs.

Distribution

Tissue Perfusion: The flow of blood to a tissue.
Protein Binding: Drug binding to proteins in the blood.
Blood-Brain Barrier: This barrier system prevents many drugs from reaching the central nervous system, restricting drug access to the brain.
Placenta and Human Milk: Drugs can pass through the placenta and into breast milk.
Biotransformation (Metabolism): Drugs may undergo transformation within the body, sometimes affecting their efficiency.
First-pass effect: When drugs metabolized in the liver prior to reaching the rest of the body; may result in decreased efficiency.
Hepatic Enzyme System: System of enzymes in the liver that works to metabolize many substances.
Half-Life: The length of time for a drug to reach half of its peak level and for that to reduce again to half its level, and continuing this pattern throughout the body's handling of the substance.

Excretion

Excretion Routes: Kidneys, liver, lungs, intestines. (Different organs excrete different substances).

Factors Influencing Drug Effects

Weight: Heavier people may need higher doses.
Age: Metabolism rates and effectiveness can vary by age.
Sex: Females may have different responses to medications, partly due to differences in fat tissue quantities between men and women.
Psychological Factors: A person's attitude about a drug may affect how it works.
Genetic Factors: Genetics play a large factor in how a drug affects an individual.
Immunological Factors: Allergies and diseases can cause a variance in drug responses.
Environment: Temperature, noise, and other environmental factors might influence drug effects.
Pathological Factors: Pre-existing conditions affect how a drug will interact and how it will be handled.

Drug-Drug or Drug-Alternative Therapy Interactions

Site of absorption: One medication may prevent or increase the absorption of another.
Distribution: One drug might compete with another for protein binding, preventing it from reaching its site of action.
Biotransformation: One drug may affect the metabolism of another, potentially leading to toxic drug levels and side effects.
Excretion: Competing for excretion sites reduces the effectiveness of one or both.
Site of action: One drug may be an antagonist to the other, reducing or preventing a desired effect.

Additional Questions and Answers/Key Concepts:

(See specific questions in the provided text for concise answers. These concepts are likely to be covered in the answers.)

Drug Metabolism
Drug Interactions
Drug Toxicity
Drug Safety (Patient Safety)
Nursing Process
Clinical Judgement
Pharmacokinetic and Pharmacodynamic Principles
Assessment and Evaluation

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Description

Test your knowledge on key pharmacological concepts, including drug absorption, distribution, and the significance of the blood-brain barrier. This quiz covers essential topics such as the first-pass effect, half-life, and selective toxicity. Get ready to explore the intricate world of drug interactions and therapeutic applications.