ExcretionExcretion through the kidneysConversionBiliary and fecal excretionExcretion by other routesModule 1 Study Questions (Chapters 1-12 in Lehne)Instructions: Students are encouraged to answer each question completely but briefly with full sentences.1. Why do nursing students need to learn pharmacology?Nurse are licensed to administer medications to patients. Even though the Dr. chooses what medicines to give to the patient, the nurse is responsible to know:1) how the medication works within the body2) be able to explain to the patient how it works, side effects, how often to take and why3) how much of each medicine is acceptable (if the Dr orders too much or too little, the nurse needs to question the Dr)4) how the medicine is to be administered (pill, by mouth-liquids, by mouth or IV, etc)5) how to reconstitute a med (for example some meds come in powdered form and need to have certain fluids added to them right before being administered-this is reconstituting)6) how often can a med be given (if a med is given too frequently or not frequently enough, it could harm or not help the patient)7) potential side effects and what to monitor the patient forThere are many other reasons, but most important is that the nurse needs to know so much about pharmacology and the meds they give because they are responsible for their actions. By administering the med, it places as much responsibility on the nurse, as on the Dr.Drs, like nurses and pharmacists are capable of making errors-by all 3 being responsible and accountablefor errors increases the likelyhood for safer medication administration for the patient.2. What is the difference between a generic name, trade name and brand-name medication? Do they work the same?First of all, what is a brand-name drug?When a new drug is developed by a pharmaceutical company, the company applies to a government patent office for a patent. This patent or brand gives the company the right to sell its drug without competition. In most countries the life of a patent is 20 years from registration.What is a generic drug?Pharmaceutical companies can manufacture and sell an original brand-name drug as a generic after the brand-name drug's patent expires in 20 years. The generic drug must contain the same medicinal ingredient(s) as the brand-name drug. Both brand-name drugs and generic drugs must meet the same rigorous government standards. Drugs in Canada are only approved and marketed after lengthy review by the government.So what is the relationship between generic drugs and brand-name drugs?Generic drugs are copies of brand-name drugs whose patents have expired. Since less time is needed to do the initial research, generic drugs almost always cost less.What's the main difference between a brand-name and a generic drug?The answer is price! Generic drugs on average cost between 40% to 50% less than brand-name drugs. The quality, purity, effectiveness and safety of the drug are identical.trade namen.1. A name used to identify a commercial product or service, which may or may not be registered as a trademark. Also called brand name.2. The name by which a commodity, service, or process is known to the trade.3. The name under which a business firm operates.3. Listed are common routes of medication administration; please describe what the abbreviation stands for and how the medication will move into the bloodstream.a. PO – by mouthb. PR - inserted in the rectum suppository (suppos)c. IM – intramuscular injectiond. SC – subcutaneous e. IV – intravenouslyf. SL – sub lingual : under the toungeg. capsuleh. VT- vaginal?4. What are some factors that affect drug metabolism?Factors Affecting Drug Metabolism (5)1. Physiological Conditions (age, diet, hormone balance) 2. Pathological Conditions (impaired liver or kidney function) 3. Genetic Factors (species/strain difference, sex, ethnic polymorphism,individual differences) 4. Drug-drug Interactions (enzyme inhibition, enzyme induction)5. Stereochemistry (substrate stereoselectivity, product stereoselectivity,regioselectivity)5. How are medications excreted from the body?6.7.8.9.10.11.12.13.14.15.16.17.18.19.20.21.22.23.24.25.26.27.28.29.30.31.32.33.34.35.36.37.38.39.40.41.42.43.44.45.46.47.48.49.50.What is a drug half-life? When can you expecta steady state?ExcretionDrugs are eliminated from the body either unchanged as the parent drug or as metabolites (a changed form of the drug).Organs that excrete drugs eliminate polar compounds (water soluble) more readily than components with high lipid (fat) solubility. The exception to this premise is the lungs.Lipid soluble drugs are not readily eliminated until they are metabolized to more polar compounds.Possible sources of excretion include:- Breath- Urine- Saliva- Perspiration- Feces- Milk- Bile- HairThe kidney is the most important organ involved in the elimination of drugs and their metabolites.Substances excreted in the feces usually involve orally ingested unabsorbed drugs or metabolites excreted in the bile that are not reabsorbed from the intestinal tract.Excretion of drugs in milk is relevant because excreted drugs can produce drug toxicity in the nursing infant. Pulmonary excretion (through breathing) is important as it pertains to the elimination of anesthetic gases and vapors, as well as alcohol.Excretion through the kidneysOn its way through the kidneys the blood is filtered. The liquid or "primary urine" consists of a considerable amount of the blood's water, together with all substances dissolved in this water (including drugs). The kidneys reabsorb most of the water and some of the dissolved substances. Components that are fat-soluble tend to diffuse back into the bloodstream.The kidneys perform two major functions:- They excrete most of the end-products of body metabolism (including drugs); They closely regulate the levels of most of the substances found in body fluids.- Substances that must be excreted include the end-products of body metabolism, as well as sodium, potassium, and chloride, which frequently accumulate in the body in excess quantities. The kidneys must also be capable of conserving water,sugar, and the necessary quantities of sodium, potassium and chloride.Since drugs are small particles dissolved in theThe half-life of a given medication is how long it takes for the body to get rid of half of the dose. When the patient is taking a medication on a regular basis, there is an ongoing process of drug absorption in