Giáo trình surgical technology examination QA 7e by sherman

Sterilization and Disinfection Questions Answers and Explanations 7.. Operating Room Environment Questions Answers and Explanations 8.. Specimens Questions Answers and Explanations 11..

McGraw-Hill Education eBooks are available at special quantity discounts to use as premiums and salespromotions or for use in corporate training programs To contact a representative, please visit the Contact Uspage at www.mhprofessional.com.

Notice

Medicine is an ever-changing science As new research and clinical experience broaden our knowledge,changes in treatment and drug therapy are required The authors and the publisher of this work have checkedwith sources believed to be reliable in their efforts to provide information that is complete and generally inaccord with the standards accepted at the time of publication However, in view of the possibility of humanerror or changes in medical sciences, neither the authors nor the publisher nor any other party who has beeninvolved in the preparation or publication of this work warrants that the information contained herein is inevery respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for theresults obtained from use of the information contained in this work Readers are encouraged to confirm theinformation contained herein with other sources For example and in particular, readers are advised to checkthe product information sheet included in the package of each drug they plan to administer to be certain thatthe information contained in this work is accurate and that changes have not been made in the recommendeddose or in the contraindications for administration This recommendation is of particular importance inconnection with new or infrequently used drugs

may be terminated if you fail to comply with these terms.

THE WORK IS PROVIDED “AS IS.” McGRAW-HILL EDUCATION AND ITS LICENSORSMAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY ORCOMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK,

INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIAHYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS

OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF

MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE McGraw-Hill Educationand its licensors do not warrant or guarantee that the functions contained in the work will meet your

requirements or that its operation will be uninterrupted or error free Neither McGraw-Hill Education nor itslicensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in thework or for any damages resulting therefrom McGraw-Hill Education has no responsibility for the content ofany information accessed through the work Under no circumstances shall McGraw-Hill Education and/or itslicensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that resultfrom the use of or inability to use the work, even if any of them has been advised of the possibility of suchdamages This limitation of liability shall apply to any claim or cause whatsoever whether such claim or causearises in contract, tort or otherwise

Answers and Explanations

3 Pharmacology and Anesthesia

Answers and Explanations

6 Sterilization and Disinfection

Questions

Answers and Explanations

7 Operating Room Environment

Questions

Answers and Explanations

8 Transportation and Positioning

Questions

Answers and Explanations

10 Specimens

Questions

Answers and Explanations

11 Medical, Ethical, and Legal Responsibilities

Answers and Explanations

14 Skin Preparation and Draping

Questions

Answers and Explanations

15 Instruments

Questions

Answers and Explanations

16 Sutures, Stapling Devices, and Drains

Questions

Answers and Explanations

17 Wound Healing and Dressings

Questions

Answers and Explanations

18 General Surgery

Questions

Answers and Explanations

19 Obstetrics and Gynecology

Answers and Explanations

22 Plastic and Reconstructive Surgery

31 Occupational Hazards/Fire Safety

Questions

Answers and Explanations

32 Endoscopy, Minimally Invasive Surgery, and Robotics

Questions

Answers and Explanations

Bibliography

Index

Lange Q&A: Surgical Technology Examination, Seventh Edition, has been designed to assist surgical technicians

planning to take the National Certification Examination for Surgical Technologists Although unable toguarantee a perfect score, a study guide can provide a good deal of assistance in test preparation by enablingthe student to review relevant material while becoming familiar with the type of questions that will beencountered on the examination

The ever-growing body of knowledge necessary to prepare the surgical technologist for a professional role

in the operating room requires that competency be measured by an examination that tests both constant andtechnologically up-to-date information With this in mind, the authors have prepared a seventh edition of thereview book that has been extensively revised and updated to include those advances in technology that haveemerged since the previous edition

The book contains over 1,900 questions that closely correlate in percentage the amount prescribed in theStudy Guide for Certification provided by the Liaison Council of the Association of Surgical Technologists.The text is divided into 32 chapters Following each chapter are questions Each question has one answer and

a full-length explanation, a difficulty in a single area indicates a need for individual study emphasis

We would like to give special thanks to Mark Sherman and John Chmielewski for giving us their

overwhelming support throughout the process of writing this review book We also would like to thank allstudents past, present, and future for giving us the inspiration to write this review book

ORGANIZATION OF THE BOOK

The book is organized into 32 chapters covering the major topic areas found on the Certifying Examinationfor Surgical Technologists Each chapter is designed to facilitate your review of the major content areas ofsurgical technology Each chapter ends with detailed explanations of each question for reinforcement ofknowledge

HOW TO ANSWER A QUESTION INTELLIGENTLY

Unlike many examinations, which are a composite of several multiple-choice questions, the National

Certification Examination for Surgical Technologists uses only one major type of question Each question willhave one correct answer and the other options are incorrect However, the remaining three choices may bepartially correct, but there can only be one best answer

When the question reads “EXCEPT’’ it is to remind you that the correct answer will be the exception tothe statement in the question

(D) common bile duct

This question could be answered from rote memory, placing the term “subcostal” with the anatomic structure

“spleen.” It is more likely that the student will conjure up a picture of the human abdomen and discountgallbladder (choice A) and common bile duct (choice D) immediately because they are located on the rightside of the abdominal cavity Thus, two choices are ruled out as possible answers, improving the odds ofselecting the correct answer from 25% to 50% Although the tail of the pancreas reaches over to the left side ofthe body and is adjacent to the spleen, spleen is clearly the best choice and the only correct answer

Sample Question 2

An elderly female, sleeping soundly, arrives in the OR via stretcher with siderails in place and safety strapintact She is placed alone outside her assigned OR The woman awakes, climbs off the stretcher, and, falling,

(B) can be charged with simple assault

(C) can be charged with battery

(D) cannot be charged because safety devices were in place

This question is more difficult Although we clearly see choices B and C as incorrect because the nurse had nophysical part in the injury to the patient, the difficulty is now in choosing between the remaining answers.Choice D may seem correct because the stem of the questions tells us that all safety devices were intact It is

only with knowledge of the legal aspect of OR procedure that we know that the key word alone signifies

culpability on the part of the nurse Standard OR procedures claim that one is guilty of abandonment if a

patient is left alone at any time when in the care of OR personnel and may be charged as such in a court of

law

Table 1 Strategies for Answering Questionsa

1 Remember that only one choice can be the correct answer

2 Read the question carefully to be sure that you understand what is being asked

3 Quickly read each choice for familiarity (This important step is often not done by test takers.)

4 Go back and consider each choice individually

5 If a choice is partially correct, tentatively consider it to be incorrect (This step will help you lessen yourchoices and increase your odds of choosing the correct choice/answer.)

6 Consider the remaining choices, and select the one you think is the answer At this point, you may want toquickly scan the stem to be sure you understand the question and your answer

7 Select the appropriate answer Even if you do not know the answer, you should at least guess—you arescored on the number of correct answers, so do not leave any blanks

aNote that steps 2 through 7 should take an average of 45–55 seconds total The actual examination is timedfor an average of 45–55 seconds per question

HOW TO USE THE BOOK

Read the chapter review followed by answering the questions at the end of the chapter Continual notation inthis book will provide you with a quick review at the end of the chapter This will help you determine thoseareas that require the most emphasis for study and those areas that require additional review Most of thereferences are texts that are readily available at your nearest library, or that you may already own

The official source of applications for and information about the surgical technology examination can beobtained from The National Board of Surgical Technology and Surgical Assisting (http://nbstsa.org)

• This is the language spoken by health professionals in hospitals, surgicenters, clinics, and physicians’offices.

• You must be able to identify the four basic word parts, construct medical terms by using the word partsand use the correct pronunciation

• The four word parts include: root words, prefixes, suffixes, and combining words

Root Rword—primary meaning

Prefix—placed before the root word

Suffix—placed after the root word

Combining forms—usually an O but can be an I or E

• ASEPSIS—absence of disease causing micro-organisms

• STERILE—free of all living microorganisms including spores

• SURGICALLY CLEAN—mechanically disinfected but not sterile

• AERATION—this is the method by which ethylene oxide (a type of sterilization process) is removedfrom the ETO-sterilized items

• AEROBES—microbes that cannot live and reproduce without oxygen

• FACULTATIVE ANAEROBES—can live in both environments

• ANAEROBES—microbes living in the presence of oxygen

• FOMITE—inanimate object that contains microorganisms

• CELLS—smallest unit of living things

MITOCHONDRIA—they are the power house of the cell and provide energy

FLAGELLA—provides locomotion to the cell

CELL WALL—protects the cell

CYTOPLASMIC MEMBRANE—semipermeable membrane within the cell

• BACTERIA—all living cells are classified into two groups:

PROKARYOTES—less complex organisms Single circular chromosome, without a nuclear membrane

• BACTERICIDE—kills gram-positive and gram-negative bacteria

• BACTERIOSTATIC—inhibits (to prevent something from developing) the growth of bacteria

• BIOBURDEN—the amount of microorganisms on an item before sterilization

• BIOLOGICAL INDICATOR—a sterilization monitoring system used to test the effectiveness of thesterilization process used

GEOBACILLUS STEAROTHERMOPHILUS—is the microbes used in steam sterilization

animate (living being) and inanimate (nonliving) objects

• DECONTAMINATION—process by which chemical or physical agents are used to clean inanimateobjects, NONCRITICAL surfaces

• SSI—SURGICAL SITE INFECTION

• DEEP INCISIONAL SSI—an infection involving deep soft tissue, fascia DISINFECTION—not used

ARTIFICIALLY ACQUIRED ACTIVE IMMUNITY—vaccination

NATURALLY ACQUIRED PASSIVE IMMUNITY—antibodies from mother to child through theplacenta

ARTIFICIALLY ACQUIRED PASSIVE IMMUNITY—a short-term immunization by theinjection of antibodies, such as gamma globulin, that are not produced by the recipient’s cells

• INFECTION—invasion and multiplication of microorganisms in body tissues, causing cellular damage

• SKIN—it is the first line of defense against bacteria

• NOSOCOMIAL INFECTION—an infection that was acquired in the hospital

• PASTEURIZATION—this is not a method of sterilization but a heating process of destroying

pathogenic microorganisms such as in milk or wine

• PARASITES—microorganisms that reside on or within living organisms Some are OBLIGATORY(means they depend on living tissue) and others are FACULTATIVE (meaning they can live on deadtissue)

• PATHOGEN—any disease-producing micro-organism

• RESIDENT MICROORGANISMS—these are microorganisms that live deep in the epidermis (outermost layer of skin), they live in the folds and crevices of the skin

• TRANSIENT MICROORGANISMS—these are microorganisms that live on the surface of theepidermis, they have a very short life span and can be removed with a good hand scrub

• VIRUCIDE—kills viruses

• MICROORGANISMS:

STAPHYLOCOCCUS AUREUS—commonly found in RESPIRATORY PASSAGES

ENTEROCOCCI—found in the normal flora of the GI tract These organisms are associated withsurgical site infections (SSIs)

STREPTOCOCCI—found in the GI tracts, upper respiratory tracts, and genitourinary tracts

CLOSTRIDIA—produces virulent toxins

CLOSTRIDIUM PERFRINGENS—GAS GANGRENE (serious infection in body tissue, thesevere infection causes a buildup of gas)

C TETANI—TETANUS (muscle twitching, cramps that are caused by a problem with theparathyroid glands involving calcium)

C DIFFICILE—the normal flora in the intestines is altered usually caused by the overuse ofantibiotics causing severe diarrhea and dehydration

MYCOBACTERIUM TUBERCULOSIS—it is transmitted directly from the respiratory tract,causing TB

VIRUSES—some examples of a virus include: HIV, herpes simplex, hepatitis B, C, and D

METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA)—this is a particularstrain of a virus that is resistant to most all antibiotics; the only antibiotic that works on this virus isVANCOMYCIN

CREUTZFELDT–JAKOB DISEASE—this is a fatal neurodegenerative disease of the centralnervous system caused by a HUMAN PRION

• PRION/PROTEINACEOUS INFECTIOUS PARTICLE—is the smallest infectious particle; it isneither viral, bacterial, nor fungal Prions are also responsible for the disease known as mad cow disease.This disease is important for the STSR because there is no sterilization process that kills these prions,when surgery is performed on these patients, disposable instruments are used so they can be disposed of

• BIOTERRORIST AGENTS—

Anthrax

Smallpox

Plague (pneumonic, bubonic)

Tularemia (various types of insect bites)

Botulism

• MUTUALISM—when different organisms exist and benefits from the other

• COMMENSALISM—when one organism benefits and the other does not benefit and is not harmed

• PARASITISM—when one organism benefits from the other and is harmed

• OSMOSIS—a fluid, usually water passes through a membrane solution of higher concentration whichequalizes the concentrations of materials on either side of the membrane

• MITOSIS—division of a single cell into two identical cells Each cell has an identical number ofchromosomes as the parent cell They have the same genes

• MEIOSIS—cell division involving sexually reproducing organisms

• CHRONIC INFECTION—there is a continued presence of infection

• ACUTE INFECTION—a rapid onset of the disease but for a short time

• MICROSCOPE—an instrument used to view microorganisms that cannot be seen by the naked eye.Invented by Anton Von Leeuwenhoek

• JOSEPH LISTER—father of modern medicine Discovered antiseptic techniques

• LOUIS PASTEUR—founded the science of microbiology and that diseases are caused by microorganisms

1 The English surgeon who established the first principles of aseptic technique is?

7 Microbial death occurs when an organism is:

(A) reproducing at a slower rate

(B) reduced in population

(C) no longer capable of reproduction

(D) exposed to heat

8 What immune protection is available to the fetus?

(A) Natural active

10 The bodys first line of defense against the invasion of pathogens is:

(A) the immune response

(B) skin and mucous membrane linings

(C) cellular and chemical responses

12 Herpes simplex is commonly called:

(A) cold sore

(B) shingles

(C) smallpox

(D) chicken pox

15 A laboratory procedure useful in classifying bacteria using a staining procedure is:

(A) gram stain

17 A severe allergic reaction possibly resulting in death is called:

(A) arthus reaction

20 Which type of wound would favor the development of gas gangrene?

24 The space caused by separation of wound edges is called:

(A) lag phase

(D) Candida

27 Hospital-acquired infections are known as:

(A) Antibiotic resistant

(B) Bacteremia

(C) Nosocomial

(D) MRSA

28 Methicillin-resistant S aureus (MRSA) is a strain of S aureus that is resistant to most antibiotics What

is the only drug of choice to treat MRSA at this time?

(D) None of the above

30 The type of immunity that is acquired by a vaccination is:

(A) naturally acquired active immunity

(B) naturally acquired passive immunity

(C) artificial active acquired immunity

(D) artificial passive acquired immunity

31 What gram stain turns red at the end of the staining procedure?

33 Universal precautions is a previous policy, it is now called:

(A) recommended precautions

(D) None of the above

36 All factors increase the surgical patient’s risk for infection EXCEPT:

(A) location of surgery

(B) health of the patient

(C) length of the procedure

(D) position of the patient

37 What is responsible for bacterial motility?

(B) commensalism

(C) parasitism

(D) none of the above

40 When there is a relationship between two organisms and one benefits from the expense of the other it is

44 What is the term for the division of a reproductive cell into two cells with chromosome cells?

(A) Binary fission

48 The definition of pandemic:

(A) disease that has spread throughout a school

(B) disease that has spread during the winter season

(C) disease that has spread throughout the world

(D) disease that has spread quickly and causes serious illness

1 (D) In 1867, Lister began the age of chemical control of the atmosphere He used aqueous phenol to

disinfect instruments, soak dressings, and spray the air of surgical rooms

2 (C) Osmosis allows the passage of a solvent, usually water, to pass through the membrane from the

region of lower concentration of solute to the region of higher concentration This tends to equalize theconcentration of the two solutions

3 (D) The majority of microbes are aerobes This means they grow and flourish in the presence of oxygen.

4 (D) Leukocytes known as phagocytes rush to a wound to engulf and destroy the bacteria present.

Phagocytosis means “cell eating.”

5 (A) Agents that destroy or inactivate microorganisms are bactericidal An agent that inhibits the growth

of bacteria is known as a bacteriostatic agent

6 (C) S aureus is commonly present on skin and mucous membranes, especially those of the nose and the

mouth It is gram-positive and is the cause of such suppurative conditions as boils, carbuncles, andinternal abscesses

7 (C) Microbial death occurs when an organism, or population of organisms, is no longer capable of

reproduction

8 (B) In passive natural immunity, maternal antibodies cross the placenta Infants are immune to the same

infectious diseases as their mothers for 6 to 12 months after birth Breast-fed babies receive additionalprotection from the breast milk

9 (B) Microorganisms can multiply in the blood Infection of bacterial origin carried through the

bloodstream is referred to as bacteremia or septicemia Microorganisms invade from a focus of infection

in the tissue

10 (B) The unbroken skin acts as a mechanical barrier to pathogens Only when it is cut, scratched, or

burned can pathogens gain entrance Mucous membranes entrap invaders

11 (A) Bacteria generally appear in one of several shapes: bacilli are rod shaped, cocci are spherical, and

spirilla and spirochetes are corkscrew shaped

12 (A) Herpes simplex, commonly called “cold sores” or fever blisters, is an example of a viral agent capable

13 (C) Local irritation causes the small blood vessels to dilate and become more permeable The tissue

spaces become engorged with fluid, and edema results In inflammation there is pain, redness, heat,swelling, vasodilation, and disturbance of function

14 (A) C tetani is the causative organism of tetany, or lockjaw Commonly found in soil contaminated with

animal fecal waste Protection is provided by receiving tetanus toxoid to stimulate antibodies againsttetanus toxins A booster may be given when a dangerous wound is received

15 (A) The gram stain is very useful because it classifies bacteria into two large groups: gram-positive and

gram-negative This provides valuable treatment options Gram-positive bacteria tend to be killed easily

by penicillins and cephalosporins Gram-negative bacteria are generally more resistant

16 (B) When the organisms of gas gangrene are introduced into tissues where conditions permit anaerobic

multiplication, they utilize amino acids and carbohydrates freed from dead or dying cells

17 (C) Anaphylactic shock is the state of collapse resulting from injection of a substance to which one has

been sensitized It is a severe allergic reaction Death may occur if emergency treatment is not given

18 (A) S aureus is associated with skin infections such as boils, carbuncles, furuncles, and impetigo.

19 (B) P aeruginosa most frequently found in burns, presents very difficult problems because the organism

is generally resistant to many clinically useful antibiotics

20 (D) An ischemic necrotic wound caused by C perfringens causes gas gangrene.

21 (D) Gas gangrene is caused by the microorganism C perfringens.

22 (A) The most resistant form of microbial life is the endospore Spores have a thick wall making them

difficult to destroy This enables them to withstand unfavorable conditions such as heat They require aprolonged exposure time to high temperatures to destroy them

23 (A) E coli is by far the best known enteric bacterium and is found in the intestinal tract of animals and

humans

24 (D) Serum or blood clots can form in this dead space and prevent healing by keeping the cut edges of

the tissue separated It is the space caused by separation of wound edges that have not been closelyapproximated

25 (C) Hazardous body fluids include amniotic fluid, blood, pericardial fluid, peritoneal fluid, pleural fluid,

semen, spinal fluid, synovial fluid, and vaginal secretions Saliva has not been implicated in HIVtransmission

27 (C) Hospital-acquired infections are known as nosocomial They can be acquired due to improper

technique

28 (A) Vancomycin destroys bacteria by inhibiting cell wall synthesis and is now the frontline antibiotic

therapy used against MRSA

29 (C) E coli is part of the normal flora of the intestinal track of humans, most strains are harmless.

30 (C) Artificial active acquired immunity is acquired immunity gained by getting a vaccination.

31 (B) Gram-negatives appear red from the safranin stain and gram-positives remain purple.

32 (A) Eukaryotes are more complex and include protozoa, fungi, green, red, and brown algae and all plant

and animal cells including human cells

33 (D) Aseptic technique is among the behaviors and protocols specified in the standard precautions These

evolved from a previous policy called universal precautions established by the CDC for control andprevention

34 (D) Asepsis means absence of microbes and infection.

35 (B) Transient flora are microbes which reside on the skin and are easily removed.

36 (D) Risk factors include location of the surgical site, the health of the patient, condition of tissues and

organs, resistance of body tissue, length of the preoperative stay, duration of the procedure, and surgicaltechnique

37 (A) Flagella is responsible for bacterial motility Mitochondria are known as the “power house of the

cell.” The cell wall gives shape to the cell and provides a barrier to the outside of the cell Ribonucleicacid (RNA) is manufactured in the nucleolus and controls cellular protein synthesis

38 (B) Rickettsia are gram-negative bacteria, they reproduce in the host cell of arthropods (type of

invertebrate—insects, spiders, centipedes) and mammals S aureus is a gram-positive bacterium and isfrequently found in the respiratory tract and on the skin Tape worms are flat worms that live in theintestines of animals Fungi are part of the group of eukaryotic organisms, they are unicellular, andinclude yeasts and molds

39 (B) Commensalism is the relationship between two organisms that occupy the same space One

organism benefits and the other does not but neither is harmed Mutualism is the relationship betweentwo organisms and both benefit Parasitism is the relationship of two organisms and one benefits at theexpense of the other

does not but neither is harmed Fungi are part of the group of eukaryotic organisms, they are

unicellular, and include yeasts and molds

41 (A) The smallest structural and functioning unit of an organism is a cell Tissues are made up of

specialized cells that perform a specific function Organs are made up of tissues and are grouped intosystems Mitochondria are known as the “power house” of the cell

42 (D) The biological indicator for ETO is Bacillus atrophaeus/subtilis Geobacillus stearothermophilus is

the biological indicator used for steam sterilization

43 (D) The parotid gland is the primary gland that is affected by the mumps This disease is caused by a

virus and is highly contagious The thyroid gland is an endocrine gland and it is found in the neck.Sublingual glands are salivary glands found in the mouth The submandibular glands are salivary glandslocated below the lower jaw

44 (B) Mitosis is a type of cell division that results in two daughter cells each having the same number of

chromosomes Binary fission is when the cell divides into two equal daughter cells Meiosis is a type ofcell division that results in four daughter cells each with half the number of chromosomes of the parentcell Osmosis is when liquid passes from a lower concentration through a membrane into an area with ahigher concentration to balance them

45 (A) Fomite is an inanimate object that contains microorganisms Prion is a small proteinaceous

infectious disease-causing spore It is neither bacterial, fungal, nor viral They are responsible fordegenerative brain diseases Obligatory is in regard to bacteria that can grow under aerobic or anaerobicconditions Flagella are responsible for bacterial motility

46 (B) A prion is responsible for the disease “mad cow.” Virus—there is many diseases caused by viruses.

Examples include cold, chickenpox, meningitis, and many others Spores—two of the major forming diseases include food poisoning caused by (Bacillus cereus), and (C tetani) which is found insoil

spore-47 (C) A chronic infection is considered a continued presence of infection An acute infection is a serious

infection with an abrupt onset and progresses rapidly Pandemic is an outbreak of a disease over a widegeographic area infecting much of the population of that area Nosocomial—is a hospital-acquiredinfection

48 (C) The definition of a pandemic disease is one that spreads throughout the world Epidemic is the

rapid spread of an infectious disease to a large number of people in a short period of time

• Drug sources include: plants, animals, lab synthesis, and biotechnology

• Pharmacodynamics—what the drug does to the body

• Pharmacokinetics—what the body does to the drug

• Antagonist—it is a chemical drug that counteracts or blocks the action of another drug

• Synergist agent—one drug works with another drug (boosts the result) to provide the same effect; however

by combining the two drugs the dose is lower and safer

• Therapeutic effect—the drug is intended to produce a desirable and beneficial effect to the patient

• Side effect—it is the secondary effect to a therapeutic drug It is usually undesirable but tolerable

• Adverse effect—this is an undesirable and potentially harmful effect from a therapeutic drug

• Anaphylaxis—a severe allergic reaction, immediate attention is required or the patient could die

• Toxic effect—undesirable effect could cause cancer

• Toxic effect—undesirable effect could cause cancer

• Addiction—a dependency on the effect of the drug

• Onset—time required for the drug to work

• Peak effect—period of time when the maximum effect of the drug works

• Duration—how long the medication works