Nokea
A nurse is instructing a client who has a new prescription for Timolol how to insert eye drops. The nurse should instruct the client to press on which of the following areas to prevent systemic absorption of the medication?
- A. Bony orbit
- B. Nasolacrimal duct
- C. Conjunctival sac
- D. Outer canthus
Correct Answer: B
Rationale: Pressing the nasolacrimal duct prevents systemic absorption by blocking drainage into the nasal cavity.
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A thorough understanding of herbs is critical to patient safety. An example is the use of cinnamon to treat type II diabetes. It is important the patient uses Ceylon cinnamon, as the commercially available cassia cinnamon contains:
- A. Coumadin, which may lead to bleeding problems
- B. Coumarin, which can cause liver and kidney damage
- C. Cinnamic aldehyde, which is toxic to the kidney
- D. Cinnamate eugenol, which is toxic to the liver
Correct Answer: B
Rationale: Cassia cinnamon contains coumarin, which can be hepatotoxic and nephrotoxic in high doses.
The following drug is used for diabetic coma:
- A. Glibenclamid
- B. Long acting insulin preparations
- C. The rapid and intermediate acting insulin preparations
- D. Metformin
Correct Answer: C
Rationale: Rapid and intermediate-acting insulins are used to quickly correct hyperglycemia in diabetic coma.
No physical dependence is seen in:
- A. Dextropropoxyphene
- B. Fortwin
- C. Fluoxetine
- D. Alprax
Correct Answer: C
Rationale: Fluoxetine (SSRI) has no physical dependence; others do.
Cruciferous vegetables may alter drug pharmacokinetics by:
- A. Enhancing absorption of weakly acidic drugs
- B. Altering CYP 3A4 activity, leading to elevated levels of drugs, such as the statins
- C. Inducing CYP 1A2, possibly leading to therapeutic failure of drugs metabolized by CYP 1A2
- D. Decreasing first-pass metabolism of drugs
Correct Answer: C
Rationale: Cruciferous vegetables (e.g., broccoli) induce CYP1A2, accelerating metabolism of drugs like theophylline, potentially reducing efficacy.
Several processes enable a drug to reach a specific concentration in the body. Together they are called dynamic equilibrium. What are these processes? (Select one that does not apply.)
- A. Distribution to the active site
- B. Biotransformation
- C. Absorption from the muscle
- D. Excretion
Correct Answer: C
Rationale: The actual concentration that a drug reaches in the body results from a dynamic equilibrium involving several processes: Absorption from the site of entry (can be from the muscle, the gastrointestinal (GI) tract if taken orally, of the subcutaneous tissue if given by that route); Distribution to the active site; biotransformation (metabolism) in the liver; excretion from the body. Interaction with other drugs is not part of the dynamic equilibrium.