What factor has the most impact on the pharmacokinetic phase of distribution?

Low albumin

Renal disease

Hepatic disease

An elevated gastric pH

Answer and Explanation

The Correct Answer is A

A) Low albumin: This factor has the most impact on the pharmacokinetic phase of distribution. Albumin is a key protein in the blood that binds to many medications. When albumin levels are low, fewer drug molecules will be bound, leading to an increased concentration of free (unbound) drug in the bloodstream. This can result in enhanced drug effects or toxicity, as the unbound drug is pharmacologically active and more readily able to cross cell membranes.

B) Renal disease: While renal disease can impact drug elimination and excretion, it does not have as direct an effect on the distribution phase of pharmacokinetics. Renal function primarily affects the clearance of drugs from the body rather than how the drug is distributed within the tissues.

C) Hepatic disease: Hepatic disease can affect the metabolism of drugs and their clearance, but it does not directly affect the distribution phase. While the liver is involved in metabolizing drugs, it is the ability to clear or process the drug that is most influenced, rather than its distribution to tissues.

D) An elevated gastric pH: Elevated gastric pH (which can occur with antacid use or in certain conditions) can affect the absorption of some medications but has minimal direct impact on the distribution phase of pharmacokinetics. Distribution is primarily concerned with how a drug moves from the bloodstream into tissues, and this is more influenced by factors like blood flow, protein binding, and the drug's lipophilicity, rather than the pH of the stomach.

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Correct Answer is D

Explanation

A) "I will wash the inhaler once a week with running warm water.": This statement is accurate. It is important to wash the inhaler, especially the mouthpiece, at least once a week to prevent the build-up of medication residue and ensure proper function. The recommendation of using warm water is appropriate, and washing weekly is commonly advised by healthcare providers.

B) "I will administer the second puff 1 minute following the first puff.": This is correct. When using a metered-dose inhaler, it is recommended to wait about 1 minute between puffs to allow the medication to be inhaled properly and for the first dose to be fully delivered before administering the second dose. This ensures that each dose is effective.

C) "I will rinse my mouth with water or mouthwash after inhaler use.": This is a correct statement, particularly for inhaled corticosteroids. Rinsing the mouth after using an inhaler helps prevent the development of oral thrush and other side effects such as irritation or infection. It’s also a good habit to remove any leftover medication from the mouth.

D) "I will take slow deep breaths while activating the inhaler.": This statement indicates the need for additional education. The correct technique involves inhaling slowly and deeply after activating the inhaler, not while activating it. If the client exhales forcefully while pressing the inhaler, they may not be able to inhale the medication effectively. It is crucial that the client activates the inhaler and then takes a slow, deep breath to ensure the medication is delivered properly into the lungs.

A. 387.5 B. 375 C. 393.8 D. 350

Correct Answer is B

Explanation

Here's the process for calculating the drug concentration after multiple half-lives:

First half-life: After 1 half-life, 50% of the original dose remains in the body.

200 mg x 0.50 = 100 mg remains after 1 half-life.

Second half-life: After 2 half-lives, 50% of the remaining drug will be eliminated.

100 mg x 0.50 = 50 mg remains after 2 half-lives.

Third half-life: After 3 half-lives, 50% of the remaining drug will be eliminated again.

50 mg x 0.50 = 25 mg remains after 3 half-lives.

Fourth half-life: After 4 half-lives, 50% of the remaining drug will be eliminated once more.

25 mg x 0.50 = 12.5 mg remains after 4 half-lives.

Now, we need to sum up the amount of drug remaining in the body at each half-life:

After 4 half-lives, there are 12.5 mg left from the original dose.

Total drug in the body after 4 half-lives = 200 mg - 12.5 mg = 375 mg.

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What factor has the most impact on the pharmacokinetic phase of distribution?

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