501 QUIZ 1

if the patient has a head ache, the nurse doesn’t want to give some really strong pain medication, like morphine.  We would probably want something with a lower _______  such as aspirin.

if a drug LACKS _______, that can be important.  What can happen is that very large doses may be used to get the effect needed, and this might not be very convenient.

_______ is the largest effect that a drug can produce as 
indicated by height of ____-_____ ______.

Match the ______ of the response with the patient’s need

"point of saturation" is another term for ____ _____.

___________ is the remainder of an orally administered drug that reaches systemic circulation.

Chemically equivalent drugs can differ in bioavailability because of different ______ __ ______ and ________ __ ______.

The rate drugs are  ______ is the primary determinant of the concentration of drug in the blood stream.

Renal ______ accounts for most drug excretion, however drugs are also subjected to  _______ in the renal tubule.

3 processes of excretion

water-soluble drugs would be excreted by ______ ______ unless the drug was bound by a _______.

lipid-soluble drugs could  avoid excretion because of ______ ______, which will move drug from tubule into blood stream.

lipid-soluble drugs could only be excreted in the kidneys by means of _____ ______ _____, which requires active transport.

______ ______ drives reabsorption of drug from lumen of tubule back into bloodstream.

pharmacokinetic processes determine drug concentrations at ____ __ _____.  However, you can only MEASURE the drug levels in the _____ _____.

therapeutic window vs. therapeutic ratio is parallel to therapeutic ______ vs. therapeutic _____

At some point, the amount eliminated in the dosing interval will equal the dose.  This is know as _______.

______, as the highest plasma level, must be kept below ____ concentration.

______, as the lowest plasma level, must be kept above _____.

Drug A administered 10mg/day.  Peaks exceed toxic concentration and troughs fall below MEC.  However, mean concentration is in therapeutic range.  What are 2 nursing implication?

How would pharmacological therapy affect half-life in a patient with liver disease who is receiving a drug that undergoes hepatic metabolism?

How would pharmacological therapy affect half-life in a patient who is taking Drug A and Drug B, where Drug A is an inducer of metabolizing enzymes for Drug B?  List 2 nursing implications.

an immune response that requires prior sensitization of immune system

Direct chemical example of drug-drug interactions.

antacids increase gastric pH and impacts ionization of drugs; laxatives decrease transit time for absorption; narcotics decrease peristalsis and prolong transit time. 

these are examples of what.  check all that apply.

competition for protein binding; alteration in extracellular pH.

these are examples of what.  check all that apply.

induction/inhibition of enzymes (cytochrome P450 enzyme families); common inducers are phenobarbital & carbamazepine (anti-seizure drugs), rifampin (tuberculosis drug), tobacco, & some “herbal supplements,” such as St. John’s wort.

these are examples of what.  check all that apply.

decreased CO decreases perfusion of glomerulus; alteration in urinary pH affects ionization; competition for transporter binding

these are examples of what.  check all that apply.

P-glycoprotein subject to induction/inhibition by drugs;
interaction at same or different receptor sites (agonist-antagonist)

these are examples of what.  check all that apply.

Acetaminophen, a drug metabolized by the liver, is administered to a patient with liver failure.  Which of the following is true?

A.The half-life may be shortened in this patient.
B.Drug levels will be decreased in this patient.
C.The patient will metabolize the drug more quickly.
D.The patient is more likely to experience a toxic effect of acetaminophen.

To reach the therapeutic range more quickly, we can give a ________, which is a large dose given at the start of therapy

A more potent drug produces desired effect at lower dosage, as indicated by position of curve along X-axis.

amount of drug that must be given to produce a desired effect

Selectivity

________ is reflected in drug’s potency in direct proportion.

________ is in direct proportion to maximal efficacy.

Intensity of response to drug related to # receptors occupied, but also related to activation of receptors after binding

Accounts for differences in potency and maximal efficacy

nursing implications for protein binding.

nursing implication for 1st pass

active acquired immunity

passive acquired immunity

stages of inflammation

vascular phases of inflammation

vascular phase
s/s
fxn

cellular phases of inflammation

migration & adhesion

transmigration

chemotaxis

phagocytosis

phagocytic leukocytes

an immune cell that phagocytizes an antigen

cells of inflammation

eosinophil

basophils

mast cells

*Complement proteins: vasodilation; é capillary permeability; promote leukocyte activation, chemotaxis, and augment phagocytosis

Complement system –cascade of plasma proteins

2 types of inflammatory mediators

2 types of cell-derived inflammatory mediators

2 types of plasma-derived inflammatory mediators

vasodilation; capillary permeability; promote leukocyte activation, chemotaxis, and augment phagocytosis

an effector of innate and humoral/adaptive immunity

peptides, polysaccharides, lipids, nucleic acids; has unique molecular shape recognized by specific receptor on lymphocyte

Recognition of antigen and stimulation by cytokines

clones that differentiate into effector and memory cell

B lymphocyte immunity is to _____, as T lymphocyte immunity is to ________.

MHC

Membrane-bound proteins that display peptides to T cells; recognizes self vs nonself; expressed on APCs

In adaptive immunity, activation requires 2 signals.  what are they?

IgG

IgA

IgM

IgD

IgE

master switch; T_H cell receptor binds to MHC-II and antigen complex on APC; secretes cytokines; helps activate B cells bound with same antigen

effector; T_C cell receptor binds MHC-I and antigen complex; injects preformed cytotoxic proteins into target cell

Discrimination of self and non-self

Can initiate, maintain, and down-regulate without help of the nervous system or other systems

Targets very select antigens

Can invoke specific immune response to an indefinite number of different antigens

only Immune system and CNS have these types of cells memory