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Pharmacology
| Question | Answer |
|---|---|
| What are the 8 patient rights | patient, time, route, dose, medication, documentation, response, indication |
| what 3 questions do you always ask yourself when solving for medical math? | What am I solving for? Is this weight based question? Are all my units the same? |
| what is a drug vs medication? | drug is a foreign substance introduced into the body while a medication is a drug administered for medical purposes |
| When making a medical environment free of pathogens with medical clean techniques and using disinfectants and antiseptics(non-toxic to living tissue; what are we practicing? | medical asepsis |
| PO, gastric tube, and PR are all what kinds of route of administration? | enteral |
| How do you confirm NG/OG tube placement? | inject 30-50mL of air and listen in epigastric region then gently suction to evacuate air and fluids |
| how do you administer medication through a NG/OG tube? | flush with 50-100mL of NS, crush meds into 30mL warm fluid and draw up with 50-60mL syringe. Flush with 50-100mL then clamp for approximately 30min |
| ID, SQ, IM, IV, IO are all what kind of route of med administration? | parenteral |
| how much fluid can you inject to the forearm/upper back via ID route? at what degree? | <1mL at 10-15 degrees bevel up |
| how much fluid can you inject to SQ? what degree? | <1mL, 45 degrees |
| What are the volumes able to administer to the deltoid, dorsal gluteal, vastus lateralis, and rectus femoris? what angle? | 90 degrees; delt = 2mL, glute = 5+mL, lateral = 5+mL, rectus = up to 5mL |
| transdermal (patches, ointments, creams, and lotions) and mucus membranes (SL, buccal, ocular, nasal, aural) are what type of route for med admin? | percutaneous |
| SVN/LVN, ETT injection are what type of med admin route? | pulmonary or inhalation |
| what medications can be injected into a ETT? | NAVEL (Narcan, Atropine, Vasopressin, Epi, Lidocaine) |
| 60% of total body weight is water, what are the compartments and % in each? | 45% intracellular, 15% extracellular which includes interstitial (10.5%) and intravascular (4.5%) |
| what degree to you catheterize for IV access? | 10-30 degrees |
| what size catheter minimum should be used with EJ placement? | at least 16g |
| what is the TKO/KVO flow rate? | 20-25mL/hr |
| what is this describing: adults ~3cm (2 fingers) below patella and 2cm medial.. or 2cm medially from tibial tuberosity. Pediatrics ~1-2cm below patella and 1cm medial, tuberosity 1cm medial | IO placement in the proximal tibia |
| What is this describing: adult ~3cm above medial malleolus : easiest spot for if you have to place it with your hand and not a drill. Peds ~1-2cm above medial mal | IO placement distal tibia |
| How much lidocaine can you use to help with administration via IO in conscious pt? | 20-40mg |
| How do you check BGL from an IO? | Aspirate from the catheter with a syringe (don't attach extension yet |
| most common type of manual IO | Jamshidi |
| sternal IO, 12yo+, uses template, have pt inhale while forcefully push down | FAST-1 |
| double beveled needle, attach by magnet, 15mm pink (3-39kg), 25mm blue (>=3kg), 45mm yellow (>=40kg); type of IO? | EZ IO Drill |
| Long-term med admin, vaso-irritating meds, fluids/nutritional compounds (hyperalimentation; excessive nutrition?); TPN (total parenteral nutrition), blood transfusion, multiple Dx blood draws: these are all reasons for what kind of access? | Central line |
| 3 most common types of central lines? | PICC, Implanted port, tunneled venous access device |
| what size syringe preferred/required for central line access? | 20mL |
| what techniques can be used for troubleshooting aspiration from a central line? | moving head side to side, shrugging shoulders, coughing |
| what is a Dacron cuff? | it helps stabilize tunneled venous access devices |
| what is it called if you look at the name of a drug in the USP? | the official name |
| Act that prohibits sale of medical preparations that had little or no use and restricted sale of drugs with potential for abuse, names USP and National Formulary (NF) as official drug standards | Pure Food and Drug Act 1906 |
| Act that controls importation, manufacture, and sale of opium, coca plant and derivatives | Harrison Narcotic Act 1914 |
| Act that provided truth-in-labeling clause, has to state if med contains habit-forming drugs and if so what %; didn't have to say how safe it was | Federal Food, Drug & Cosmetic Act 1938 |
| Amendment that made meds require written or oral Rx from physician to fill meds | Durham-Humphrey Amendment 1951 |
| Amendment to Food drug and cosmetic act that mandated manufacturers provide proof of safety and effectiveness | Kefauver-Harris Amendment 1962 |
| Act that classified drugs into 5 different schedules, mandated rx filling and refilling schedules | Comprehensive drug abuse, prevention and control Act 1970 or Controlled Substance Act |
| Schedule drugs defined as high abuse potential with no medical indications | Schedule I heroin, LSD, and mescaline |
| Schedule drugs with high abuse potential leading to possible dependence with accepted medical indications | Schedule II opium, cocaine, morphine, codeine, secobarbital |
| Schedule drugs with less abuse potential than Schedule I and II leading to possible moderate or low dependence physically but high psychologically with medical inidcations | Schedule III; opioid or combined with noncontrolled; norco, buprenorphine |
| Schedule of drugs with low abuse potential compared to Schedule III, limited dependence with medical indications | Schedule IV: benzos, phenobarbital |
| schedule of drugs with lower abuse potential compared to IV limited dependence and with medical indications | Schedule V: limited opioids often for cough or diarrhea |
| pregnancy category for drugs with adequate studies in pregnant women that have not demonstrated risk to fetus in first or later trimesters | A |
| pregnancy category for drugs which animal studies have not demonstrated risk to fetus but no adequate studies in pregnant women OR adequate studies in pregnant women demonstrated no risk but animals showed adverse effects | B |
| pregnancy category for drugs which animal studies showed adverse effects but no adequate studies in women but benefits may > risks OR no adequate studies in either | C |
| pregnancy category for drugs which fetal risk is demonstrated but certain benefits > risks | D |
| pregnancy category for drugs which fetal risk demonstrated and risk outweighs any possible benefit to mother and should be avoided | X |
| what cholinergic receptors are located on the SA/AV node where the vagus nerve innervates? | M2 receptors |
| what are the 3 buffer systems? quickest/best? slowest? | best is carbonic acid-bicarbonate, protein (blood), and phosphate (slowest in the kidneys renal tubules) buffer systems |
| what is ADME in pharmacokinetics? | hoe the body works on the drug: Absorption, Distribution, Metabolism, Excretion |
| What is pharmacodynamics? | how the drug works on the body such as agonist vs antagonist |
| what is the neuron resting potential and action potential and what causes depolarization? | RP: -70mV, AP: -55mV, sodium channels |
| what are the phases of a neuron firing from depolarization to reset? | Depolarization is phase 0, repolarizing is phase 3, sodium/potassium pump (putting things back to where they belong) phase 4 where energy is required |
| If you overdose on atropine what is the solution/antidote? | Physostigmine |
| when do we usually give half the adult dose in pediatrics? | <2YO |
| what is the autorhythmic cell RP and AP? how does it get to AP and what causes depolarization? | RP: -60mV, AP: -40mV; gets to AP via slow sodium channels and depolarizes via influx of calcium |
| What is the contractile cell RP, AP and how do they depolarize? | RP: -90mV, AP = -85mV via calcium and sodium leaking into the cells from autorhythmic cells; depolarize by rapid influx of sodium |
| what are the phases of the contractile cell firing? | depolarization 0, 1 early repolarization have small amount K+ leaving. Phase 2 plateau has muscle contraction; Ca in and Potassium out, 3 repolarization, potassium efflux. Phase 4 equalizing via Na/K and Ca pumps |
Created by:
Lindsey.George