Download Nurs 316 Exam #1 Questions and Answers: Pharmacokinetics, Drug Action, and Pain and more Exams Nursing in PDF only on Docsity!
Nurs 316 Exam #1 Questions With
Complete Solutions
4 processes of pharmacokinetics correct answer: 1. Absorption
- Distribution
- Metabolism
- Excretion What drugs that are administered take the longest to be absorbed? correct answer: orally (PO) What drugs that are administered are instantly absorbed? correct answer: intravenously (IV) Gastric acidity correct answer: promotes disintegration and dissolution of most drugs What three major factors determine distribution? correct answer:
- blood flow to tissues
- ability of drug to exit vascular system
- ability of drug to enter cells What does the ability of a drug to exit the vasculature to be available for action depend on correct answer: protein binding What is the most significant and abundant plasma protein correct answer: albumin
Distribution of a drug to the CNS is impacted by the presence of the correct answer: Blood-Brain barrier Bioavailability of a drug correct answer: describes the amount of drug that reaches the systemic circulation after metabolism (bio-transformation) Metabolism correct answer: involves the enzymatic alteration of the drug structure; method by which drugs are inactivated or biotransformed Most drug metabolism takes place in the correct answer: liver Pro-drugs correct answer: drugs that are inactive until they are metabolized P-450 system correct answer: the hepatic microsomal enzyme system; set of enzymes that influence our biotransformation Cytochrome P450 (CYP) enzymes correct answer: a group of enzymes expressed as membrane bound proteins primarily found in the hepatic endoplasmic reticulum Where is the majority of drug excretion correct answer: kidneys Drug excretion is influenced by correct answer: - whether the drug is bound or unbound to proteins
- whether or not the drug is lipid soluble or water soluble
- GFR
- urine pH
Safety correct answer: a safe drug is one that does not produce harmful effects Relative safety of a drug correct answer: can be increased by proper drug selection, dosage, and monitoring Selectivity correct answer: a truly selective drug is one that elicits only the desired response and not undesired or adverse effects Principles of drug action correct answer: Principle 1: Drugs modify existing functions within the body; they do not create new functions Principle 2: No drug has a single action Principle 3: Drug effects are determined by the drug's interaction with the body Orphan drug act (1983) correct answer: a law passed to facilitate the development of drugs for rare diseases, orphan drugs Rare disease correct answer: defined as one that affects fewer than 200,000 people in the U.S. Teratogenesis correct answer: the indication of developmental defects in the somatic tissues of a fetus Mutagenesis correct answer: the induction of changes in genetic material
Adverse drug reactions (ADR) correct answer: a response to a medicine that is noxious, unintended, and undesired side effect that occurs at normal drug doses A drug interaction is an altered or modified effect of a drug as a result of interaction with correct answer: -Two or more drugs -Nutrients -Herbal preparations Drug interactions can be correct answer: -intended and desired -unintended and undesired Drug sensitivity in the very young results largely from organ system correct answer: immaturity Drug sensitivity in the elderly results largely from age-related organ system correct answer: degeneration polypharmacy correct answer: 5 or more prescribed medications Absorption in geriatric patients correct answer: -delayed gastric emptying time Decreased: -GI motility -gastric acidity -absorptive surface area -splanchnic blood flow
Premature infants correct answer: less than 36 weeks gestational age Full-term infants correct answer: 36-40 weeks gestational age Neonates correct answer: first 4 postnatal weeks Infants correct answer: weeks 5 to 52 postnatal Children correct answer: 1 to 12 years Adolescents correct answer: 12 to 16/17 years FDA Pregnancy Categories correct answer: A= No risk to fetus B= Little risk to fetus C= Risk to fetus; must evaluate risks vs benefits D= Proven risk to humans X=Risks outweigh benefits Drugs that mimic correct answer: adrenergic agonists, adrenergics, sympathomimetics, adrenomemetics *Initiate a response similar to that of the SNS Drugs that block correct answer: adrenergic blockers, sympatholytics, adrenolytics *Prevent a SNS response Autonomic nervous system (ANS) correct answer: -acts on smooth muscle, cardiac muscle, and glands
-control and regulation of the heart, respiratory system, GI tract, bladder, eyes and glands -Involuntary: person has little or no control 4 types of adrenergic receptor cells correct answer: 1) Alpha-
- Alpha-
- Beta-
- Beta- Alpha-1 correct answer: -vasoconstriction -increased: blood return to heart, circulation, blood pressure Alpha-2 correct answer: -inhibits release of norepinephrine -decreased: vasoconstriction, blood pressure Beta-1 correct answer: -heart -increased heart rate and force of contraction Beta-2 correct answer: relaxes of smooth muscle in bronchi, uterus, peripheral blood vessels Monoamine oxidase (MAO) correct answer: an enzyme located in liver, intestinal wall, and terminals of neurons that produce monoamine neurotransmitters How is epinephrine effected by MAO correct answer: It undergoes enzymatic degradation in the liver by MAO What 2 things does MAO do correct answer: 1) acts as a "safety valve" to deactivate any excess neurotransmitter molecules that may leak out of synaptic vesicles
Chronic pain correct answer: lasts for a long time Vascular pain correct answer: blood is not being delivered to an area, lack of oxygen (ex: heart attack) Referred pain correct answer: real site of the problem is not where you are feeling pain Neuropathic pain correct answer: brought on by diseased nerves, heaviness, burning What is the 5th vital sign correct answer: pain Nociception correct answer: the sensation or perception of pain; processing of pain signals Nociceptors correct answer: a subclass of sensory nerves that transmit pain signals to the central nervous system from other body parts; these have free nerve endings and are found in most tissues in the body Respond to noxious stimuli correct answer: -Thermal (burn, frostbite) -Chemical (toxins, chemotherapy) -Mechanical (trauma, tumor growth) What does pain do correct answer: perform a protective function by identifying changes that may endanger the body A-Delta fiber (afferent nerve fibers) correct answer: - myelinated
-large diameter -Fast (5-10 m/sec) -Responsible for acute, sharp pain -Synapses with spinal motor neurons: protective reflex A-Beta fiber (mechanoreceptive fibers) correct answer: -2nd most highly myelinated -Stimulation of these fibers can prevent nociceptive fibers from reaching the higher centers in the brain, thus reducing pain C-fiber (chemosensitive nociceptors) correct answer: - unmyelinated -small diameter -Slow (0.6-2 m/sec) slow pain -responsible for fibromyalgia, aching, and chronic pain -most numerous type of nociceptor -Spinal tracts that terminate in the area responsible for ANS (subthalamic) Nociception involves 4 basic processes correct answer: 1) Transduction (cell damage, chemical mediators released)
- Transmission (impulses traveling to the CNS)
- Perception (what happens in the CNS; past experience with pain)
- Modulation (CNS response to the pain) Acute inflammation characterized by correct answer: Localized signals: warmth, redness, swelling, pain, loss of function Systemic signs: pyrexia (increased temp), leukocytes (increased WBC's)
-they do not produce tolerance or physical or psychological dependence -they are antipyretic -their primary MOA is the inhibition of COX, preventing the formation of prostaglandins Prostaglandins correct answer: -a group of chemicals found in almost all tissues -act locally (paracrine) on the tissues where they are synthesized as a result of normal and pathophysiologic processes Opioids are divided into 2 groups correct answer: 1) Agonists (mu receptors)
- Agonist-antagonists (mu and kappa receptors) 3 main opioid receptors correct answer: 1) mu: brain, spinal column, GI, peripheral sensory neurons
- kappa: brain, spinal column, periphery
- delta: inflammation, chronic pain 6 effects of opioid receptors correct answer: 1) analgesia (good)
- sedation (good)
- euphoria (good)
- respiratory depression (bad)
- constipation (bad)
- dependency (bad) Tolerance correct answer: a decrease in sensitivity to opioids resulting in less effect from the same dose, or the need for progressively larger doses to maintain the same effect
Physical dependence correct answer: a physiological adaptation to a drug characterized by the emergence of a withdrawal syndrome if the drug is abruptly stopped, reduced in dose, or antagonized Addiction correct answer: a pattern of compulsive drug use of characterized by a continued craving for the drug and the need to experience its psychic effects and not pain relief Characterized by 1) loss of control over the drug use 2) compulsive use 3) continued use despite harm Pseuoaddiction correct answer: drug-seeking behavior caused by need for better pain relief
