Medication Admin.
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| adverse reaction | any noxious, unintended, and undesired result of taking a drug in appropriate doses; also called an adverse effect
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| allergic reaction | an immune response to a drug, ranging in intensity from mild itching to severe rash to anaphylaxis
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| anaphylaxis | an immediate and life-threatening allergic response characterized by bronchospasm, laryngeal edema, and a rapid drop in blood pressure
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| buccal | pertaining to or directed toward the (cheek), the fleshy portion of the side of the face that makes up the lateral wall of the oral cavity
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| compatible | capable of harmonious coexistence; used to refer to two or more medications that can be given simultaneously without changing the effects of each other or causing any new responses not seen with any of the drugs administered alone
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| contraindication | a pre-existing condition that makes it unsafe or otherwise inappropriate to administer a particular drug
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| dosage | the determination and regulation of the size, frequency, and number of doses of a medication to be given to or taken by an individual patient
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| dose | a measured quantity to be administered at one time, such as a specified amount of medication
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| drug | any chemical or other nondrug substance that can affect living processes
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| duration of action | how long a drug actively produces a therapeutic effect
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| enteral | within or by way of the intestines
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| generic | referring to a noncommercial name assigned to a drug, usually less complex than the drug’s chemical name and more complex than a brand or trade; also known as a nonproprietary name
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| idiosyncratic reaction | an uncommon, unexpected, or individual drug response thought to result from a genetic predisposition
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| indication | a reason for administering a particular medication
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| instillation | administration of a liquid drop by drop
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| intradermal | within or into the dermis (skin)
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| intramuscular | within or into a muscle
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| intravenous | within or into a vein
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| medication | term used for drug when it is given to or taken by a particular individual for therapeutic purposes
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| medication administration record (MAR) | a document that is completed as per agency policy to verify that a patient’s medications were administered as prescribed
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| narcotic | an umbrella term that has been used to refer to opioids, controlled substances, illicit drugs, central nervous system depressants, strong analgesics, and drugs capable of causing physical dependence
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| nebulizer | a device for creating and delivering an aerosol spray
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| NPO | nothing by mouth, derived from the Latin words nil per os
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| onset of action | the point in time after administration when a drug begins to exert its therapeutic effect
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| ophthalmic | pertaining to the eye
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| over-the-counter | referring to drugs sold without a prescription
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| paradoxical reaction | causing an effect opposite of the intended effect
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| parenteral | via a route other than the gastrointestinal tract, such as subcutaneous, intramuscular, intrathecal, or intravenous
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| peak action | the point in time after administration when a drug exerts its maximal therapeutic effect
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| plateau | a steady level of a drug achieved after repeated doses; a state in which the amount of drug eliminated between doses equals the amount administered with each dose
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| polypharmacy | the concurrent use of multiple drugs
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| PRN | as needed, derived from the Latin words pro re nata
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| side effect | any unintended and usually predictable result of taking a drug in appropriate doses
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| subcutaneous | under the skin
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| sublingual | under the tongue
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| synergistic effect | an increase in the effects of any or all of two or more drugs taken together
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| therapeutic effect | the beneficial and intended result for which a drug is taken
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| topical | applied externally
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| toxic effect | a seriously adverse drug reaction; caused by excessive dosing
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| transdermal | entering through the dermis (skin); usually refers to a drug applied to the skin via an adhesive patch
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| unit-dose system | provision of drugs in single-dose packages
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| chemical names | description of drugs chemical composition and molecular structure
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| brand name | what the drug is sold as in stores
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| official name | generic name that is listed in publications
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| prescription drugs | require written order from a healthcare provider who is licensed by the state to prescribe or dispense drugs
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| Advil, Nuprin, Motrin are brand names but are all... | ibuprofen
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| what are the three ways a drug can be classified? | usage, body system, and chemical or pharmacological class
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| Ibuprofen is a...? | analgesic, anti-inflammatory, antipyretic agent
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| Diazapam (valium) acts on | anti anxiety effects, decreased activity of intestinal system and smooth muscles
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| What are four ways a drug can be named | brand, chemical, generic, official
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| what is drug administration controlled by? | federal, state and local laws
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| controlled substances | drugs considered to have either limited medical use or high potential for abuse of addiction
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| stock supply | bulk quantity, labeled and in central location
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| automated dispensing system | computer database that contains records and counts the medications, med prescription
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| what legislation defines controlled substances in the United States? | US. DEA
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| How is medication quality managed? | stock supply, unit-dose, and automated dispensing systems
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| pharmacokinetics | refers to the absorption, distribution, metabolism, and excretion of a drug
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| absorption | movement of drug from administration site into the blood stream
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| where does excretion occur? | liver, kidneys, lungs, skin
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| where does metabolism primarily occur? | in the liver
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| local effect | occur at the site of application (no or limited absorption occurs)
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| systemic effect | absorbed into blood stream before it can be distributed to distant location
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| solubility of a drug | ability of medication to be transformed into a liquid form that can be absorbed into the bloodstream
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| When does absorption occur more? | with highly soluble drugs
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| oral medications | must be water soluble and partially lipid soluble to be absorbed in the GI tract
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| water soluble drugs | more rapidly absorbed from GI tract and take effect faster
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| lipid soluble drugs | penetrate lipid-rich cell membranes and enter cells; preferred when longer affect is desired; more slowly released into the circulatory system
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| highly fat-soluble drugs | can pass through brain barrier and effect sedation (nitrous oxide)
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| enteric-coated drugs | cannot be broken down by gastric acids because coating prevents medication from being diluted before reaches intestines; delays the action of the drug and decreases irritating effects on stomach
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| time-release (sustained-release) drugs | medications formulated to dissolve slowly; releasing small amounts for absorption over several hours
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| acidic medications | more readily absorbed in the stomach (Aspirin)
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| basic (alkaline) medications | readily absorbed in the small intestine; sodium bicarbonate
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| ionized molecules | electrically charged; lipid insoluble (cannot pass through phosolipid layer of cell membranes; can easily converted from one form to another
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| lower pH | pass through membranes quicker
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| higher pH | takes longer to pass through membranes
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| a patient that is in shock lacks blood supply, what route of administration would be best? | intravenous because it does not have to be absorbed
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| what factos affect absorption? | pH, solubility, bloow flow, ionization
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| distribution | transportation of a drug in body fluids tot he various tissues and organs of the body
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| what does the rate of distribution depend on? | the local blood flow in the target area
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| target area | where drug effect occur
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| what determines the intensity and duration of a drugs actions? | absorption, distribution, metabolism, excretion
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| with oral and enteral medications, they travel through the stomach and intestine. What happens after this? | it is absorbed into the the bloodstream
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| vasodilation | increases circulation; application of warmth, fever, rest
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| vasoconstriction | decreases circulation; shock, chilling of the body
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| membrane permeability | drug molecules must leave the blood and cross capillaries to reach site of action
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| If liver function is impaired, the elimination of drugs slows. What can happen due to this? | toxic levels may accumulate
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| A patient with diabetes does not metabolize sugar effectively, what should they not take? | elixirs because they are high in sugar content
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| What is the term for when an oral medication almost completely is inactivated when passing through the liver? | first-pass effect
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| oral medications can be formulated with higher concentrations of the drug than parenteral medications because... | it allows the drug to be distributed directly to target sites
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| Enterohepatic recirculation | fat soluble agents that are reabsorbed by the bloodstream, distributed to target its, and returned to the liver; anything that increases peristalsis
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| what are the 4 things that determine drug effectiveness? | onset, peak, and duration of drug action
therapeutic ranges
bioavaiability of the drug at target sites
concentration of drug at target sites
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| when a serum level of medication is lower that the minimum effective concentration what happens? | it is not effective during that time
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| when drug level in higher than the peak level what happens? | drug toxicity
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| even when absorption stops.. | distribution, metabolism, excretion continue
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| trough level | lowest concentration; right before next dose is due
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| biological half-life | time it takes for half of the drug to be eliminated
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| what are the reasons medications are given? | palliative effects, supportive effects, substitutive effects, chemotherapeutic effects, restorative effects
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| palliative effects | relieve signs and symptoms of disease but have no effect on disease itself
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| supportive effects | support integrity of body functions until meds/treatment can become effective
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| substitutive effects | replace either body fluids or a chemical required by the body for improved functioning
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| chemotherapeutic effects | destroy disease-producing microorganisms or body cells
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| restorative effect | return the body to or maintain the body at optimal levels of health
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| cumulative effect | increase response to repeated doses of a drug that occurs when the rate of administration is greater than the rate of metabolism/excretion
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| drug interaction | one drug alters or modifies action of another
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| antagonistic drug relationship | one drug interferes with actions of another and decreases resultant drug effect
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| tolerance | decreasing response to repeated doses of a medication
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| dependence | persons reliance on, or need for drug
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| drug abuse | inappropriate intake of a substance by amount, type, or situation, continuously or periodically
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| illicit drugs | street drugs, sold illegally
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| What are three ways of medication measurement? | metric system, apothecary system, household system
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| metric system | allows for calculations of small dosages
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| apothecary system | british measurement, only a few medications measured using this, usually written using roman numerals
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| household system | less precise, can lead to medication dosage error
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| what are electrolytes measured in? | MEq
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| What are the types of medication prescriptions? | standard written, automatic stop dates, STAT, single, standing orders, prn prescription
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| If a prescription is given verbally, how long does the provider have to cosign? | 24 hours
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| while administering medications you should asses | your patients mental status, coordination, ability to self-administer, swallowing
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| after medication patients, you should asses | effectiveness of drug, side effects, signs of toxicity/adverse reactions
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| What are the three checks for administering medications? | before, after, at bedside
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| what are the six rights? | right medication, right dose, right route, right patient, right time, right documentation
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| what type of medications should you NOT administer through a feeding tube? | hydrophilic
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| what should you do when you need to administer medications to a person with a continuous feeding tube? | disconnect before giving the medications
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| what do you do when administering medications to a patient with enteral tube suction? | discontinue the suction for 30 minutes after administration by keeping the tube clamped to allow the drug to be absorbed
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| what is the formula for dimensional analysis? | X= quantity/have x desired
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| what is the formula for ration and porportion? | have/quantity = desired/X
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| what is the formula for desired over have method? | desired/have x quantity = X
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| AC | before meals
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| PC | after meals
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| daily | every day
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| STAT | given immediately
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| PO | by mouth
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| SL | sublingually
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| ID | intradermal
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| IM | intramuscular
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| IV | intravenous
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| top | topical
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| p | after
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| c | with
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| s | without
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| liq | liquid
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| susp | suspension
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| parenteral | intramuscular, subcutaneous, intradermal, intravenous, intrathecal, epidural
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| nonparenteral | oral, sublingual, topical, transdermal, ophthalmic, otic, nasal, rectal, vaginal
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| canthus | angles formed by an eyes upper lid meeting lower lid
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| cerumen | waxlike substance found within the external meatus or ear; earwax
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| conjunctival sac | space between the eyelids and the eyeball
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| dermatitis | inflammation of the skin
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| dorsal recumbent position | lying on back with knees flexed
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| eczema | long term, inflammatory skin condition that can appear as red, blistering, oozing, scaly, crusted, thickened, itchy skin rashes
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| enteral | within or by way of the intestines
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| ethmoid sinuses | air cavities on each side of the nose within the ethmoid bone, maintaining a separate path to the nasal chamber
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| eustachian tubes | bony and cartilaginous passageways connecting the middle ears with the nasopharynx and equalizing air pressure on both sides of the tympanic membrane
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| expectorate | expel secretions from the throat or lungs by coughing and spitting
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| frontal sinuses | air cavities with in the frontal bone
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| instillation | administration of a liquid drop by drop
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| intraocular medication disk | small medication-delivery device resembling a contact lens and inserted into the conjunctival sac so it floats on sclera between iris and lower lid
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| liniment | liquid or semiliquid preparation containing oil, alcohol, or water and applied to the skin often as a counterirritant
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| maxillary sinuses | air cavities in the maxilla below the bony orbit and above the hard palate that drain into the middle meatus of nasal cavity
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| meter-dosed inhaler | medication-delivery device that disperses medication as an aerosol spray, mist, or powder into airways via inhaltion
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| mydriatic | any drug that dilates pupil
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| naris | external orifices of the nose
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| ointment | semisolid preparation
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| pinna | external ear
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| pruritus | itching
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| sim's position | lying on side with lowermost arm behind body and uppermost leg flexed
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| sphenoid sinuses | air cavities in sphenoid bone that drain into the sphenoethmoidal recess at the top of the nasal cavities
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| suppurating | forming/ discharging pus
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| suspension | liquid preparation, consisting of solid particles dispersed throughout liquid phase in which they are not soluble
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| a patient is using a MDI and needs to take more than one puff of the same medication, how long should he/she wait in between puffs? | 20-30 minutes
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| tympanic membrane | obliquely placed, thin partition between the external acoustic meatus an the eardrum
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| small-volume nebulizers | handheld device that deliver medication continuously for a short period of time
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| when should a patient use an aerosol mask? | when they cannot hold nebulizer mouthpiece
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| what should patients do if they are receiving corticosteroids and using MDI or small-volume nebulizer? | rinse mouth with warm water after treatment
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| what should a patient do before administering nasal medications? | blow nose gently to clear mucous and secretions and place patient in supine position with head positioned properly
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| when you are trying to administer nasal drops to the posterior pharynx how should the head be positioned? | tilt head backward
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| when you are trying to administer nasal drops to the ethmoid or sphenoid sinus, how should the head be positioned? | tilt head backward over the edge of the ned or small pillow
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| when you are trying to administer nasal drops to the frontal or maximally sinus, how should the head be positioned? | tilt head over edge of bed or over pillow with head turned to the side
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| how should nasal spray be administered? | sit up right with head slightly hyperextended
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| rebound effect | prolonged used of nasal spray that increases mucosal swelling and nasal congestion
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| What position should a patient be in that had NG tube before administering medications? | High Fowler's position
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| Before administering medications to a patient with an NG tube, what should you check? | tube placement by aspirating a small amount of gastric contents through the NG or enteral tube with a syringe and checking the pH of the contents
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| what is the average size syringe used when checking gastric residual? | 60 mL
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| After you check the gastric residual, what should you do? | flush with 15 mL of sterile water
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| A patient is on continuous feeding, what should you do when administering medications? | stop feeding for 30 minutes while giving the medications and then flushing the tube with 15-30 mL of sterile water and resuming feeding at least 30 minutes after. The head needs to be elevated for at least one hour after medicating
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| to prevent NG or enteral tube from being occluded, what should you do? | flush tube with 15-30 mL of sterile water before and after administering medications
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| where should ophthalmic drops be administered? | the conjunctival sac
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| where should ophthalmic ointments be administered? | from the inner canthus to the outer canthus
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| if the ophthalmic medications produce a systemic effect what should you do when administering the medication? | apply gentle pressure to the nasolacrimal duct 30-60 seconds to prevent medications from entering the nasal/pharyngeal passages and being absorbed by systemic circulation
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| When using otic medications, what prevents dizziness, nausea? | keeping the medication at room temperature
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| what should you do when administering otic drops to an adult? | pull pinna up and outward
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| what should you do when administering otic drops to a child younger than three? | pull pinna down and back
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| what position should a patient who is receiving rectal suppositories be in? | left lateral sim's position for approx. 5 minutes after administration
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| when using nitroglycerin ointment what should you do before administering another dose? | remove the previous dose to prevent an inadvertent overdose
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| What is important to do when using nitroglycerin ointment? | make sure you use the measuring strips to ensure accurate dose; secure the strip to the skin to allow for gradual absorption, label the patch or dressing with date, time and initials
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| What is important a patient do before using a dry-powder inhaler? | make sure the patient can inhale deeply
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