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Pharm objective
test 1
| Question | Answer |
|---|---|
| 4 Specific aspects of pt drug use to be included when performing a pt drug therapy assessment | home remedies diet illegal otc hormonal current meds allergies |
| 3 physical characteristics to include in drug thereapy | height weight chronic illness muscle mass |
| 4 psychosocial aspects of drug therapy | age/development education/ reading ethnic group cultural beleifs |
| drug info needed to know prior to admin | drug info use, dosage, route, frequency mechanism of action expected therapeutic action adverse reactions (signs & Sx) allergic reaction drug-drug. drug-food interactions incompatibilities lab monitoring nursing actions (v/s pre and post admin) |
| required components of med order | pt name date of order name of drug dosage- amount, frequency, number of dose delivery route signature |
| 3 nursing Dx commonly associated with drug therapy | deficient knowledge risk for injury noncompliance |
| examples: when developing nursing care, pt outcomes related to pt drug therapy | admin tech storage purpose pulse w/i 2 beats |
| six rights of meds | right drug right document right dose right pt right time right route |
| right drug | check name with order and MAR, 3 times |
| right dose | check dose w/ pt. & availability |
| right time | military time |
| right route | enternal, parenteral, topical |
| right pt | name, medical record number, dob |
| right documentation | prescribers sign. legal and ethical issues |
| med error includes | prescribing order, product label, packaging, dispensing, distribution, admin, ed, monitoring |
| evaluation of drug therapy (monitoring) | systematic, ongoing, dynamic. adverse effects, toxic effects, pt ed |
| 3 principles of pharmacodynamics | where and how it interacts with body dont create body function, modifies it no drug has single action |
| 3 types of names given to each drug & id characteristics | chemical generic- nonproprietary, US adopted name trade- proprietary, trade name |
| normal length of patent life | 17 years |
| drug absorption | enteral, parenteral, topical |
| 3 most common drug design forms | liquids, powders, capsules, tablets, coated, enteric coated |
| 4 most common forms of parenteral meds | intradermal, subcutaneous, intramuscular, intravenous |
| first pass routes | hepatic arterial oral portal venous rectal * both* |
| entero-hepatic crculation onset and duration | onset of 1-2 hours duration of action is long |
| 5 factors that may affect absorption of enterally admin drugs in stomach | acidity foods/liquids time of day age other meds |
| 3 factors affect absorption of enterally admin drugs in sm. intestine | destruction surgical removal diarrhea concurrent drug therapy decreased blood flow to Gi: exercise, sepsis, stress responce |
| If pt is malnourished, albumin is low. 99% protein bioavailability- what will happen to pt | OD- most common drug cumadin |
| primary site and mechanism for drug biotransformation is | liver! cytochrome p-450 |
| 3 commonly factors that affect liver | age genetic disease states polypharmacy |
| microsomal enzyme INDUCER | increase rate of microsomal enzymes |
| microsomal enzyme INHIBITOR | decrease rate of microsomal enzymes |
| 3 common lab test to assess liver function | ALT/SG ALT/ SGPT bilirubin Alkaline phosphatase |
| 3 primary mechanisms of renal drug excretion | glomerular filtration active tubular reabsorption active tubular secretion |
| 4 common lab test to assess renal function | BUN creatinine total protein electrolytes |
| cardiovascular dysfunction category and metabolism | disease decrease |
| renal insufficiency category and metabolism | disease decrease |
| obstructive jaundice category and metabolism | condition decrease |
| slow acetylator category and metabolism | condition decrease |
| ketoconazole & erythromycin category and metabolism | drugs (antibiotics) p-450 INHIBITOR decrease |
| fast acetylator category and metabolism | condition increases |
| barbituates category and metabolism | drugs increases |
| rigampin & phenytion category and metabolism | drugs p-450 INDUCER increase |
| when metabolism is decreased, the risk for what is increased | toxicity |
| p-450 INDUCER does what to metabolism | increases |
| p-450 INHIBITOR does what to metabolism | decreases |
| 3 basic drug mechanisms of action | receptor enzyme nonselective |
| agonist | receptor- causes response - morphine (opiods) |
| partial agonist- agonist/ antagonist | receptor- causes diminished response- immed withdrawl- oxycotin & talwon |
| antagonist | receptor- binds and blocks- beta blockers (narcane) |
| enzyme | ace inhibitors- works on enzymes in body, via inhibiting. |
| angiotension | vasoconstricts, elevated b/p. enzyme inhibits, therefore it dilates and lowers b/p |
| nonselective | do not interact with receptors or enzymes. works on cell wall, destroys itself |
| examples of nonselective | penicillin; cephlosprins. cipro, levaquin, erythromycin, chemotherapeutic |
| common outcomes of drug therapy | curing disease elimination or reduction of Sx prevention of disease or unwanted condition |
| 6 types of drug therapy | acute maintenance supplemental supportive prophylactic empiric pallitive |
| acute | vasopressors |
| maintenance | chronic b/p, bc |
| supplemental | iron defic, diabetic insulin |
| supportive | fluids to prevent dehydration in flu |
| prophylactic | cardiac Hx, antibiotics pre dental |
| empiric | give meds, test cultures (wound testing, strep throat) |
| palliative care | end of life care. high dose of pain meds |
| low therapeutic range | increased risk for toxicity (digoxin) |
| high therapeutic range | decreased risk for toxicity |
| factors that can cause toxic serum levels | lack of adequate plasma protein, as level of free drug may increase |
| common types of drug interactions | additive effects synergistic effects antagonistic effects incompatibility |
| additive effects | equal to sum. Tylenol/ codine |
| synergistic effects | greater than the sum |
| antagonistic effects | less than sum. antibiotic/ antacid |
| in pharmacologic reaction, give insulin for high sugar | sugar levels drop too low |
| idiosyncratic reaction | give sleeping meds, pt up for 3 days |
| 3 characteristics of idiosyncratic reaction | occurs unexpect abnormal responce usually caused by deficiency |
| teratogenic drugs | cross placenta and can harm baby. listed as 'x' in drug cats |
| mutagenic | permanent changes in the genetic composition of living. alters chromosome structure, number of chromosomes, or genetic code of DNA |
| carcinogenic | cancer causing |
| priority for effective Tx of poisoned Pt | first- preserve pt vital functions= maintaining airway, ventilation, and circulation second= prevent absorption and/or speed elimination |
| digoxin (pg 431) | digitals glycosides |
| coumadin (1299) | warfarin coumarins |
| lovennox (647) | antithrombotics |
| Heparin (644) | antithrombotics |
| insulin (707) | pancreatics |
Created by:
KP1031
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