Chapter 3, Pharmacokinetics and Pharmacodynamics - EAQ PDF

Performance Exit Chapter 3, Pharmacokinetics and Pharmacodynamics - EAQ Due May 12, 2024 by 10:59 pm Failed 16 out of 24 questions answered correctly Completed on May 12, 2024 11:31 pm Incorre...

Performance Exit Chapter 3, Pharmacokinetics and Pharmacodynamics - EAQ Due May 12, 2024 by 10:59 pm Failed 16 out of 24 questions answered correctly Completed on May 12, 2024 11:31 pm Incorrect (8) Report content error Which type of effect occurs when a psychological benefit is Which type of effect occurs when a psychological benefit is obtained from a compound that may not have a drug effect? Side Toxic Placebo Adverse Rationale The placebo effect is a psychological benefit from a compound that may not have a drug effect. Side effects are physiologic effects not related to desired drug effects. Drug toxicity can be measured by checking the blood level of a drug. An adverse reaction is actually more severe than a side effect. p. 27 Report content error Which term is used to describe the biotransformation of a drug? Distribution Excretion Absorption Metabolism Rationale The pharmacokinetic phase includes four processes: (1) absorption, (2) distribution, (3) metabolism (biotransformation), and (4) excretion (elimination). Metabolism connotes a breakdown of a product. Biotransformation is a more accurate term because some drugs are actually changed into an active form in the liver, in contrast to being broken down for excretion. The terms absorption, distribution, and excretion are not used to describe the process of biotransformation of a drug. p. 23 Report content error Which effect will the nurse suspect when a patient receiving pain medication for more than 24 hours states, “This medication is not helping my pain like it did yesterday”? Tolerance Toxic effect Placebo effect Tachyphylaxis Rationale Tachyphylaxis is a rapid decrease in the response to a drug. In other words, tachyphylaxis may be thought of as “acute tolerance.” The patient’s response must be assessed further to prevent misinterpretation, because drug-seeking behavior is associated with addiction. Tolerance is a gradual decrease in the response to a drug over the course of therapy. The patient must be monitored for toxic effects while receiving a drug with a narrow therapeutic effect, such as an aminoglycoside antibiotic or an anticonvulsant. A patient may feel better after taking an inert compound that does not have the chemical structure or actual therapeutic benefit of the real drug; this experience is known as the placebo effect. p. 27 Report content error Which instruction would the nurse include when teaching a patient about the administration of phenelzine? “Take the medication 1 to 2 hours before meals.” “Eat bananas daily for as long as the medication has been prescribed.” “Crush the medication and mix it with yogurt to enhance absorption.” “Refrain from sour cream for as long as the medication has been prescribed.” Rationale Because phenelzine is an antidepressant of the monoamine oxidase inhibitor (MAOI) type, the nurse would instruct the patient to refrain from eating tyramine-rich foods, such as sour cream. These food items have sympathomimetic-like effects that might cause a hypertensive crisis when taken with an MAOI. The patient should take the medications as prescribed by the primary health care provider. Bananas and yogurt are also rich in tyramine and should not be taken with MAOIs. p. 29 Report content error Which action occurs when a drug reaches its half-life? It exerts a response. It is absorbed by the body. It is being eliminated by the body. It reaches a therapeutic level. Rationale In pharmacokinetics, the time required for half of an administered dose of drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%, is the drug’s half-life (also called theelimination half-life). A drug’s half-life does not involve exerting a response, being absorbed by the body, or reaching a therapeutic level. p. 23 Report content error Which intervention will the nurse implement when caring for a patient who is receiving a drug with a narrow therapeutic index? Monitor the patient’s plasma drug level periodically. Monitor the patient’s serum albumin levels periodically. Instruct the patient not to drive after taking the medication. Instruct the patient not to take the drug after a high-fat meal. Rationale The therapeutic range of a drug is the range between the minimum effective concentration of the drug in the plasma to obtain the desired drug action and the minimum toxic concentration. The nurse will monitor the plasma drug level periodically to avoid drug toxicity while caring for a patient who is receiving a drug with a narrow therapeutic index, such as digoxin. Some drugs bind to the protein molecules in the body. The nurse monitors serum albumin levels in patients receiving such drugs to determine the possibility of drug toxicity. Some medications, such as diphenhydramine, cause drowsiness as a side effect. In such cases, the nurse instructs patients not to drive after taking the medications. A patient who has been prescribed enteric- coated tablets should not eat high-fat meals before taking the tablets because that would decrease the absorption rate of the drug. Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation. p. 24 Report content error Which information will the nurse consider when caring for a patient who has been prescribed digoxin once daily? The body eliminates excess digoxin within 1 day. The patient must be monitored frequently for drug toxicity. The drug has a half-life of 12 hours in patients with normal renal function. The body reaches a steady state of drug concentration in 3 days. Rationale The nurse will assess the patient’s renal function and monitor the patient frequently for drug toxicity. Digoxin has a large volume of drug distribution and stays in the body for a longer period of time. It has a long half-life of 36, not 12, hours in patients with normal renal function. It takes several days, not 1 day, for the body to completely eliminate the drug. For a patient with normal renal function, it would take approximately 5 days to 1 week (three to five half-lives) rather than 3 days to reach a steady state of digoxin concentration. Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation. p. 24 Report content error Which action by the nurse when reviewing a new medication prescription is consistent with pharmacogenetic principles and the Precision Medicine Initiative? Provides genetic testing for each prescribed medication Avoids complex medication regimens Reduces multiple prescribed medications Treats the patient with the right medication Rationale Pharmacogenetic principles and the Precision Medicine Initiative both support the review of genetic testing and patient variables to determine the right medication for a specific patient. Genetic testing is not  possible for all medications. Complex medication regimens may increase a patient’s risk for complications, but avoiding complex therapy is not always possible. The correct selection using pharmacogenetic principles may minimize the risks to patients. Pharmacogenetic principles and the Precision Medicine Initiative both support selection of the correct medication. Multiple medications may increase a patient’s risk for complications, but the correct selection using pharmacogenetic principles may minimize those risks. Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation. p. 33 Correct (16) Report content error Which term is used to describe the study of drug effects on the body? Pharmacology Pharmacokinetics Pharmacodynamics Pharmacotherapeutics Rationale Pharmacodynamics refers to what the drug does to the body (that is, how it influences cellular physiology). Pharmacology is the study of drugs. Pharmacokinetics is the study of what the body does to the drug. Pharmacotherapeutics refers to the study of the therapeutic use of drugs. p. 24 Report content error Which term is used to describe the ratio between a drug’s therapeutic effects and its toxic effects? Affinity Tolerance Cumulative effect Therapeutic index Rationale The ratio of a drug’s therapeutic benefits to its toxic effects is referred to as the drug’s therapeutic index (TI). Affinity refers to a similarity of characteristics suggesting a relationship. Tolerance refers to a decreased responsiveness to a drug over the course of therapy. Cumulative effect refers to the state at which repeated administration of a drug may produce effects that are more pronounced than those produced by the first dose. p. 24 Report content error Which route of drug administration provides the fastest therapeutic effect? Oral Topical Intravenous Subcutaneous Rationale Intravenous drugs are absorbed more quickly than oral, topical, or subcutaneous drugs. The bioavailability for intravenous drugs is 100%, and these drugs would provide the fastest therapeutic effect. p. 22 Report content error Which term is used to describe the study of the properties of drugs and how they influence the body? Pharmacology Pharmacokinetics Pharmacodynamics Pharmacotherapeutics Rationale In simpler terms, pharmacodynamics is the study of what drugs do to the body. Pharmacology is the study of the uses, effects, and modes of action of drugs. Pharmacokinetics is the study of the movement of drugs within the body. Pharmacotherapeutics is the study of therapeutic uses and effects of drugs. p. 24 Report content error Which time frame would a nurse select for a blood sample to be drawn from a patient to obtain a trough level? 1 hour after administration Just before the administration of the next dose 10 minutes after administration  Immediately after administration Rationale A trough level measures the rate at which the drug is eliminated from the body. Therefore the blood sample must be drawn just before the next dose is administered. At this time, the concentration of the drug in the plasma is the lowest. The blood sample for the peak level must be drawn at the proposed peak time. Peak time for oral drugs may range from 1 to 3 hours. Peak time for intravenous drugs may start as early as 10 minutes after administration. Neither the peak nor the trough level occurs immediately after the drug is administered. p. 25 Report content error Which laboratory test would indicate the highest plasma concentration of a drug at a specific time? Peak drug level Trough drug level Therapeutic index Therapeutic range Rationale Peak drug level indicates the rate of absorption of the drug and is the highest plasma concentration of a drug at a specific time. Trough drug level, which indicates the rate of elimination of the drug, is the lowest plasma concentration of a drug at a specific time. The therapeutic index estimates the margin of safety of a drug through the use of a ratio that measures the effective dose and the lethal dose. The therapeutic range of a drug concentration in plasma is the level of drug between the minimum effective concentration in the plasma for obtaining a desired drug action and the minimum toxic concentration. p. 25 Report content error Which factor will the nurse consider when administering a drug with a narrow therapeutic index (TI)? There is less possibility of developing dependence. There is a high possibility that overdose events will occur. The drug will have low tolerance compared with other drugs. The chances of side effects are low with this drug relative to other drugs. Rationale A narrow TI indicates that the difference between the therapeutically active dose and the toxic dose of a drug is small. Therefore a drug that has a narrow TI has a high possibility of overdose, which the nurse will consider when administering such a drug. Dependence is not related to the TI. There is a greater, not lower, likelihood of side effects relative to other drugs. Tolerance is not related to the TI. p. 29 Report content error Which drug delays the renal excretion of penicillin? Ibuprofen Fenoprofen Flurbiprofen Probenecid Rationale Probenecid delays the renal excretion of penicillin. It increases the serum levels of penicillin and prolongs its effect. Therefore the dose of penicillin should be reduced while administering probenecid. Ibuprofen, fenoprofen, and flurbiprofen are propionic acid derivatives. These drugs do not interfere with the renal excretion of penicillin. Test-Taking Tip: Multiple-choice questions can be challenging because students think that they will recognize the right answer when they see it or that the right answer will somehow stand out from the other choices. This is a dangerous misconception. The more carefully the question is constructed, the more each of the choices will seem like the correct response. p. 28 Report content error Which instruction would the nurse include when teaching a patient about the administration of sulfonamide? “Do not drink milk with this medication.” “Do not use vitamin supplements while taking this medication.” “Do not take any over-the-counter medications while on this drug.” “Stay out of the sun when possible, and use sunscreen when you are outside.” Rationale Sulfonamide has been reported to cause photosensitivity in patients, so the nurse would advise the patient to stay out of the sun and use sunscreen outside while taking this drug. The use of sunscreen with ultraviolet protection is recommended. Milk and vitamin supplements do not reportedly interact with this drug. Not all over-the-counter medications will react with this drug; however, it is always prudent to check with the health care provider before adding any medication. p. 31 Report content error Which statement describes a characteristic of highly protein-bound drugs? “They increase the risk of drug-drug interactions.” “They typically provide a short duration of action.” “They must be administered with 8 ounces of water.” “They have a decreased effect in patients with a low albumin.” Rationale When two medications that are highly protein bound are administered, the medications can compete for binding sites on plasma proteins. This competition results in either less of both or less of one of the drugs binding to the proteins, thus increasing the risk of toxicity. Highly protein-bound drugs do not typically provide a short duration of action or need to be administered with 8 ounces of water. Highly protein- bound drugs do not have a decreased effect in patients with low albumin levels. p. 22  Report content error Which pharmacokinetic phase is affected by a compromised renal system? Absorption Metabolism Excretion Distribution Rationale The kidneys are the primary organs responsible for excreting drugs from the body. An impaired renal system often leads to compromised excretion and may result in toxic levels of a drug in the bloodstream. Absorption occurs through various parts of the body apart from the kidneys. Kidneys are not responsible for metabolism and distribution of a drug in the body. p. 24 Report content error Which effect on the bioavailability of a drug occurs when a patient takes an enteric-coated medication with a large amount of food? It becomes zero. It decreases. It increases. It is unaffected. Rationale An enteric coating is designed to protect a drug from dissolution until it can be absorbed in the intestines. Taking an enteric-coated drug with a large amount of food may cause the drug to be dissolved by acidic stomach contents, thereby reducing its intestinal absorption. This will further reduce the bioavailability of the drug. Taking an enteric-coated tablet with a large amount of food does not make the bioavailability zero. The bioavailability does not increase, because the drug may become inactive due to gastric acids. Taking an enteric-coated tablet with food interferes with the drug’s bioavailability. p. 21 Report content error Which percentage would indicate the bioavailability of an intravenous drug? 100% 50% 60% 90% Rationale Bioavailability is the quantity of a drug available in the body after it is administered either orally or via other routes. Bioavailability of 100% is recorded when drugs are administered intravenously directly into the bloodstream. Many drugs administered orally go through first-pass metabolism in the liver before beginning systemic circulation. Therefore the bioavailability of drugs taken orally, rather than those given intravenously, is less than 100%. p. 22 Report content error Which drug will the nurse administer to a patient in need of an immediate drug response? A placebo An oral drug A loading dose  A high first-pass drug Rationale When an immediate drug response is desired, a large initial dose, also known as a loading dose, will be administered to the patient. This achieves a rapid minimum effective concentration in the plasma. A placebo is an inert substance that does not have the chemical structure or therapeutic benefit of the actual drug. Oral drugs take longer to go into systemic circulation, so an oral drug will not produce an immediate drug response. Drugs with a high first-pass effect have less bioavailability in systemic circulation. A patient who needs an immediate drug response will not be administered a placebo, an oral drug, or a drug with a high first-pass effect. p. 24 Report content error Which side effect will the nurse include when teaching a patient about diphenhydramine prescribed for the treatment of allergies? Mild sedation Bladder contraction Increase in peristalsis Decrease in blood pressure Rationale Diphenhydramine can cause both primary and secondary effects. The primary effect is to treat all the symptoms of allergies. The main secondary effect, mild sedation, is on the central nervous system. Bladder contraction can be seen with bethanechol. Laxatives increase the peristaltic movement of the gastrointestinal tract. A decrease in blood pressure is another effect of bethanechol, which acts on cholinergic receptors. p. 24 Report content error Which type of effect occurs when a psychological benefit is obtained from a compound that may not have a drug effect? Side Toxic Placebo Adverse Rationale The placebo effect is a psychological benefit from a compound that may not have a drug effect. Side effects are physiologic effects not related to desired drug effects. Drug toxicity can be measured by checking the  blood level of a drug. An adverse reaction is actually more severe than a side effect. p. 27 1 topics covered Chapter 3, Pharmacokinetics and Pharma… Intermediate McCuistion: Pharmacology, 11th Edition Novice Intermediate Proficient Questions answered You 50 Quiz me on this topic