Pharm One Exam One Preparation Lecture Notes

Exam Structure and Strategies

• Nursing exams are challenging due to critical thinking requirements.
• Utilize resources like Kaplan, Pearson, and med-surge books for practice questions.
• Focus on learning concepts rather than memorization.
• Manage exam anxiety.

Exam Logistics

• Topics: Role of the nurse, principles of drug action, ANS, dosage calculations.
• Exam time: 1:00 PM.
• ADA students have specific rooms; non-ADA will have announcements.
• Dress code: Navy blue scrubs, closed-toe and heel shoes.
• Allowed items: Pencil, ID, keys (no electronics).
• Exam soft: Know your password; calculator provided.
• Exam format: 90 minutes, 15 minutes review, includes next gen and select all that apply questions.

Role of the Nurse in Pharmacotherapy

Drug Approval Process

1. Preclinical: Lab testing on animals/human cells.
2. Clinical: Testing on humans.
3. NDA: Review data for FDA approval.
4. Post Marketing: Population testing.

Joint Commission Guidelines

• Label all medications; be cautious with blood thinners.
• Conduct medication reconciliation for home meds.

Generic vs. Trade Names

• Use generics; lower-case for generics, capitalized for trade.

Scheduled Drugs

• Table 2.1 outlines schedule 1-5 drugs.
• Level 1: High addiction risk (e.g., heroin).
• Level 5: Low addiction risk (e.g., cough medicines with codeine).

Tolerance and Dependence

• Tolerance: Less effect over time.
• Dependence: Need for the drug (psychological/physiological).

Critical Judgment Model (ADPIE)

1. Assessment: Baseline data, med reconciliation, allergies.
2. Identification: Identify problems with meds.
3. Planning: Prioritize and plan solutions.
4. Implementation: Administer meds correctly.
5. Evaluation: Check effectiveness and re-assess.

Error Management

• Address errors immediately; assess patient condition first.

Principles of Drug Action

Pharmacokinetics

1. Absorption: Entry into bloodstream via various routes.
2. Distribution: Drug movement to target tissues.
3. Metabolism: Primarily in the liver; liver issues increase toxicity risk.
4. Excretion: Via kidneys; kidney issues increase toxicity risk.

Key Definitions

• Onset: Time to start effect.
• Duration: How long it lasts.
• Half-life: Time to reduce concentration by half.
• Therapeutic Index: Narrow index increases toxicity risk.

Considerations for Elderly Patients

• Increased toxicity risk due to decreased organ function.

Medication Administration

Six Rights

1. Right patient
2. Right medication
3. Right dose
4. Right frequency
5. Right route
6. Right documentation

Routes of Administration

• Enteral: Oral, NG, PEG.
• Topical: Creams, patches.
• Parenteral: IV, IM, subQ.

Dosage Calculation

• Understand rounding rules and when to use leading/trailing zeros.
• Use dimensional analysis for calculations.

Autonomic Nervous System (ANS)

Sympathetic vs Parasympathetic

• SNS (Fight or Flight): Increased heart rate, hypertension, bronchodilation.
• PNS (Rest and Digest): Constricted pupils, increased saliva, bronchoconstriction.

Drug Actions

• Anticholinergics and Adrenergic Agonists: Mimic SNS effects.
• Cholinergic Agonists: Mimic PNS effects; monitor for safety.

Practice Question Strategies

• Focus on keywords like "first" in questions.
• Understand side effects and adverse events distinctions.

Final Tips

• Study to understand, not memorize.
• Re-watch lectures if needed.
• Focus on understanding key concepts and practicing questions.