NCLEX Drug Action: Pharmaceutic, Pharmacokinetic, and Pharmacodynamic Phases

NCLEX Drug Action: Pharmaceutic, Pharmacokinetic, and

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24 terms lolo2734Preview Fluid an 33 terms Ale The nurse recognizes that the administration of a drug influences cell physiology. What is the term for this concept?

• Pharmacokinetics
• Pharmacotherapeutics
• Pharmacodynamics
• Pharmacology

C Pharmacodynamics refers to what the drug does to the body, that is, how it influences cellular physiology. Pharmacokinetics is the study of what the body does to the drug. Pharmacotherapeutics refers to the study of the therapeutic use of drugs. Pharmacology is the study of drugs.Which statement best indicates that the nurse understands the meaning of pharmacokinetics?

• "It involves the study of physiologic interactions of

drugs."

• "It explains the distribution of the drug between

various body compartments."

• "It explains interactions between various drugs."
• "It explains the adverse reactions to drugs."

B Pharmacokinetics involves the study of how the drug moves through the body, including absorption, distribution, metabolism, and excretion.The nurse is administering an injection to a patient and wants the medication to take effect as quickly as possible.Which injection site will the nurse select?

• Subcutaneous tissue
• Ventrogluteal
• Deltoid
• Dorsogluteal

C Drugs given intramuscularly are absorbed faster in muscles that have more blood vessels (e.g., deltoids) than in those that have fewer blood vessels (e.g., gluteals).Subcutaneous tissue has fewer blood vessels, so absorption is slower in such tissue.

The pharmacist states that the patient's biotransformation of a drug was altered. The nurse interprets this to mean that

• absorption has affected the drug.
• dilution has affected the drug.
• excretion has affected the drug.
• metabolism has affected the drug.

D Metabolism connotes a breakdown of a product. Biotransformation is actually a more accurate term because some drugs are actually changed into an active form in the liver in contrast to being broken down for excretion. Biotransformation of a drug does not occur during absorption, nor with dilution, nor during excretion.The nurse realizes that a drug administered by which route will require the most immediate evaluation of therapeutic effect?

• Intravenous

B.Oral

• Subcutaneous
• Topical

A The percentage of bioavailability for the oral route is always less than 100%, but for the IV route it is 100%.The nurse reads that the half-life of the medication being administered is 12 hours. What interpretation will guide the nurse's care of this patient?

• This medication will be 50% eliminated in 12 hours, so

the dosing will be spread apart.

• The medication will be administered every 6 hours to

maintain consistent blood levels.

• The medication will not work for the first 12 hours.
• The patient will require two doses of the medication

before there is an effect.A The half-life (t½) of a drug is the time it takes for one-half of the drug concentration to be eliminated. Metabolism and elimination affect the half-life of a drug. For example, with liver or kidney dysfunction, the half-life of the drug is prolonged, and less drug is metabolized and eliminated. When a drug is taken continually, drug accumulation may occur.The nurse administers 650 mg of aspirin at 7 PM. The drug has a half-life of 3 hours. The nurse interprets this information to mean that 325 mg of the medication will have been eliminated from the patient's system by what time?

A. 7 AM

B. 10 PM

C. 1 AM

D. 10 AM

B The half-life (t½) of a drug is the time it takes for one-half of the drug concentration to be eliminated. If 650 mg of aspirin is administered at 7 PM, half of the amount (325 mg) will be eliminated in 3 hours, which would be 10 PM.A nurse is administering two highly protein-bound drugs to the patient. Which is the safest course of action for the nurse to take?

• Assess the patient frequently for the risk of drug-drug

interactions.

• Administer the drugs with food.
• Administer the drugs with 8 ounces of water.
• Assess baseline liver function tests.

A When two highly protein-bound drugs are given concurrently, they compete for protein-binding sites, thus causing more free drug to be released into the circulation. In this situation, drug accumulation and possible drug toxicity can result. Also, a low serum protein level decreases the number of protein-binding sites and can cause an increase in the amount of free drug in the plasma. Drug toxicity may then result. Drug dose is prescribed according to the percentage in which the drug binds to protein.

A patient is complaining of pain rated "10" on a scale of 1 to 10. The nurse has several choices of pain medication to administer. Which order is the best for the nurse to administer at this time?

• Morphine sulfate 1 mg IV (intravenous)
• MS Contin 2 tablets PO (by mouth)
• Transdermal patch
• Tylenol suppository

A When a drug is administered intravenously, it does not need to be absorbed because it is placed directly into general circulation. The other medications will not have an immediate effect.The nurse is administering medications to a patient with chronic renal failure. What is the nurse's priority action?

• Administer all medications via IV route.
• Assess drug levels daily.
• Assess the patient for toxicity to the medications.
• Hold medications for low urinary output.

C The kidneys are responsible for the majority of drug excretion. With excretion impaired, the medication can remain in the system longer, and there is more chance for toxicity to develop.The patient is scheduled to receive an enteric-coated tablet immediately after a meal. The nurse will choose which food to include as part of the patient's meal?A.Hot dogs

• Avocados
• Salami
• Skim milk

D Advise not to eat high-fat food before ingesting an enteric-coated tablet, because high-fat foods decrease the absorption rate.The nurse has administered several oral medications to the patient. Which factors will influence the absorption of these medications? (Select all that apply.)

• Presence of food in the stomach
• pH of the stomach
• Patient position upon intake of medication
• Form of drug preparation
• Pain
• Amount of saliva

A, B, D, E

The presence of food in the stomach usually decreases absorption of drugs but may increase absorption for a few specific medications. The pH of the stomach affects absorption of drugs dependent on the pH of the drug. Alkaline drugs are absorbed more readily in an alkaline environment, and acidic drugs are absorbed more readily in an acidic environment. The form of the drug also affects absorption, with liquid drugs being absorbed the fastest and enteric-coated tablets the slowest. Pain can affect absorption by slowing gastric emptying time.Position will not influence absorption. Amount of saliva will not influence absorption.