Nurs 3315 Module A Exam Questions
And Already Passed Answers.
Cumulation - Answer Process by which blood levels of a drug build up.
Increases therapeutic and toxic effects.
May result from poor elimination due to slow metabolism, binding the drug to plasma proteins or
inhibition of excretion as occurs in sufferers of a kidney disease
Off-Label - Answer when a drug is prescribed for a different purpose than what the FDA has approved
Therapeutic Levels - Answer Toxicity: occurs if the peak blood level of the drug is too high
Peak: Highest blood level of a drug
Trough: lowest blood level of a drug
Pharmacodynamic Changes in Aging - Answer Alterations in receptors
Beta Blockers less effective
Warfarin, CNS Depressants more intense
More adverse drug reactions
Mostly dose related
Usually non-specific (dizziness, cognitive impairment)
Considerations in Pregnancy: Lactation - Answer Contraindicated:
Illicit Drugs
Anticancer agents/immunosuppressants
Atenolol
Bromocriptine
Ergotamine
Lithium
Nicotine
, Radioactive compound
COX-1 inhibitors (First Gen NSAIDS) - Answer indicatio mild-moderate pain, ns:fever, inflammation (RA,
OA)
MOA: interferes with COX-1 which promote synthesis of prostaglandins that have primarily beneficial
effects on bodily function
teaching: AE include Gi side effects (dyspepsia, heartburn, nausea, gastric or duodenal mucosal
injury/ulceration). Alert for increased risk of bleeding. Risk for thrombotic CV event
Other Things to Know:
Aspirin-like drug but few
GI, Renal and hemorrhagic effects.
Inhibition of cox-1+2, inhibition is reversible (Unlike aspirin)
NO PROTECTION AGAIST MI OR STROKE
COX-2 inhibitors (Celecoxib/Celebrex) - Answer indications: OA/RA, acute pain symptoms, ankylosing
spondylitis, primary dysmenorrhea
MOA: interferes with COX-2 which promote synthesis of prostaglandins involved in inflammatory
processes
teaching: AE include headache, diarrhea, fatigue, dizziness, hypertension, do not use if sulfa allergy
Other Things to Know:
Little effect on platelet function and lower risk for GI side effects
Can't be used with sulfa allergy
Can impair renal function and cause hypertension and edema (bc blocks prostaglandins)
Increased risk of MI + Stroke, so its the last choice for long-term pain
Aspirin (Salicylic Acid) - Answer indications: headahce, algia, arthritis, pleurisy, pericarditis, lupus,
antipyretic action. LOW dose aspirin (81 or 325mg) for thromboprevention. Pain, fever, arthritis doses
higher.
contraindications: children under 12 - reyes syndrome (neurologic deficits, coma, liver damage. Swelling
of the liver and brain)
adverse/side effects: increased HR, tinnitus, N/V/D, sweat, thirst, hyper/hypoglycemia, renal impairment
warnings: salicylism (tinnitus, sweating, headache, dizziness)
