NUR 334 Exam 1 (Pharm 1) PDF

NUR 334 Exam 1 (Pharm 1) Study online at https://quizlet.com/_f6oiv1 Usually food has what effect on drug dissolution & absorption? Interferes with What occurs during the vascular phase of inflammation? Vasodilation wit...

NUR 334 Exam 1 (Pharm 1) Study online at https://quizlet.com/_f6oiv1 Usually food has what effect on drug dissolution & absorption? Interferes with What occurs during the vascular phase of inflammation? Vasodilation with increased capillary permeability A client who is taking NSAIDs complains of heartburn. What it is a known side effect of NSAIDs, but the RN should investigate should concern the nurse about this symptom? further The client asks how the NSAID he just took works. What is the "It inhibits synthesis of prostaglandins, reducing pain and inflam- nurse's best response? mation." -Tinnitus is common symptom of early toxicity The client is taking large doses of aspirin for an arthritic condition. -The half-life of aspirin in large doses is approximately 15-30 hours Which manifestations should concern the nurse? -Aspirin not taken at mealtime or with food can cause GI distress A 25-year-old client with asthma has been prescribed aspiring for Aspirin can cause bronchospasms arthritis. What should concern the RN about this? Which statement by a client would indicate a need for further "I will be glad to decrease how much I drink daily." education on ibuprofen? Which route of drug absorption has the greatest bioavailability? IV the time required after absorption for half of the drug to be elimi- Which statement is the best description of a drug's serum half-life? nated Which factors most commonly affect a drug's action? poor circulation, pain, stress, hunger, fasting Excretion or elimination primarily occurs by which organ? Kidneys Which is the best determinant of the biologic activity of a drug? the fit of the drug at the receptor site Which type of drug prevents or inhibits a cellular response? antagonists Which indicator measures the margin of safety of a drug? Therapeutic index To avoid drug toxicity, how often should blood levels be drawn? At Periodic intervals -Client should report epigastric distress What information should the nurse provide to an individual taking -Client should observe for tarry stools & bruising w/ extended use NSAIDs? (SATA) -Clients w/ mentrual flow should avoid NSAIDs during heavy flow Which statement is true regarding anti-gout agents? colchicine is used for an acute gout attack When discontinuing steroid therapy, the dosage should be tapered 5 to 10 over a period of how many days? -Increase fluid intake When planning patient education r/t antigout drugs, what informa- -Avoid alcohol & caffeine tion should be included? (SATA) -Avoid foods high in purine -Take medication with food Which factor is most relevant to the relief of chronic pain? Use of drugs with long half-lives What is the opioid antagonist used to treat an overdose of mor- naloxone phine-like substance? Withdrawal symptoms usually occur how many hours after the 8-24hrs opioid dose? The client is taking morphine for her post-operative pain. What Urinary retention should the RN assess to check if she is having SE? The client is taking morphine & reports having dizzy spells. What "You should move slowly when changing positions." is the nurse's best response to this concern? Which type of physiologic effect is not related to the intended Side Effects effect(s) that are associated with the use of a drug? Trade names Created by the distributor and can have multiple names The time it takes for an active substance to be reduced by 1/2 Half life rendering it to be not as effective anymore What the drug does to the body Pharmodynamics *Biggest obstacle for a med. to get to where it is going is mem- branes* 1/4 NUR 334 Exam 1 (Pharm 1) Study online at https://quizlet.com/_f6oiv1 What the body does to the drug A: Absorption Pharmokinetics D: Distribution M: Metabolism (Liver) E: Excretion/Elimination (Kidneys) The concentration of drug in the blood serum that produces the Therapeutic Range desired effect without causing toxicity Minimum effective concentration Lowest amount of drug required to produce effect Toxic concentration Leads to adverse effects Label on a medication as adverse events of medication that can Black Box Warning cause serious injury or death Steven-Johnson syndrome Blister-like lesions with sloughing Movement of drug from site of administration to various tissues of Absorption the body Distribution Movement of drug by circulating system to intended site of action Excretion Elimination of a drug through various parts of the body Onset When drug first takes effect Peak Highest concentration in blood (max effect) Length of time needed to decrease drug plasma concentration by Half-life half (50%) Intended use of drug, treat specific illness Therapeutic classification Ex. Antianginal for chest pain Mechanism of action, how it works Pharmacologic classification Ex. beta blockers block effects of epinephrine (adrenaline) Medication goes through liver to be metabolized, then goes out to First Pass effect rest of the body -IV medications bypass this effect Strength of drug itself, to get to desired effect Potency -Higher potency at lower dose to reach full effect Chemical processing medication changes to another form. Must Metabolism be considered when determining best route of administration Initial, high dose, at first to get drug into body system & act right Loading dose away Administering a steady amount to keep patient at a therapeutic Maintenance dose level Efficacy The maximum response that can be achieved with a drug Salicylate and belongs to the non steroid anti-inflammatory drug class Aspirin (Anti-inflammatory) -COX inhibitor For overdose give: Activated charcoal or large amounts of laxa- tives Anti-pyretic, NSAID, inhibits Prostaglandin synthesis Ibuprofen -Focus on GI bleeds For overdose give: Sodium Bicarb or charcoal Anti-finlammatory / corticosteroids Long term: Cushing's syndrome, hyperglycemia, bones easily Prednisone fractured, ulcers, insomnia, fetal harm, cataracts, glaucoma -Recommended 4-10 days, past that, will need to taper off -Do NOT use for acute infection -Do not give to children! Causes Reyes syndrome. Must know about Aspirin -Can be Ototoxic (tinnitus), GI discomfort and bleeding, Nephro- 2/4  NUR 334 Exam 1 (Pharm 1) Study online at https://quizlet.com/_f6oiv1 toxicity = tough on kidneys, blood sugar levels -Stop taking 7 days before surgery #1 cause of liver toxicity (hepatotoxicity) but you can take it for Acetaminophen chronic kidney disease for mild pain. Overdose tx - Acetylcysteine Group or class of medication has a common therapeutic use of fever. Give with food to decrease nausea, monitor for bleeding NSAIDS - Non Opioid Analgesics Aspirin - affects GI system Ibuprofen - Lower risk for GI issues This drug has the highest risk of abuse due to potency Fentanyl. 100 times stronger than morphine This is an opioid medication that is used to treat opioid dependen- Methadone cy because it causes less euphoria than others Anti-seizure drugs, calcium channel blockers, beta adrenergic What medications are used for prophylaxis of migraines blockers, Tricyclic anti-depressants Triptants, NSAIDs What medications are used for acute Tx of migraines -Vasoconstriction of cranial arteries *Worry about less blood flow, fetal toxicity SHOULD BE ROTATED Injection sites *Deltoid cannot handle 3ml injection* Renal and liver function What should be continually assessed when giving medication? *The liver is responsible for most of the metabolism of drugs that occurs in the body* Abuse Using more than one opioid, increases the risk of? Morphine Codeine Hydromorphine IV opioids should be given slowly to decrease the risk of? Adverse side effects Morphine IV is pushed over 4-5 minutes. Which side effect is the Respiratory depression most severe? What is ordered, the name, intended of proposed use of med, expected effects, contraindications, special considerations (In- Three nursing responsibilities during drug administration fants, elderly, pregnancy), side effects/adverse effects, how it's administered heat application, guided imagery, aromatherapy, distraction, Non pharmacological interventions biofeedback Elderly and medications Risk for poly-pharmacy. Older liver - increased toxicity. What kind of pain is the easiest to treat? Superficial Which patient do you treat first? -Systemic rash -Respiratory rate of 14 Systemic rash -Euphoric feeling -Nausea -Check with their provider A few things to make sure that they do prior to taking herbal -Don't believe skeptical claims medications -Recommended dose or a lower dose -Extended release Which types of oral medications cannot be crushed? -Enteric coated -Sustained release Morphine -Stimulates MUE and Capa receptors Opioid Agonist Prototype -Euphoria, pupils constrict, respiratory depression, constipation, urinary retention -Saved from acute/chronic pain when other meds have failed Opioid Antagonist Prototype 3/4 NUR 334 Exam 1 (Pharm 1) Study online at https://quizlet.com/_f6oiv1 Naloxone (Narcan) -Used for opioid overdose and misuse -BP and resp elevate, tremors, nausea, vomiting Sumatriptan (Imitrex) Anti-migraine Prototype -Worry about pregnant women, does risk outweigh benefit? -Avoid pickled foods, beer, cheese, wine (Can be triggers) Aspirin & Ibuprofen NSAIDs Prototype -Inhibits prostaglandins -Avoid St Johns Worp & Garlic Anti-inflammatory Prototype Aspirin & Ibuprofen Prednisone Corticosteroids Prototype -Can cause osteoporosis -Avoid black licorice & St. Johns Wort Acetaminophen -Fever and pain Antipyretic Prototype -COX inhibitor -Causes sweating The most important & first developed of the drug class Prototype -All new meds are based from the prototype Ex. Alpha blockers: Doxazosin Chemical make-up of the drug - really complicated/hard to pro- Chemical nounce Brand name (one name per drug) Generic Ex. Fluoxetine Company names drug (multiple names) Brand/Trade Ex. Prozac, olena, oxactin, prozep (All one drug) A- No increased risk for fetal abnormalities (Safe) B- Animal tested, no risk for fetus. However may have adverse effects, but can be controlled. Pregnancy Drug Categories C- May or may not have been animal tested D- Some risk to fetus, but benefit (of med) out-weighs the risk X- Contraindicated Binding Agonist Ex. Morphine Blocking Antagonist Ex. Nalaxone Partial blocking Partial Agonist Ex. Buprenorphine -Resp depression, less severe then agonist Side effects Expected reactions (common) Adverse effects Undesirable effects, can be fatal Nociceptor pain Injury to tissue Neuropathic pain Injury to nerves 4/4