Medical Administration
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| Prophylactics | Meds used to prevent illness like HIV - bactrim (antibiotic) – for immunosuppressant, antifungal meds.
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| Medication reconciliation | Detailed list of what they take at home. What, how much, and how often.
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| NPO | nothing per oral
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| MAR | Medication Administration Record
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| BID | 2x a day
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| QD | 1 X per day
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| PO or IV | Orally or by IV
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| PRN | as necessary – when they ask for it
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| TOV | Telephone Order Verified – when taking a doctor’s order over the phone and you have read it back to them to verify it.
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| Pt. | Patient
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| PCA | (patient controlled analgesia)
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| Pharmacology | Study of the science of drugs including: pharmaceutics, pharmacokinetics, pharmacodynamics, pharmacotherapeutics, pharmacognosy, and toxicology.
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| First American law to regulate medications | Pure Food and Drug Act 1906
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| Pure food and drug act | 1906 – 1st Drug Law in America - to control medication production, distribution, prescriptions, medical testing, labeling (because some are labeled the same and have similar names).
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| Enforcement of medication laws currently rests with? | Food and Drug Adminstration (FDA)
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| Name a state regulation of medication | No alcohol till 21 and no smoking till 18.
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| Name a health care institution medication policy | Automatic discontinuation of narcotics after a set number of days.
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| Nurse Practice Acts | Set boundaries and limitation for what we do. Protects public from unskilled activities. Have most influence over nursing practice by defining scope of functions and responsibilities.
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| Primary intent of NPAs is? | To protect the public from unskilled, undereducated, and unlicensed personnel.
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| Medication classification indicates __. | the effect of the medication on a body system, the symptoms it relieves, or its desired effect.
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| Name a medication that is part of more than one class. | Asprin – analgesic, antipyretic, and anti-inflammatory medication.
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| What determines the route of medication administration? | The form of the medication.
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| The composition of a medication enhances its __. | absorption and metabolism.
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| Name some medication forms. | solid(tablet), liquid (elixir/suspension), topical, parenteral, instillation.
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| Drugs can come with up to __ different names. | 3 – chemical name, generic name, and the trade name.
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| A medication’s chemical name provides __. | an exact description of the medication’s composition and molecular structure.
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| The manufacturer who first develops med gives it its __. | generic or nonproprietary name, with United States Adopted Names (USAN) Council approval.
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| The name Acetaminophen is an example of a __ name. | generic – for Tylenol.
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| The generic name becomes the __. | official name listed in official publications such as the USP.
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| The ___ name is the name under which a manufacturer markets a medication. | trade name, brand name, or proprietary name.
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| The ___ name has the symbol TM at the upper right of the name. | trade – indicates the manufacturer has trademarked the med’s name (e.g., Tempra TM, Panadol TM).
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| Because of the similarities between drug names it is a common cause of ___. | medical errors – The Joint commission publishes look-alike/sound-alike list.
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| Drug’s chemical name | Drugs chemical composition and molecular structure (2-p-isobutylphenylpropionic acid).
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| Which drug name is restricted by the drug’s owner? | propriety/brand/trade name (Motrin, or Advil).
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| Pharmacological Classification | ”works a specific way” – narcotic, general anesthetic, calcium blocker, antibiotic.
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| Medications are grouped by their __. | physiologic activity and mechanisms of action – beta blockers, calcium channel blockers, ACE inhibitors, Cephalosporins.
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| Therapeutic Classification | Grouped by similar therapeutic indiciations – anti-coagulants (blood thinner), anti-anxiety, anti-infectives (antibiotics).
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| Chemical Classification | Grouped by chemical structure, regardless of differences in pharmacologic activity.
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| Pharmacokinetics | Study of how medications enter the body, are absorbed, and distributed into cells, tissues, or organs, and alter physiological functions.
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| What is the fasted route? | IV
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| What must you know to consider routes and risks? | The medication’s pharmacokinetics.
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| Absorption refers to __. | passage of med molecules into blood from site of med administration.
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| Name factors that influence absorption. | Route, ability to dissolve, blood flow at admin site, body surface area, and lipid solubility of med.
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| Use knowledge of pharmacokinetics when __. | timing med admin, selecting route, considering client’s risk for alterations in med action, and evaluation of response.
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| Name some routes of med administration. | IV, IM, sub Q, PO, rectally, inter-nasally.
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| Each route has a differed rate of __. | absorption
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| Which route tends to be the slowest? | topical
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| Why is mucous membrane and respiratory airways route quick? | because these tissues contain many blood vessels.
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| The rate of absorption is usually slow PO because? | It must pass through the GI tract.
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| Why is IV route quick? | Because med is immediately available when entering systemic circulation.
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| Ability of an oral med to dissolve depends largely on __. | its form or preparation – suspension and solutions are already liquid so faster than tablets or capsules.
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| Acidic medications pass through the __ rapidly. | gastric mucosa
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| Meds that are basic are not absorbed before reaching the __.small intestine. | (blank)
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| When site of admin contains rich blood supply, body absorbs meds __. | rapidly
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| Why is med absorbed quickly with large surface area? | more room to be absorbed – that’s why meds are absorbed usually in small intestine rather than stomach.
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| Highly lipid-soluble meds easily cross __. | the cell membrane and are absorbed quickly
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| Food changes the __ of a med and sometimes impairs its absorption. | structure
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| Safe med admin requires knowledge of __. | factors that alter or impair absorption of prescribed meds based on pharmacokinetics, nursing history, and knowledge.
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| Rate and extent of distribution depends on? | physical/chemical properties of med and physiology of person.
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| Distribution depends on? | circulation, membrane permeability and protein binding.
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| Conditions that limit __ inhibit the distribution of a med. | blood flow or blood perfusion.
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| What conditions would limit distribution of a med? | Congestive heart failure.
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| Blood-brain barrier allows only __ meds to pass into brain and cerebral spinal fluid. | fat-soluble.
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| The degree to which meds bind to __ affects med distribution. | serum proteins like albumin – because they cannot exert pharmacological activity.
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| The active form of meds are __. | unbound or “free” – have not bound to protein.
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| Why are older adults at risk for med toxicity or increased med activity? | because they have less albumin in the blood stream and this leaves more med “unbound” and active.
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| Biotransformation | when med becomes metabolized into a less active or inactive form that is easier to excrete.
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| What biotransforms meds in the body? | enzymes that detoxify (break down) and remove biologically active chemicals.
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| Where does most biotransformation occur? | In the liver, but also occurs in lungs, kidneys, blood, and intestines.
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| How does liver biotransform/metabolize meds? | Its specialized structure oxidizes degrades chemicals before they become distributed to tissues.
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| If liver disease is present, a medication is __. | usually eliminated more slowly and can accumulate toxicity of med.
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| Metabolite | product of metabolism – active have pharmacologic activity even if parent drug is inactive.
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| A particular drug’s onset of action, peak effect, and duration of action are all characteristics defined by __. | pharmacokinetics.
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| Bioavailability | extent of drug absorption
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| A drug that is absorbed from the intestine must first pass through the __ before it reaches the systemic circulation. | liver
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| First-pass effect | Some of active drug inactivated or diverted by liver before it can reach circulation.
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| Drugs that are administered by IV are __% bioavailable. | 100
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| IV drugs have onset of __. | 5 minutes
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| 3 basic routes of admin are? | enteral (GI tract), parenteral, and topical.
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| Where is enteral drug absorbed? | mucosa of stomach or small intestine.
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| Half-life of drug | When drug is ½ as potent – frequency of med admin is due to this.
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| After about __ half-lives, most drugs are considered to be effectively removed from body. | 5
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| It is desireable to keep med levels as __ as possible. | level and therapeutic
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| Steady state | Blood levels of drug stay stable due to planning the amount administered by the rate at which the body is removing it.
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| Peak effect | The time required for a drug to reach its max therapeutic response – max effective concentration.
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| Duration of action | How long drug concentration is sufficient (without more doses) to elicit a therapeutic response.
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| Trough | minimum blood serum concentration before next scheduled dose.
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| Plateau | Blood serum concentration is reached and maintained.
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| Therapeutic Effect | Expected or predictable med effect – the goal of drug therapy.
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| Drugs do what to cells? | Modify (increase or decrease) rate at which that cell or tissue functions, or can modify strength of function.
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| How do drugs exert their actions? | through receptors, enzymes, and nonselective interactions (interfere with metabolic activities).
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| The use of high-dose opioid analgesics to relieve pain is __ therapy. | palliative
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| Adverse effect | Severe response to medication – ADE – undesireable that can range all the way to death.
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| Side effect | Unintended, secondary effect of med.
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| Idiosyncratic reaction | Sensitivity to drug – Over or under-rxn to med.
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| Toxic effect | Med accumulates in blood stream
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| Allergic reaction | Unpredictable response to med that involves patient’s immune system.
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