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Pharm objective

test 1

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