Download NUR 521 AVD PHARM BLUEPRINT EXAM 1 (Blueprint Answers Minus the Prototype Drug List) Actua and more Exams Nursing in PDF only on Docsity!
Terms in this set (266)
_____________Quiz____________? Why should APRNs have full prescriptive authority? Who would benefit from this? -
Answer ✓✓
To inc pt care, accessibility, quality, and affordability. Pts benefit, especially underprivileged, rural communities. Could also improve wait times and lower hc costs for pts and hc systems by reducing reliance on more expensive providers. APRNs could benefit because they could practice to the full extent of their abilities _____________Quiz____________? Schedule I Drugs -
Answer ✓✓
No medical use in the US Heroin Marijuana LSD MDMA
_____________Quiz____________? Schedule II Drugs -
Answer ✓✓
High abuse potential w/ psych/physical dependence Stimulants and depressants Opium Morphine Codeine Dilaudid Methadone Demerol Hydrocodone _____________Quiz____________? Schedule III Drugs -
Answer ✓✓
High abuse potential but less than I and II Contains compounds w/ limited amounts of certain drugs Products containing no more than 90mg of Codeine per dosage unit Tylenol w/ codeine Buprenorphine (Suboxone)
Prescriber DEA # (if applicable) NPI # Pt name/ DOB Name of med Indication for med Med concentration if liquid prep Dose, route, freq
of tab/cap to dispense
of refills
If ok to use generic _____________Quiz____________? What factors should the APRN consider when prescribing medications? -
Answer ✓✓
Cost Drug interactions Liver/ Renal function Guidelines SEs Monitoring Parameters (Coumadin, thyroid, lithium) Availability Allergies Special populations (OB, BF, PED, GERI)
_____________Quiz____________? What factors should the APRN consider when refilling medications? Especially narcotics -
Answer ✓✓
New med for pt? Changing dose/freq? Adding new meds? Undesired SEs When will I follow-up? When was pt seen last? Do they need to be seen again before refill? Is this a schedule II med? _____________Quiz____________? Considerations with telephone, written, E-prescribing meds -
Answer ✓✓
Phone- can have specified designee call in to pharmacy but cannot call in Sch II Written- never presign, write in ink, avoid abbrev, use tamper resistant scripts E-prescribing- CMS incentivizes using EMR to prescribe. "Meaningful Use" with intent to inc pt safety/ improve outcomes. Requires 2 factor authentication software to prescribe scheduled meds _____________Quiz____________?
Use illustrations Use layman's terms Check for readability _____________Quiz____________? Why is patient education so important? -
Answer ✓✓
Education is the best way to promote positive outcomes with drug therapy. For compliance and promoting safe outcomes _____________Quiz____________? What is the best way to promote positive outcomes with drug therapy? -
Answer ✓✓
Patient education, monitoring therapy, and promoting adherence to therapy _____________Quiz____________? Why do we monitor drug therapy? -
Answer ✓✓
Determining therapeutic dosage Evaluating med adequacy Identifying AEs
_____________Quiz____________? What are reasons that patient's will not take their medications? How can you address these as a provider? -
Answer ✓✓
Forgetfulness Lack of planning Cost Dissatisfaction Altered dosing Do annual med reviews to determine if the meds are necessary, what problems if any that the pt is having, polypharmacy, change in condition, if SEs outweigh condition, if there is a combo med available _____________Quiz____________? Absorption -
Answer ✓✓
The movement of a drug from the site of admin to the bloodstream/circulation.
- Rate of absorption determines how fast the drug can take effect.
- Intensity of the drug is determined by the amount of the drug absorbed. Fillers and binders can affect absorption.
6 consequences of therapeutic significance
- Accelerated rate of renal excretion
- Drug and activation
- Inc therapeutic action
- Pro drug (broken down into active ingredients)
- Inc toxicity
- Dec toxicity _____________Quiz____________? Considerations in Drug Metabolism -
Answer ✓✓
Age Induction and Inhibition of P First-pass effect of the liver Nutrition Competition between drugs Enterohepatic recirculation _____________Quiz____________? Drugs that are metabolized by P450 are called -
Answer ✓✓
Substrates
_____________Quiz____________? Drugs that inc the rate of drug metabolism are called -
Answer ✓✓
Inducers _____________Quiz____________? Drugs that dec the rate of drug metabolism are called -
Answer ✓✓
Inhibitors _____________Quiz____________? Excretion -
Answer ✓✓
The movement of drugs and their metabolites out of the body. _____________Quiz____________? Elimination -
Answer ✓✓
Combination of metabolism and excretion. _____________Quiz____________? Drugs can exit the body via: -
Answer ✓✓
_____________Quiz____________? The ability of a drug to cross a cell membrane is determined by: -
Answer ✓✓
Its ability to pass through single cells _____________Quiz____________? 3 ways drugs cross cell membranes -
Answer ✓✓
- Channels/ pores (not as common, must be a small compound like K and Na)
- Transport System: PGP transports a wide variety of drugs out of cells
- Direct penetration: most common because most drugs are too large to pass through channels and/or they lack a transport system. Must be lipid-soluble to penetrate membranes because membranes are made of lipids ("like dissolves like") _____________Quiz____________? Are polar molecules lipid soluble? -
Answer ✓✓
No, polar molecules are not lipid soluble and can't penetrate membranes. _____________Quiz____________? What is the charge distribution in polar molecules? -
Answer ✓✓
Polar molecules have no net charge and have an even distribution of electrical charge. _____________Quiz____________? What is the charge of ions? -
Answer ✓✓
Ions have a positive or negative charge. _____________Quiz____________? Can most ions cross membranes? -
Answer ✓✓
Most ions cannot cross membranes unless they are nonionized. _____________Quiz____________? What determines the electrical charge of acids or bases? -
Answer ✓✓
The pH determines the electrical charge of acids or bases. _____________Quiz____________? What happens to acids in alkaline media? -
Answer ✓✓
Acids ionize in alkaline media. _____________Quiz____________?
_____________Quiz____________? What is bioavailability? -
Answer ✓✓
The amount of an active drug that reaches the systemic circulation from its administration site. Different formulations of the same drug can vary in bioavailability. _____________Quiz____________? Factors that can affect bioavailability -
Answer ✓✓
Factors such as tablet disintegration time, enteric coatings, and sustained-release formulations can alter bioavailability and can thereby make drug responses variable. _____________Quiz____________? Explain how the same drug manufactured by different drug companies can have different absorption rates. -
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Medications can be chemically equivalent but absorbed at different rates because of things like different filler ingredients used _____________Quiz____________? What happens when a patient takes a drug that is metabolized by P450 enzymes if an inducing OR an inhibiting drug is added to the current drug regimen? -
Answer ✓✓
Significant changes in the drug's metabolism and effectiveness can occur, potentially leading to adverse effects or treatment failure. When an inducing drug is added:
- inc drug metabolism
- reduced drug levels
- reduced drug efficacy
- toxicity from prodrugs When an inhibiting drug is added:
- Dec drug metabolism
- Inc drug levels
- Toxicity
- Exaggerated therapeutic effects, potentially causing adverse reactions
- Reduced clearance of the drug, further contributing to its accumulation and potential toxicity _____________Quiz____________? Agonists -
Answer ✓✓
Molecules that ACTIVATE RECEPTORS. (Ex. neurotransmitters and hormones)
- They bind to receptors and mimic the action of the body. They have both affinity and high intrinsic activity.
The safest practice is to check for drug interactions in a reliable software application. _____________Quiz____________? What are ways to minimize adverse drug reactions? -
Answer ✓✓
Look in software apps for drug interactions, especially for pts who are on lots of meds _____________Quiz____________? What are the 4 basic mechanisms of drug interaction? -
Answer ✓✓
- Direct chemical/physical: (combining an IV solution)
- Pharmacokinetic: altered absorption, distribution,metabolism, excretion
- Pharmacodynamic: drugs acting at the same receptor site/ competing at receptor site
- Combined toxicity (create toxicity when used together or act on the same organ) _____________Quiz____________? How do you handle a patient complaint about a known or unknown side effect of a medication? -
Answer ✓✓
- Listen/ acknowledge pt concerns
- Gather info about the nature of the SE
- Verify the SE and document it even if it is one that is unknown
- Provide info/ education
- Assess the need for changing/ adjusting med dose
- Document complaint/ action taken
- Follow-up appt with pt
- Report severe/unexpected AEs to the FDA _____________Quiz____________? What factors contribute to medication errors? -
Answer ✓✓
- Prescribing practices (inappropriate drug selection, error in dosage, lack of clear instructions, illegible writing)
- Oversight (failure to keep UTD med list, failure to continue or DC meds, absence of med rec)
- Communication (inadequate/ unclear instructions, failure to verify sound-alike drugs, inadequate pt edu) _____________Quiz____________? How can a provider minimize the risk for med errors? -
Answer ✓✓
- Verify that the drug selected is the drug intended
- Make sure drug references are UTD
- Verify pt allergies
- Check for DIs (Authoritative DI software recommended)
- Consider pt factors when selecting drug
- Consider if the drug is necessary
