Nclex style: Pharmacokinetics, Pharmacodynamics, and Pharmacogenetics

Nclex style: Pharmacokinetics, Pharmacodynamics, and

Pharmacogenetics 4.5 (2 reviews) Students also studied Terms in this set (24) Science Medicine Save Pharmacokinetics nclex 10 terms rachael_gooch2 Preview

NCLEX Drug Action: Pharmaceutic, ...

12 terms rachael_gooch2 Preview

Ch 2: Pharmacokinetics and Pharma...

25 terms sarahperkalis Preview NCLEX 13 terms kath

• Which drugs will go through a pharmaceutic phase

after it is administered?

• Intramuscular cephalosporins
• Intravenous vasopressors
• Oral analgesics
• Subcutaneous antiglycemics
• Oral analgesics

ANS: C

When drugs are administered parenterally, there is no pharmaceutic phase, which occurs when a drug becomes a solution that can cross the biologic membrane.

• The nurse is preparing to administer an oral medication

and wants to ensure a rapid drug action. Which form of the medication will the nurse administer?

• Capsule
• Enteric-coated pill
• Liquid suspension
• Tablet
• Liquid suspension

ANS: C

Liquid drugs are already in solution, which is the form necessary for absorption in the GI tract. The other forms must disintegrate into small particles and then dissolve before being absorbed

• The nurse is teaching a patient who will be discharged

home with a prescription for an enteric-coated tablet.Which statement by the patient indicates understanding of the teaching?

• I may crush the tablet and put it in applesauce to

improve absorption.

• I should consume acidic foods to enhance absorption

of this medication.

• I should expect a delay in onset of the drugs effects

after taking the tablet.

• I should take this medication with high-fat foods to

improve its action.

• I should expect a delay in onset of the drugs effects after taking the tablet.

ANS: C

Enteric-coated tablets resist disintegration in the acidic environment of the stomach and disintegrate when they reach the small intestine. There is usually some delay in onset of actions after taking these medications. Enteric-coated tablets should not be crushed or chewed, which would alter the time and location of absorption. Acidic foods will not enhance the absorption of the medication. The patient should not to eat high- fat food before ingesting an enteric-coated tablet, because high-fat foods decrease the absorption rate

• A patient who is newly diagnosed with type 1 diabetes

mellitus asks why insulin must be given by subcutaneous injection instead of by mouth. The nurse will explain that this is because

• absorption is diminished by the first-pass effects in the

liver.

• absorption is faster when insulin is given

subcutaneously.

• digestive enzymes in the gastrointestinal tract prevent

absorption.

• the oral form is less predictable with more adverse

effects.

• digestive enzymes in the gastrointestinal tract prevent absorption.

.ANS: C

Insulin, growth hormones, and other protein-based drugs are destroyed in the small intestine by digestive enzymes and must be given parenterally. Because insulin is destroyed by digestive enzymes, it would not make it to the liver for metabolism with a first-pass effect. Subcutaneous tissue has fewer blood vessels, so absorption is slower in such tissue. Insulin is given subcutaneously because it is desirable to have it absorb slowly.

• The nurse is preparing to administer an oral medication

that is water-soluble. The nurse understands that this drug

• must be taken on an empty stomach.
• requires active transport for absorption.
• should be taken with fatty foods.
• will readily diffuse into the gastrointestinal tract.
• requires active transport for absorption.

ANS: B

Water-soluble drugs require a carrier enzyme or protein to pass through the GI membrane.

• A nurse is preparing to administer an oral drug that is

best absorbed in an acidic environment. How will the nurse give the drug?

• On an empty stomach
• With a full glass of water
• With food
• With high-fat food

ANS: C

Food can stimulate the production of gastric acid so medications requiring an acidic environment should be given with a meal. High-fat foods are useful for drugs that are lipid soluble.

• The nurse is preparing an injectable drug and wants to

administer it for rapid absorption. How will the nurse give this medication?

• IM into the deltoid muscle
• IM into the gluteal muscle
• SubQ into abdominal tissue
• SubQ into the upper arm

ANS: A

Drugs given IM are absorbed faster in muscles that have more blood vessels, such as the deltoid, rather than those with fewer blood vessels, such as the gluteals.Subcutaneous routes are used when absorption needs to be slower and more sustained.

• The nurse is reviewing medication information with a

nursing student prior to administering an oral drug and notes that the drug has extensive first-pass effects.Which statement by the student indicates a need forfurther teaching about this medication?

• The first-pass effect means the drug may be absorbed

into systemic circulation from the intestinal lumen.

• The first-pass effect means the drug may be changed

to an inactive form and excreted.

• The first-pass effect means the drug may be changed

to a metabolite, which may be more active than the original.

• The first-pass effect means the drug may be

unchanged as it passes through the liver.

• The first-pass effect means the drug may be absorbed into systemic circulation

from the intestinal lumen.

ANS: A

Drugs that undergo first-pass metabolism are absorbed into the portal vein from the intestinal lumen and go through the liver where they are either unchanged or are metabolized to an inactive or a more active form.

• The nurse prepares to change a patients medication

from an intravenous to an oral form and notes that the oral form is ordered in a higher dose. The nurse understands that this is due to differences in

• bioavailability.
• pinocytosis.
• protein binding.
• tachyphylaxis.
• bioavailability.

ANS: A

Oral drugs may have less bioavailability because a lower percentage of the drug reaches the systemic circulation. Pinocytosis refers to the process by which cells carry a solute across a membrane. Protein binding can occur with both routes. Tachyphylaxis describes a rapid decrease in response to drugs that occurs when tolerance develops quickly.

• The nurse is preparing to administer a drug and learns

that it binds to protein at a rate of 90%. The patients serum albumin level is low. The nurse will observe the patient for

• decreased drug absorption.
• decreased drug interactions.
• decreased drug toxicity.
• increased drug effects.
• increased drug effects.

ANS: D

Drugs that are highly protein-bound bind with albumin and other proteins, leaving less free drug in circulation.If a patient has a low albumin, the drug is not bound, and there is more free drug to cause drug effects. There would be increased absorption, increased interactions with other drugs, and increased toxicity.

• The nurse is administering two drugs to a patient and

learns that both drugs are highly protein-bound. The nurse may expect

• decreased bioavailability of both drugs.
• decreased drug effects.
• decreased drug interactions.
• increased risk of adverse effects.
• increased risk of adverse effects.

ANS: D

Two drugs that are highly protein-bound will compete for protein-binding sites, leaving more free drug in circulation and an increased risk of adverse effects as well as increased bioavailability, increased drug effects, and increased drug interactions

• A patient has been taking a drug that has a protein-

binding effect of 75%. The provider adds a new medication that has a protein-binding effect of 90%. The nurse will expect

• decreased drug effects of the first drug.
• decreased therapeutic range of the first drug.
• increased drug effects of the first drug.
• increased therapeutic range of the first drug.
• increased drug effects of the first drug.

ANS: C

Adding another highly protein-bound drug will displace the first drug from protein-binding sites and release more free drug increasing the drugs effects. This does not alter the therapeutic range, which is the serum level between drug effectiveness and toxicity.