Week 1

Question 1

Drug Schedules

Answer 1

1 - most potential for abuse
5 - lowest potential for abuse

Question 2

Drugs vs Biologics

Answer 2

Therapeutic or adverse responses

Hormones, Monoclonal antibodies, interferons, vaccines

Question 3

Rights of Medication Administration

Answer 3

Patient, Medication, Dose, Route of Administration, Time of Delivery, Reason to Give Drug, to Refuse, Knowledge and Understanding, Documentation

Question 4

Three Checks of Drug Administration

Answer 4

Check with MAR, Check drug during preparation, Check drug prior to administration

Question 5

STAT

Answer 5

Immediately and only once

Question 6

ASAP

Answer 6

Within 30 minutes of order

Question 7

Routine

Answer 7

Regularly scheduled course of treatment

Question 8

Single

Answer 8

Once at a specific time

Question 9

PRN

Answer 9

As dictated by patient’s condition

Question 10

Standing

Answer 10

Pre-approved set of instructions for med administration

Question 11

PO

Answer 11

By mouth

Question 12

SL

Answer 12

Sublingual

Question 13

Enteral Drug Admin

Answer 13

GI Tract: PO, SL, Buccal

Question 14

Topical Drug Admin

Answer 14

Absorption, usually skin

Question 15

Parenteral Drug Admin

Answer 15

not GI tract, usually injection

Question 16

Nursing Considerations for SL

Answer 16

Don’t move with tongue, don’t eat or drink until fully dissolved

Question 17

Orally Disintegrating Tablets (ODTs) and Films

Answer 17

Useful for children and adults with adherence issues, dissolve within 30 seconds of placement

Question 18

Nasogastric Tube (NG)

Answer 18

Soft, flexible tube inserted through the nose to the stomach - typically liquid but can be crushed

Question 19

Gastrostomy (G) Tube

Answer 19

Surgically placed into the stomach - typically liquid but can be crushed

Question 20

Topical Drug Examples

Answer 20

Dermatologic (creams)
Instillations and Irrigations (eye drops)
Inhalations (Inhalers)

Question 21

Transdermal Delivery System

Answer 21

Patches, site rotation technique

Question 22

Vaginal Administration Nursing Considerations

Answer 22

Explain purpose of treatment and provide privacy, patient should empty bladder, offer perineal pad after administration

Question 23

Rectal Administration

Answer 23

for unconscious and no IV, some seizure medications, partially avoids first-pass effect

Question 24

Intradermal Admin

Answer 24

Into the dermis, easily absorbed due to high vascularity, small volumes

Question 25

Subcutaneous Admin

Answer 25

Into subcutaneous tissue, more volume than intradermal ex: Insulin, heparin, vitamins, vaccines

Question 26

Intramuscular Admin

Answer 26

VACCINES, high volume Ventrogluteal site - preferred site Deltoid Site - teens and adults, small-volume Vastus lateralis - infants

Question 27

IV Admin

Answer 27

Available for immediate use, rapid onset, avoids first-pass effect, riskiest

Question 28

Three IV Admin

Answer 28

Large-volume infusion - fluid maintenance Intermittent infusion - small solution in tandem with large infusion IV Bolus or IV Push - concentrated dose of medication delivered directly to circulation (smaller volume)

Question 29

Four Categories of Pharmakinetic Processes

Answer 29

Absorption, Distribution, Metabolism, Excretion

Question 30

PK Process: Absorption

Answer 30

Bioavailability, First Pass Effect, primary factor determining length of time to produce effect

Question 31

Bioavailability

Answer 31

Fraction of drug absorbed into systemic circulation, inversely proportional to dose needed to reach minimum effective concentration

Question 32

First pass Effect

Answer 32

Some of drug is metabolized by liver before entering circulation

Question 33

Diffusion of Chemical Molecules Across Cell Membrane

Answer 33

Nonionized passes through, Ionized does not Small-sized passes through, large-sized does not Lipophilic passes through, hydrophilic does not

Question 34

PK Process: Distribution

Answer 34

Affected by blood flow and protein binding - acidic binds to albumin, basic binds to lipo or glycoproteins - limiting facotr - Blood-brain barrier, fetal-placental barrier

Question 35

PK Process: Metabolism

Answer 35

Phase 1: CYP-450 system inactivates drug, accelerates drug excretion, converts drug to polar metabolites (water-soluble) Phase 2: Addition of conjugates to change drug to more water soluble form, renal excretion

Question 36

PK Process: Excretion

Answer 36

Kidneys, drugs are retained for extended times, must reduce dosages

Question 37

Loading Dose

Answer 37

Normally takes 4-5 plasma half-lives to reach steady state in therapeutic range Loading dose is for more urgent needs to achieve steady dose (larger initial dose)

Question 38

Drug Efficacy

Answer 38

Ability of a drug to produce maximum effect

Question 39

Drug Potency

Answer 39

Minimum dose of drug required to produce effect

Question 40

Agonist

Answer 40

Drug that has affinity for receptor and produces similar effect to endogenous substance

Question 41

Antagonist

Answer 41

Drug that has affinity for receptor but does not produce same effect as endogenous substance

Question 42

EC50

Answer 42

Concentration of drug that gives half-maximal response

Question 43

ED50

Answer 43

Dose that produces half maximum response to 50% of population

Question 44

LD50

Answer 44

Dose that kills 50% of population

Question 45

TD50

Answer 45

Dose that produces toxic response to 50% population

Question 46

Drug Selectivity

Answer 46

Preference of a drug to specific binding sites or receptors, causes less adverse effects

Question 47

Competitive vs Noncompetitive Antagonists

Answer 47

Reversible, can be overcome vs. Irreversible, cannot be displaced from receptor

Question 48

Drug Affinitiy

Answer 48

Attraction to receptor, associated with lower dose requirement

Question 49

Therapeutic Index

Answer 49

LD50/ED50, higher is safer