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PatientCare2 Midterm
| Question | Answer |
|---|---|
| Define drugs | Chemical substances not required for normal sustenance that produce a biologic effect on a organism |
| Define pharmacokinetics | The process that controls absorption, distribution, metabolism, and excretion of drugs by the body |
| Define pharmacodynamics | The study of the response of drugs on normal physiologic body functions, or the response of tissue to a chemical agent |
| What are the 3 medication classifications? | Prescribed, OTC, and controlled |
| What are the two types of dependence? | Physical and physiological |
| Product packing inserts should include... (name 7) | Chemical composition, generic name, trade name, usual dose, indications, contraindications, and side effects |
| The Food and Drug Act regards... | The production, import, export, and transport of food, drugs, contraceptive devices, and cosmetics |
| The Food and Drug Regulations regard... | Standards of composition, strength, potency, purity, quality, and other properties of articles in the Food and Drug Act |
| The Controlled Drugs and Substances Act regards... | Federal laws related to controlled substances in Canada |
| What phases does not occur for liquid and parentarel drugs? | The pharmaceutic phase |
| What is the pharmaceutic phase? | The dissolution of drugs in the body (they must be in a solution to be absorbed) |
| What is the first stage of the pharmacokinetic phase? | Absorption: movement of the drug from site of administration into systemic circulation |
| How are injected drugs absorbed? | Through blood vessels (into muscles, SC tissues, or dermal layers) |
| How are drugs absorbed in the GI tract? | Either by active absorption (carrier molecule moves drug across membrane), passive absorption (diffusion), or pinocytosis (cell engulfs particle) |
| What drugs do not require absorption? | Parenteral |
| What influences the rate of absorption? | Route of administration, solubility, and certain conditions |
| List the fastest to slowest routes of admission | Intravenous, intramuscular, subcutaneous, oral |
| What is the second stage of the pharmacokinetic phase? | Distribution: systemic circulation spreads drug to target sites |
| What is the third stage of the pharmacokinetic phase? | Metabolism (or biotransformation): chemical reaction in which liver enzymes convert drug into metabolites (inactive compounds) to be eliminated |
| What consideration do patient's with liver disease require? | Lower doses |
| What is the first pass effect? | The partial metabolism of oral medication by the liver before it reaches circulation (can be significantly enough to render inactive, in which case alternate route would be necessary |
| What are risks of slow or fast metabolism? | Slow: drug can accumulate. Fast: drug may not have intended affect |
| What affects rate of metabolism? | Age, health, time of day, emotional status, genetic variations, disease status, presence of other drugs |
| What's the fourth stage of the pharmacokinetic phase? | Excretion: removal of drugs (intact or metabolized) from the body, primarily by kidneys through urine |
| What are less common modes of excretion? | Breast milk, lungs, intestines, exocrine glands |
| What is half life? | Time required for body to eliminate 50% of a drug |
| How many half lives until 98% of a drug is excreted? | 5-6 |
| Does contrast media have a short or long half life? | Short (excreted within 24 hours) |
| Define pharmadynamics | The actions and effects of drugs within a normally functioning body |
| What is the primary effect? Secondary? | Primary is the desired therapeutic effect. Secondary effects are all others, desirable or not. |
| At what level are the greatest effects of drugs exerted? | Cellular. |
| Can drugs fundamentally change cellular function? | No. Only enhance or diminish it |
| What are the 3 main drug-receptor interactions? | Agonist (binds at receptor site to produce therapeutic effect), antagonist (bonds to receptor site to block therapeutic effect), and partial agonist (partial therapeutic response) |
| What are the 7 classifications of medication effects? | Adverse, allergic/hypersensivity, idiosyncrasy, tolerance, synergistic, cumulative, and toxic |
| Do all adverse drug reactions appear immediately? | No |
| How is anaphylactic shock treated? | Raise BP, improve breathing, restore cardiac function |
| Define drug idiosyncrasy | Unusual or abnormal reaction with unclear cause |
| Define the drug synergistic effect | Responses to combined drugs that differ from their individual effects |
| What patients are at risk for toxicity from drug accumulation? | Those with kidney or liver disease |
| What classifications of drugs are safe from toxic effects? | None |
| How might a normally safe drug become toxic? | Administered in a large dose, inadequate excretion, impaired metabolism, or drug sensitivity exists |
| Define antidote | Drug which treats the toxic effect of another drug |
| What the the antidote to fentanyl? | Naloxone (an opioid receptor antagonist) |
| Are side effects considered predictable or unpredictable actions? | Predictable |
| What is the most common emergency antihistamine used? How is it administered for adults? | Diphenhydramine (Benadryl). 25-50 mg orally, or IV in emergencies |
| When are adrenergic drugs (epinephrine) used? | In cardiovascular, respiratory, and allergic emergencies (including shock and respiratory distress) |
| What do adrenergic drugs do? | Stimulate heart and sympathetic nervous system |
| How are adrenergic drugs administered? | 0.2-1 ml in a 1:1000 solution, via IV, IM, OR SC |
| What are used as replacement therapy for disease of the adrenal glands, as well as for inflammatory relief, stress relief, and treatment of severe allergic reactions? | Glucocorticoids (Cortef) |
| Antimicrobial contain what categories? Subcategories? | Antiseptics (e.g. alcohol for slider boards, Betadine for skin prep) and antibiotics. Subcategories are antibacterial and antifungal |
| What preventative medication is taken by patients with chronic seizure disorders? | Anticonvulsants |
| What is used in both freezing and to treat cardiac arrhythmia? | Lidocaine (xylocaine) |
| How do controlled analgesics vary from uncontrolled? | Controlled depresses the CNS and produce drowsiness, overdose can result in coma or death (ex: opioids/morphine) |
| Are tranquilizers or sedatives more effective at reducing anxiety and mental tension? | Tranquilizers |
| What dose of valium would be given? | 2-20 mg, injected via IV or IM very slowly (extremely painful/burns if gets into SC!) |
| What's the dosage for ativan? | <2 mg, or 0.03 mg/kg for larger patients |
| What's the dosage for versed? | 1-10 mg, with the peak effect being immediate |
| What sedative can also be used to induce amnesia? | Versed |
| Why would lidocaine be used with epinephrine? | Epinephrine constricts adjacent blood vessels, localizing the freezing effect of lidocaine |
| What hypoglycemic agent is used to control type 2 diabetes? | Glucophage (Metformin) |
| What are the 2 classes of antihypertensives? | Angiotensin-converting enzyme (ACE) inhibitors, and Beta blockers |
| What is an example of an ACE inhibitor? What does it do? | Captopril (Capoten), interrupt BP regulation cycle by stimulating adrenal gland to lower BP |
| What is an example of a beta blocker? What does it do? | Propranolol (Inderal), suppresses the sympathetic nervous system by blocking epinephrine and norepinephrine to decrease BP |
| What should be done if there's a bit of blood in patient's IV line? | Nothing, this is normal. |
| After how many doses of nitroglycerin should you seek help for your patient? | 2 |
| Do verbal orders require written confirmation by the attending physician? | Yes, but it can be done after the fact |
| When is a physician's signature not needed? | To carry out standing orders |
| How many times should drug label be checked? When? | 3. When taken from storage, before drawing up, and before handing to physician or injecting |
| Where is iodinated contrast stored? Why? | Oven. Makes it less viscous |
| Who must administer the drug? | Whoever prepared it |
| What are the 6 rights of medication administration? | Right dose, right medication, right patient, right time, right route, right documentation |
| What are the enteral routes? | Oral, sublingual, buccal, nasogastric, rectal |
| When would a drug be given orally? | When they're not destroyed by gastric secretions (enteric coating can help) and slow absorption is desired |
| When is rectal administration contraindicated? | Children and unconscious patients |
| How does rectal absorption affect dose? | Bypasses liver so dose is higher |
| What enteral route is indicated for a local effect? | Sublingual or buccal |
| What route uses droplets, vapor, or gas? | Inhalation |
| What are the different classes of routes of administration? | Enteral, inhalation, topical, parenteral, |
| What topical route allows a constant blood concentration of the drug over a local or systemic area? | Transdermal (drug places directly on skin and absorbed slowly) |
| What needle angles are used in IM, and SC, and ID injections? | IM:90°. SC:45°. ID:15°. |
| What is a common site for IM injection? Why is this important for pediatrics? | Vastus lateralis muscle; develops faster than the gluteus maximus in babies and children |
| How might the flu shot, HBV vaccine, and lidocaine be administered? | Intramuscular |
| What parenteral route places drug directly into an artery? What Guage needle is used? | Intra-arterial injection. 18 g (usually followed by a catheter) |
| What is done to bypass the Blood-Brain Barrier (BBB), directly into the cerebrospinal fluid (CSF)? | Intra-thecal injection, places drug into subarachnoid space |
| What route places drug into a joint? | Intra-articular injection |
| What are two common types of IV flushes? | Saline and heparin |
| Why would a vented IV system be used? | Allows fluid to be administered quicker |
| What is most common needle range? | 18-25 g |
| What needle Guage is most commonly used for an IV? And to draw up contrast? | 21 g for IV, 18 g to draw up contrast |
| What is a salem sump pump? | A dual lumen (meaning has 2 ports) system that goes through nose and into stomach to keep it empty |
| What is a "luer lock"? | A corkscrew twist tip on a syringe |
| What tips are used for a bolus contrast injection via a nasogastric tube? | Catheter tip |
| How long after opening does a vile expire? | 24 hours |
| What is an ampule? | Glass container with a single dose of emergency medication within |
| What are the 2 most commonly stoked IV solutions in DI? | Normal saline 9% (0.9% NaCl), and 5% solution of dextrose in water (D5W) |
| What is extravasation? | Escape of fluid from blood vessel into tissue when catheter is in vein |
| What is infiltration? | Escape of fluid into tissues when catheter is out of vein |
| Should a hot or cold pack be applied if extravasation occurs? Why? | Cold. Limits area of involvement and alleviates pain |
| What thick should a vein be to insert a catheter? | Twice the diameter of the catheter |
| How long should a warm compress be applied to help find a palpable vein? | 5-10 minutes |
| What should go on a catheter label? | Date, time, guage, your initials |
| What is standard IV infusion rate? | 15-20 drops per minute |
| How high should IV bag he above level of vein? Why? | 18-20 inches. Too high and hydrostatic pressure becomes a problem, too low and there could be back flow into catheter |
| What are the 3 types of medication pumps? | Patient-controlled, parenteral nutrition, and continuous administration |
| What one button can we push on med pumps? | Silence the alarm |
| Do we ever recap needles before discarding in sharps container? | No |
| What needs to be charter when meds administered? | Date, time, drug name, dose, route of administration, patient's full name |
| How is contrast media charted? | As a medication. Include name and strength of contrast, volume, route, date/time, and signature |
Created by:
Ewood61
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