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GALEN COLLEGE PHARM EXAM 1 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS|LATEST UPDATEGALEN COLLEGE PHARM EXAM 1 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS|LATEST UPDATEGALEN COLLEGE PHARM EXAM 1 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS|LATEST UPDATEGALEN COLLEGE PHARM EXAM 1 2024 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS BY EXPERTS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST |GUARANTEED PASS|LATEST UPDATE
Typology: Exams
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When the drug is in bloodstream after administration, is disintegrated out of stomach this is called? A. metabolism B. absorption C. excretion D. distribution B The movement of a drug from circulatory system to body tissues is called what? A. distribution B. metabolism C. excretion D. absorption A This occurs when a drug is altered in chemical structure, most are done in the liver. A. excretion B. distribution C. absorption D. metabolism (biotransformation) D Elimination of drug from body through the following: kidneys, liver, feces, lungs, saliva, sweat, breast milk. A. excretion B. distribution
C. metabolism D. absorption A 100% of a drug is used when it is given by which route? A. intramuscular (IM) B. intravenously (IV) C. subcutaneously (subq) D. orally (PO) B 1st pass effect goes from the ____ to the ____.
Only ____ % of med is going to make it through bloodstream due to this process. -stomach, liver
-30% What are the two routes that can skip the 1st pass effect? A. IM, sublingual B. IV, sublingual C. IM, subq D. IV, subq B When drug comes out of the first pass effect, it can go into the blood & be used in some way, the % of administered drug available for activity is called? A. peak B. onset C. trough D. bioavailable D What in the blood have receptor sites that will grab onto, hold onto med and decreased therapeutic effect on drug? A. carbs B. electrolytes C. proteins D. cells C What is it called when the drug causes the effect & do not get taken up by proteins in blood? A. free drug
B. extended release drug C. protein binding drug A When you take TWO high protein binding drugs the effect of the med is going to be _____ effect on the body.
They are going to compete with one another for ____ sites which makes them become ____ higher,
protein, free drugs When a med has a ____ half life you may only need to take that med a couple times a week.
When a med has a ____ half life, it may need to be taken more often because when it ____ it becomes ____ therapeutic long,
short, decreases, less When a drug becomes therapeutic this is called? A. onset B. peak C. duration of action
The length of time a drug exerts a therapeutic effect is called? A. duration of action B. peak C. onset
This occurs when a drug reaches its highest concentration in blood. A. onset B. duration C. peak -A
-A
-C Lowest conc of drug & it measures rate at which drug is eliminated, these labs are drawn just before the next dose of drug regardless of route. A. peak level B. trough level
Highest conc of drug at specific time, indicates rate of drug absorption, draw this 30-60 mins after A. peak level B. trough level A Drugs that activate receptors and produce desired response are called? A. antagonists B. agonists B Drugs that prevent receptor activation and block a response are called? A. antagonists B. agonists A What the drug does to the body, this is called? A. pharmacogenetics B. pharmacokinetics C. pharmacodynamics C What the body does to the drug, describes the movement of the drug through the body. this is called? A. pharmacogenetics B. pharmacokinetics C. pharmacodynamics B Free drugs are able to ____ blood vessels & reach their site of action causing a _____ response. exit, pharmacological (therapeutic) What is a sign of toxicity in elderly? A. confusion B. hypertension C. bradycardia D. tachypnea A Put in the correct order of how you would administer (optic) eye drops.
C. we don't crush any pill D. you can crush, cut any pill A when you start by giving a large initial dose that is significantly higher than maintenance dose this is known as? A. therapeutic B. loading dose C. preload D. toxicity B When a drug causes a reaction to the skin caused by exposure to sunlight this is called? photosensitivity When you identify the most accurate list of all meds a pt is taking at transitions in care this is called? drug reconciliation if you encounter that you have made a med error, what is the FIRST thing to do as the nurse? ASSESS the pt what are the 5 cardinal signs of inflammation? redness, swelling, heat, pain, loss of function (compartment syndrome) Aspirin is not given to children, because it can cause what? A. bradycardia B. hypotension C. death D. reye's syndrome D If a pt is on a blood thinner what meds do they want to avoid? select all that apply. A. ibuprofen B. aspirin C. acetaminophen D. antacids
What med would you educate to take as an alternative? A. antacids B. ibuprofen
C. acetaminophen D. aspirin A, B
C When older adults are taking NSAIDs what do you want to look for? select all that apply. A. neuro changes B. GI distress C. tremors D. ulcers B, D What is the degree of a IM injection? A. 70 B. 90 C. 45 D. 30 B What forms because of uric acid being present?
What maintenance med would a pt take for this condition? -gout
-allopurinol What will acetaminophen NOT heal? A. headache B. fever C. pain D. inflammation D What is the antidote for acetaminophen? A. alprazolam B. allopurinol C. acetylcysteine D. aripiprazole C What labs would you take to assess kidney function? select all that apply. A. GFR B. creatinine
Parental mediation includes which routes? ID SubQ IM IV What would you use a intradermal route for?
What is the degree of administering a ID route?
What do you expect to see after administration? -skin testing
-10 to 15
-blep under skin When administering subq meds what are two things to remember as the nurse?
What is the degree of a subq injection?
What do you not want to do when giving subq meds? -rotate sites, squeeze/pinch skin
-aspirate What is the degree of administering a IM injection?
What is the preferred site of IM injections?
You can administer IM injections in the deltoid if the dose is equal to or less than? If more than 1 mL, what is the site to administer this?
-ventral gluteal
-1 mL, vastus lateralis When giving IM injections, what do you do first?
What will help with irritation and keep meds from seeping out with IM injections? -aspirate check blood, dispose and redraw meds if blood return
-z track method When giving an IV med, what are two things to keep in mind? apply anesthetic 30 mins prior & flush cath for patent Put in correct order of administering otic (ear) meds.
Right: Dose Route Time Individual (pt) Medicine Documentation What is the enzyme called that is responsible for converting arachidonic acid into prostaglandins and their products? cyclooxygenase (COX) There are two forms of COX enzyme, COX 1 and COX 2. Which form protects stomach lining and regulates blood platelets? A. COX 2 B. COX 1 B There are two forms of COX enzyme, COX 1 and COX 2. Which form triggers inflammation and pain? A. COX 2 B. COX 1 A ______ block COX 1 & 2 resulting in decreased stomach lining protection & chance for bleeding, and decreased inflammation, pain NSAIDs what are the two anti inflammatory drug groups? NSAIDs & antigout drugs This set of drugs inhibit biosynthesis of prostaglandins and platelet aggregation and have a analgesic & antipyretic effect. A. Stimulants B. Antiinflammatory C. Antidepressant D. Antipsychotics B NSAIDs have what type of effects? analgesic, anticoagulant, antipyretic, anti inflammatory What is the NSAID aspirin used for? select all that apply. A. antiinflammatory B. analgesic
C. antipyretic D. antiplatelet E. anticoagulant A, B, C, D What are the side effects of aspirin? A. dizzy, drowsy, headache B. edema C. GI distress D. bleeding A, C The following adverse reactions can be caused from which drug: tinnitus, hearing loss (toxicity), bleeding, GI ulcer, thrombocytopenia, reye's syndrome (children) A. Ibuprofen B. Tylenol C. Aspirin D. Celecoxib C With the NSAID aspirin what are the 4 G's that cAn cause an increase in bleeding? A. green leafy veggies B. garlic C. gouda cheese D. ginseng E. ginko biloba F green tea B, D, E, F Aspirin has an increased bleeding with ____ and other ____, and an increased gastric ulcer risk with
anticoagulants, NSAIDs, glucocorticoids Some cautions you should take with aspirin are what? other NSAIDs, don't give to children, avoid during last trimester of preg symptoms that can come with aspirin if given to children can include? A. N/V, coma B. drowsiness, headache C. Seizures, death D. change in LOC A, C, D What is the most widely used NSAID?
Ibuprofen What is the NSAID ibuprofen used for? A. analgesic B. osteoarthritis, RA (antiinflammatory) C. antipyretic D. anticoagulant A, B, C The following side effects go with which drug: dizzy, headache, gastric distress, peripheral edema. A. aspirin B. tylenol C. ibuprofen D. naloxone C Interactions of ibuprofen?
contraindication? drugs/herbs that cause bleeding, other protein binding drugs
bleeding disorders COX-2 Inhibitors: Celecoxib (NSAID) is used for what? A. dysmenorrhea B. osteoarthritis, RA C. pain D. ankylosing spondylitis A, B, C, D with aspirin & ibuprofen what are nursing interventions to watch for? bleeding (gums, petechiae, ecchymoses, black tarry stools) Side effects of celecoxib
adverse reactions?
what is a contraindication of celecoxib? dizzy, headache
GI distress/ulcers, HTN, peripheral edema, renal dysfunction
hx of heart disease
With aspirin & ibuprofen what are important things to tell the pt to do? stop taking 7 days prior to surgery, take with food, don't give to children for flu/virus symptoms (reye's syndrome) the drug allopurinol is a ______ drug and inhibits ________. antigout, uric acid side effects of allopurinol include? A. drowsy B. dizzy C. GI distress D. headache B, C, D adverse reactions of allopurinol? liver or kidney damage nursing interventions for antigout drug allopurinol? record I&O, monitor labs (liver/kidney function), have pt increase fluid, pt yearly eye exam Acetaminophen is used for?
what is the max dose?
side effects of acetaminophen?
Toxic effects? -pain, fever
-4g/day
-low incidence of GI distress
-(excessive dosing) hepatotoxicity (liver) nursing interventions for acetaminophen include liver enzyme tests, away from children's reach, pt avoid alcohol, teach max dose and what else? seek medical attention if no relief in 10 days acetaminophen is in what class? nonopioid analgesic opioid analgesic: morphine is used for?
moderate-severe pain, antitussive & antidiarrheal effects drowsy, sedation, dizzy, confusion, depression, miosis (pupil constrict), GI distress, constipation, urinary retention are side effects of? A. ibuprofen B. acetaminophen C. aspirin D. morphine D Hypotn, bradycardia, psychological dependence, resp depression are adverse effects of A. ibuprofen B. morphine C. aspirin D. acetaminophen B what is the antidote for morphine?
contraindication of morphine?
interactions of morphine naloxone
allergy, CNS or resp depression, sleep apnea, increased ICP, head injury
other CNS depressants
nursing interventions for naloxone Monitor VS/bleeding, Naloxone may wear off before opioid. Monitor for s/s of overdose unilateral throbbing pain, N/V, light sensitivity are characteristics of? migraine headaches causes vasoconstriction of cranial arteries is action of what drug?
what is this drug used for? sumatriptan
acute treatment migraine/cluster headaches contraindication of sumatriptan (triptans)
cautions?
interactions of sumatriptans HTN, CAD, CVA (stroke)
Smoking, obesity, older adults, seizures
Antidepressant meds bradycardia, Thromboembolism (clot), elevated liver enzymes, suicide ideation are adverse reactions of? sumatriptan take when symptoms appear, can be given subq/IM, get up slowly these are teachings for what drug? sumatriptan side effects of sumatriptan dizzy, drowsy, flushing, fatigue, GI distress what drugs would you use for sleep disorders & anxiety? alprazolam, lorazepam what is the action of benzodiazepines? reduce neuron excitability ____ also used for pre-op sedation, alcohol/substance & antiseizure lorazepam
lethargy, drowsy, confusion, memory impair, depression, tolerance/dependence, hypotn are effects/reactions to? benzodiazepines (pams & iams) interactions of benzodiazepines?
contraindications?
cautions? CNS Depressants, alcohol
resp depression, allergy
older adults, depression suicide ideation, severe liver/kidney problems nursing interventions for benzodizepines? monitor VS, teach nonpharm methods for sleep, observe reactions, teach pt to report resp depression or feeling of depression, teach that these drugs should be gradually withdrawn What does Zolpidem do?
what is it used for? neurotransmitter inhibitor, CNS depression
short term (<10d) insomnia, use smaller doses for older adults side effects of zolpidem?
adverse reactions? drowsy, lethargy, dizzy, memory impair
Residual drowsiness (hangover), vivid dreams, nightmares, dependence/tolerance, excessive depression, resp depression, hypersensitivity Contraindications of zolpidem?
interactions? Allergy, resp depression, severe renal/liver disease, children, older adults
Other CNS depressants, alcohol, food decreases absorption nursing interventions for zolpidem?
teaching?
monitor VS, LOC, observe for reactions, give at bedtime
use nonpharm interventions first, avoid other CNS depressants, take at bedtime, don't drive, report hangover feeling Induction & maintenance of anesthesia or conscious sedation for minor surgery or procedures, pts are sedated and relaxed but responsive to commands. what drug is this?
adverse effects? midazolam
resp & CV depression rapid onset, longer duration, blocks pain at site where drug is given, consciousness is maintained lidocaine use of lidocaine? Dental procedures, suturing skin lacerations, minor surgery at localized area, blocking nerve impulses (nerve block) below the insertion of a spinal anesthetic Local anesthetic injected in the spinal or epidural space in spine. Used commonly for C-sections
side effects of this?
adverse reactions? spinal & epidural anesthesia
headache
hypotn, resp distress nursing interventions for anesthetics? monitor safety, urine output, VS (esp. with midazolam) medically approved uses for CNS stimulants ADHD, narcolepsy, reversal of resp distress what is the action of methylphenidate modulates serotonergic pathways by affecting changes in dopamine transport side effects/adverse reactions of methylphenidate dry mouth, diarrhea, constipation, restlessness, tremors, irritable, tachycardia, palpitations, HTN, dysrhythmias, anorexia
contraindications of methylphenidate
caution?
interactions? htn, dysrhythmias, hyperthyroidism, anxiety
kids under 6, cardiac disease
caffeine, decreased effects of antihypertensives, other cns stimulants nursing interventions for methylphenidate monitor VS, effects, reactions, give before breakfast & lunch, record ht, wt & growth of children teaching for methylphenidate take before breakfast/lunch, avoid anything with caffeine, alcohol, diet w/good calorie intake, report irregular heartbeat, don't stop abruptly action of phenytoin?
uses?
therapeutic level? decrease excitability in brain
prevent seizures
10-20 mcg/mL side effects of phenytoin? adverse reactions? headache, dizzy, slurred speech, confusion, drowsy, depression, gingival hyperplasia, hyperglycemia, pink-red, brown urine
thrombocytopenia, leukopenia, suicide ideation, steven johnson contraindications of phenytoin?
interactions? preg
decreased effects of anticoag & oral contraceptives, decreased folic acid, vit K, decrease absorption of calcium, vit D
phenobarbital does what?
uses? decrease excitability of brain
seizures, status epilepticus effects of phenobarbital?
education? cns depression, sedation, resp depression, tolerance
don't stop abruptly, caution w/other CNS depressants valproic acid does what?
uses? depress excitability of brain
seizures side effects of valproic acid? dizzy, drowsy, insomnia, diplopia (double vision), weak, GI distress adverse effects of valproic acid? hepatotoxic, suicide ideation, thrombocytopenia nursing interventions for valproic acid? monitor level of drug to know therapeutic range (phenytoin level), use another form of birth control, oral care, use seizure precautions for at risk pts teaching for antiseizure drugs? take same time everyday, no driving, no alcohol, (monitor glucose levels, change in urine color, report sore throat, bruising, bleeding phenytoin) what two drugs treat acute seizure & status epilepticus and must be administer IV for status epi. diazepam, lorazepam haloperidol does what?
used for?
blocks dopamine receptors
treats psychoses, schizophrenia, ADHD, tourette's side effects of haloperidol? drowsy, headache, photosensitivity, urinary retention, sexual dysfunction, orthostatic hypotn adverse reactions of haloperidol tachycardia, blood dyscrasias, EPS, NMS contraindications of haloperidol narrow angle glaucoma, CNS depression, liver/kidney/cv disease, parkinson's, blood dyscrasias interactions of haloperidol increased sedation with alcohol, CNS depressants Block serotonin and dopaminergic D4 receptors
uses of this drug? aripiprazole
manage schizophrenia, bipolar, autism, depression, tourette Side effects of aripiprazole
adverse reaction? drowsy, dizzy, photosensitivity, ortho hypotn
tachycardia (dysrhythmias), increased glucose, contraindications of aripiprazole dysrhythmias, blood dyscrasias, liver damage, diabetes, parkinson's interactions of aripiprazole increased effects of antihypertensives, diabetic drugs, other antipsychotics, grapefruit juice, st john's wort nursing interventions for aripiprazole monitor VS, oversedation, stay w/pt til med taken, observe for eps, assess for nms block uptake of neurotransmitter serotonin, which increase level of usable serotonin fluoxetine uses of fluoxetine
major depression, ocd, panic attacks, phobias, PTSD, prevent migraines, eating disorders, substance use Side effects of fluoxetine
adverse effects? headache, nervous, blurred vision, insomnia, dry mouth, GI distress, sexual dysfunction
suicide ideation, seizures, hypoglycemia contraindication of fluoxetine?
caution?
interactions? allergy
breastfeeding, suicidal, liver/kidney disease, glaucoma
increased sedation w/alcohol, grapefruit juice with SSRIs can lead to toxicity inhibits reuptake of serotonin & norepi.
uses of this drug? venlafaxine
major depression, generalized & social anxiety, side effects of venlafaxine drowsy, dizzy, insomnia, headache, photosensitivity, ejaculation dysfunction adverse effects of venlafaxine nephrotoxic, tachycardia, htn, ortho hypotn, suicidal, seizures, steven johnsons venlafaxine interactions? st john's wort, MAOIs, cns depressants, alcohol contraindications of venlafaxine preg, breastfeeding, anticoag therapy, suicidal blocks uptake of neurotransmitters norepi & serotonin in brain, blocks histamine receptors which lead to sedation
uses?
amitriptyline
major depression side effects of Amitriptyline
adverse reactions? dizzy, sedation, dry mouth/eyes, ortho hypotn, urinary retention, sexual dysfunction, wt gain
cardiotoxicity, eps, nms interactions with amitriptyline?
contraindications alcohol, cns depressants
cv disease, htn monoamine oxidase enzyme inactives norepi, dopamine, epi & serotonin, this are all increased
uses? phenelzine
uncontrolled depression side effects of phenelzine? agitation, restless, insomnia, ortho hypotn, anticholinergic effects adverse effects of phenelzine hypertensive crisis from tyramine interactions, suicidal drug interactions of phenelzine cns stimulants (vasoconstrictors, cold meds containing phenylephrine pseudoephedrine) alter ion transport in muscle & nerve cells, increased receptor sensitivity to serotonin.
uses? lithium
bipolar manic episodes side effects of lithium? drowsy, dizzy, memory impair, headache, dry mouth, metallic taste, GI distress
adverse effects of lithium edema (hands/ankles) dehydration, increased urination, hyponatremia, nephrotoxicity lithium interactions increased lithium level with NSAIDs & haloperidol, st john's wort, kav kava contraindications of lithium? liver, renal, cardiac disease, preg, hypoNa, dehydration Adverse reactions of ibuprofen include? A. tinnitus B. ulcer, bleeding C. steven johnson syndrome D. nephrotoxicity all What is Pharmacokinetics what the body does to the drug What is Pharmacodynamics what the drug does to the body What phase is Pharmacokinetics Absorption phase Where does absorption of a drug take place Small intestine What affects absorption time -Pill type -stomach contents -blood circulation -pain, stress, anxiety -route of administration Contraindicators for medications Grapefruit juice and antacids what is disintegration breakdown of oral drug into smaller particles What is dissolution Process of combining small drug particles with liquid to form a solution
What is drug absorption Drug movement from GI tract into bloodstream happens in small intestine What is bioavailability What is left of drug after swallowing. PO meds will never have 100% bioavailability Factors affecting Bioavailability -Absorption -first pass metabolism -Drug form -route of admin -gastric mucous % motility -changes in liver metabolism -Administration w/ food and other drugs What is first pass effect drugs absorbed from the GI tract enter the portal vein and pass through the liver before entering circulation. PO meds only Characteristics of ADHD Inattentiveness, inability to concentrate, restlessness, hyperactivity, inability to complete tasks, impulsivity Characteristics of narcolepsy recurrent attacks of drowsiness and sleep during daytime unable to control sleep falling asleep while driving, talking, eating, standing Where does drug metablosim occur In the the liver What is drug metabolism process of body chemically changing drug into a form to be excreted What is the half-life of a drug? the time it takes for the drug in body to be reduced by half What is a loading dose Large initial dose of medication followed by small maintence dose
Where does drug excretion occur? kidneys Ways drug excretion takes place Kidneys, liver (bile), feces, lungs, saliva What is the primary effect of a drug Why you're taking the drug (desirable response) What is the secondary effect of a drug Side effects (can be desirable or undesirable) What is the therapeutic index? ratio of toxic dose to therapeutic dose What is ED50? effective dose for 50% of the population What is TD50? toxic dose in 50% of the population What is the peak level of a drug? highest blood level of a drug What is the trough drug level? lowest blood level of a drug What is the onset of a drug The amount of time it takes a drug to begin working. When do you draw a peak for PO meds 2-3 hours after taking When do you draw peak for IV meds 30-60 meds What is polypharmacy? use of multiple medications (more than 5) S/S of infection fever, chills, redness, swelling, fatigue, increased WBC, pus, sweats Purpose of COX-1