GRNU 615 Study Guide (2019-20) Graduate Nursing 615 | Maryville University of St. Louis. This study guide contains Last minute GRNU 615 of information you MUST know to pass your exam.

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GRNU 615 Study Guide (2019-20) What factors are associated with clinical judgment when prescribing medications? Patient-centered care, least invasive, least expensive and least likely to prevent a... dverse reactions Factors associated with clinical judgment when prescribing medications What are the criteria for picking an effective drug? Black box warning? How does hypoalbuminemia affect the process of prescribing? Low albumin = more free drug = increased adverse effects How does hypoalbuminemia affect the process of prescribing? How does hypoalbuminemia affect the process of prescribing? What is the drug's half-life? Use half-life to determine the length of time required between dosage admin What do you use a drug's half-life for? Drug's half life Onset of action Onset of action Duration of action ( The length of time you have the drug in your system) Duration of Action What is steady state? Steady State What is steady state reached? Explain first pass metabolism Another name for first past metabolism Route of first pass metabolism Which route can bypass first-pass metabolism? What 5 factors affect drug absorption? What factors affect the drug's absorption? Which admin route does not involve absorption or loss of drug? Fastest route of admin? What cells must the drug go thru to be absorbed into the circulatory system? What is one cellular barrier that may prevent absorption? Pure lipid bilayers are generally permeable only to Solubility favors Permeability favors Henderson-Hasselbalch equation Henderson-Hasselbalch Equation In the stomach, drugs that are weak acids In the stomach, drugs that are weak bases will be in their Weak acids have a higher absorption in the In the intestines, weak bases will What are the major enzymes involved in drug metabolism? What is a major source of adverse drug reactions? Bioactive compounds such as grapefruit juice do what? If 2 drugs are both metabolized by the p450 system the drugs should be admined What is the reason behind drug interactions and the rationale of why drugs affect different people in different ways What is the efficacy of a drug? Intrinsic activity Effectiveness On the drug concentration curve, what is the first sign of a therapeutic response? What is the purpose of peak and trough? What is the BBB What is the BBB formed of? The BBB allows passage of Placental barrier impedes How will renal insufficiency effect drug elimination? General theme of metabolism What factors determine the rate of a drug excreted by the kidneys How is renal function assessed? The best treatment Criteria for choosing an effective drug Peak of Action First Pass Metabolism Identify drug metabolism and the role of the isoenzymes of the P450 system Efficacy On the drug concentration curve, what is the 1st sign of a therapeutic effect? What is the purpose of peak and trough levels? Describe the purpose of blood-brain barrier Placental Barrier What is the difference in distribution in each medication route How will renal insufficiency affect drug elimination According to the WHO what is the 1st step in the prescribing process? 2nd step by WHO 3rd step by WHO What does the FDA have the authority to approve? What is off-label prescribing? What factors place an infant at which when prescribing medications? What adverse drug reactions are the elderly at risk for developing? What are the ADRs related to special populations? Type 1 Hypersensitivity Type II Hypersensitivity Type III Hypersensitivity Type IV Hypersensitivity Which medications react w/ St. John's Wort How does doxazosin work? How does doxazosin work? What is the action and effect of beta blockers? What is the action and effect of beta blockers? Non-selective beta blockers Cardio-selective beta blockers What are the adverse effects of beta blockers? What are the adverse effects of beta blockers? What effect will rapid withdrawal of beta blocker have? What patient teaching should be provided when prescribing clonidine or any other centrally-acting adrenergic blocker? What are the effects of a beta 1 selective blocker? What effects produced w/ cholinergic blockers? What effect is produced with cholinergic blockers? the role of the isoenzymes of the P450 system. Which medications interact with St. John’s Wort? What patient teaching should be provided when prescribing clonidine (alpha 2 agonist) or any centrally acting adrenergic blocker? Explain the 4 adrenergic agonist receptor types. What precautions should be considered before prescribing an Alpha 1 antagonist? What are anticholinergics used to treat? What should be considered before prescribing a beta blocker to a patient with high cholesterol? What teaching should be done with a diabetic patient who is taking a beta blocker? Contraindications for macrobids Labs to order for a patient on tobramycin A combo of pcn or cephalosporin with aminoglycoside are used to treat... Patients with poor immune function will need what type of antibiotics? How can a patient with low albumin levels, decreased renal function, and underweight affect abx treatments? What are the mechanisms in which bacteria can become resistant? A patient who handles livestock is dx with MRSA, what would be the treatment options you would prescribe? Patients who have existing bacterial resistance, would require hospitalization for treatment of . What abxs expected to use to treat this infection? What factors would place patients at risk for developing VRE? What can be used for treatment? What abx has narrow coverage of gram (+) bacteria, although it is poorly absorbed orally, it can be very toxic to the ear and kidney parenterally? What can cause a patient to develop histamine type realese w/ symptoms of flushed skin, fever, chills, tachycardia, pruritis, and paresthesia? What abx is a broad spectrum, bactericidal used to treat strep throat, otitis media, UTIs, and some pneumonias? It is the safest drug for pregnancy and peds. PCN and cephalosporins can decrease gut flora, what should a patient be educated on if they develop diarrhea while taking these meds? Cephalexin and Cefazolin have coverage while Ceftrixone and Cefepime have A patient has allergies to PCN and azithromycin, what medication would be a proper alternative? why? What broad spectrum bactericidal abx that can be used on anaerobic and aerobic bacteria? This abx is reserved for treatment of community-acquired PNA in patients with comorbidities? This abx is concentrated in the prostate and kidneys making it great for treatment of prostatitis. What needs to be monitored in patients taking levofloxacin? The use of these two medications concurrently will displace albumin from inhibiting CYP450 enzyme and cause what? This abx has a huge risk for c. diff and works on protein synthesis 50S ribosomes that is bactericidal and -static. A patient on clindamycin for tx of PNA c/o of bloody diarrhea, what should you do? What causes arrhythmias in patients on clindamycin? What class of abx are used to treat chlamydia, prophylaxis for pertussis, and whopping cough? What should be closely monitored on patients taking aminoglycosides? Patients on Linezolid should be specifically educated on interactions with? What would you as the provider need to monitor? What patient factors should a provider consider before prescribing sulfonamides and why? A patient is allergic to sulfamethoxazole, what medication should a provider avoid prescribing? Which medications can cause a dangerous adverse effect of painful sloughing of the skin? Why should levofloxacin be avoided in the elderly, pregnant women, and pediatrics? When prescribing levofloxacin, providers need to educate patients on? [Show More]

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