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A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication?
- A. One
- B. Two
- C. Three
- D. Four
Correct Answer: A
Rationale: A long half-life of 4 days means the drug remains effective for an extended period, typically requiring once-daily dosing.
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A pharmacology student asks the instructor what an accurate description of a drug agonist is. What is the instructor's best response?
- A. A drug that reacts with a receptor site on a cell preventing a reaction with another chemical on a different receptor site
- B. A drug that interferes with the enzyme systems that act as catalyst for different chemical reactions
- C. A drug that interacts directly with receptor sites to cause the same activity that a natural chemical would cause at that site
- D. A drug that reacts with receptor sites to block normal stimulation, producing no effect
Correct Answer: C
Rationale: Agonists are drugs that produce effects similar to those produced by naturally occurring neurotransmitters, hormones, or other substances found in the body. Noncompetitive antagonists are drugs that react with some receptor sites preventing the reaction of another chemical with a different receptor site. Drug-enzyme interactions interfere with the enzyme systems that stimulate various chemical reactions.
Which source contains information specific to nutritional supplements?
- A. USP Dictionary of USAN & International Drug Names
- B. Natural Medicines Comprehensive Database
- C. United States Pharmacopoeia/National Formulary (USP NF)
- D. Drug Interaction Facts
Correct Answer: C
Rationale: United States Pharmacopoeia/National Formulary contains information specific to nutritional supplements. USP Dictionary of USAN & International Drug Names is a compilation of drug names, pronunciation guide, and possible future FDA approved drugs; it does not include nutritional supplements. Natural Medicines Comprehensive Database contains evidence-based information on herbal medicines and herbal combination products; it does not include information specific to nutritional supplements. Drug Interaction Facts contains comprehensive information on drug interaction facts; it does not include nutritional supplements.
A nurse is teaching a client who has a new prescription for Diphenhydramine for allergic Rhinitis. The nurse should instruct the client to monitor for which of the following adverse reactions of this medication? (Select one that does not apply.)
- A. Dry mouth
- B. Nonproductive cough
- C. Urinary Hesitation
- D. Drowsiness
Correct Answer: B
Rationale: Diphenhydramine causes dry mouth , drowsiness , and urinary hesitation due to anticholinergic effects.
While administering a medication that the nurse has researched and found to have limited effectiveness, the patient tells the nurse, I have read all about this drug and it is such a wonder drug. I'm so lucky my doctor prescribed it because I just know it will treat my problem. The nurse suspects this drug will be more effective than usual for this patient because of what effect?
- A. Cumulative effect
- B. First-pass effect
- C. Placebo effect
- D. Cross-tolerance effect
Correct Answer: C
Rationale: A drug is more likely to be effective if the patient thinks it will work than if the patient believes it will not work. This is called the placebo effect. If a drug is taken in successive doses at intervals that are shorter than recommended, or if the body is unable to eliminate a drug properly, the drug can accumulate in the body, leading to toxic levels and adverse effects. This is a cumulative effect. First-pass effect addresses the reduction of available drug when taken orally due to metabolism in the liver before the drug reaches the bloodstream. Cross-tolerance is resistance to drugs within the same class.
Before prescribing phentermine to Sarah, a thorough drug history should be taken including assessing for the use of serotonergic agents such as selective serotonin reuptake inhibitors (SSRIs) and St John's wort due to:
- A. Additive respiratory depression risk
- B. Additive effects affecting liver function
- C. The risk of serotonin syndrome
- D. The risk of altered cognitive functioning
Correct Answer: C
Rationale: Phentermine with serotonergic agents increases serotonin syndrome risk.