Download Pharmacology Exam Q&A: Drug Classifications and Mechanisms and more Exams Nursing in PDF only on Docsity!
MSN 623 Exam 1 QUESTIONS WITH
COMPLETE ANSWERS. NEW UPDATES!
schedule I - CORRECT ANSWER -Potential for abuse is so high as to be
unacceptable. May be used for research with appropriate limitations. Examples are heroin, LSD, and cocaine.
schedule II - CORRECT ANSWER -High potential for abuse and severe
dependence liability; current, accepted medical use; prescription drug-signed, not stamped prescription. 30-day supply, no refills. Examples: opium, morphine, methadone.
schedule III - CORRECT ANSWER -Less abuse potential, than C-II; low-
moderate physical dependence. High psychological dependence; by prescription only, which expires in 6 months. Maximum of five refills on one script. Examples: Tylenol with codeine and hydrocodone
schedule IV - CORRECT ANSWER -Less abuse potential than C-III; accepted
medical use; limited physical and psychological dependence; written or verbal prescription, expires in 6 months; maximum of five refills on one script. Examples: Librium, and valium.
schedule V - CORRECT ANSWER -Limited abuse potential; accepted medical
use; small amounts of narcotics used as antitussives (cough medicine) or antidiarrheals; may not need a prescription but must be recorded as a transaction. Examples: lomotil and Robitussin A-C.
info included in writing prescription - CORRECT ANSWER -a. Date
b. Patients full name, legal name c. Name of medication written out d. The dose e. The SIQ: directions f. Dispensing amount, how much you want them to get g. Refill: zero or none h. Signature, full signature. APNP at the end.
a. Decongestants: - CORRECT ANSWER -pseudoephedrine. They work like the
sympathetic nervous system they cause vasoconstriction, so the histamine doesn't cause boogers, drainage, inflammation b. Cause blood vessels to constrict
Sympathomimetics - CORRECT ANSWER -Drugs used therapeutically that
mimic the catecholamines epinephrine, norepinephrine, and dopamine. Also called adrenergic agonists. i. Reduce nasal congestion (do not reduce rhinorrhea, sneezing, or itching) ii. Activate alpha1-adrenergic receptors on nasal blood vessels iii. Adverse effects
- Rebound congestion
- CNS stimulation
- Cardiovascular effects and stroke
- Abuse
Antihistamine-sympathomimetic combinations - CORRECT ANSWER -1.
Ipratropium bromide [Atrovent]
- Montelukast [Singulair]
- Omalizumab [Xolair]
steady state - CORRECT ANSWER -The physiologic state in which the amount
of drug removed via elimination is equal to the amount of drug absorbed with each dose. In pharmacokinetics, steady state refers to the situation where the overall intake of a drug is fairly in dynamic equilibrium with its elimination. In practice, it is generally considered that steady state is reached when a time of 4 to 5 times the half-life for a drug after regular dosing is started. Whatever medication is going in is coming out.
minimum effective concentration - CORRECT ANSWER -there is a minimum
amount of the medication in the body doing the job. It is defined as the minimum concentration of drug in plasma required to produce the therapeutic effect. It reflects the minimum concentration of drug at the receptor site to elicit the desired pharmacological response.
therapeutic levels - CORRECT ANSWER -is the concentration of a drug in the
blood serum that produces the desired effect without toxicity. what they will check for, must be at certain level to make sure there is enough medication on board. The therapeutic level of a drug in the bloodstream is the range within which that drug is expected to be effective without causing any serious problems to the patient.
toxic levels - CORRECT ANSWER -too high. Need to bring the level down. The
person will start to see side effects and adverse effects.
synergistic effect - CORRECT ANSWER -interaction of two or more medicines
that results in a greater effect than when the medicines are taken alone
- Step 3.- moderate persistent- add inhaled corticosteroid , may add theophylline.
- Step 4.- Severe persistent- add po steroids
Green Zone: Doing well - CORRECT ANSWER -1. No cough, wheeze, chest
tightness, or shortness of breath during the day or night. Can do usual activities.
- Peak flow: more than 80% or more of best peak flow
yellow zone - CORRECT ANSWER -50-80% of personal best, indicates caution,
something is triggering asthma
- Cough, wheeze, chest tightness, or shortness of breath. Waking at night due to asthma, can do some but not all usual activities
- Peak flow 50-79% of best
red zone - CORRECT ANSWER -50% or less than personal best = serious
problem
- Very SOB, quick-relief medications have not helped, cannot do usual activities, symptoms are same or getting worse after 24 hours in yellow zone
- Peak flow 50% of best
asthma medications - CORRECT ANSWER -Medications
- Quick relief (rescue): Short-acting β2 agonists, systemic corticosteroids
- Long term (preventer): Corticosteroids, antiallergy agents, NSAIDS, long-acting β agonists, leukotriene modifiers (Singulair), long-acting bronchodilators, nebulizers Theophylline: monitor serum levels-ER settings Leukotriene modifiers-(Singulair) block inflammation & bronchospasm effects Chest physiotherapy
- Breathing exercises; physical training
- glucocorticoids 2.Leukotriene Modifiers 3 Cromolyn 4.Omalizumab [Xolair] 5.Bronchodilators- Beta 2: 5. Inhaled long-acting beta2 agonists (LABAs) or Inhaled short-acting beta2 agonists (SABAs)
- Methylxanthines Bronchodilator: theophylline
- Ipatropium
- Treatment for cat bites, cellulitis and cellulitis caused by MRSA (community
acquired). - CORRECT ANSWER -a. Augmentin is what is used to treat cat bites
b. Clindamycin next choice.
c. Levaquin: black box warning! Fluoroquinolones d. Cellulitis: cephalosporins, cephalexin or Keflex. If community acquired caused by MRSA: use Bactrim. If bad use clindamycin and Bactrim e. Send out cultures
strep - CORRECT ANSWER -strep group A is usual what we treat. Penicillin. If
allergic use erythromycin or clindamycin
sinusitus - CORRECT ANSWER -under 7 days its considered a viral infection,
treat symptomatically. Augmentin is first choice. Second is doxycycline 100mg twice a day for 7-10 days. Clindamycin is next choice. Levofloxacin is last: causes tendon rupture in elderly and children.
bronchitis - CORRECT ANSWER -: presume it's viral. If wheezing, put on short
burst of prednisone for 5-7 days. Albuterol inhaler. Fluids, Mucinex. If respiratorally compromised COPD, asthma: put on antibiotic (Augmentin or Zithromax).
Bacteriostatic: - CORRECT ANSWER -: it stops, holds, limits. Trimethoprim,
Bactrim, sulfamethoxazole. Prevents future growth of bacteria
bacteriocidal - CORRECT ANSWER -: bacteria die. Penicillin, cephalosporins:
destroy the cell wall
Who monitors the prescribing of narcotics? - CORRECT ANSWER -DEA
Who grants us the authority to practice as APNP's? - CORRECT ANSWER -c.
ANCC for certification d. State: APNP
first pass effect - CORRECT ANSWER -the initial metabolism in the liver of a
drug absorbed from the GI tract before the drug reaches systemic circulation through the bloodstream the rapid uptake and metabolism of an agent into inactive compounds by the liver, immediately after enteric absorption and before it reaches the systemic circulation. If high first pass effect, not a lot of the drug will be bioavailable to the body because it is metabolized
pro-drug - CORRECT ANSWER -An inactive substance that is converted to a
drug in the body by the action of enzymes or other chemicals
Nasal antihistamines (Astelin, Patanase) Nasal GCs (Rhinocort, Nasonex) Nasal cromolyn (Nasal crom) Decongestants (phenylephrine, pseudophedrine)
otitis media - CORRECT ANSWER -first choice, amoxicillin, ceftomir (2nd
generation cephalosporins) i. Treat new babies to prevent further illness ii. If children have red ears, treat symptomatically. Not antibiotics at first iii. Amoxicillin = 10% reaction possible with cephalosporins
What are the four components of pharmacokinetics? - CORRECT ANSWER -a.
Absorption: by mouth point of going in to mouth to the point of getting into the blood stream b. Distribution: gets to target tissue and organ c. Metabolism and biotransformation d. Excretion: most occurs in kidneys and liver, sometimes lungs or skin
Pharmacodynamics - CORRECT ANSWER -what the DRUG DOES to the
BODY!
Pharmacokinetics: - CORRECT ANSWER -: what the body does to the drug
Before treating a condition, i.e. cough, fever or infection, what must we do first? -
CORRECT ANSWER -a. Clinical exam
b. Get all the tests done that you need. Ex: chest x-ray, labs, cultures, blood gases c. Empiric treatment: treatment based on what the symptoms are, experience, what the client is telling you, and what is normally done for the particular illness d. Treat empirically with broad spectrum antibiotics and when you get cultures back you can change them e. The more the narrow the spectrum = the less side effects that you will see Review the different routes of medication administration and rate of absorption. -
CORRECT ANSWER -a. IV = quickest route
b. Sub-q c. IM d. Intra-nasal e. Rectal f. Oral = slowest g. Do not give IM to a patient with a stroke on left side = do not give it in the impaired side.
