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NUR110 Meds

Pharmacology Study of drugs and their action on the living body
Medications Drug or substance administered for:CureDiagnosisTreatmentRelief (Palliative)Prevention of diseases
Brand Name vs. Generic Dosage and active ingredient identical Bioequivalence is required by the FDA Inactive ingredients may varyPrice
OTC drugs drugs do not require a physician’s orderEasily obtainedLess expensivePotential for wrong drug Less knowledge of side effectsPotential for disease progression
Prescription Drugs Require a physicians orderDrug more likely to be appropriate for patientAmount and frequency controlledInstructed on use and side effectsGenerally more costlyWait time to fill prescriptions
Therapeutic classification Denotes the therapeutic useAntihypertensive
Pharmacological classification Refers to how the drug produces its effectRequires an understanding of pharmacologyCalcium channel blocker
4 stages of drug approval Pre-clinical investigation,Clinical investigation, Review of NDA, Post-marketing studies
Pre-clinical investigation Basic scientific research, testing on cells and animalsAverage time 18 months
Clinical investigation Evaluation of human benefit, testing on volunteers Can take 2-10 years
Review of NDA FDA reviews new drug application then approves or rejectsFollowing review, drug goes on the market or testing stopsAverage 17 months
Post-marketing studies Testing continues, looking for harmful effects in larger and more diversified populations
Prescription Drug User Fee Act of 1992 Drug company pays a yearly user fee to help offset costs of the FDA review and approval process
FDA Modernization Act Allows drug companies to disseminate info about unapproved uses of a drug
Nurses’ Legal Responsibilities for Drug Administration Are: Defined by the nurse practice actControlled by common lawControlled by the policies and procedures of health care agencies
When delivering medications, the nurse MUST know important information about the drug being administered Reason, dosage range, common use, action, contraindications, side effects, nursing process considerations
Controlled Substances Drugs that have either limited medical use or high potential for abuse or addiction
Controlled Substances Divided into 5 categories Schedule I; Schedule II; Schedule III; Schedule IV; Schedule V
Schedule I illegal; high potential for abuse
Schedule II accepted for medical use with severe restrictions; high potential for abuse
Schedule III accepted for medical use; potential for abuse less than schedule II
Schedule IV = low potential for abuse
Schedule V low potential for abuse; includes drug mixtures containing limited amounts of narcotics
Controlled Substance Handling Must be stored in safe locked cabinetRecords must be kept regarding the administration of controlled substances
Teratogenic Able to disturb the growth and development of an embryo or fetus
Two General Types of Drug Actions Local; Systemic
Local affects only the targeted area
Systemic has affects throughout the body
Side effect undesirable or unwanted response; frequently predictable
Adverse effect severe side effect
Drug toxicity drug accumulates in the blood because it cannot be readily metabolized
Cumulative effect buildup of a drug
Drug tolerance : reaction to drug decreases, larger doses required to achieve desired effect
potentiation The action of a substance, at a dose that does not itself have an adverse action, in enhancing the effect of another substance
Idiosyncratic effect A reaction to a medication that is unusual and unpredictable, specific to a particular person. Unlike allergy, it can occur on first exposure to the medication, unlike a side effect, it affects only very few individuals.
Incompatibility Producing an undesirable effect when used in combination with a particular substance: a medication that is incompatible with alcohol.
Contraindications specific situation in which a drug, procedure, or surgery should NOT be used, because it may be harmful to the patient.
Patient Noncompliance with Medications Not taking medication at allTaking the medication at the wrong timeTaking the medication the wrong way
Reasons for noncompliance Stop taking meds due to side effectsCostInsurance coverageFrequent dosingPatient self-adjusts med doses
Terms Used with Dosages Minimum doseMaximum doseToxic doseLethal dose
Routes Used to Administer Medications OralSublingualBuccalRectalVaginalParenteralTopical/transdermalNasogastric or gastrostomy tubeIntravenousInhalation
Sublingual/Buccal Sublingual and buccal medications are administered by placing them in the mouth, either under the tongue (sublingual) or between the gum and the cheek (buccal).
Parenteral Medicine Taken into the body or administered in a manner other than through the digestive tract, as by intravenous or intramuscular injection.
PRN as needed
Essential Parts of a Medication Order Full name of clientDate and time the order is written Name of the drug to be administeredDosage of the drugRoute of administrationFrequency of administrationSignature of the person writing the orderSpecial instructions
If drug order is ambiguous, unusual, or contraindicated: Discuss order with the RN and or nursing supervisorContact physician and discuss the drug order with the physician
ID intradermal
IM intramuscular
IV intravenous
IVP intravenous push
IVPB intravenous piggyback
NG nasogastric tube
PO by mouth
PR per rectum
Supp suppository
Sub Q subcutaneous
ac before meals
hs bedtime
ad lib as desired
B.I.D., b.i.d.= 2 times a day
h, hr hour
pc after meals
q every
q2h every 2 hours
Q.I.D. q.i.d.= 4 times daily
Stat immediately
d.a.w dispense as written
extended release ER
gtt drop
NKA no known allergies
Sig directions to the patient
Susp suspension
SR sustained release
XL extended release
K potassium
KCL potassium chloride
mEq milliequivalent
Na sodium
NaCl sodium chloride
P after
D/C discontinue
V.O. verbal order
T.O. telephone order
Six Rights of Drug Administration 1. Right patient2. Right medication3. Right dose4. Right route of administration5. Right time of delivery6. Right documentation
Additional Patient Rights Right to refuseRight to receive drug education
Right Patient Two patient identifiersID bracelet, ask patient to state their nameAssess for medication allergies
Right medication Check physician order against MARNever give medication prepared by another personNever prepare or administer medication not labeledThree Befores
The Three Befores 1. Check drug with MAR when removing medication from med drawer2. Check when preparing medication3. Check before administering to the client
Right Dose Check MAR and physician order to verify correct dosageCheck label on container for medication concentrationCalculations verifiedAssess appropriateness of dosage
Right Time Medications should be given within 30-60 minutes of scheduled timeMeds given outside the allowable time must be documented as such
Right Route Route of administration depends on several factorsMedication can only be administered per route ordered
Right Documentation Document ASAPNever record medication as given prior to administrationChart site of injections and patient complaints at time of administrationChart:Med namedoserouteSitePatient response
Older Adult Considerations Polypharmacy;Altered hepatic and renal function;Dysphagia; Underweight
Created by: Natalie Willis Natalie Willis