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NUR123 Pharm

INTRO to Pharm Chp 1,2,3

What is a drug? A chemical that can affect living processes
What is pharmacology? Pharmacology is the study of drugs and their interactions with living systems
What is Clinical pharmacology? Clinical pharmacology is study of drugs in humans
What is drug therapy? Drug therapy is the use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy
Name the three most important properties of an Ideal Drug. Effectiveness, Safety, and Selectivity
What are additional properties of an Ideal Drug Reversible action, Predictability, Ease of administration, Freedom from drug interactions, Low cost, Chemical stability. Simple generic name
Four factors that determine the intensity of drug response are: Administration Pharmacokinetics Pharmacodynamics Sources of individual variation
What are the aspects of administration that influence intensity of drug response? dosage size, route, timing Medication errors Patient adherence
What is Pharmacokinetics? It is the movement of a drug and how it reaches it's site of action;or impact of body on drugs
What are the four major pharmacokinetic processes? absorption, distribution, metabolism, excretion
What is pharmacodynamics It is the impact of drugs on the body.
What is the process undertaken by a drug that induces a response body Drug-receptor interaction:binding to the cell's receptor; Patient's functional status influences pharmacodynamics (disease; Placebo effect determine response that a drug elicits.
Describe the therapeutic objective of drug therapy Provide maximum benefit with minimum harm where benefits outweigh risks
What are the factors that determine intensity of a drug responses Administration, Pharmacokinetics, Pharmacodynamics,and Individual variation
What are sources of individual variations that influence drug response? PHYSIOLOGIC: age, gender, weight; PATHOLOGIC: diminished kidney, liver function; GENETICS: may alter drug metabolism and predispose patient to unique interaction; Drug interactions
Key points about drug? All drugs cause harm and side effects; Obj is to provide max benefit with min harm; Drug therapy must be tailored for each individual.
What are the 6 rights of Drug Administration Right patien; right medication; right route; right time; right dose; right documentation.
What must the nurse know when giving drugs to a Pt Is Med appropriate for Pt? Any contraindication for Pt? Anticipate consequences of interaction b/t drug and Pt.
What are the responsibilities a nurse fulfills when administering drugs to a patient? Conduct a PREADMISSION ASSESSMENT relative to med; Determine dose and administer; EVAL and PROMOTE therapeutic effects; Minimize Adverse effects and interactions; Make PRN decisions; Manage toxicity by monitoring blood.
What is the goal of Preadmission Assessment? Gather baseline data to eval therapeutic responses and adverse effects; Identify High Risk Pts
Who is considered a high risk patient for drug therapy? Patient with Liver and kidney impairment; Genetic factors; Drug allergies;Pregnancy; Elderly and pediatrics.
What should the nurse do before administering a drug to a Pt? Read medication order; Verify Pt id; Read medication label; Verify dosage calculations; Implement any special handling instructions; Don’t administer drug if don’t understand the reason for its use.
what should the nurse know to EVALUATE a drug's therapeutic response? Know the rational for treatment; the nature, and time course of intended response.
What does the nurse promote to achieve a drug's therapeutic effects? Pt adherence (aka compliance or concordance) to the extent to which Pt's behavior coincides with medical advice.
What is another way therapeutic effects can be promoted? Implementing nondrug measures such as Biofeedback, emotional support, weight reduction, smoking cessation, sodium restriction
What should the nurse always now about adverse effects The major adverse effects the drug can produce The time when these reactions are likely to occur Early signs that an adverse reaction is developing Interventions that can minimize discomfort (ie food)
How does nurse minimize adverse effects Take a thorough drug history (allergies) Advise the patient to avoid OTC drugs that can interact with the prescribed medication. Monitor for adverse interactions known to occur. Be alert for as-yet unknown interactions.
What is important when nurse makes PRN decision? know the reason for the drug use assess the Pt's medication needs
When teaching the patient about dosage and adminstration, the nurse provides what information? Name of drug Dosage and schedule of administration Technique of administration Duration of drug use Storage of drug
When teaching the patient about Promoting therapeutic effects and minimizing effects? Nature and time course of expected beneficial effects
When educating Pt about minimizing adverse interactions, The nurse informs about what? hazardous drug-drug and drug-food interactions Example: phenelzine and amphetamines or figs
What are the nursing process steps for drug therapy? Preadministration assessment Analysis and nursing diagnoses Planning Implementation Evaluation
Preadministration assesment during drug therapy includes: Collection of baseline data to evaluate therapeutic effects Collection of baseline data to evaluate adverse effects Identification of high-risk patients Assessment of the patient’s capacity for self-care
Analysis and nursing diagnoses during drug therapy includes 3 objectives,what are they? Judge the appropriateness of the prescribed regimen Identify potential health problems that the drug might cause Determine the patient’s capacity for self-care
Planning during drug therapy includes: Defining goals Setting priorities Identifying specific interventions Drug administration Interventions to enhance therapeutic effects Interventions to minimize adverse effects Patient education Establishing objective criteria for evaluation
Implementation during drug therapy includes: Drug administration Patient education Interventions to promote therapeutic effects Interventions to minimize adverse effects
Evaluation during Drug therapy Includes Therapeutic responses achieved Adverse drug reactions and interactions Adherence to the prescribed regimen Satisfaction with treatment
Chapter 3 Drug Regulation, Development, Names and information Chapter 3 Drug Regulation, Development, Names and information
Landmark Drug Legislation: Federal Pure Food and Drug Act, 1906 1906 Required drugs be free of adulterants but nothing about safety and effectiveness
Landmark Drug Legislation: Food, Drug, and Cosmetic Act, 1938 Legislated drug safety
Landmark Drug Legislation: Harris-Kefauver Amendments, 1962 Drugs be proven safe and effective All drugs introduced b/t 1932-62 undergo testing for effectiveness Established rigorous testing procedures for new drugs
Landmark Drug Legislation: Controlled Substances Act, 1970 Established rules for manufacture and distr of drugs with potential for abuse Established categories for controlled substances
What is Class I drug? no accepted medical use and high potential for abuse
What are Class II through V Have accepted medical use and progressively decline in potential for abuse
Landmark Drug Legislation: Permission of accelerated drug approval, 1992 Accelerated approval of drugs for AIDS and cancer
Landmark Drug Legislation: Prescription Drug User Fee Act, 1992 Drug manufacturers pay FDA feeds to contract additional application reviewers. Drugs reach the market sooner than in the past.
Landmark Drug Legislation: Food and Drug Administration Modernization Act, 1997 Fast tracking now includes drugs other than AIDS and CA drugs 6-month notice to public before Mfr stops making a drug Clinical trial DB for drugs directed at serious or life-threatening illnesses Drug can provide off-label information to prescriber
landmark Drug Legislation: Best Pharmaceuticals for Children Act, 200 Provides 6-month patent extension to evaluate an approved drug for safety, efficacy and dosage in children
Landmark Drug Legislation: Pediatric Research Equity Act, 2003 FDA has power to require drug companies to pediatric clinical trials on drugs that might be used on children
Landmark Drug Legislation: FDA Amendments Act, 2007 Most imp since Harrris ammendment FDA has oversight of drug safety after a drug approved incl post-market studies, labeling, and restrict distribution based on safety concerns
New Drug development: What are the aspects of RCT? Control use Randomization Blinding
What are the stages of New Drug Development? Preclinical testing Clinical testing Phase I Phase II and III Phase IV: Postmarketing surveillance
What takes place during Preclinical testing drugs eval for toxicity, pharmacokinetics, potentially use biologic effects
What Happens during Phase I of clinical testing? Healthy volunteers who have the disease under consideration Eval for metabolism, pharmacokinetics, and biologic effects
What happens during phase II and III of clinical testing? Drug testing on patients to determine therapeutic effects, dosage range, safety. effectiveness.
What happens during Phase IV? After FDA has granted conditional approval of drug, then drug is released for general use.
What are the problems with trade names? Single drug can have multiple trade names. U.S. drugs and drugs outside the U.S. may have different active ingredients. Products with the same trade name may have different active ingredients.
What are the characteristics of OTC Drugs their benefits outweigh their risks the potential for misuse and abuse is low consumer can use them for self-diagnosed conditions they can be adequately labeled health practitioners are not needed for the safe and effective use of the product
Created by: jai855