Routes, Classes
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| Route of medication administration(Under the tongue) | Sublingual
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| Route of medication administration(Allowed to dissolve on mucous membrane of cheek) | Buccal
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| OD | Right eye
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| OS | Left eye
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| OU | Both eyes
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| Injection into the fatty layer under the skin. Sites include upper abdomen, upper thigh, or lateral upper arm. Amounts are usually 0.5-1.5 Medication is to be absorbed slowly with prolonged effect. | Subcutaneous
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| Good for poorly soluble drugs, irritating drugs, provides systemic effect | Intramuscular
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| Provides rapid onset. Gives option of larger fluid volume therefore diluting irritating drugs, Amounts are usually over 5 ml | Intravenous
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| Usually used for allergy or TB tests Inner aspect of arm is usual site Normally should not be over 0.1 ml | Intradermal
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| Otic medications Adult ear canal should be pulled | up and back
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| Otic medications Child ear canal should be pulled | down and back
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| Patient should lie on left side for insertion and water-soluble lubricant should be used. | suppositories
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| Tyramine containing foods | cheese, red wine, beer, and yogurt
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| When taken with tyramine foods can cause severe hypertension | MAO inhibitors
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| What do you assess the patient for (medication administration) | 1. Food or drug allergies 2. past medical history and present condition 3. knowledge deficits and teaching needed
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| Suspension of fat globules in water | emulsion
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| Drugs dissolved in alcohol | tincture
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| liquid dispersion of drug for topical use | lotion
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| Drug coated with substance that delays release of drug until it reaches the intestine (should not be crushed) | enteric coated
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| Drug incorporated into a sugar or fruit base which will dissolve in the mouth | Lozenge
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| Usually predictable, undesirable responses | Side effects
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| Movement of drugs throughout the body. Four components: absorption, distribution, metabolism, excretion | Pharmacokinetics
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| Process of moving a drug from the site of administration to the bloodstream. | Absorption
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| How drugs are transported throughout the body. | Distribution
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| Enzymatic alteration of drug structure, also known as biotransformation | Metabolism
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| Primarily occurs in the liver | Metabolism
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| Removal of drugs from the body. Usually occurs through the kidneys and urine. | Excretion
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| Between minimum effective level and the toxic level | Therapeutic range
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| The length of time the body takes to reduce the plasma level of a drug to 50% of its peak value. Duration of action for most drugs. | Half-life
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| Reactive site on the surface or inside of a cell. | Receptor
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| Drugs that bind to a receptor and cause effects that mimic normal cell activities. | Agonists
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| Drugs that bind to a receptor and inhibit normal cell activities | Antagonists
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| Drugs that attach, elicit some response, and also block other responses | Partial agonists
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| Health history info., physical assessment data, lab values, medication effects | Assessment related to medication administration
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| Most common nursing diagnosis related to medication administration | Knowledge deficit, Noncompliance
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| Sympathetic NS mimics the "fight or flight" response selectively stimulating alpha & beta adrenergic receptors Includes vasoconstrictors (Norepinephrine) & Inotropes (Dopamine & Dobutrex)Increase HR and B/P | Adrenergic
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| Dopamine involvement in CNS regulation, having a major effect on the akinesia of Parkinson's (Sinemet & Levodopa) | Dopaminergic
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| Drugs that stimulate the PSNS by mimicking ACh. Promote muscle contraction & bladder emptying treating urinary retention. Side effects: abdominal cramps, salivation, N/V & diarrhea. | Cholinergic drugs
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| Drugs that block or impede the activity of the neurotransmitter acetylcholine (ACh) at cholinergic receptors in the brain. Relax smooth muscles. | Anticholinergic drugs
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| When two drugs with similar actions are given together. Ex. acetaminophen and oxycodone | Additive effects
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| When two drugs administered together interact in such a way that their combined effects are greater than the sum of the effects for each drug given alone. Vistaril potentiates the effect of Demerol. | Synergistic effects
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| Combination of two drugs results in drug effects that are less than the sum of the effects for each drug given separately. Beta blocker plus a beta stimulant cancel each other out. | Antagonistic effects
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| Antibiotic: broad spectrum, gram +, first choice for meningitis, syphillis | Penicillin's
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| Chemically very similar to Penicillin. If have allergic reaction to Penicillin can also have a reaction to this | Cephalosporin's
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| Used to treat MRSA, adverse reaction includes ototoxicity, administer slowly, poorly absorbed orally | Vancomycin
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| Used to treat GI infections, Rocky Mountain Spotted Fever. Take on empty stomach, no milk products. Decrease the effectiveness of oral contraceptives. | Tetracycline
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| Dilation of arteries and veins. Treat dopamine infiltration sites. Side effect: orthostatic hypotension. A-blocker | Regitine
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| Vasoconstriction | Alpha
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| Muscle activity | Beta
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| Mycoardium, increased HR, increased contraction | B1
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| Bronchial & Vascular smooth muscles: Bronchial relaxation and arterial dilation to skeletal muscles | B2
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| Affects rate | Chronotrope
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| Affects force of muscular contraction by activating beta cells | Inotrope
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| The main clinical usage of calcium channel blockers | Decrease blood pressure
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| Calcium channel blockers work by | blocking voltage-gated calcium channels (VGCCs) in muscle cells of the heart and blood vessels. When Ca+ decreases, Blood pressure decreases
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| Angiotensin II | Potent vasoconstrictor, causes increase in B/P, water retention
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| Reduce arterial pressure by preventing generation of angiotensin II from angiotensin I | Ace Inhibitors
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| Cause decrease in B/P and increased renal perfusion. A persistent dry cough is a relatively common adverse effect. | Ace Inhibitors
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| End in pril, captopril, enalapril, lisinopril | Ace Inhibitors
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| Block the binding of angiotensin II to specific tissue receptors in vascular smooth muscle & adrenal glands. Produces decrease in B/P. | Angiotensin II Inhibitors
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| End in olol, propanolol, labetalol. Decrease heart rate and force of contraction. | Beta adrenergic antagonist-Beta blockers
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| A common mnemonic used to describe the physiologic manifestations of atropine overdose is | "hot as a hare, blind as a bat, dry as a bone, red as a beet, and mad as a hatter".
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| Reverse cholinergic (parasympathetic) effects. Blocks ACh at receptor sites in smooth muscles, secretory glands, SA & AV nodes & cardiac muscle Ex: Scopolamine-motion sickness, Atropine- treatment for bradycardia | Anticholinergics
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| CNS neurotransmitter, Action: Inhibits excitatory signals produced by ACh. Decrease levels cause tremors (pill rolling) rigidity, bradykinesia, akinesia | Dopamine
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| Extensive deterioration of neurons at basal ganglia. | Parkinson's Disease
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| Dopamine cannot cross the blood-brain barrier, dopamine given as a drug does not directly affect the central nervous system. To increase the amount of dopamine in the brains of patients with diseases such as Parkinson's disease combo therapy is given | Levodopa, precursor to dopamine
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| Treat moderate to severe pain by crossing blood brain barrier | Opioids
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| Major effects of Opioids | Decreased level of consciousness, respiratory depression, orthostatic hypotension, decreased muscle tone, urinary retention
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| Opioid antagonist: Drug used to counter the effects of opioid overdose ex. heroin or morphine overdose | Narcan
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| Produce maximal response (schedule II drugs)Ex: codeine, morphine, demerol, oxycodone | Opioid agonist
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| Activate opioid receptor without causing respiratory depression Ex: stadol, nubain, talwin | Opioid agonist-antagonist
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| Blocks prostaglandins that arise from the cyclooxygenase (COX) metabolic pathway. A non-steroidal drug to treat arthritic pain. | Cox 2 Inhibitors
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| Cautions with Cox 2 & NSAIDS | GI bleed, Renal failure, Asthma reaction
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| Hinder future clot formation by inhibiting conversion of prothrombin to thrombin (heparin or lovenox) or reducing amount of vit. K (coumadin) | Anticoagulation
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| Prevents production of TXA2 causes platelet aggregation adn vessel constriction ex: ASA, plavix | Antiplatelet
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| Dissolves thrombi after formation ex: TPA, retavase, used in combo with anticoagulants | Thrombolytic
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| Inhibit platelet aggregation, used as adjunct with ASA & heparin to decrease clot formation ex: Reopro, Integrilin | Glycoprotein IIB/IIA Inhibitors
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| Stimulates gastric acid secretion | Histamine
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| Blocks release of histamine, esp w/stress, stress ulcers, allergic reactions ex: zantac, pepcid | H-2 Blockers
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| Supress gastric acid secretion by irreversibly binding with proton pump system that controls hydrogen ion secretion. Use on high risk patients ex: Prevacid, Prilosec | Proton Pump Inhibitors
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| Used for Asthma, COPD, Anti-inflammatory effect-reduced mucus secretion in respiratory conditions | Corticosteroids
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| Side effects of Corticosteroids | Mask infections, hyperglycemia, slow wound healing
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| Relieve bronchoconstriction, open airway ex: alupent, serevent proventil (inhalers) | Beta Agonists
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| Side effects of Beta Agonists | Tachycardia, headache, angina, muscle tremors
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