Nokea
What is the entry of drugs into the plasma?
- A. Absorption
- B. Distribution
- C. Elimination
- D. Metabolism
Correct Answer: A
Rationale: Absorption is the process by which a drug enters the plasma from its administration site, the first step in pharmacokinetics.
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A patient has been using sleeping pills every night for the past several months. Now admitted to the hospital, he is prescribed his usual dose of sleeping pill. After administration, the patient continues to be restless and is wide awake. The nurse notifies the health care provider, who prescribes an increased dose. After receiving the new dose, the patient falls asleep. The nurse interprets this as which of the following?
- A. Drug idiosyncrasy
- B. Cumulative drug effect
- C. Drug tolerance
- D. Toxic reactions
Correct Answer: C
Rationale: The patient has developed drug tolerance and has to be administered an increased dosage of the drug to achieve the desired effect. Cumulative drug effect occurs when the body is unable to metabolize and excrete one (normal) dose of a drug before the next dose is given. Drug idiosyncrasy is a term used to describe any unusual or abnormal reaction to a drug. Toxic reactions are caused when blood concentration levels exceed the therapeutic levels of a drug.
Patient education regarding the use of ciprofloxacin-hydrocortisone (Cipro HC otic) ear drops includes:
- A. Fill the canal with the drops with each dose
- B. Some redness and itching around the ear canal is normal
- C. Warm the bottle of ear drops in his or her hand before administering
- D. Cipro HC otic may cause ototoxicity
Correct Answer: C
Rationale: Warming Cipro HC improves comfort; filling or ototoxicity aren't standard advice.
Patients who have a poor metabolism phenotype will have:
- A. Slowed metabolism of a prodrug into an active drug, leading to accumulation of prodrug
- B. Accumulation of inactive metabolites of drugs
- C. A need for increased dosages of medications
- D. Increased elimination of an active drug
Correct Answer: A
Rationale: Poor metabolizers (e.g., CYP2D6) slowly convert prodrugs to active forms , causing prodrug buildup, not metabolite accumulation or faster elimination .
Drug levels should be monitored in the treatment of
- A. Diabetes
- B. Epilepsy
- C. Status Asthmatics
- D. Hypertension
Correct Answer: B
Rationale: Therapeutic drug monitoring is critical in epilepsy (e.g., phenytoin) due to narrow therapeutic ranges.
The nurse, assisting with Phase I drug studies, is talking with a woman who asks, Why can't I participate in this study? What would be the nurse's best response?
- A. Drugs pose a greater risk to women of reproductive age.
- B. Drugs are only tested on men because they are stronger.
- C. Women are more prone to adverse effects from medications.
- D. Drugs affect women differently than they affect women.
Correct Answer: A
Rationale: Phase I drug trials usually involve healthy male volunteers because chemicals may exert an unknown and harmful effect on ova in women which could result in fetal damage when the woman becomes pregnant. Drugs are tested on both men and women, but women must be fully informed of risks and sign a consent stating they understand the potential for birth defects. Women are not more prone to adverse effects of medications. Although some drugs may affect women differently than men, this is a rationale for why drugs need to be tested on women, not an explanation of why women are not included in a phase I study.