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Pharmacology Study Guide: Pharmacokinetics, Drug Interactions, and Prescribing, Exams of Nursing

Texas A & M University - Texarkana Nursing

This study guide provides a comprehensive overview of key concepts in pharmacology, focusing on pharmacokinetics, pharmacodynamics, and factors influencing drug efficacy. It covers essential topics such as drug absorption, distribution, metabolism, excretion, and the impact of genetic variances on drug metabolism. Additionally, it addresses adverse drug reactions, contraindications, and special considerations for prescribing to elderly and pregnant patients. The guide emphasizes the importance of evidence-based prescribing and the use of trusted resources, offering practical insights for healthcare providers to ensure patient safety and optimize therapeutic outcomes. It also includes questions and answers that reinforce learning and critical thinking, making it a valuable resource for students and practitioners in the field of medicine and pharmacology. Useful for university students.

Typology: Exams

2024/2025

Available from 05/19/2025

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PC707 Module 1 Study Guide | 100% Correct

Answers | Verified | Latest 2025/2026

Version

What is prescriptive authority? - ✔✔Legal right to prescribe drugs

Is the Physicians Desk Reference a reliable source to use when prescribing drugs? - ✔✔No--it is not

evidence-based and it is not updated

What is the sunshine act? - ✔✔

-part of the affordable care act

-limits providers on accepting gifts from pharmaceutical companies

-reduces bias

What is pharmacology? - ✔✔

-study of the drugs and their actions and effects on living things

-legal drugs, illegal drugs, prescription drugs, OTC drugs

How does the FDA define drugs that they approve? - ✔✔-chemicals that have been proved for safety and

efficacy

What must providers consider when prescribing? - ✔✔-the dose

-the route of administration

-indications

-side effects of consequence

-adverse effects

-contraindications

-significant drug-drug interactions

-appropriate monitoring

-treatment of side effects if necessary

Partial preview of the text

Download Pharmacology Study Guide: Pharmacokinetics, Drug Interactions, and Prescribing and more Exams Nursing in PDF only on Docsity!

PC707 Module 1 Study Guide | 100% Correct

Answers | Verified | Latest 2025/

Version

What is prescriptive authority? - ✔✔Legal right to prescribe drugs Is the Physicians Desk Reference a reliable source to use when prescribing drugs? - ✔✔No--it is not evidence-based and it is not updated What is the sunshine act? - ✔✔

part of the affordable care act
limits providers on accepting gifts from pharmaceutical companies
reduces bias What is pharmacology? - ✔✔
study of the drugs and their actions and effects on living things
legal drugs, illegal drugs, prescription drugs, OTC drugs How does the FDA define drugs that they approve? - ✔✔-chemicals that have been proved for safety and efficacy What must providers consider when prescribing? - ✔✔-the dose
the route of administration
indications
side effects of consequence
adverse effects
contraindications
significant drug-drug interactions
appropriate monitoring
treatment of side effects if necessary

What is pharmacokinetics? - ✔✔-how drugs move in the body and what the body does with it How does pharmacokinetics influence prescribing? - ✔✔-the route

the dosage needed
dosing intervals What are the 4 aspects of pharmacokinetics? - ✔✔-absorption
distribution
metabolism
excretion What affects bioavailability the most? - ✔✔PO administration What is a pro-drug? - ✔✔-a drug that needs to be metabolized to become "activated" What is the major organ of metabolism? - ✔✔-Liver
Uses enzymes called "CYPs"
these enzymes can induce or inhibit metabolism What is protein-binding? - ✔✔-drugs that have a high affinity for proteins will bind with them and therefore become unable to bind to receptor sites
in order to activate receptors they must be free circulating molecules What is the half-life of a drug? - ✔✔-how long it takes for a drug at its original amount to be reduced by 50% Why is it important to know the half-life of a drug? - ✔✔-to help determine dosing intervals to maintain therapeutic levels What is the first-pass effect? - ✔✔-alteration of the drug dose by metabolism before it reaches systemic circulation

What are contraindications? - ✔✔-do not give

the risks outweigh the benefits What are relative contraindications? - ✔✔-the consideration that there are rare exceptions to the rule
the risk of NOT taking the medication potentially is greater than the risk of taking it What are precautions? - ✔✔-"warnings"
clinically significant
providers must weight the risks vs benefits What is a black box warning? - ✔✔-a potential adverse effect is serious enough that the risk must be thoughtfully considered OR
a potential adverse effect that can be reduced or eliminated by appropriate use OR
FDA has approved with restrictions to assure safe use If a drug has a high protein affinity--the protein binding sites must saturated in order for what to happen? - ✔✔-free drug to be able to circulate and activate receptors When taking two different drugs that are both highly protein bound, how does stopping or starting a drug affect the levels of the other drug? - ✔✔-if one drug is suddenly stopped it opens up protein binding sites for the other drug to bind to--reducing plasma drug levels
if a new drug is started--it will replace some of the protein binding sites--which then increases the plasma drug levels of the drug that was already present What sources should providers use when prescribing? - ✔✔-whenever possible you must utilize the highest levels of evidence
OR trusted experts in the field (ACOG, CDC, American Cancer Society, etc.)

What is an enzyme inhibitor? - ✔✔-inhibits the enzyme action causing decreased metabolism

this can increase the drug levels
it can affect all drugs that utilize the same metabolic pathway What is an enzyme inducer? - ✔✔-increases the enzymes that induces metabolism
this decreases drug levels
it can affect all drugs that utilize the same metabolic pathway What is an agonist? - ✔✔-a drug that binds to AND activates a receptor What is a partial agonist? - ✔✔A drug that binds to and activates a receptor but produces a smaller effect at full dosage than a full agonist What is an antagonist? - ✔✔-A molecule that binds to a receptor but does NOT activate it--it blocks the activating drug from binding to the receptor When is a drug-drug interaction risk the greatest? - ✔✔-when a patient is taking multiple medications (poly-pharmacy) What is the most common cause of ER visits from an adverse drug reaction? - ✔✔-bleeding from anticoagulants Why must a person limit or discontinue use of grapefruit juice when taking certain drugs? - ✔✔-it inhibits metabolism
this can increase drug levels--potentially to dangerous levels
one cup of juice can inhibit metabolism for up to 72 hours! Rule of safe prescribing? - ✔✔AVOID M pneumonic--Ask and Consider A-Allergies V-Vitamins & Herbs

What is type 4 hypersensitivity? - ✔✔-Cell mediated (cytotoxic t cells)

delayed response
diffuse, bilateral, symmetrical
Ex: drug rash, contact dermatitis, steven-johnson syndrome What is a pseudo allergy? - ✔✔-mast cell degranulation by a non-IgE mediated mechanism
Ex: opiate analgesic causes direct mast cell activation--causing itching What does the QT interval represent? - ✔✔ventricular depolarization and repolarization A longer QT interval increases the risk of what? - ✔✔-ventricular dysrhythmias (particularly Torsades de pointe)
sudden cardiac death Who is at an increased risk of a long QT interval? - ✔✔-females
electrolyte imbalances (hypokalemia, hypomagnesemia, hypocalcemia)
renal or hepatic problems
taking multiple drugs that can prolong QT interval
grapefruit juice that might inhibit metabolism of drugs that prolong QT interval
diuretic use (reduces electrolytes)
bradycardia
underlying cardiac disease
digitalis therapy
family history of long QT syndrome
congenital long QT syndrome What factors can impact pharmacokinetics, pharmacodynamics, drug efficacy and likelihood of drug reactions? - ✔✔-age, sex, weight, genetics, diet, co-existing diseases, etc. Why are pharmaceutical companies less likely to research children? - ✔✔-ethical risks

health risks
cost Why are infants at a higher risk of adverse effects from drugs? - ✔✔-organ immaturity
under-developed blood brain barrier
variable peristalsis
variable blood flow to muscles
increased total % body water (affects distribution)
reduced metabolism What is polypharmacy? - ✔✔use of multiple medications Number of drug reactions is closely related to number of drugs a person is taking. True or false? - ✔✔True What are some prescribing issues with the elderly? - ✔✔-polypharmacy
disease-drug reactions (Ex: cirrhosis and tylenol)
physiologic changes (Ex: renal & hepatic dysfunction)
multiple prescriptions from different specialities
poor adherence What is the Beers criteria? - ✔✔-lists potentially inappropriate drugs that lead to adverse effects in the elderly
particularly in those greater than 65 years old
not applicable to those in hospice or palliative care
a tool not a guideline--must use your own clinical judgment What is a START and STOP criteria? - ✔✔START--criteria to help determine the right tx for the elderly STOP--criteria to help determine medications to stop
these are tools not guidelines--must use your own clinical judgment

How is prophylactic treatment different from acute treatment? - ✔✔-action is taken to PREVENT disease Number of refills are based on what? - ✔✔-when you want them to come back for follow-up Reconciling of medications must occur with every patient at every encounter. True or false? - ✔✔True Can you send an electronic prescription for a schedule II drug? - ✔✔No--a written prescription is required. In a prescription, what is the "Sig"? - ✔✔-means "to write"

your directions on how to take the medication Does a generic substitution contain the same amount of active drug as the brand name drug? - ✔✔-Yes
They are "essentially similar"
They have bioequivalence
The generic drug has to be within 80 - 125% of the same pharmacokinetics as the brand drug Do generic drugs and brand name drugs have the same bioavailability? - ✔✔No, just because they are bioequivalent (they have the same amount of the active drug) does not mean they have the same bioavailability (the rate and extent that the active drug is absorbed and becomes available at the target site) When would a brand name be medically necessary? - ✔✔-certain chronic diseases
drugs with a narrow therapeutic index and consistency in the medication is important What is pharmacogenomics? - ✔✔-the study of how genes affect a person's response to drugs
"personalization" of drug therapy What is a very important aspect of genetic variations to consider when prescribing? - ✔✔-variations of genes that code for metabolism
is the person a poor, intermediate, extensive, or ultra-rapid metabolizer?

What happens if a person who is a ultra-rapid metabolizer takes a "pro-drug"? - ✔✔Since the pro-drug needs to be metabolized to become active, the ultra-rapid metabolizer will quickly activate the medication and the person will experience a quicker than normal drug response What happens if a person who is a poor metabolizer takes a "pro-drug"? - ✔✔Since the pro-drug needs to be metabolized to become active, the poor metabolizer will most likely not be able to activate the medication and the person will not experience a drug response What is ethnopharmacology? - ✔✔-understanding the specific impact of cultural factors on patient drug response

does not 100% predict a specific outcome based on racial or cultural factors--but can predict a potential risk for a particular response Patient teaching for women of child-bearing age is important to: - ✔✔-keep good communication so the patient tells you as soon as they are pregnant or plan to become pregnant Things to remember when prescribing to pregnant and lactating women: - ✔✔-start low and increase dose only if necessary
avoid medications whenever possible
use drugs with the safest profile and have been studied the longest
use one drug rather than many
make sure dating of the pregnancy is accurate
try to avoid medications during the first trimester
try to pick topical over systemic
shared decision making is very important! What is the "all or none" period? - ✔✔-in the preimplantation period--a teratogen will either cause a miscarriage or will survive How does a teratogen affect the embryogenesis or "organogenesis" period? - ✔✔-most critical period of high sensitivity and susceptibility of potential complications from exposure
the first trimester

patients can self-diagnose in order to take it
condition can be self-managed All OTC's are safe. True or false? - ✔✔False
there is still the potential for adverse effects, drug interactions, and potential for abuse Commonly used OTC: - ✔✔-NSAIDS
Aspirin (ASA)
Acetaminophen (APAP)
Antacids
Decongestants
Topical nasal decongestants
Antihistamines All complementary and alternative medicines are considered safe and effective. True or false? - ✔✔False
they are not all safe
they do not require FDA approval for "safety and efficacy"
potential for drug interactions exist What are RDAs? - ✔✔-Recommended Dietary Allowance
nutrient intake goals for individuals that meets the needs of nearly all healthy people What is the general recommendations for RDAs? - ✔✔-do not take more than 150% of the RDA What are water-soluble vitamins? - ✔✔-Vitamin B and C
water soluble--easily excreted by the kidneys
not stored in large amounts so need to ingest frequently

What are fat-soluble vitamins? - ✔✔-A, D, E, K

stored in the liver and fatty tissue Vitamin A in high doses is: - ✔✔-highly teratogenic What is chelation? - ✔✔-bonding of drug molecules to metal ions
chelation can reduce drug absorption
if a patient is taking "metals" like iron, magnesium, calcium, aluminum--make sure they space their medications at least 2 hours apart in order to decrease chance of chelation
this is why patients taking tetracyclines should not take milk products with it because of the potential chelating effect of "calcium" What is absorption? - ✔✔-movement of a drug from site of administration into the blood Distribution? - ✔✔-movement from blood to interstitial space of tissues and into the cells Metabolism? - ✔✔-enzymes changing the drug structure
usually into an "inactive form" to be excreted, but sometimes metabolism is needed to produce active metabolites (pro-drugs) The rate of absorption determines: - ✔✔-how soon effects will begin
the amount absorbed determines how intense the effects are Why are malnourished individuals at risk for drug toxicity? - ✔✔-they have reduced nutrients and co- factors available for proper metabolism
this decreases metabolism and allows for drug levels to build up in the body What types of drugs are excreted more often in the breastmilk? - ✔✔-Lipid soluble drugs Although plasma drug levels are not able to tell us the actual drug levels available at the target sites, they are highly predictive of: - ✔✔-therapeutic and toxic responses

What is the PLLR system? - ✔✔-the new labeling system for drugs in pregnancy and lactation

contains a pregnancy exposure registry
categories for pregnancy, lactation, females and males of reproductive potential
provides risk summaries, clinical considerations, data
easier to navigate
helps the provider to weigh risks versus benefits Antioxidants help to: - ✔✔-neutralize free radicals (normal by-products of metabolism that can cause tissue injury or "oxidative stress") What is an off-label use? - ✔✔-using a medication for a purpose other than what it was FDA approved for
just because labeling is lacking for a specific age group or condition does not mean it is unsafe or improper to use--it just means there is insufficient evidence for approval at this time
many drugs are utilized as "off-label" for children--because ethically, there are limited evidence for children When a drug is used "off-label" what should the provider make sure to do? - ✔✔-Shared decision making
Informed consent
Document these in the medical chart What is an anticholinergic reaction? - ✔✔-when a drug produces effects caused by opposing of acetylcholine
dry mouth, blurry vision, constipation, drowsiness, trouble urinating etc.
elderly patients are most at risk because of the changes from aging Ace inhibitors in pregnancy: - ✔✔-contraindicated
known teratogens
especially in the first trimester
must use a hypertension medication with a safer profile

Accutane in pregnancy: - ✔✔-contraindicated

teratogen
category X Can you prescribe to family members or friends? - ✔✔-every person deserves the same level of care in a professional setting
must have a bona-fide patient provider relationship
some states deem it illegal
it can be unethical to do so
avoid whenever possible Can you write a prescription for a patient and change the directions in order for the patient to save money? - ✔✔-no, you must write the prescription exactly as you want the patient to take it
you can potentially write a prescription for a higher mg and have the patient take half of it in order to save money--but you must indicate exactly the amount the patient will be taking and for exactly how many days the dosage will provide What are the main components on a prescription? - ✔✔-patient name, address, birth date
date of issuance
name, strength, dosage, and quantity of the medication
Sig (directions for use)
refills authorized
prescribers signature
DEA number when applicable
for controlled substances always write numbers out
if a brand name is indicated--make sure to write why WHO's six step model of rational prescribing: - ✔✔-define the patient problem
specify the therapeutic objective
choose the treatment
start the treatment

Kava and Comfrey are alternative therapies that should be used with extreme caution or should be avoided because they can cause: - ✔✔-severe liver damage Cranberry juice may cause what: - ✔✔-increased bleeding in those taking warfarin St johns wort should be used with caution because it can: - ✔✔-can induce metabolism and increase other drugs to dangerous levels

cause serotonin syndrome when taking with other serotonin increasing drugs Glucocorticoids can cause what in children? - ✔✔-growth suppression Drug accumulation secondary to reduced renal excretion is the most important cause of what in older adults? - ✔✔-adverse drug reactions and side effects Extreme caution must be taken with iron and children because it may cause: - ✔✔-iron poisoning and death How much vitamin D is recommended? - ✔✔- 1000 - 2000 IU/day
good reference for therapeutic level is 30 - 50 ng/mL

Pharmacology Study Guide: Pharmacokinetics, Drug Interactions, and Prescribing, Exams of Nursing

Related documents

Partial preview of the text

Download Pharmacology Study Guide: Pharmacokinetics, Drug Interactions, and Prescribing and more Exams Nursing in PDF only on Docsity!

PC707 Module 1 Study Guide | 100% Correct

Answers | Verified | Latest 2025/

Version