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Author Question: A primary care NP is prescribing a drug for a patient who does not take any other medications. The ... (Read 37 times)

piesebel

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on: Jul 24, 2018
A primary care NP is prescribing a drug for a patient who does not take any other medications. The NP should realize that:
 
  a. CYP450 enzyme reactions will not interfere with this drug's metabolism.
  b. substrates such as alcohol cannot interfere with the drug when the patient is abstaining.
  c. food-drug interactions are limited to those where food enhances or inhibits drug absorption.
  d. a thorough history of diet, alcohol use, smoking, and over-the-counter and herbal products is required.

Question 2

A primary care NP is preparing to prescribe a drug and notes that the drug has nonlinear kinetics. The NP should:
 
  a. monitor frequently for desired and adverse effects.
  b. administer a much higher initial dose as a loading dose.
  c. monitor creatinine clearance at baseline and periodically.
  d. administer the drug via a route that avoids the first-pass effect.


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joneynes

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Reply #1 on: Jul 24, 2018
Answer to Question 1

D
Drugs are not the only substances that interfere with drug kinetics and dynamics. The primary care NP should conduct a thorough history of food and alcohol intake, smoking, and over-the-counter and herbal supplements to identify things that might interfere with a drug. All of these may interfere with CYP enzymes. Alcohol intake can influence this even when the patient is abstaining because of long-term effects on the liver.

Answer to Question 2

A
Drugs with nonlinear kinetics are not eliminated based on dose or concentration of the drug, and these drugs have a narrow therapeutic window and must be monitored closely for desired effects and toxicity.


piesebel

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Reply 2 on: Jul 24, 2018
Great answer, keep it coming :)

LVPMS

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Reply 3 on: Yesterday
Excellent

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