Ch 2 Pharm

Front 1

__________ are chemicals that alter basic process in body cells.

Back 1

Drugs

Front 2

Drugs must reach and interact with or cross the _________ to stimulate or inhibit cellular function.

Back 2

Cell Membrane

Front 3

___________ involves drug movement through the body (ie, " what the body does to the drug") to reach sites of action, metabolism, and excretion.

Back 3

Pharmacokinetics

Front 4

___________ is the process that occurs from the time a drug enters the body to the time it enters the bloodstream to be circulated.

Back 4

Absorption

Front 5

Liquid medication are absorbed ___________ than tablets or capsules because they need not be dissolved.

Back 5

Faster

Front 6

___________ occur when two drugs with similar pharmacologic action are taken.

Back 6

Additive effects

Front 7

___________ occurs when two drugs with different sites or mechanisms of action produce greater effects when taken together.

Back 7

Synergism

Front 8

_________________ by one drug with the metabolism of a second drug may result in intensify effects of the second drug.

Back 8

Interference

Front 9

______________ of one drug from plasma protein binding sites by a second drug (ie a drug with a strong attraction to protein binding sites my displace a less tightly bound drug) increases the effects of the displaced drug.

Back 9

Displacement

Front 10

A or An ________________ drug can be given to antagonize the toxic effects of another drug.

Back 10

Antidote

Front 11

Explain how a drug is absorbed systemically.

Back 11

To act on body cells drugs given from systemic effects must reach adequate concentrations in the blood and other tissue fluids surrounding the cells. Therefore, they must enter the body and be circulated to their sites of action (target cells). After they have acted on cells they must be eliminated from the body.

Front 12

Although cells differ from one tissue to another, their common characteristics include the ability to perform what functions?

Back 12

Although cells differ from one tissue to another, their common characteristics include the ability to perform the following functions:

Exchange materials with their immediate environment.
Obtain energy from nutrients
Synthesize hormones, neurotransmitter, enzymes, structural proteins, and other complex molecules.

Front 13

Identify several factors that may affect the rate and extent of drug absorption.

Back 13

Numerous factors affect the rate and extent of drug absorption, including dosage form, route of administration and blood flow to the site of administration, gastrointestinal function, the presence of food or other drugs and other variables.

Front 14

Rapid movement through the stomach and small intestine may increase drug absorption by what mechanisms or factors?

Back 14

Rapid movement through the stomach and small intestine may increase drug absorption by promoting contact with absorptive mucous membrane; it also my decrease absorption, because some drugs may move through the small intestine to rapidly to be absorbed. For many drugs, the presence of food in the stomach slows the rate of absorption and may decrease the amount of drug absorbed.

Front 15

Why is drug distribution into the central nervous system (CNS) limited because of the brain barrier?

Back 15

Drug distribution into the CNS is limited because the blood brain barrier, which is composed of capillaries with tight walls, limits movement of drug molecules into brain tissue. This barrier usually acts as a selectively permeable membrane to protect the CNS

Front 16

The method by which drugs are inactivated or transformed by the body.

Back 16

Metabolism

Front 17

An important factor in drug distribution

Back 17

Protein binding

Front 18

A laboratory measurement of the amount of a drug in the blood at a particular time.

Back 18

A serum drug level

Front 19

Elimination of a drug from the body

Back 19

Excretion

Front 20

Involves the transport of drug molecules within the body after a drug is injected or absorbed into the bloodstream.

Back 20

Distribution

Front 21

You are explaining to your patient what bio availability is. Which of the following statements is true of bio availability?

a. It is portion of a dose that reaches the systemic circulation.

b. It is the portion of a dose that causes toxicity.

c. It is the portion of a dose that is absorbed by the system to achieve a therapeutic drug level.

d. It is the portion of a dose that reaches the systemic circulation and is available to act on body cells.

Back 21

d

Front 22

A drug is 100% bio available when it is administered by which of the following routes?

a. Oral

b. Parental

c. Intravenous

d. Rectal

Back 22

c

Front 23

Ms. Anderson is prescribed a medication to control her hypercholesterolemia. Two years later, the physician prescribes a higher dose of her medication due to a process called enzyme induction. A student nurse asks you to explain the change in the drug dosage. You explain that with chronic administration some drugs stimulate liver cells to produce with of the following?

a. smaller amounts of drug metabolizing enzymes.

b. Toxic amounts of drug metabolizing enzymes.

c. Larger amounts of drug metabolizing enzymes.

d. Therapeutic amounts of drug metabolizing enzymes.

Back 23

c

Front 24

Mr. Elliot is prescribed a combination of medications to treat his disease process. He is exhibiting signs of toxicity related to his new drug regimen. A possible cause of the change in the absorption of his medications may be enzyme inhibition. Which of the following is true of enzyme inhibition? (select all that apply)

a. It may occur with concurrent administration of two or more drugs that compete for the same metabolizing enzymes.

b. It may occur with concurrent administration of two or more drugs that compete for different metabolizing enzymes.

c. It may necessitate the administration of larger doses of the medication.

d. It may necessitate the administration of smaller doses of the medication.

d. It may necessitate the administration of smaller doses of the medication.

Back 24

a,b

Front 25

In the first pass effect or presystemic metabolism a drug is extensively metabolized in the liver, with only part of the drug dose reaching the systemic circulation for distribution to sites of action. The first pass effect occurs when some drugs are given why which of the following routes?

a. Orally

b. Rectally

c. Parentally

d. Intravenously

Back 25

a

Front 26

Whereas some drugs or metabolites are excreted in bile and then eliminated in feces, others are excreted in bile, reabsorbed from the small intestine, and then returned to the liver. Which of the following is the name of the process?

a. Enterophepatic Recirculation

b. Interohepatic recirculation

c. Enterorenal recirculation

d. Interorenal recirculation

Back 26

a

Front 27

For most drugs, serum levels indicate the onset peak, and duration of drug action occurs when the drug level reaches which of the following?

a. MAX

b. MIC

c. MEC

d. MAC

Back 27

c

Front 28

In clinical practice, measurements of serum drug levels is useful in which of the following circumstances? ( select all that apply)

a. When drugs with a narrow margin of safety are given, because their therapeutic doses are closed to their toxic doses.

b. When the mediation used is experimental.

c. To document the serum drug levels associated with particular drug dosages, therapeutic effects, or possible adverse effects.

e. To monitor unexpected responses to a drug dose, such as decreased therapeutic effects or increased adverse effects.

f. When a drug over dose is suspected.

Back 28

a, c, e, f

Front 29

___________________ also called elimination half life is the time required for the serum concentration of a drug to decrease by 50%

Back 29

Serum Half life

Front 30

When a drug is given at a stable dose how many half life periods are required to achieve steady stat concentrations and develop equilibrium between tissue and serum concentrations?

a. 2 to 3

b. 3 to 4

c. 4 to 5

d. 5 to 6

Back 30

c

Front 31

Pharmacodynamics involves drug action on target cells and results in which of the following?

a. Alterations in cellular biochemical reactions and functions.

b. Alterations in cellular pharmacologic reactions

c. Alterations in drug absorption

d. Alterations in drug secretion

Back 31

a

Front 32

Relatively few drugs act by mechanisms other than combination with receptor sites on cells. Drugs that do not act on receptor sites include which of the following? (select all that apply)

a. Antacids

b. Salicylates

c. Osmotic diuretics

d. Purines

e. NSAID's

Back 32

a, c, d

Front 33

Mrs. Geonity is prescribed a medication and the physician modifies the dose on multiple occasions to achieve the maximum therapeutic effect of the drug. She asks you what the rationale is for the dosage changes. How would you respond?

a. Dosages determines whether the drug actions may be therapeutic or toxic.

b. Dosage varies based on the brand name.

c. Your generic drug does not work as efficiently and the physician increased your dose.

d. Your HMO requires that we change the drug dose frequently.

Back 33

a

Front 34

Mr. Dow works the evening shift. The physician orders a medication that must be taken three times a day on an empty stomach. He asks you if he can take his evening dose with supper for the sake of convenience. How should you respond?

a. If it is only the one meal the food will not make a difference

b. Food may slow the absorption of the drug

c. Food may slow the absorption of the drug

d. It does not matter if the drug is taken on an empty stomach or not.

Back 34

b

Front 35

Mr. Ansgow is diagnosed with Parkinson's disease. His physician orders selegiline. As part of his eduation plan, you instruct the patient to avoid with of the following foods?

a. Grapefruit

b. Cheese

c. Chicken

d. Corn

Back 35

b

Front 36

Mrs. Adams is diagnosed with atrial fibrillation and prescribed the drug Coumadin. The nurse would instruct her to avoid which of the following foods?

a. Foods with vitamin B

b. Foods with vitamin C

c. Foods with vitamin K

d. Foods with niacin

Back 36

c

Front 37

Mr. Grey diagnosed with hypercholesterolemia and is prescribed a statin by his physician. As part of his education plan, the nurse should reach Mr. Grey to avoid which of the following foods?

a. Grapefruit

b. Cheese

c. Chicken

d. Corn

Back 37

a

Front 38

Changes in aging in the geriatric patient that may affect excretion and promote accumulation of drugs in the body include which of the following?

a. Rigidity of the diaphragm

b. Increased gastric motility

c. Decreased mentation

d. Decreased globular filtration rate

Back 38

d

Front 39

Mr. Abo, an African American male, ask you why the physician orders a diuretic as part of his treatment plan for hypertension, when the physician ordered an ACE inhibitor for his friend with the same diagnosis. After consulting with the physician, how would you respond?

a. Diuretics are more cost effective

b. Diuretics are shown to be more effective

c. The physician ordered diuretics to reduce the stress on your heart.

d. You must take the drug that the doctor orders, because he knows best how to manage your hypertension.

Back 39

b

Front 40

Mrs. Smith has a 12 year history of ETOH abuse. She is injured in a motor vehicle accident and requires surgery with general anesthesia. Which of requires surgery with general anesthesia. Which of the following would you expect for this client?

a. A smaller than normal dose of the general anesthetic

b. A larger than normal dose of the general anesthetic

c. The same dose of the general anesthetic as another female of her age and medical history

d. No general anesthesia because general anesthesia should not be given to a client with her history

Back 40

b