NUR110 Meds
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| Pharmacology | Study of drugs and their action on the living body
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| Medications | Drug or substance administered for:CureDiagnosisTreatmentRelief (Palliative)Prevention of diseases
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| Brand Name vs. Generic | Dosage and active ingredient identical Bioequivalence is required by the FDA Inactive ingredients may varyPrice
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| OTC drugs | drugs do not require a physician’s orderEasily obtainedLess expensivePotential for wrong drug Less knowledge of side effectsPotential for disease progression
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| Prescription Drugs | Require a physicians orderDrug more likely to be appropriate for patientAmount and frequency controlledInstructed on use and side effectsGenerally more costlyWait time to fill prescriptions
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| Therapeutic classification | Denotes the therapeutic useAntihypertensive
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| Pharmacological classification | Refers to how the drug produces its effectRequires an understanding of pharmacologyCalcium channel blocker
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| 4 stages of drug approval | Pre-clinical investigation,Clinical investigation, Review of NDA, Post-marketing studies
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| Pre-clinical investigation | Basic scientific research, testing on cells and animalsAverage time 18 months
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| Clinical investigation | Evaluation of human benefit, testing on volunteers Can take 2-10 years
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| Review of NDA | FDA reviews new drug application then approves or rejectsFollowing review, drug goes on the market or testing stopsAverage 17 months
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| Post-marketing studies | Testing continues, looking for harmful effects in larger and more diversified populations
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| Prescription Drug User Fee Act of 1992 | Drug company pays a yearly user fee to help offset costs of the FDA review and approval process
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| FDA Modernization Act | Allows drug companies to disseminate info about unapproved uses of a drug
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| Nurses’ Legal Responsibilities for Drug Administration Are: | Defined by the nurse practice actControlled by common lawControlled by the policies and procedures of health care agencies
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| When delivering medications, the nurse MUST know important information about the drug being administered | Reason, dosage range, common use, action, contraindications, side effects, nursing process considerations
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| Controlled Substances | Drugs that have either limited medical use or high potential for abuse or addiction
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| Controlled Substances Divided into 5 categories | Schedule I; Schedule II; Schedule III; Schedule IV; Schedule V
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| Schedule I | illegal; high potential for abuse
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| Schedule II | accepted for medical use with severe restrictions; high potential for abuse
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| Schedule III | accepted for medical use; potential for abuse less than schedule II
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| Schedule IV | = low potential for abuse
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| Schedule V | low potential for abuse; includes drug mixtures containing limited amounts of narcotics
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| Controlled Substance Handling | Must be stored in safe locked cabinetRecords must be kept regarding the administration of controlled substances
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| Teratogenic | Able to disturb the growth and development of an embryo or fetus
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| Two General Types of Drug Actions | Local; Systemic
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| Local | affects only the targeted area
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| Systemic | has affects throughout the body
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| Side effect | undesirable or unwanted response; frequently predictable
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| Adverse effect | severe side effect
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| Drug toxicity | drug accumulates in the blood because it cannot be readily metabolized
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| Cumulative effect | buildup of a drug
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| Drug tolerance | : reaction to drug decreases, larger doses required to achieve desired effect
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| potentiation | The action of a substance, at a dose that does not itself have an adverse action, in enhancing the effect of another substance
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| Idiosyncratic effect | A reaction to a medication that is unusual and unpredictable, specific to a particular person. Unlike allergy, it can occur on first exposure to the medication, unlike a side effect, it affects only very few individuals.
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| Incompatibility | Producing an undesirable effect when used in combination with a particular substance: a medication that is incompatible with alcohol.
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| Contraindications | specific situation in which a drug, procedure, or surgery should NOT be used, because it may be harmful to the patient.
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| Patient Noncompliance with Medications | Not taking medication at allTaking the medication at the wrong timeTaking the medication the wrong way
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| Reasons for noncompliance | Stop taking meds due to side effectsCostInsurance coverageFrequent dosingPatient self-adjusts med doses
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| Terms Used with Dosages | Minimum doseMaximum doseToxic doseLethal dose
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| Routes Used to Administer Medications | OralSublingualBuccalRectalVaginalParenteralTopical/transdermalNasogastric or gastrostomy tubeIntravenousInhalation
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| Sublingual/Buccal | Sublingual and buccal medications are administered by placing them in the mouth, either under the tongue (sublingual) or between the gum and the cheek (buccal).
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| Parenteral | Medicine Taken into the body or administered in a manner other than through the digestive tract, as by intravenous or intramuscular injection.
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| PRN | as needed
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| Essential Parts of a Medication Order | Full name of clientDate and time the order is written Name of the drug to be administeredDosage of the drugRoute of administrationFrequency of administrationSignature of the person writing the orderSpecial instructions
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| If drug order is ambiguous, unusual, or contraindicated: | Discuss order with the RN and or nursing supervisorContact physician and discuss the drug order with the physician
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| ID | intradermal
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| IM | intramuscular
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| IV | intravenous
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| IVP | intravenous push
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| IVPB | intravenous piggyback
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| NG | nasogastric tube
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| PO | by mouth
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| PR | per rectum
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| Supp | suppository
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| Sub Q | subcutaneous
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| ac | before meals
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| hs | bedtime
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| ad lib | as desired
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| B.I.D., b.i.d.= | 2 times a day
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| h, hr | hour
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| pc | after meals
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| q | every
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| q2h | every 2 hours
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| Q.I.D. q.i.d.= | 4 times daily
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| Stat | immediately
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| d.a.w | dispense as written
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| extended release | ER
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| gtt | drop
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| NKA | no known allergies
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| Sig | directions to the patient
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| Susp | suspension
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| SR | sustained release
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| XL | extended release
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| K | potassium
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| KCL | potassium chloride
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| mEq | milliequivalent
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| Na | sodium
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| NaCl | sodium chloride
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| P | after
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| D/C | discontinue
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| V.O. | verbal order
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| T.O. | telephone order
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| Six Rights of Drug Administration | 1. Right patient2. Right medication3. Right dose4. Right route of administration5. Right time of delivery6. Right documentation
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| Additional Patient Rights | Right to refuseRight to receive drug education
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| Right Patient | Two patient identifiersID bracelet, ask patient to state their nameAssess for medication allergies
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| Right medication | Check physician order against MARNever give medication prepared by another personNever prepare or administer medication not labeledThree Befores
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| The Three Befores | 1. Check drug with MAR when removing medication from med drawer2. Check when preparing medication3. Check before administering to the client
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| Right Dose | Check MAR and physician order to verify correct dosageCheck label on container for medication concentrationCalculations verifiedAssess appropriateness of dosage
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| Right Time | Medications should be given within 30-60 minutes of scheduled timeMeds given outside the allowable time must be documented as such
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| Right Route | Route of administration depends on several factorsMedication can only be administered per route ordered
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| Right Documentation | Document ASAPNever record medication as given prior to administrationChart site of injections and patient complaints at time of administrationChart:Med namedoserouteSitePatient response
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| Older Adult Considerations | Polypharmacy;Altered hepatic and renal function;Dysphagia; Underweight
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