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Pharmocology
Study Guide 1
| Question | Answer |
|---|---|
| Pharmacodynamics definition | Study of how drugs affect the body |
| Pharmacokinetics | How medication travels through the body |
| How is pharmacology used in nursing? | Promoting therapeutic drug effects minimizing adverse drug effects/toxicity maximizing PTs ability for selfcare (skills, knowledge, resources, safe & effective drug admin) |
| Medication reconciliation | Report and document |
| Drug orders and time schedules | • STAT: medication that is needed immediately • ASAP: admin to Pt w/in 30 min • Single: single drug order 1x @specific time • prn: admin as required on Pt condition • routine orders: with in 2hrs • Standing orders: Advanced order |
| What happens in the Nursing Process | ADPIE |
| Enteral administration and types | Tablet, capsule, liquid Sublingual Buccal Nasogastric & Gastrostomy |
| Tablet, capsule, liquid | • Assess Pt is alert and ability to swallow • tablets/capsule in cup, liquid form shake bottle to mix measure eye level. offer H2O to swallow medication • remain with Pt until medication is swallowed |
| Sublingual | • Assess Pt is alert and has ability to hold medication under tongue • place under tongue, do not chew or swallow or move around with tongue. Allow to dissolve completely. Remain w/ Pt until dissolved. Offer water after |
| Buccal | • Assess Pt is alert and has ability to hold medication between gums and cheek. Place between gums & cheek • NO chewing or swallowing or moving around with tongue • allow to dissolve |
| Nasogastric and gastrostomy | • Admin liquid forms, when possible, to avoid clogging tube • medication is solid crush firmly mix with 30mL-dissolving • NO CRUSH enteric-coated/extended release. Tube placement, turn off feeding, aspirate stomach content/measure. |
| Topical administration and types | Transdermal (SKIN) Ophthalmic (EYE) Otic (EAR) Nasal drops Vaginal Rectal |
| Transdermal (SKIN) | patch & read the manufacturer’s guidelines. Application sites need rotating Gloves before handling to avoid absorption of the agent by the Rn Label patch w/ date, time, and the Rns initials. Remove the previous medication or patch and cleanse the area. |
| Ophthalmic (EYE) | supine pull lower eyelid down gently to expose the conjunctival sac, creating a pocket. Pt to look up. eyedropper 1/4–1/8in. finger to the nasolacrimal duct at the inner canthus for 1–2 minutes to avoid overflow drainage |
| Otic (EAR) | Affected ear is facing up Hold the dropper 1/4 inch above the ear canal and instill the prescribed # of drops into the side of the ear canal, allowing the drops to flow downward. Avoid directly on tympanic membrane • 2-3 min after |
| Nasal drops | blow the nose to clear the nasal passages. open and breathe through the mouth. Pt remain in position for 5 minutes • superior concha of the ethmoid bone—not the base of the nasal cavity |
| Vaginal | • supine position with knees bent & separated. water-soluble lubricant.8–10 cm. Remain lying in the supine or side-lying position for 5–10 minutes following insertion |
| Rectal | lie on left side (Sims position) water-soluble lubricant. less pressure on internal anal sphincter. beyond the anal–rectal ridge to ensure retention. Retain the suppository for at least 30 minutes |
| parenteral administration and types | Intradermal route Subcutaneous |
| Intradermal route | Small amounts of solution 0.01-0.1mL in tuberculin syringe Observe in 48 to 72 hours. Advance the needle until the entire bevel is under the skin; do not aspirate26-27g needle with a 10-15 angle |
| Subcutaneous | • Small doses, nonirritating • Water-soluble meds (heparin, insulin) • 3/8-5/8in to 25-27 gauge (insulin 28-31) • Sites- adequate fat-pad (abdomen, upper hips, lateral upper arms, thighs) • 45-90 angle (obese always 90 angle) |
| Intramuscular administration and types | Intramuscular |
| Intramuscular | Solutions in oils and aqueous suspensions Sites= ventrogluteal, deltoid, vastus lateralis(peds) Dorsogluteal NO longer 18-27gauge 1 -1.5in with a 90-degree angle |
| Advantages of intramuscular : | poorly soluble meds, slow absorption for extended periods |
| Disadvantages of intramuscular: | more costly, inconvenient, pain with local tissue/nerve damage |
| Intranasal | MDI, DPI |
| MDI | Shake 5-6x vigorously Hold inhaler with mouthpiece at bottom Thumb near mouthpiece index on top 2-4cm(1-2in) way from the front of your mouth, eyes closes Hold breath for 10 secs Spacer will keep medication in device longer-increasing amount of meds |
| DPI | Do not shake Exhale completely Mouthpiece between your lips and take deep inhale Hold for 5-10 secs Rinse mouth with water Remove canister and rinse inhaler, cap, spacer once a day w/ warm water dry completely |
| Medication errors | Wrong mediation or IV fluid, Incorrect dose or IV rate, Wrong client, route, or time, Admin of an allergy inducing med Omission of a dose or administration of extra doses, Incorrect discontinuation of a med or IV fluid, Inaccurate prescribing |
| What is a classification | Therapeutic classification • Organization based on therapeutic usefulness on treating disease or disorder • Pharmacologic classification • Organization based on the way the drug works at a molecular tissue or body system level |
| How do we classify drugs? | Chemical name and Generic name Prototype drug Drugs or meds Biologics and biosimilar drugs Complementary and alternative med therapies |
| Generic Name: | official or nonproprietary name the US adopted names council gives medication (each meds has only one generic name) (Ibuprofen) |
| Trade name: | Trade name= brand or proprietary name the company that manufactures the medication gives it. One medication can have multiple trade names (advil, motrin) |
| Absorption | Process involving the movement of a substance from site of administration across body membranes circulating fluids |
| Distribution | Involves transport of drugs throughout body |
| Metabolism | Process of chemically converting a drug to a form that is usually more easily removed in the body |
| Excretion | Process by which drugs are removed from the body |
| Agonists- | medications that bind to or mimic the receptor activity that endogenous compounds regulate. (Activates receptors that produce analgesia, sedation, constipation) |
| Antagonists | medications that can block the usual receptor activity that endogenous compounds regulate or the receptor activity of other medications (ex: losartan, angiotensin II receptor blocker, works by blocking, prevents vasoconstriction) |
| Partial agonist | act as agonists and antagonists w/ limited affinity to receptor sites |
| Therapeutic class: | Organization based on therapeutic usefulness on treating particular diseases or disorders |
| Pharmacological class | Organization based on the way the drug works at a molecular tissue or body system level Often represents mechanism of action |
| Prototypes | Well understood drug model w/ which other drugs in its class are compared |
| Chemical name | Name of medication that reflects its chemical composition and molecular structure |
| Generic name | Official or nonproprietary name the US adopted names council gives medication (each meds has only one generic name) (Ibuprofen) |
| First Pass effect | important mechanism, since a large number of oral drugs are rendered inactive by hepatic metabolic reactions |
| Excretion | Primary site of excretion of drugs is the kidneys Primary determinant of concentration of drugs Concentration in blood stream determines the duration of action Respiratory system excretes drugs in gaseous form Glandular activity is another elimination |
| Absorption | Drug formulation, dose, route of administration, surface area of absorptive site, digestive motility, blood flow, lipid solubility of the drug |
| Distribution | involves the transport of drugs throughout the body after they have been absorbed or injected |
| Onset | Represents the amount of time it takes to produce a therapeutic effect after drug administration |
| Peak- what is it? | Occur when the medication reaches its highest concentration in the blood stream |
| Duration | Amount of time the drug maintains therapeutic effect |
| Lifespan considerations | Extension of holistic medicine • Each person is an individual • Many ways to approach individual variation in • pharmacotherapeutic response |
| Hepatotoxicity | occur w/ many medications, metabolized in the liver, damage liver cells impair metabolism, many alter normal values of liver function tests w/ no obvious clinical indications |
| Nephrotoxicity – What does this mean? What happens to the patient in regards to pharmacotherapy | Occur w/ number of medication but is primarily the result of certain antimicrobial agents and NSAIDs (DAMAGE KIDNEY) |
| Loading dose What happens? | Higher amount drug given, given only once or twice to prime the blood stream with sufficient level of drug; plateau reached faster followed by maintenance dose, quickly produces therapeutic response |
| Maintenance dose | Keep plasma drug concentration in therapeutic range; blood levels of the drug fluctuate w/ this appriaccch equilibrium sate can be reached almost as rapid as continuous infusion |
| Potency | drug with higher potency produces a therapeutic effect at a lower dose compared w/ another drug in the same class |
| Efficacy | magnitude of maximal response that can be produced from a particular drug; efficacy almost always more important than potency |
| Pregnancy Category A | studies performed with pregnant woman, no increased risk of fetal abnormalities |
| Pregnancy Category B | studies in animals have shown no risk to fetus, but no studies done w/ pregnant woman & animal studies show adverse effect, but adequate well controlled studies in pregnant woman have failed show risk |
| Pregnancy Category C | animal studies have shown risk to fetus and no studies done with pregnant woman; no animal studies conducted & adequate well controlled studies in pregnant women |
| Pregnancy Category D | risk to fetus shown; benefits outweigh risk may be acceptable |
| Pregnancy Category X | studies done w/ animals or pregnant woman, fetal abnormalities shown |
| Medication Rights | Right client, Right medication, Right dose, Right time, Right route, Right documentation, Right client education, Right to refuse, Right assessment, Right evaluation |
| Drugs for Inflammation and Fever | First generation NSAIDs (COX-2 inhibitor) Decreased inflammation, fever, and pain • COX-1 decreased platelet aggregation and kidney damage • Second generation NSAIDs (COX-2 inhibitor) |
| Anti-inflammatory drugs: | (first generation) aspirin, ibuprofen, naproxen, indomethacin, diclofenac, ketorolac, meloxicam, (second generation) Celecoxib |
| Reye’s syndrome / aspirin | Occurs when aspirin is used for fever reduction in children and adolescents who have a viral illness (chicken pox/influenza) |
| adverse effects of aspirin | irritates the digestive system • may cause bleeding |
| Aspirin salicylism | occur with aspirin • petechia, tinnitus, sweating, headache, dizzy, respiratory alkalosis |
| NSAIDS | Ibuprofen Ketorolac IV |
| Ibuprofen | Bone marrow suppression, gastrointestinal distress, MI or stroke |
| Ketorolac IV | • Contraindicated in clients who have advance kidney disease. • Use no longer than 5 days • Risk for gastrointestinal, cardiovascular, and renal complications |
| Which NSAIDS can be used IV | As infusion over 30min ibuprofen |
| Nursing administration | Clients self-report is key in assessment of pain • Clients should receive a pain management plan • Older adults need careful monitoring due to increase adverse effects and medication interactions • Explain the medication to client that is being used |
| Corticosteroids | dexamethasone, prednisone |
| Nursing actions for Corticosteroids | Dose of hypoglycemic medications may need to be increased • Monitor GI bleed • Use together cautiously • Monitor K+ and cardiac rhythm • Encourage high K+ foods or administer supplements • No immunizations while on glucocorticoid therapy |
| Side effects for Corticosteroids | Suppression of adrenal gland function, hyperglycemia • Mood changes, cataracts, peptic ulcers • Electrolyte imbalances, osteoporosis |
| Antipyretics: | Acetaminophen |
| Treatment of overdose | The specific treatment for overdose is the oral or intravenous (I V) administration of N-acetylcysteine (Acetadote) as soon as possible after the overdose. This drug protects the liver from toxic metabolites of acetaminophen. |
| Wong Baker | Face scale for pain |
| Pain and assessment | subjective experience for patients, numerical scales, or surveys |
| Pain Perception | psychological factors can increase or decrease perception of pain |
Created by:
Kristi.bohannon2
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