NURS 5334 Final questions and answers 100% correct 2022
Prescribing basics - correct answer Prescribing is regulated by state BON
Proper RX - correct answer Providers name and address, Telephone
DEA
Pt name/DOB/Addres
Name of Drug, strength, SIG(directions) with indication/Route and frequency, Quantity and signature.
Drug Schedules: Most addictive to least - correct answer 1: Heroin,LSD, MJ
2: hydrocodone, cocaine, Methamphetamine, methadone, oxycodone, meperidine, fentanyl, adderall, ritalin
3: codeine, ketamine, testosterone
4: xanax, valium, soma, ambient, tramadol
5: antidiarrheal, antitussives, lomotil, lyrica
Pharmicodyamics - correct answer The effects of drug on the body. Receptors are large
molecules usually proteins, that interact and mediate the action of drugs
agonist - correct answer produce receptor stimulation and a conformational change every time they bind. Do not need all available receptors to produce a maximum response
Partial agonist - correct answer drugs that have properties in b/w those of full agonist and antagonist. They bind to receptors but when they occupy the receptor sites, they stimulate only some of the receptors.
antagonist - correct answer drugs with affinity for a receptor but with no intrinsic activity. Affinity allows the antagonist to bind to receptors, but lack of intrinsic activity prevents the bound antagonist from causing receptor activation. The block action of drugs (ex. Narcan)
Bioavailabity - correct answer % of administered dosage of the drug that survives the first pass through the liver and reaches the blood stream
half life - correct answer Time required for the amount of a drug in the body to decline by 50%, drugs with shorter half lives must be administer frequently. 4.5-5.5 times the half life to get steady state and to be limited from the body
what the body does to the drug - correct answer absorption, distribution, metabolism, excretion Distribution - correct answer movement of absorbed drug in bodily fluids throughout the body to target tissue. Properties affecting: lipid/water solubility, PH affects ionization of drug, protein binding, size of molecule (smaller molecules are more able to diffuse)
Tissue: fat, bone, blood/brain barrier (only lipid soluble will pass), placental barrier (many drugs can pass)
Protein binding - correct answer unbound drug is free which is active, crosses membrane. Low plasma proteins result in more free drug. Competition: when 2 highly bound drugs are given it increases the level of both drugs
Metabolism - correct answer take place in the liver mostly. Chemical change of a drug structure to: Enhance excretion, inactivate the drug, increase therapeutic action, active a prodrug (inactive until metabolized in the body into the active compound, ex: levodopa), increase
or decrease toxicity
CYP450 - correct answer enzymes constitutes the most important of the phase I metabolizing enzymes (account for about 75% of drug metabolism in the liver)
Phase 2: conjugation reaction occur leading to large increases in hydrophilicity of the substrates rendering them more readily excretable
Substrate - correct answer an agent that is metabolized by an enzyme into a metabolite and product and eventually excreted
Inhibitors - correct answer compete with other drugs for a particular enzyme affecting the metabolism (decreased) of the substrate and decreases the excretion of the substrate and increasing the circulating drug
inducer - correct answer competes with other drugs for a particular enzyme affecting metabolism of the substrate (increases) decreasing the efficacy of the drug
excretion - correct answer renal: passive glomerular filtration, active tubular secretion, tubular reabsorption, gi tract, lung, sweat and salivary, mammary
genomics - correct answer study of the complete set of genetic information present in a cell, an organism, or species
pharmacogenetics - correct answer the study of the influence of hereditary factors on the response of individual organisms to drugs, and the study of variations of DNA and RNA characteristics as related to drug response
Pharmacogenetics tests - correct answer Mentioned on drug labels can be classified as "test required," "test recommended," and "information only." Currently, four drugs are required to have pharmacogenetics testing performed before they are prescribed: cetuximab, trastuzumab, maraviroc and dasatinib wafarin, carbamazepine, valproic acid and abacavir are recommended to tests prior to initial dosing
Carbamazepine and Asisans - correct answer Initiating carbamazepine therapy in these
patients (allele HLA-B*1502) are at high risk for developing Steven Johnson syndrome or toxic epidermal necrolysis (TEN)
The ability of the anesthetic to penetrate the axon membrane is determined by 3 properties. What are they? - correct answer Molecular size, Lipid solubility, degree of ionization at tissue pH
Why is epinephrine given with local anesthetics? - correct answer Decreases local blood flow (decreased risk of bleeding)
Delays systemic absorption of the anesthetic
prolongs anesthesia
reduces the risk of toxicity
What is the most widely used local anesthetic? - correct answer Lidocaine
What is a possible fatal reaction to benzocaine - correct answer Methemoglobinemia
What is included in application guidelines for topical anesthetics - correct answer avoid wrapping the site and heating the site, avoid application to open skin
Which medication will not cause rebound headaches from overuse? - correct answer propranolol (preventative)
What is the best option for menstural migraine? - correct answer low dose estrogen about 3 days prior to menses
What food can trigger migraines? - correct answer Hot dog d/t nitrates
What medication is a Seratonin 1B1D receptor agonist? - correct answer Sumatriptan
Butterbur can help as prevention for migraine therapy. What side effect can occur? - correct answer Liver damage
What are the 3 main classes of opiod receptors? - correct answer Mu kappa delta
Which of the following will reserve he effects caused by opioid agonist? - correct answer
naloxone
Which of the medications are used to treat OIC? - correct answer Naloxegol, methylinaltrexone, lubiprostone
