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Pharmacology 3&4

Medication's & Injection's

Pharmacology Study of drugs (medication's) and their action on the living body
Metabolite A substance produced by metabolic action, which results in the breakdown of the drug
Cumulative Effect Drug that builds up in the body (increasing by increments)
Dosage Schedule of administration (amount & frequency) of a drug prescribed for the patient
Dose Refers to a single administration of a drug
Therapeutic Beneficial
Local action Produces an effect only on the area where the drug has been placed
Systemic action Affects the entire body because the drug enters into the patient's systemic circulation
Drug interaction When one drug alters the action of another, a modification of the effects of a drug when administered with another drug
Potentiation When one drug increases the action or effect of another drug (synergism)
Compatibility The quality or state of harmonious coexistence
Drug incompatibility Medications do not combine well chemically or physically
Cardiotonics Drugs that slow & strengthen the heart
Antihypertensives Drugs that lower BP
Hypoglycemic Agents Oral medications that lower blood glucose levels
Insulin Injectable medication that lowers blood glucose levels
Heparin Medication that decreases the clotting of blood
furosemide (Lasix) Medication used to treat fluid build up due to heart failure, liver scarring or kidney disease
Agonist Drug that produces a predictable response at the intended site of action
Antagonist A drug that blocks the action of another drug
Idiosyncratic Results from the individual's unique hypersensitivity to a particular drug (it is an unexpected response to a medication)
Tolerance Reduced response to a drug over time
Adverse drug reaction A harmful, unintended reaction to a drug administered at a normal dosage
Contraindications Conditions in which the drug should not be used
Enteral Absorbed via the GI tract
Enteric-coated tablets Tablets encased by a coated shell that keeps the tablet from being absorbed in the stomach; absorption takes place in the GI tract
Pulverized Crushed to a powder
Percutaneous Through the skin or mucous membrane
Sublingual Under the tongue
Buccal In the cheek
Parenteral Those routes other than the digestive system
Syringe Consist of the barrel, plunger, and tip
Lumen Inside of the hollow shaft of needle
Gauge A standard or scale measurement of needle
IM Injections 20-22g / 1-1.5" / 90 degree Deltoid 1", Dorsogluteal 1.5" Max vol. 3mL
ID Injections 25-26g / 3/8 - 5/8" / 15 degree
Subcut. Injections 27-28g / 1.5 - 5/8" / 45 or 90 degree (depends on size of Pt.) Max vol. 1mL
Insulin Injections 29-30g / 1.5 - 5/16" / 90 degree
Chronotropic Effect Act or process of affecting the regularity of a periodic function, especially interference with the rate of the heart beat
Inotropic Effect Pertaining to the force of energy of muscular contractions, particularly the heart
Potassium-sparing Diuretic Enables retention of potassium by not allowing it to pass through the urine
Loop Diuretic Act on the thick ascending limb of the loop of henle to inhibit sodium, chloride, and potassium re-absorption
ACE Inhibitor Reduce the activity of renin-angiotensin aldosterone system as the primary etiologic (casual) even in the development of HTN in people with diabetes melitis
Beta-adrenergic blocker Blocks stimulation of B1 receptors in cardiac smooth muscle of B1 receptors, elevated plasma renins are reduced
Right Eye OD
Left Eye OS
Both Eye's OU
Two times a day BID
Three times a day TID
Four times a day QID
As needed PRN
Right Ear AD
Left Ear AL
Both Ears AU
Bed time HS
Before meals AC
After meals BC
In-between meals i.c.
Intramuscular IM
Intravenous IV
Subcutaneous Subcut.
Intradermal ID
Antibiotics ABX
As desired ad lib
What are the commonly used medication distribution systems? Multiple dose systems (floor stock), Unit dose system, and Computer or Automated dispensing system
What levels of regulation must a facility be compliant with for controlled substance medication distribution? Federal, State, and individual hospital/agency rules
How are narcotics stored? Double lock system, must be signed out and must be inventoried
When and who does inventory on narcotics? Counted by a nurse from each shift, prior to the start and end of a shift
Who must witness the "waste" of a narcotic? Two licensed nurses witness and sign off
What is the procedure if you accidentally spill a liquid narcotic? Show to another nurse prior to clean up
What are the different types of oral medications? Tablets, capsules, powders, liquids & suspensions, enteric coated, pills, and lozenges`
What types of medications can you not crush or puncture? Capsules & enteric coated
What are the medications given via mucosal route? Eye drops & eye ointments, nasal sprays, suppositories, sublingual tablets, and Buccal tablets
What are the medications given via the topical route? Transdermal patches, ointments, creams, and lotions
What are the different types of routes that medications can be given? Oral, mucosal, sublingual, Buccal, inhalant/nebulizing, topical, nasogastric or G-tube, ophthalmic, and otic
What are the six rights of medication? Patient, Dose, Route, Time, Drug, Documentation
What two identifiers must you use to verify the patient? Name, room & bed #, DOB, ID band, and identify allergies
What system do you use before administering medication? 3 check
Describe the 3 check system Check label when pulling medication from where it is stored, check label before pulling medication from container, and check label before discarding/replacing the medication container before giving meds to patient
What does the route of medication depend on? Drug properties, desired effects, physical effects, and mental condition
How do you ensure a correct dose? Double check physicians orders, check dosage written on the label, also ask yourself if the dose is appropriate for the patient's age, diagnosis, and gender
When are PRN medications given? On time! DO NOT GIVE EARLY
When is the right time to document? As soon as you give the medication, or ASAP afterwards
What should be on the MAR list? Drug given, dose, and time it was given
What do you document after you have given an immunization? Drug given, lot number on bottle, and expiration date of drug
What is important to document when giving medications or parenteral therapy? The effects (i.e., any changes in symptoms; adverse effects should be reported promptly)
What are the steps to take when a med error occurs? Check your patient (v/s & s/s), notify your RN & physician, carry out any orders given, document occurrence & actions taken, and fill out facility incident reports as needed
Do the med error incident reports go in the patient's chart? No
What are the steps when a patient refuses medications? Explain the purpose, chart on the MAR that it wasn't given, write narrative note with refusal reason, notify the prescribing physician
How do you administer meds to a confused patient? Explain in clear simple terms what is expected, and you may need to place medication in patient's mouth with a gloved hand
How do you administer meds to a patient that has difficulty swallowing? Give water before & after meals, keep head forward when swallowing, and discuss the issue with physician
How do you evaluate the effectiveness of medication? Know why you are giving the medication, know your patients pain level, compare the data before & after administration of meds, and monitor lab values
What is the procedure when a patient exhibits adverse effects of a medication? Notify RN & physician, administer antagonist, and monitor the patient
What are the procedures for clarifying an illegible prescription? Call ordering physician, verbally confirm any new orders on patients chart, and transcribe new orders on patients chart
What must you include when transcribing a new order on a chart? Your name, physicians name, and the order
When must the new order be signed by the physician? Within 24hrs
What are the factors that affect needle selection? Whether the injection is going to be ID, Subcut., IM, the viscosity, amount to be injected, and size of the patient
What must you do when combining two medications in one syringe? Check compatibility
When you are drawing insulin that needs to me mixed, which one do you draw first? Shorter acting
When do you give regular & lente insulin's that are mixed? Within 5 minutes of mixing
What are the locations on the body when giving an IM injection? Deltoid, ventrogluteal, Dorsogluteal, vastus lateralis, and rectus femorus (Be able to label pictures)
What are the locations on the body when giving a Subcut. injection? Upper arms, upper back, abdomen, scapular region, and thighs
What are the locations of the body when giving a ID injection? Inner aspect of forearm, scapular area of back, and upper chest
What are the reasons a patient may need parenteral administration? Unable to take oral meds, need quick onset of medication, med is destroyed by gastric enzymes, medication is removed during "first pass", medication is to be given at a steady rate, and medication is not available in enteral form
Define onset Beginning of therapeutic/adverse effects
Define peak Optimal point of effectiveness
Define duration Length of therapeutic effectiveness
Define subjective Pain scales, patient comments
Define objective Lab values, vital signs, blood sugar
What information do you give patients when teaching them about medications? Common adverse reaction, suggestions to adjust tolerable side effects, rotation schedules, and to notify physician if there are financial difficulties with getting meds
What do you list when documenting adverse reactions? Signs & symptoms, actions taken, new orders, and patients response
How do you locate the dorsogluteal muscle? By placing one hand on the iliac crest and locating the posterior superior iliac spine. By drawing an imaginary line below the greater trochanter and the iliac spine.
How do you locate the deltoid muscle? Locating the clavicle, the acromion process and the scapula. Imaginary rectangle can be formed to locate the this site.
How do you locate the rectus femoris muscle? By dividing the anterior thigh in thirds from the patella to the greater trochanter of the femur
How do you locate the vastus lateralis muscle? By locating the greater trocanter and the lateral condyle of the femur
Describe a schedule 1 drug Heroin, marijuana, LSD
Describe a schedule 2 drug Amphetamines, meperidine, methadone, morphine, secobarbital, oxycodone, fentanyle
Describe a schedule 3 drug Aspirin with codeine, Tylenol with codeine
Describe a schedule 4 drug Ativan, valium, Xanax, Soma
Describe a schedule 5 drug Lomotil, Robitussin AC, Lyrica, Pseudophedrine
What are the positive effects of Echinacea? Used to stimulate the immune system
What are the potential adverse effects of Echinacea? May actually be harmful to patients taking immunosuppressive medications
What are the positive effects of Ephedra? Widely used as a dietary suppressant
What are the potential adverse effects of Ephedra? May be harmful to persons with hypertension and even inhibit antihypertensive agents' effectiveness
What are the positive effects of Ginkgo? A herbal medication know to prevent blood clotting
What are the potential adverse effects of Ginkgo? Can be dangerous for patients on therapeutic aspirin regimens
What are the positive effects of Green tea? Antioxidant potential of this herb
What are the potential adverse effects of Green tea? May antagonize the therapeutic effect of anticoagulant medications
What are the positive effects of St. Johns Wort? May be helpful with depression, smoking cessation, PMS, physical symptoms due to mental disorders, and ADHD
What are the potential adverse effects of St. Johns Wort? May be harmful when used with protease inhibitors. May cause dry mouth, dizziness, constipation, and other GI symptoms
Created by: tandkhopkins



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