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NR 567 EXAM PREP LATEST ADVANCED PHARMACOLOGY FOR THE AGACNP ANSWERED
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NR 567 EXAM PREP LATEST ADVANCED PHARMACOLOGY FOR THE AGACNP ANSWERED
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lOMoARcPSD|176 160 83NR 567 EXAM PREP LATEST
Advanced Pharmacology for the Adult-Gerontology
Acute Care Nurse Practitioner
ANSWERED
2023/2024
, lOMoARcPSD|176 160 83
1. What are the four main processes of pharmacokinetics and how do they affect the drug concentration
in the body? Explain with an example of a drug used in acute care settings.
- The four main processes of pharmacokinetics are absorption, distribution, metabolism, and excretion.
They affect the drug concentration in the body by determining how fast and how much of the drug enters
the bloodstream, reaches the target tissues, is transformed by enzymes, and is eliminated from the body.
For example, a drug that is poorly absorbed from the gastrointestinal tract will have a low bioavailability
and a low plasma concentration, while a drug that is highly bound to plasma proteins will have a large
volume of distribution and a long half-life.
2. What are the factors that influence the pharmacodynamics of a drug, i.e., the relationship between the
drug concentration at the site of action and the resulting effect? Give an example of how each factor can
modify the drug response in an older adult patient.
- The factors that influence the pharmacodynamics of a drug are receptor affinity, intrinsic activity,
receptor number and sensitivity, second messenger systems, and feedback mechanisms. For example,
receptor affinity determines how strongly a drug binds to its receptor and influences its potency; intrinsic
activity determines how well a drug activates its receptor and influences its efficacy; receptor number
and sensitivity can change due to up-regulation or down-regulation in response to chronic exposure or
withdrawal of a drug; second messenger systems mediate the intracellular effects of a drug and can be
affected by other drugs or diseases; and feedback mechanisms regulate the homeostasis of the body and
can counteract or enhance the drug effect.
3. What are the types and mechanisms of drug interactions and how can they affect the therapeutic
outcome or cause adverse effects? Provide an example of each type of interaction and explain how it can
be prevented or managed in acute care settings.
- The types and mechanisms of drug interactions are pharmacokinetic interactions, pharmacodynamic
interactions, and combined toxicity. Pharmacokinetic interactions occur when one drug alters the
absorption, distribution, metabolism, or excretion of another drug, resulting in changes in plasma
concentration or bioavailability. For example, antacids can reduce the absorption of some antibiotics by
forming insoluble complexes in the stomach; enzyme inducers can increase the metabolism of some
drugs by stimulating their breakdown in the liver; protein-binding displacers can increase the free
fraction of some drugs by competing for binding sites on plasma proteins; and diuretics can increase the
excretion of some drugs by increasing urine output. Pharmacokinetic interactions can be prevented or
managed by adjusting the dose, timing, route, or formulation of the drugs involved; monitoring plasma
levels; or avoiding concomitant use of incompatible drugs.
Pharmacodynamic interactions occur when two drugs have additive, synergistic, or antagonistic effects
on the same or different receptors or physiological systems. For example, opioids and benzodiazepines
have additive effects on central nervous system depression and can cause respiratory depression; beta
blockers and calcium channel blockers have synergistic effects on cardiac output and blood pressure
reduction and can cause bradycardia or hypotension; and antihistamines and anticholinergics have
antagonistic effects on histamine receptors and muscarinic receptors and can reduce each other's
, lOMoARcPSD|176 160 83
efficacy. Pharmacodynamic interactions can be prevented or managed by selecting drugs with different
mechanisms of action, using lower doses, monitoring clinical response, or using antidotes or reversal
agents if available.
Combined toxicity occurs when two drugs have similar or overlapping adverse effects that exceed the
individual toxicity of each drug. For example, nonsteroidal anti-inflammatory drugs (NSAIDs) and
corticosteroids have combined toxicity on gastric mucosa and can cause peptic ulcers or bleeding;
aminoglycosides and vancomycin have combined toxicity on renal function and can cause nephrotoxicity;
acetaminophen and alcohol have combined toxicity on hepatic function and can cause hepatotoxicity.
Combined toxicity can be prevented or managed by avoiding concurrent use of drugs with similar
toxicities, using alternative drugs with less toxicity, reducing doses or frequency, monitoring organ
function tests, or providing prophylactic or supportive measures.
During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's
assessment reveals that the patient has been taking
over-thecounter laxatives for the past 7 years. The nurse informed the patient that
prolonged use of laxatives
Selected may cause nutrient deficiencies.
Answer:
Question 10
1 out of 1 points
A home health nurse notes that there have been changes to a patient's oral
drug regimen. The nurse will closely monitor the new drug regimen to
Selected identify any changes in drug absorption that would change the
Answer: drug effect.
Question 11
1 out of 1 points
What critical piece of information is missing from the following medication
order: Amoxicillin 250 mg every 8 hours?
Selected Route
Answer:
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