Exam (elaborations)
NURS 615 PHARM EXAM 1 MARYVILLE QUESTIONS AND ANSWERS 100% PASS
Course
Maryville University NURS 615
Institution
Maryville University NURS 615
NURS 615 PHARM EXAM 1 MARYVILLE
QUESTIONS AND ANSWERS 100% PASS
What factors are associated with clinical judgment when prescribing medications? -
ANSWER-Prescribing a drug is based on a thorough assessment of the patient and
the patient's environment. The determination of potential medical and...
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NURS 615 PHARM EXAM 1 MARYVILLE
QUESTIONS AND ANSWERS 100% PASS
What factors are associated with clinical judgment when prescribing medications? -
ANSWER✔✔-Prescribing a drug is based on a thorough assessment of the patient and
the patient's environment. The determination of potential medical and nursing
diagnoses, a review of the potential alternative therapies, specific knowledge about the
drug chosen, and the disease process it is going to treat, known as patient centered care.
The best therapy is usually the least invasive, least expensive, and the least likely to
cause adverse reactions
What are the criteria for choosing an effective drug? - ANSWER✔✔-Multiple drugs may
be able to treat a specific condition. You must consult nationally recognized guidelines
for disease management to determine the most effective drug.
How does hypoalbuminemia affect the process of prescribing? - ANSWER✔✔-Many
drugs that carry an electric charge are bound to albumin in the blood. The distribution
of the drug to target tissues may be affected if hypoalbuminemia is present.
What is the drug's half-life? - ANSWER✔✔-In clinical practice it takes about four to five
times the half-life for a drugs concentration to read steady state after a drug is started,
stopped or changed. Hal life is the amount of time for a drug to be half cleared.
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,What is meant by the onset of action, peak of action, duration of action of medications? -
ANSWER✔✔-The onset of action is the time between the drug administration and the
time that you see the drugs minimum effect. Onset is the first sign of a drugs
therapeutic effect. Peak of action is the time of the maximum concentration of the drug
in the blood. Duration of action is the onset of action and the metabolism of the drug
below the dose needed for an effect.
Explain first pass metabolism. - ANSWER✔✔-This occurs when the concentration of the
drug is greatly reduced before it reaches the systemic circulation. It is the portion of the
drug lost during absorption. Generally, occurs in the liver or gut wall. After a drug is
swallowed it is absorbed by the digestive system and enters the hepatic system. It is
then carried by the portal vein to the liver before it reaches the rest of the body. The
liver metabolizes many drugs to such an extent that only a small portion of the drug
reaches the rest of the body. bioavailability of the drug thus is greatly reduced by the
liver. Sublingual administration can bypass the first pass system plus it is also faster
than oral route.
What is a steady state? - ANSWER✔✔-The overall intake of a drug is fairly and
dynamic equilibrium with its elimination. Steady state is reached when the time of four
to five times the half-life is reached since the drug had been started.
What factors affect the drug's absorption? - ANSWER✔✔-Absorption involves several
steps. First the drug must be introduced via route of administration and the form of
medication like tablet or capsule. In IV or IM administration the absorption is less
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, variable and bioavailability is near 100%. IV administration is considered to lose no
portion of the drug. The fastest route of absorption is inhalation. Drugs must pass
through the epithelial cells of the GI tract to be absorbed by the circulatory system. Cell
membranes may affect the absorption of some drugs because they are made of lipid
bilayers that are semi permeable. This means only small uncharged solutes can pass
through the membrane. Whether or not a molecule is ionized affects the absorption,
since ionic molecules are charged. Solubility favors charged species. Permeability favors
neutral species. Some molecules have special channels to facilitate movement from the
lumen into the circulation. The Henderson Hasselbeck equation offers a way to
determine the portion that is ionized in a given pH. Weak acids will be present in their
nonionic form in the stomach because of the acidic pH and bases will be in their ionic
form. Nonionic species diffuse easier through cell membranes. Weak acids have a
higher absorption rate in the stomach. The opposite is true in the basic environment of
the stomach.
Identify drug metabolism and the role of the isoenzymes of the P450 system. -
ANSWER✔✔-CYPs are the major enzymes in drug metabolism. Must drugs undergo
deactivation by CYPs are directly facilitated secretion from the body. Many substances
are bioactivated by CYPs to form their active compound. Many drugs increase or
decrease the activity of CYPs isoenzymes either by inducing biosynthesis of an isozyme,
which is enzyme induction or by directly inhibiting the activity of CYP which is enzyme
inhibition. This is a major source of adverse drug reactions since changes in CYPs
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