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NUR112 Pharm exam 1
study guide
| Term | Definition |
|---|---|
| pharmacodynamics | ways in which drugs work to change body function; the study of how drugs work with other medications, enzymes or cell receptor sites in the body |
| pharmacokinetics | the study of how drugs move through the body; mechanism of action drug metabolism |
| four steps of pharmacokinetics | 1. absorption - how it gets into bloodstream 2. distribution - how it gets to target tissue 3. metabolism - how cells convert drug for use 4. elimination - how it is removed from body |
| pharmaceutics | ceutic = magician + pharmakon = drug the science of preparing and dispensing drugs to a patient after he or she has been examined by a licensed HCP |
| factors affecting absorption | where and how much was given |
| intrinsic drugs | chemicals that the body makes; hormones, enzymes, growth factors etc |
| extrinsic drugs | made outside the body, must be taken into the body to change cell, organ or body action |
| OTC - what must the patient know | have less potential for harmful side effects, no prescription required, allow you to control your own health care, can still cause health problems and may interact with prescription drugs |
| generic name | always lower case, USAN creates generic names, some part of all generic names for drugs of one class will be the same (-statin, -olol) once a name is approved it is public and not owned by any one drug company |
| brand name | created by each drug company, always capitalized, will have a TM (trademark) or R (registered) after the name |
| steady state | balancing drug entry with drug elimination |
| why discuss herbal supplements with pharmacist | herbal supplements have cellular effects that can be harmful or can interact with other drugs, people may take large quantities because if a little is good for me then a lot is better for me, |
| organ of elimination of drugs from the body | intestinal tract, kidneys and lungs |
| 2 patient identifiers | name and birth date |
| 7 Rights | 1. right patient 2. right drug 3. right dose 4. right route 5. right time 6. right documentation 7. right to refuse a drug |
| SL | sublingual |
| PO | oral (per os) |
| BID | twice per day |
| TID | three times per day |
| standing order | an order written when a patient is to receive a drug on a regular basis |
| High alert drugs | P-potassium I-insulin N-narcotics C-chemotherapy agents H-heparin |
| agonist | mimics intrinsic drugs activates receptor site |
| antagonist | blocks receptor sites so intrinsic drugs can not bind, slows or stops the activity; it is similar so that it binds to receptor site but doesn't activate it; competes with intrinsic drug |
| nonreceptor actions | does not use receptors |
| physiological effect | outcome of the mechanism of action of a drug, expected and unexpected response, allergic reaction, personal (idiosyncractic) |
| side effects | mild changes |
| adverse effects | (ADR)harmful side effect more severe than expected toxic or toxicity |
| bioavailability | the amount of drug dose that acturally reaches the bloodstream |
| percutaneous | skin or mucous membrane, must be lipid soluble, a drug placed in lowest 1.5 inches of rectum |
| enteral | GI tract drug placed high in rectum, feeding tubes |
| parenteral | injection, IV drugs are 100% bioavailable |
| compartments | 1st - blood stream or blood volume 2nd - blood volume and interstitial spaces 3rd - blood volume, interstitial spaces and intracellular spaces |
| hydrophilic drugs | limited on entering intracellular spaces |
| fist-pass loss | rapid inactivation or elimination of oral drugs as a result of liver metabolism |
| when is a drug considered eliminated | when less than 10% of the drug remains in the system in general it is 5 half-lives after the last dose |
| paradoxical effect | effect of a drug is opposite expected effect |
| toddler through adolescent | have higher metabolism than an adult, a drug would be given at a lower dose but more often |
| infants and young children | water soluble drugs are eliminated faster due to increased water content and surface area |
| teratogenic or teratogens | drugs that cause birth defects 3rd-8th week is most critical time of embryo development |
| category A | studies show no risk to fetus |
| category B | no studies on humans, animal studies show no risk to fetus |
| category C | no studies have been done on humans or animals |
| category D | human studies show increased risk to fetus |
| category X | studies show risk to fetus DO NOT GIVE TO PREGNANT WOMEN |
| nurses role | administer drug, teach, know desired effects and side/adverse effects |
| minimum info on written RX | date , patient name, name and address of subscriber, generic or brand name of drug, strength, times taken per day, instructions, number of doses to dispense, number of refills, prescriber's signature, |
| principle of administration of drugs | must know the drug know pt drug history, allergies, ADR, lab values and changes in condition be aware of prescribed limitations listen to the patient |
| enteral drugs | Before: check order, wash hands, check identifiers, check wrist band After: document, check pt for side effects, ADR and desired effects |
| feeding tube (enteral) | Before: check about crushing tablets or opening capsules, sit pt upright, withdraw stomach contents with syringe or use end-tidal CO2 detector to make sure tube is in stomach After: flush with 50 mL of water; if suction is used, clamp tubing for 30 mins |
| Rectal drugs | Before: does pt have diarrhea, surgery or trauma to rectum? know history of vasovagal reaction use sims position (left lateral) lubricate suppository insert about 1 inch |
| Parenteral drugs | IV IM intradermal Subcutaneous |
| interdermal drugs | 3/8 inch, 25 guage between layer of skin 15 degree angle, bevel up DO NOT aspirate drug volume - 0.01 to 0.1 mL |
| subcutaneous | 3/8 to 5/8 inch, 25-27 guage between skin and muscle 45 degree angle (90 degree if pt is obese) aspirate for anything except insulin or heparin apply pressure drug volume - 0.5 to 1 mL |
| IM | 1-1.5 inches, 20-22 guage use deltoid, vastus lateralis or dorsogluteal muscles 90 degree angle aspirate drug volume: children no more than 1 mL, adults no more than 3 mL |
| Z track | if drug is irritating or would permantly stain tissue; pull tissue laterally and hold while injecting drug |
| IV | check patency of IV site remove air from tubing document site and flow rate check for infection, extravasation (fluid escaping from vein) and infiltration (fluid collecting in tissues) |
| Percutaneous drugs | absorption affected by size of area, concentration of drug, contact time, condition of skin |
| topical drugs | applied to skin for local effects |
| transdermal drugs | applied to skin but enters blood stream |
| topical/transdermal drugs | clean area,apply in smooth, thin layer, cover area remove old patch, clean site (previous also), rotate sites: for children, place a transdermal patch on back between shoulder blades |
| mucous membranes | includes: buccal, sublingual, eyes, ears, nose, inhaled, vagina |
| learning | to acquire new knowledge that results in a persistent change of behavior |
| listening | the key to know what is taught is actually being learned |
| cognitive | intellectual learning |
| psychomotor | motor skills |
| affective domain | attitudes, values, interests, appreciation and adjustment - helps the pt value information - motivation, longest lasting form of learning |
| androgogy | adult learning |
| pedagogy | child learning |
| give this info clearly to pt | drug name, purpose of drug, how it works, how to take it, special instructions, expected response, side effect, ADR, when to call provider |
| polypharmacy | pt is prescribed many drugs |
| normal body temp | 97-100 F 36.1-37.8 C |
| Celsius to Fahrenheit | (C x 1.8) + 32 round to tenth |
| Fahrenheit to Celsius | (F - 32)/1.8 round to tenth |
| 60 gtt | 1 tsp |
| 15 gtt | 1 mL |
| 3 tsp | 1 TBS |
| 1 tsp | 5 mL |
| 2 TBS | 1 oz or 30 g or mL |
| 8 oz | 240 mL |
| 16 oz (1 pt) | 454 g (dry) 500 mL |
| 32 oz (1 qt) | 1000 mL |
| 4 qt | 1 gallon |
| mEq | used to measure electrolytes: KCl, KPO4, Ca++ |
| Mother killed her dog under duress cause Max made noise (my favorite mnemonic) | M K H D U D C M . . M . . N |
| compared to basic unit | K 1000 H 100 D 10 d 0.1 c 0.01 m 0.001 mcg 0.000001 micro gram 0.000000001 |
| drug error | most caused due to not following one or more of the rights |
| pounds to kilograms and vise versa | lb / 2.2 kg x 2.2 |
| inch to centimeter | inch = 2.54 cm |
| buccal drugs | given between cheek and molar teeth of upper jaw |
| sublingual | placed under tongue |
| controlled substance | Controlled substances are drugs that have some potential for abuse or dependence. These drugs are regulated by the federal Controlled Substances Act (CSA) – this law helps the US Government fight against the abuse of these drugs. |
| half-life | time span needed for half of the drug to be eliminated. |
| peak and troughs | peak=maximum blood drug level: trough= minimal blood drug level |
| prodrug | an inactive substance that is converted to a drug within the body by the action of enzymes or other chemicals. |
| what factors slow the absorption of drugs | affected by anything occurring in the stomach or intestines. diarrhea can move the drug too quickly, calcium can bind with some drugs and keep them from absorbing, |
| what factors affect drug distribution | size and chemical nature of the drug, dehydration, low blood pressure, trapping of the drug in certain tissues (sequestration) |
| single dose order | an order to give a drug once only |
| PRN order | given to the pt as needed |
| stat order | given ASAP, per class notes you have 10 minutes to give a stat order |
| right time | you have a 30 minute window to give ordered drugs in order to stay within the "right time" |
| sentinel event | A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof |
| what drug route is most dangerous | IV, 1. the IV may infiltrate. 2. it is expensive and nursing intensive. 3. rapid administration of a drug can lead to toxicity. 4. the patient always has more side effects. |
Created by:
nursingTSJC2013
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