INTRO to Pharm Chp 1,2,3
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| What is a drug? | A chemical that can affect living processes
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| What is pharmacology? | Pharmacology is the study of drugs and their interactions with living systems
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| What is Clinical pharmacology? | Clinical pharmacology is study of drugs in humans
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| What is drug therapy? | Drug therapy is the use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy
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| Name the three most important properties of an Ideal Drug. | Effectiveness,
Safety,
and Selectivity
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| What are additional properties of an Ideal Drug | Reversible action, Predictability, Ease of administration, Freedom from drug interactions, Low cost, Chemical stability. Simple generic name
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| Four factors that determine the intensity of drug response are: | Administration
Pharmacokinetics
Pharmacodynamics
Sources of individual variation
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| What are the aspects of administration that influence intensity of drug response? | dosage size, route, timing
Medication errors
Patient adherence
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| What is Pharmacokinetics? | It is the movement of a drug and how it reaches it's site of action;or impact of body on drugs
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| What are the four major pharmacokinetic processes? | absorption, distribution, metabolism, excretion
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| What is pharmacodynamics | It is the impact of drugs on the body.
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| What is the process undertaken by a drug that induces a response body | Drug-receptor interaction:binding to the cell's receptor;
Patient's functional status influences pharmacodynamics (disease;
Placebo effect determine response that a drug elicits.
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| Describe the therapeutic objective of drug therapy | Provide maximum benefit with minimum harm where benefits outweigh risks
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| What are the factors that determine intensity of a drug responses | Administration,
Pharmacokinetics,
Pharmacodynamics,and
Individual variation
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| What are sources of individual variations that influence drug response? | PHYSIOLOGIC: age, gender, weight;
PATHOLOGIC: diminished kidney, liver function;
GENETICS: may alter drug metabolism and predispose patient to unique interaction;
Drug interactions
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| Key points about drug? | All drugs cause harm and side effects;
Obj is to provide max benefit with min harm;
Drug therapy must be tailored for each individual.
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| What are the 6 rights of Drug Administration | Right patien;
right medication;
right route;
right time;
right dose;
right documentation.
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| What must the nurse know when giving drugs to a Pt | Is Med appropriate for Pt?
Any contraindication for Pt?
Anticipate consequences of interaction b/t drug and Pt.
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| What are the responsibilities a nurse fulfills when administering drugs to a patient? | Conduct a PREADMISSION ASSESSMENT relative to med;
Determine dose and administer;
EVAL and PROMOTE therapeutic effects;
Minimize Adverse effects and interactions;
Make PRN decisions;
Manage toxicity by monitoring blood.
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| What is the goal of Preadmission Assessment? | Gather baseline data to eval therapeutic responses and adverse effects;
Identify High Risk Pts
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| Who is considered a high risk patient for drug therapy? | Patient with Liver and kidney impairment;
Genetic factors;
Drug allergies;Pregnancy;
Elderly and pediatrics.
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| What should the nurse do before administering a drug to a Pt? | Read medication order;
Verify Pt id;
Read medication label;
Verify dosage calculations;
Implement any special handling instructions;
Don’t administer drug if don’t understand the reason for its use.
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| what should the nurse know to EVALUATE a drug's therapeutic response? | Know the rational for treatment; the nature, and time course of intended response.
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| What does the nurse promote to achieve a drug's therapeutic effects? | Pt adherence (aka compliance or concordance) to the extent to which Pt's behavior coincides with medical advice.
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| What is another way therapeutic effects can be promoted? | Implementing nondrug measures such as Biofeedback, emotional support, weight reduction, smoking cessation, sodium restriction
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| What should the nurse always now about adverse effects | The major adverse effects the drug can produce
The time when these reactions are likely to occur
Early signs that an adverse reaction is developing
Interventions that can minimize discomfort (ie food)
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| How does nurse minimize adverse effects | Take a thorough drug history (allergies)
Advise the patient to avoid OTC drugs that can interact with the prescribed medication.
Monitor for adverse interactions known to occur.
Be alert for as-yet unknown interactions.
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| What is important when nurse makes PRN decision? | know the reason for the drug use
assess the Pt's medication needs
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| When teaching the patient about dosage and adminstration, the nurse provides what information? | Name of drug
Dosage and schedule of administration
Technique of administration
Duration of drug use
Storage of drug
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| When teaching the patient about Promoting therapeutic effects and minimizing effects? | Nature and time course of expected beneficial effects
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| When educating Pt about minimizing adverse interactions, The nurse informs about what? | hazardous drug-drug and drug-food interactions
Example: phenelzine and amphetamines or figs
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| What are the nursing process steps for drug therapy? | Preadministration assessment
Analysis and nursing diagnoses
Planning
Implementation
Evaluation
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| Preadministration assesment during drug therapy includes: | Collection of baseline data to evaluate therapeutic effects
Collection of baseline data to evaluate adverse effects
Identification of high-risk patients
Assessment of the patient’s capacity for self-care
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| Analysis and nursing diagnoses during drug therapy includes 3 objectives,what are they? | Judge the appropriateness of the prescribed regimen
Identify potential health problems that the drug might cause
Determine the patient’s capacity for self-care
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| Planning during drug therapy includes: | Defining goals
Setting priorities
Identifying specific interventions
Drug administration
Interventions to enhance therapeutic effects
Interventions to minimize adverse effects
Patient education
Establishing objective criteria for evaluation
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| Implementation during drug therapy includes: | Drug administration
Patient education
Interventions to promote therapeutic effects
Interventions to minimize adverse effects
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| Evaluation during Drug therapy Includes | Therapeutic responses achieved
Adverse drug reactions and interactions
Adherence to the prescribed regimen
Satisfaction with treatment
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| Chapter 3 Drug Regulation, Development, Names and information | Chapter 3 Drug Regulation, Development, Names and information
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| Landmark Drug Legislation: Federal Pure Food and Drug Act, 1906 | 1906
Required drugs be free of adulterants but nothing about safety and effectiveness
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| Landmark Drug Legislation: Food, Drug, and Cosmetic Act, 1938 | Legislated drug safety
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| Landmark Drug Legislation: Harris-Kefauver Amendments, 1962 | Drugs be proven safe and effective
All drugs introduced b/t 1932-62 undergo testing for effectiveness
Established rigorous testing procedures for new drugs
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| Landmark Drug Legislation: Controlled Substances Act, 1970 | Established rules for manufacture and distr of drugs with potential for abuse
Established categories for controlled substances
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| What is Class I drug? | no accepted medical use and high potential for abuse
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| What are Class II through V | Have accepted medical use and progressively decline in potential for abuse
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| Landmark Drug Legislation: Permission of accelerated drug approval, 1992 | Accelerated approval of drugs for AIDS and cancer
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| Landmark Drug Legislation: Prescription Drug User Fee Act, 1992 | Drug manufacturers pay FDA feeds to contract additional application reviewers. Drugs reach the market sooner than in the past.
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| Landmark Drug Legislation: Food and Drug Administration Modernization Act, 1997 | Fast tracking now includes drugs other than AIDS and CA drugs
6-month notice to public before Mfr stops making a drug
Clinical trial DB for drugs directed at serious or life-threatening illnesses
Drug can provide off-label information to prescriber
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| landmark Drug Legislation: Best Pharmaceuticals for Children Act, 200 | Provides 6-month patent extension to evaluate an approved drug for safety, efficacy and dosage in children
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| Landmark Drug Legislation: Pediatric Research Equity Act, 2003 | FDA has power to require drug companies to pediatric clinical trials on drugs that might be used on children
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| Landmark Drug Legislation: FDA Amendments Act, 2007 | Most imp since Harrris ammendment
FDA has oversight of drug safety after a drug approved incl post-market studies, labeling, and restrict distribution based on safety concerns
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| New Drug development: What are the aspects of RCT? | Control use
Randomization
Blinding
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| What are the stages of New Drug Development? | Preclinical testing
Clinical testing
Phase I
Phase II and III
Phase IV: Postmarketing surveillance
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| What takes place during Preclinical testing | drugs eval for toxicity, pharmacokinetics, potentially use biologic effects
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| What Happens during Phase I of clinical testing? | Healthy volunteers who have the disease under consideration
Eval for metabolism, pharmacokinetics, and biologic effects
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| What happens during phase II and III of clinical testing? | Drug testing on patients to determine therapeutic effects, dosage range, safety. effectiveness.
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| What happens during Phase IV? | After FDA has granted conditional approval of drug, then drug is released for general use.
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| TOPIC: DRUG NAMES | TOPIC: DRUG NAMES
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| What are the problems with trade names? | Single drug can have multiple trade names.
U.S. drugs and drugs outside the U.S. may have different active ingredients.
Products with the same trade name may have different active ingredients.
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| What are the characteristics of OTC Drugs | their benefits outweigh their risks
the potential for misuse and abuse is low
consumer can use them for self-diagnosed conditions
they can be adequately labeled
health practitioners are not needed for the safe and effective use of the product
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