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MN553 Unit 2 Quiz / MN 553 Unit 2 Quiz (Newest
2020): Pharmacology: Kaplan University(ANSWERS
VERIFIED ALL CORRECT)
half life - answers - :the amount of time requrided for a drug to decrease in the body 50% is
called steady state half life phase II metabilism reduced bioavaliblity time
Down regulate the numbers of that specfic receptor - answers - :An agonist activates a receptor
and stimlates a rsponse when given frequently over time, the body may... upregulate the total number of receptors block the receptor witha partial agonist alter the drugs metabolsim downregulate the numbers of that specific receptor
Is modified by the concurrent administration of another drug - answers - :Drug antagonsim is
best defined as an effect of a drug that leads to major phsiolgical and psychological dependence is modified by the concurrent administration of anothe drug cannot be metabolized before another dose is administered leads to a drecrese physolgical response when combined with another drug.
to achieve the best effect, take the tablet with at least 8 ounces of water - answers -
:Instructions for a client regarding self administration of oral enteric coated tableted should include which of the following statements... avoid any other oral medicenes while taking this drug if swallowing this tablet is difficult dissolve in orange juice the tablet may be crushed if you have trouble taking it to achieve the best effect, take the tablet with at least 8 ounces of water
toxicity - answers - :The main reason for not crushing a sustained release tablet is that if
crushed the coated beads of the drugs could result in disintegration
Absrobed rapidly - answers - :an advantage of prescribing a sublingual medicaiton is that the
medication is absorbed rapidly excreted rapidly metabilized minmally distrubted equally
both 1 and 2 - answers - :Drugs that use CYP3A4 isoenzymes for metabolism may
induce the metabolism of another drug inhibit the metabolism of another drug both 1 and 2 not 1 or 2
After for to five half lifes - answers - :theraputic drug levels are drawn when a drug reaches
steady state drugs reach steady state.... after second dose
after four to five half lives when the patient feels the full effect of the drug one hour after IV administration
an exaggerated response if the drug is withdrawn - answers - :Upregulation or
hypersensitization may lead to increased response to a drug decreased response to a drug an exaggerated response to a drug if it is withdrawn refractories or complete lack of response All aplications for new active ingredients, new indications, new dosage forms, or new routes of
adminstration require pediatric studies - answers - :The Pediatric Research Equity Acts require
All children be provided equal acess to drug research trials children to be included in the planning phase of new drug development that pediatric drug trials guarantee chiclren of multiople ethnich groups are included
Prescribing dosages, will vary based on the developmental acivity of each enzyme. at times requireing lower doses than adult doses and other times hiher than adult doses based on the age of the child
Lower doses of renally excreted drugs may be prescribed to infants youger than age 6 months -
answers - :Developmental variations in renal function has what impact on prescribing for infants
and children? Lower doses of renally excreted drus may be prescribed to infants younger than age 6 months higher doses of water soulable drugs may need to be prescribed becasue of increased renal excretion renal excretion reates have no impact on prescribing parents need to be instructed on whether drugs are renally excreted or not
Of hyopothalamic, pituitary adrenal axis supression - answers - :Topical corticosteroids are
prescribed cautiously in young children because they may cause and intense hypersensitivity reaction of hypothalamic pituatiry adrenal axis supression corticosteroids are less effective in young children young children may accumulate corticosterods, leading to toxic levels
All the above - answers - :Liza is breastfeeding her 2 month old sone and has an infection that
requires an antibiotic. what drug factors influence the effect of the drug on the infant maternal drug levels half life lipid soluablility all the above
antineoplastic drugs such as methotrexate - answers - :Drugs that are absoluely contraindicated
in lactating women include SSRI antiepileptic drugs such as carbamazapine antineoplastic drugs such as methotrexate all the above
how to administer and oral drug using a medication syringe - answers - :Zia is a 4 month old
patietn with otitis media, education of his paretns regarding administering oral abx to an infant include how to administer and oral drug using a medication syringe mixing teh med with formula and putting it in a bottle
CYP P450 - answers - - :Liver enzyme that detoxifies substances,
Makes them easier to be excreted.
single nucleotide polymorphism (SNP) - answers - - :minor mutations that can result in
metabolic activity changes, including increased and decreased drug responses
primary organ of excretion for drugs - answers - - :kidney
blood flow differences in infants - answers - - :increased blood flow to muscles 1-6 mo EXCEPT
during illness, can cause slower or rapid perfusion
Pediatric GI function - answers - - :pH increases gradually- reaches adult levels @ 20-30 months
preemies are even slower
Diarrhea and kids - answers - - :kids with diarrhea have poor absorption of oral drugs
Pediatric skin absorption - answers - - :Kids have thinner stratum corneum so topical
medications are absorbed more readily: increased risk of toxicity
Infants and Lipid Soluble drugs - answers - - :decreased volume distribution, less plasma proteins
for binding, require higher doses of hydrophilic drugs
CYP1A2 (phase 1 enzyme) pediatric - answers - - :reaches adult level by 4 mo and then higher
than adult levels through childhood then declines
CYP2D2 (Phase 1 enzyme) pediatric - answers - - :absent or 5% active at birth reaches adult
levels by 3-5 yrs but has significant genetic variability
CYP2D6 ultrametabolizers - answers - - :up to 20 percent of Ethiopians are 2D6 ultra-
metabolizers but 3.4-6.5 percent of non-Ethiopian African Americans are ultra-metabolizers, same for caucasians
small intestine and drug metabolism - answers - - :small intestine is a major site of drug
metabolism d.t. CYP450 enzymes and may be a large variation in capacity of SB to metabolize drugs
Common drugs metabolized in phase II - answers - - :acetaminophen, morphine, Propofol, and
caffeine
Body Fat and drugs - answers - - :women have more body fat means a larger volume of
distribution for lipophilic agents, women experience more adverse reactions after drugs saturate all sites in adipose tissues and more drugs stay in the blood stream
CYP3A4 and Women - answers - - :activity higher in women : group of isoenzymes responsible
for drug metabolism ex: azole antifungal, calcium channel blocker, antihistamines, anticonvulsants, antimicrobials, and corticosteroids
CYP1A2 and Women - answers - - :activity lower in women enzyme responsible for metabolizing
many drugs :theophylline, cruciferous foods like broccoli and cabbage may induce drug metabolism apiaceous vegetables like carrots, parsnip, celery, or parley may inhibit CYP1A activity
CYP2D6 - answers - - :metabolizes 25% of prescribed drugs
34*5 majority of bad metabolizers Antidepressants Antipsychotics Antiarrythmics *carvedilol, *metoprolol
poor metabolizer - answers - - :metabolize drugs slow due to the lack of a working enzyme and
can lead to accumulation of an active drug
Intermittent metabolizer - answers - - :heterogeneous of one working enzyme
Extensive Metabolizers - answers - - :Respond as expected to standard doses
Ultrarapid metabolizers - answers - - :- break down drugs at faster rates than extensive
metabolizers
- no effect or less-than-expected effectiveness from drugs
CYP2D6 and Codeine - answers - - :codeine is an opioid prodrug that is catalyzed by CYP2D6 into
morphine the efficacy/safety of patients using codeine is determined by CYP2D6 phenotype *poor metabolizers get small/no effect, but UM have high risk of toxicity
ultra-metabolizer and breastfeeding - answers - - :mom can pass codeine to baby through breast
milk causing CNS effects
Poor metabolizers and codiene - answers - - :they are unable to convert it into its active form
What properties affect the distribution of drugs - answers - - :drug size, charge, chemical
structure, pH, molecular size, lipid or water solubility
first pass metabolism - answers - - :metabolism by the liver following oral administration
Phase 1 reactions - answers - - :Oxidation, reduction, hydrolysis or non-synthetic reactions that
prepare the drug for further metabolism - to make the drug more water soluble
Phase II reactions - answers - - :synthetic or conjugation reactions, something is added to drug
to make it more water soluble and more easily excreted by the kidneys
Distribution of the drug to target tissue may be effected - answers - :A patients nutritional intake
and lab results reflect hypoalbuminemia, this is critical to prescribing because: Distribution of the drug to target tissues may be effected the soluability of the drug will not match the site of absrobriton there will be less free drug availible to give an effect drugs bond to albumin and are redily excreted by the kidneys
Are rapidly metabolized by the liver and may have little if any desired action - answers - :Drugs
that have a significant first pass effect must be given by the enteral route only bypass the hepatic circulation are rapidly metabolized by the liver and may have little if any desired action are converted by the liver to more active and fat soluable forms
pharmacodynamics saftey and side effects
Rapidly achieves drug levels in the therapeutic range - answers - :Azithromycin dosing requires
that the first days dosage be twice those of the other 4 days of the prescription. This is considered a loading dose. Loading doses: Rapidly achieve drug levels in the theraputic range Require for to five half lifes to attain Is influenced by renal function Is directly related to the drug circulating to the target tissues
Onset of action - answers - :The point in time on the drug concentration curve that indicates the
first sign of a theraputic effect is the minimum adverse effect level peak of action onset of action theraputic range
To determine if the drug is in theraputic range - answers - :Phenytoin requies a trough level to
be drawn. Peak and trough are done when the drug has a wide theraputic range when the drug will be admin. for a short time only when there is a high correlation between the dose and the saturation of receptor sites to determine if a drug is in the theraputic range
Concentration will produce an adverse response - answers - :A labratory result indicates that the
peak level for a drug is above the minimum toxic concentration. This means that the: Concentration will produce theraputic effects Concentration will produce an adverse response time between doses must be shortened Duration of action of the drug is too long
Desensitization or downregulation with continuous use - answers - :Drugs that are receptor
agonists may demonstrate what property Irreversible binding to the drug receptor site
Begin distribution into the body immediately - answers - :Drugs administered via IV
need to be lipid soluable to be easily absorbed Begin distribution into the body immediately Are easily absorbed if the are non ionized May use pinocytosis to be absorbed
Greater than the sum of the effects of each drug individually - answers - :When a medication is
added to a regimen for a synergistic effect, the combinded effect of the drug is The sum of the effects of each drug individually Greater than the sum of the effect of each drug individually Less than the effect of each drug individually Not predictable, as it varies with each individual Bioavailiblity issues are especially important for drugs with narrow theraputic ranges or
sustaned release mechanisms - answers - :Which of the following statements about
bioavalibility is true?
Bioavailiblity issues are especially important for drugs with narrow theraputic ranges or sustaned release mechanisms All brands of a drug have the same bioavaliblity Drugs that are administed more than once a day have a greater bioavlilbltiy than drugs given once a day Combining an active drug with an inert substance does not affect bioavlaliblity
The blood bran barrier slows the entry of many drugs into and from brain cells - answers -
:Which of the following statements about the major distribution barries is true Water soluable and ionized drugs cross the barieers rapidly The blood brain barrier slows the entry of many drugs into and from brain cells The fetal placental barrier protects the fetus from drugs taken by the mother lipid soluable drugs do not pass these barriers and are safe for pregnant women
Change drug molecules to a form that an excretory organ can excrete - answers - :Drugs are
metabolized mainly be the liver via phase I or phase II reactions. the purpose of both these types of reactions is to Inactivate prodrugs before they can be activeated by target tissues
