NUR 105 Final Exam Complete with Solutions. Latest 2020/2021

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Final Exam NUR 105 This exam includes 2 questions and 8 case studies. All questions/case study must be completed in your own words. You may need to use resources outside of your textbook. You must i... nclude a bibliography that identifies all used resources. Each question/case study is worth 10 points. 1. Choose 5 of the following drugs and address the following: a. Lasix f. Robaxin b. Rexulti g. Stelara c. Protonix h. Metropolol d. Augmentin i. Levalbuterol e. Latuda j. Norco Pharmacodynamics • Receptor sites • Drug-Enzyme interactions • Selective toxicity Pharmacokinetics • Absorption, distribution, metabolism, excretion • First-pass effect • Half-life • Protein-binding • Routes of administration • Drug-drug interactions and drug-food interactions Lasix is used for patients with Edema due to heart failure, hepatic disease, hypertension, and renal disease. Its action is to inhibit reabsorption of sodium and chloride, and in turn increases the excretion of Sodium, Chloride, Mag, water, potassium, and calcium. Therapeutic effects are to help decrease BP and to mobilize excess fluid. Its absorption rate is 60-70% after oral medication has been taken. The Distribution example is when it crosses over from the placenta to breast milk. Protein binding occurs at 90-91%, and its half-life is 30-60 minutes but increased in renal impairment. Metabolism and excretion are minimally metabolized by the liver. Ways for it to be given are IM, PO, IV. These medications can cause toxicity and interactions with the Lasix and they include, antihypertensive, lithium, digoxin, and corticoid steroids to name a few. Profound diuresis may cause fluid and electrolyte depletion. Excessive dehydration and potassium depletion may occur. Excessive diuresis may cause rapid weight loss, orthostatic hypotension or acute hypotensive episodes. May also cause tinnitus, reversible or permanent hearing loss or reversible deafness. Latuda is a medication used for schizophrenia patients and depressive episodes associated with Bipolar 1 disorder. The therapeutic effect is to decrease the schizophrenia and depressive episodes. Absorption rate is 9-19% after oral administration, the distribution is unknown, and the protein binding is increased 99%. Mostly metabolized by the CYP3A4 enzyme system. Two metabolites are pharmacologically active; 80% eliminated in feces, 8% in urine primarily as metabolites. The half life of the medication is 18 hours. The Food drug interactions are as followed, Grapefruit Juice causes an increase in the blood levels which in return causes adverse reactions. Medications that can cause increase in levels an adverse reaction are ketoconazole, clarithromycin, ritonavir. Medications that decrease levels are rifampin, phenytoin, and carbamazepine. Norco is a mix between Hydrocodone and Ibuprofen. It is therapeutic for cold, allergies, and cough remedies with opioid agonist and nonopioid antagonist. It has an extended release mechanism for patients in pain that need it to be taken daily. Bind to opiate receptors in the CNS. Alter the perception of and response to painful stimuli while producing generalized CNS depression. Suppress the cough reflex via a direct central action while Decreasing in severity of moderate pain, and Suppression of the cough reflex. It is well absorbed by oral administration and the distribution is unknown. Drug is mostly metabolized by the liver; eliminated in the urine (50–60% as metabolites, 10% as unchanged drug). Half life is 2.2 hours but with the extended release its 8 hours. Drug interactions are kava-kava, valerian, skullcap, chamomile, or hops can increase CNS depression. RItonavir, ketoconazole, itraconazole, fluconazole, clarithromycin, erythromycin, nefazodone, diltiazem, verapamil, nelfinavir, and fosamprenavir increase levels and risk of opioid toxicity; careful monitoring during initiation, dose changes, or discontinuation of the inhibitor is recommended. [Show More]

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