Prepare: Introduction to Pharmacology

• Which of the following substances can be defined as a drug? Select all that apply.
• Which term describes the proprietary name for a medication?
• Which word describes how the drug is delivered through the body?

Self Check: How Drugs Move Through the Body

• Please place the following in the order they occur in the body:

Self Check: Drug Names

• Using the drop-down menus, choose the correct definition of each name type.

Self Check: Drug Naming By Pharmaceutical Companies

• Which actions may a pharmaceutical company take to create a new drug? Select all that apply.

Self Check: Administration of Medication

• Using the labels below, drag and drop the route to the correct location on the image.

Self Check: Medication

• Phenytoin, an anti-seizure drug can cause drowsiness. Which medication related term or phrase best describes this occurrence?

Reflect: Introduction to Pharmacology

Medication Administration

• Match the medication administration route to the correct location on the image.

FDA Regulations

• The U.S. Food and Drug Administration (FDA) regulates the production of which products? Select all that apply.

Administering Medication

• What must the nurse consider when administering a medication? Select all that apply.

Medication Labels

• Bill is looking at a blood pressure medication. The label says Basicide 10mg/25mg. Which of the following is accurate?

Medication Names

• Which name, when used by health care professionals, increases the safe administration of medications?

Medication Errors

• A medication error just occurred. Prioritize the following actions in order from the first to last actions the nurse must complete.

Medication Route

• Select the correct medication route based on location.

Medication Information

• Label the information below correctly using the drop-down menus.

Prepare: Pharmacokinetics

Order of Pharmacokinetics

• Put the following pharmacokinetics in the order in which they occur within the body.

Pharmacokinetics

• What is pharmacokinetics?

Biomechanical Alteration

• Which step describes the biochemical alteration of a drug into an active or inactive metabolite?

Self Check: Drug’s Journey Through the Body

• Match the steps of how a drug moves through the body to their descriptions.

Self Check: Absorption & Distribution

• Using the drop-down menus, select the words that complete the sentences accurately.

Self Check: Metabolism

• If two drugs both go through the cytochrome p450 3A4 enzyme system in the liver, which statement accurately describes what occurs?

Self Check: Elderly Patients

• Which factor affects absorption in an elderly patient?

Self Check: Half-Life

• The half-life of morphine is 2 hours. How long would it take for morphine sulfate to get to steady state in someone provided the maintain the same strength and dose?

Reflect: Pharmacokinetics

Transport of Medication

• How are most medications transported through the body?

Movement Through the Liver

• Oral medication goes through the liver after being absorbed by the intestine. What is the movement through the liver known as?

Insulin Effects

• Insulin is used to reduce blood glucose levels in diabetic patients. Reviewing the graph below which of the following are accurate statements? Select all that apply

Half-Life & Steady State

• Calculate the following for each medication and select the correct response from the drop-down menu. What is the amount of medication left after one half life? How long will the medication take to reach steady state assuming 5 half-lives if the patient takes the medication as ordered?

Duration of Insulin

• Look at the following onset, peak, and duration graphic showing five different types of insulin. Select the correct duration for the following based on the table:

Pharmacokinetics in the Elderly

• Click and drag each item to where it affects pharmacokinetics in the elderly.

Terms in Pharmacokinetics

• Which terms are used when discussing pharmacokinetics? Select all that apply.

Peaks and Troughs

• Julie is on vancomycin, a powerful antibiotic. Julie’s peaks and troughs are being monitored by intermittent serum levels of vancomycin. You know that a trough level is drawn to determine the lowest therapeutic dose you want the patient to be at. The peak level is drawn to monitor and adjust the highest level the patient should be at without the medication being toxic. The peak level should be drawn two hours after the medication is given, and the trough level should be drawn immediately before the next dose is given.

Pharmacodynamics

Prepare: Pharmacodynamics (SIMILAR WORDING - DOUBLE CHECK QUESTION)

Diminished Response

• When a drug binds to a receptor and has a diminished response, how is the drug best described?

Preventing Responses

• When a drug binds to a receptor and prevents a response, how is the drug best described?

Binding to Receptors

• When a drug binds to a receptor and has a response, how is the drug best described?

Self Check: Pharmacodynamic Targets

Pharmacodynamic Targets

• Which are the pharmacodynamic targets of all drugs? Select all that apply.

Self Check: Selective Interaction

Blocking Receptors

• Which term describes the binding of a drug to a receptor without completely blocking the receptor, causing a diminished response or effect?

Receptor and Enzyme Activation

• A drug that prevents a receptor or enzyme from activating is referred by which term?

Naloxone

• Naloxone is a drug that blocks the effect of an opioid by binding to the opioid receptor. What is the receptor interaction that takes place when both morphine (an opioid) and naloxone are taken?

Self Check: Interaction of Antibiotics

Interaction of Antibiotics

• Which of the following describes the interaction of antibiotics on the inhibition of cell wall synthesis?

Reflect: Pharmacodynamics

Faulty Physiologic System

• When a drug has a positive change to a faulty physiologic system, it is known as which of the following?

Important Definitions

• Drag and drop the terms and match them with the correct definition.

Interaction of Drugs

• The interaction of a drug with a receptor site or enzyme is called its pharmacodynamic effect. A drug can modify the effect of tissues or cells by activating a receptor, or acting as an agonist. A drug can deactivate with a cell, or act as an antagonist. Finally, a drug can compete with an agonist to deactivate a cell, which makes the drug a competitive antagonist.

Antibiotic Targets

• Select which target the antibiotic is using in the image to the right.
• Blocked pathways and inhibit metabolism: Folic acid

Action of a Drug: PAY ATTENTION TO EACH BOLDED ONE

Drug, Receptor, Cell turns on

• The example below describes a drug acting as a(n) agonist.

Drug, Receptor, Cell turns off

• The example below describes a drug acting as a(n) antagonist.

Cell turns on but diminished

• The example below describes a drug acting as a(n) partial agonist.

Chemical, Drug, Drug blocks chemical, Receptor, Cell turns off

• The example below describes a drug acting as a(n) competitive antagonist.

Pharmacotherapeutics

Prepare: Pharmacotherapeutics

Type of Therapy

• Which type of therapy is used to treat someone based on the clinical probability that the drug will work based on patient’s symptoms only?

Factors in Drug Evaluation

• Which factors are included in the pharmacotherapeutic evaluation of a drug? Select all that apply.

Low Therapeutic Index

• Which sentence describes a drug with a low therapeutic index?

Self Check: Drug Therapies

Drug Therapies

• Which type of therapy is a treatment used to prevent a high risk condition from occurring?

Self Check: Drug Therapy Monitoring

Drug Therapy Monitoring

• Drag and drop the type of monitoring that was used in each of the situations

Self Check: Therapeutic Index

Therapeutic Index

• A low therapeutic index means that there is a small difference between a drugs active dose and its toxic dosage. A drug with a low therapeutic index has a higher likelihood of causing an adverse reaction. Warfarin has a low therapeutic index because a slight change in dose could be toxic. Amoxicillin has a high therapeutic index because it is rarely toxic at a higher dose.

Self Check: Drug Toxicity

Drug Toxicity

• Which conditions can cause drug toxicity? Select all that apply.

Self Check: Drug Reactions

Drug Reactions

Using the drop-down menus, select the correct drug reaction.

• Fred says that when he doesn’t take his morphine, he gets a sweaty, a runny nose, and nauseous with vomiting. Once he takes it, the symptoms go away.
• Sara says that when she doesn’t take her tramadol, it is all she thinks about and craves. She will do anything to get her tramadol.
• Murray says that he takes his pregabalin for his neuropathy symptoms, but it doesn’t seem to work as well as it once did. He thinks he needs more.

Self Check: Drug Combinations

Drug Combinations

• Which sentence describes how acetaminophen combines with codeine to work in Tylenol #3?

Reflect: Pharmacotherapeutics

Toxic Levels

• Which situation can cause a toxic level of a drug in a person’s system? Select all that apply.

Therapeutic Index

• Drag and drop the correct label to the appropriate location in the image below.

Choose Reaction Types

Which type of reaction each of the following people is experiencing.

• Priscilla was arrested for stealing Percocet from her mother.
• Elden was admitted to a detox center because he ran out of pain medication and started experiencing anxiety, tremors, and dizziness.
• Mandy says that one drink used to make her drunk, but now it takes 4 drinks to feel about the same.

Types of Therapy

• Drag and drop each type of therapy to match which is being used in the example.

Interactions

• Drag and drop each interaction to match each situation presented below.

Treatment Therapies

• Drag and drop the following treatment therapies to match the with their descriptions.

Offered Therapy

• Julie experienced a sexual assault. After the Sexual Assault Nurse Examiner (SANE) completed her interview and exam she suggested that Julie take azidothymidine (AZT) to prevent HIV. Which type of therapy is the nurse offering?

Type of Reaction

• Laura took the first dose of amoxicillin for her upper respiratory infection. She quickly developed a rash over her body and started experiencing shortness of breath. What is the best description below for this reaction?

Pharmacogenetics

Prepare: Pharmacogenomics

Specialties of Pharmacogenomics

• Which of the following specialties does pharmacogenomics incorporate? Select all that apply.

An Increased Risk

• Which of the following suggests an increased risk for a genetic disorder? Select all that apply.

Area of Focus

• What is a large area of focus that is currently impacted by pharmacogenomics?

Self Check: Pharmacogenomics

Pharmacogenomics

• Which of the following best describes Pharmacogenomics?

Self Check: Metabolism

Metabolism

• A person has a 2d6 enzyme deficiency. How would a drug metabolize through the 2d6 pathway?

Self Check: Treatments for Cancer

Treatments for Cancer

• New treatments for cancer include which of the following?

Self Check: Drug Attributes

Drug Attributes

• What drug attribute might be affected by a patient’s genetics?

Self Check: Genetic Issues

Genetic Issues

• Which genetic issues are important for privacy and confidentiality? Select all that apply.

Reflect: Pharmacogenomics

How Drugs Metabolize

• Julie and Kim both take acetaminophen with codeine for chronic low back pain. That drug is metabolized by the cytochrome p450 2d6 pathway. A recent genetic test showed that Julie carries two inactive copies of the CYP2d6 gene. Which of the following would you expect to occur to Julie compared to Kim?

Pharmacogenomics

• Complete each of the sentences by selecting the correct word from the drop-down menus.

Increased Side Effects

• A pharmacist suggested dextromethorphan (a common over-the-counter cough suppressant) for Bill’s cough. Which of the following may indicate that this medication will not work for Bill, and may cause increased side effects?

Dosage Levels

• A friend of a patient calls the office to let you know they are concerned about the dosage level of the phenytoin their friend is taking. It is a much higher dose than usual. You note that the patient is a poor metabolizer of phenytoin based on genetic testing. Which of the following is an appropriate response?

Side Effects

• A friend recently started taking the antidepressant sertraline (Zoloft). She is experiencing severe side effects. Which of the following could be a reason? Select all that apply.

Metabolizing

• Pharmacogenomics involves the sciences of pharmacology and genomics. It studies how medications are metabolized by the body based on the presence of extra copies of a gene, or inactive copies of a gene. Patient’s with extra copies are ultrametabolizers and tend to metabolize medication faster. Patients with inactive copies are poor metabolizers and will metabolize medication slower.

Polymorphism

• Grant has CYP2d6 polymorphism. Which of the following suggests an understanding of this when being prescribed codeine?

Warfarin & Atrial Fibrillation

• Bill has 2d6 polymorphism and requires warfarin because of his atrial fibrillation. In reviewing his medications, you would expect which of the following conditions to apply?

Nursing Application: Introduction to Pharmacology

Prepare: Nursing Application - Introduction to Pharmacology

Medication Lists

• A nurse reviewing a medication list sees that a patient is on albuterol (beta-agonist) for their asthma, and on propranolol (beta-antagonist) for migraines. The nurse understands which of the following?

Pharmacokinetics of Medicine

• The nurse medicated Mr. Jones with Morphine 4mg IV about four hours ago. Understanding the pharmacokinetics of this medication including a half life of 3 hours, which of the following is accurate?

Elderly Patient

• The nurse is administering a medication to an elderly patient. The nurse understands that age-related changes can affect pharmacokinetics. Which of the following is accurate about medication and the elderly? Select all that apply

Self Check: Nursing Assessment

Case Study: Nursing Assessment

• Charlie is a 56-year-old father of two children who is married to his high school sweetheart, Betty. He drives a truck for a large company doing cross-country trips and often eats at fast food restaurants. Charlie recently went to see his primary health care provider for bilateral foot itching. He was diagnosed with onychomycosis and prescribed itraconazole 200mg daily.

Use a drug interaction checker to review Charlie’s medications for potential interactions. Which of the following medication(s) show at least one interaction with another one of Charlie’s medications? Select all that apply.

Case Study: Nursing Assessment

• Charlie asks when the itraconazole will start working. In reviewing the medication’s pharmacodynamics and noting that the half-life is about 40 hours, which of the following is accurate?

Self Check: Diagnosis and Planning

Case Study: Diagnosis and Planning

• As the nurse caring for Charlie, you review his current medication regimen. Prior to providing teaching instructions regarding Itraconazole, which home medication could decrease the effectiveness of Itraconazole?

Allergies

• No known drug allergies

Medication List

• Itraconazole (Sporanox) 200mg one daily
• Aspirin 325mg one daily
• Hydrochlorothiazide 25mg one daily
• Pravastatin (Pravachol) 40mg one daily Calcium Carbonate 400mg 4 tablets every 8 hours as needed

Case Study: Diagnosis and Planning

• Charlie has been increasing his use of calcium carbonate for heart burn to 5 to 6 times a day. After reviewing his home medications again, the nurse asks a few assessment questions to identify a possible drug interaction. Which one of Charlie’s statements could indicate an interaction between his increased calcium carbonate usage and aspirin?

Allergies

• No known drug allergies

Medication List

• Itraconazole (Sporanox) 200mg one daily
• Aspirin 325mg one daily Hydrochlorothiazide 25mg one daily
• Pravastatin (Pravachol) 40mg one daily
• Calcium Carbonate 400mg 4 tablets every 8 hours as needed

Self Check: Implement and Evaluate

Case Study: Implement and Evaluate

• After discovering the drug interaction, what action should the nurse take immediately?

Allergies

• No known drug allergies

Medication List

• Itraconazole (Sporanox) 200mg one daily
• Aspirin 325mg one daily
• Hydrochlorothiazide 25mg one daily
• Pravastatin (Pravachol) 40mg one daily Calcium Carbonate 400mg 4 tablets every 8 hours as needed

Reflect: Nursing Application - Introduction to Pharmacology

Carson

• Carson is a 10 year old boy who is being treated in the ER with a complaint of severe, difficulty breathing. He recent started a new antibiotic for a lower respiratory infection. Which principle best describes the scenario?

Connor

• Connor, a 57 year old man, has been taking a non-steroidal analgesic for pain for five years. He contacts his health care provider to make an appointment to discuss another medication alternative because the medication is no longer managing his pain. Which principle best describes the scenario?

Walter

• Walter, a 65 year man, is being seen in a local medical clinic for dizziness, weakness, and a possible low blood pressure. For the past month, he has been taking a calcium channel blocking drug to lower his pressure. Walter tells the nurse that he knows that grapefruits can cause increase the amount of medication in his blood and lower his blood pressure. When asked about his daily diet, Walter informs the nurse that he drinks a half a glass of pink grapefruit juice and white toast for breakfast every morning. The nurse checks his blood pressure on the left alarm and it is alarmingly low. Which principle best describes the scenario?

Amanda

• Amanda is a 43 year old woman who has been diagnosed in the early stages of liver failure. She asks the nurse, as her disease worsens, will the effects of her oral medications change? Which principle best describes the scenario?

Corleen

• Corleen is a 72 year old woman who is being hospitalized for a hip repair surgery. After the procedure, Corleen was given a small dose intravenous morphine for pain. A few hours later, Corleen notifies the nurse that she still is experiencing pain. The nurse adds an oral pain medication to increase the effects of the pain medication therapy. Which principle best describes the scenario?

Ariana

• Ariana is a 25 year old who is being treated for a bacterial infection. The health care provider prescribed vancomycin, an antibiotic used to treat methicillin resistant staphylococcus aureus (MRSA) infection, two days ago. The nurse has an order to determine Ariana's vancomycin blood levels. The dose of vancomycin was started at 8:00 AM and takes 2 hours to infuse below are her laboratory results. Which principle best describes the scenario?

Ariana

• Ariana's vancomycin infusion is completed at 10:00 AM and the nurse has also received another order to determine Ariana’s vancomycin blood levels. The image to the right shows her laboratory results. Which principle best describes the scenario?

Safety, Lifespan, and Professional Identity

Prepare: Safety

Safety and Drug Therapy

• Safety is part of drug therapy. Safety considerations include collecting key information prior to medication (i.e. drug) administration. Choose which of the following primary drug topics are essential knowledge in drug safety. Select all that apply

Safety

• Which of the following are not primary considerations as it pertains to drug therapy?

Introduction to Safety

• Healthcare professionals have a role to play in ensuring medication safety. Medication safety helps:

Self Check: Adverse Effects

Adverse Effects

• Locate these two (2) drugs in your drug guide. Identify the high alert adverse effects for each.

Self Check: Contraindications

Contraindications

• Contraindication is the opposite of indication for use, which is a reason to use a certain medication.

Self Check: Drug Combinations

Drug Combinations

• Using your drug guide or other learning resources, identify if the following combinations are compatible in the same IV line.

Self Check: Know, Ask, Check – Talking Points

Know, Ask, Check – Talking Points

• Patient teaching is an important health care provider role and responsibility. To help reduce medication errors, educate your patien