Term
| Therapeutic effects of drugs are: |
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Definition
| Preventative, palliative, restorative |
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Term
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Definition
| study of the absorption, distribution, biotransformation (metabolism) and excretion of drug. It's what the body does to the drug. |
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Term
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Definition
study of drug action on living tissue at the cellular level. It's what the drug does to the body.
may increase, decrease, or replace enzymes, hormones or body metabolic functions.
Chemotherapeutic drugs alter an abnormal growth on the body such as bacteria, viruses or neoplastic tissue. |
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Term
| Three Phases of Drug Action |
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Definition
| Pharmaceutical, Pharmacokinetics, and Pharmacodynamics |
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Term
Pharmaceutical Phase
Disintegrate |
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Definition
| Solid drug goes through this before being absorbed |
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Term
Pharmaceutical Phase
Dissolution |
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Definition
| Process where a solid goes into a solution |
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Term
Pharmaceutical Phase
Additives |
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Definition
| alter the location of disintegration of drug |
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Term
Pharmaceutical Phase
Enteric Coating |
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Definition
| allows a drug to dissolve only in an alkaline environment such as the small intestine. |
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Term
Pharmaceutical Phase
Sustained release drug |
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Definition
| Released slowly over time unlike conventional tablets |
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Term
Pharmacokinetics
Absorption |
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Definition
Movement of drug from site of administration into bloodstream.
Determines how long it takes a drug to take effect.
More rapid, faster drug works. |
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Term
Pharmacokinetics
Factors Effecting Absorption |
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Definition
Surface Area
Circulation
Lipid Solubility
Bioavailibility
Drug form & drug concentration
Route of administration |
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Term
Pharmacokinetics
Sites of Absorption
& Methods |
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Definition
Sites:
Oral Mucosa
Stomach
Small Intestine
Rectal Mucosa
Lungs
Topical
Eyes
Ears
Nasal Mucosa
Methods:
Intravenous
Subcutaneous
Intramuscular
Intradermal
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Term
Pharmacokinetics
Distribution |
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Definition
Drug movement from the blood to the site of action.
Drugs are also distributed to tissue where it has no effect. |
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Term
pharmacokinetics
Factors Effecting Distribution |
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Definition
Circulation
Plasma Protein Binding (if protein binds to drug, the drug is considered useless)
Lipid solubility
Blood Brain Barrier
Placenta |
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Term
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Definition
| Time it takes the drug to reach a concentration that produces a response (starts working) |
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Term
Pharmacokinetics
Biotransformation (Metabolism) |
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Definition
Process by which after a drug reaches its action site, the body changes the chemical structure of the drug to a less active or inactive form called metabolite (more water soluble compound that can be easily excreted)
Major organ for this is the liver.
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Term
Pharmacokinetics
Metabolism: First Pass Phenomenon |
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Definition
Drugs that are first absorbed through the small intestine, arrive at the liver via the portal circulation.
There they undergo considerable biotransformation before entering the systemic circulation.
Less active drug available for action in the body cells. |
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Term
Pharmacokinetics
Excretion |
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Definition
Process where drugs are removed from the body.
Kidneys are major organ.
Lungs excrete gaseous drugs.
Intestines, sweat, saliva, and breast milk.
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Term
pharmacokinetics
Excretion: Clearance of drugs |
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Definition
| elimination of drugs from circulation by all routes. It affects the time a drug remains in the body and the dosage required. |
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Term
Medication Actions
Duration |
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Definition
| the time during which the drug is present in a concentration large enough to produce a response (continues working) |
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Term
Medication Action
Peak Level |
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Definition
| time it takes for the drug to reach its highest effective action |
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Term
Medication Action
Trough Level |
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Definition
| the lowest point of drug concentration. Occurs immediately before a drug is given or once sufficient drug is eliminated. |
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Term
Medication Action
What measures peak & trough levels? |
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Definition
Plasma blood levels.
Blood sample must be taken just before the next drug dose is scheduled for accurate trough level. |
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Term
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Definition
Time a drug stays in the body is measured by elimination half-life.
Time required to decrease drug by 50%.
Plasma concentrationof drugs used to measure this. |
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Term
Medication Actions
Effective Dose |
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Definition
| dose necessary to produce the desired result. |
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Term
Medication Actions
Lethal Dose
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Definition
dose that elicits the death of cells, tissues or the organism.
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Term
Therapeutic Index (range)
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Definition
| plasma drug concentration between minimum and toxic concentrations. |
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Term
Medication Actions
Loading Dose (bollus) |
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Definition
| Higher amount of drug given once or twice to "prime" the blood stream |
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Term
medication Action
Maintenance Dose |
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Definition
| Intermittent doses given to maintain plasma levels. |
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Term
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Definition
may increase or decrease the therapeutic effect of 1 or both drugs.
Can create a new effect or increase incidence of adverse effects. |
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Term
drug Interactions
Synergism: |
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Definition
two "unlike" drugs produce an effect which is greater than the total effects of each drug acting by itself.
1+1=3 |
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Term
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Definition
| Undesirable but mild unavoidable/predictable pharmcological effects of drug |
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Term
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Definition
| unintended often unpredictable severe response to a drug. |
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Term
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Definition
| Develops after prolonged intake or impaired metabolism. Can be lethal. Overdosage can be accidental or deliberate or it may be due to the accumulation of drug in the body stored in fatty tissue. |
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Term
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Definition
| Drug induced birth defects which follow drug therapy in pregnant women. |
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Term
Allergic reactions
Hypersensitivity reactions
Anaphylaxis |
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Definition
can result from repeated exposure to the drug. Drug acts as an antigen and triggers the release of antibodies.
Exxagerated in response to a drug.
A systemic life threatening reaction, the most severe of all the allergic reactions. |
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Term
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Definition
Health History
Medication History
Aging Considerations
diversity considerations
Sensory/cognitive status
Diagnostic and lab data
Physical Assessment |
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Term
| Assessing: Medication Reconciliation |
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Definition
Verify: obtain list of current meds.
Clarify: list is accurate
Reconcile: new meds and current meds are reviewed for discrepancies
Transmit: communicate new list to nursing staff and patient. |
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Term
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Definition
Set priorities.
Determine patient outcome.
Strategies to promote safe medication administration.
Strategies to prevent complications.
Collaboration.
Delegation. |
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Term
| Planning: Safe Administration |
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Definition
| Drug Name, Classification (i.e. antibiotic), Indications (why its given), action (what it does), dose, calculation, route (preferred: check with patient), desired effects |
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Term
| Planning: Prevent Complications |
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Definition
Drug interactions: Do they potentiate or inhibit drug action?
Food interactions: May delay absorption or inactivate drug.
Precautions: when does a special condition affect the decision to use a drug? |
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Term
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Definition
| pregnancy risk categories identify the risk to the fetus. Range from A, B, C, D or X. |
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Term
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Definition
| Presciber (writes script), Pharmacy (fills script), RN (administers meds and monitors), LPN (administers drugs), CNA |
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Term
| Info on prescriber's order (prescription) |
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Definition
| patient name, drug name, dose, route, frequency, date, signature |
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Term
STAT
Single Order
PRN order
Routine orders
Standing orders |
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Definition
-needed immediately
-given only once
-given as needed
-given within 2h of being written and carried out on schedule
-written in advance carried out under specific circumstances |
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Term
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Definition
| Obtain current knowledge of drugs, refer to authoritative sources, question unclear drug orders, refuse to administer a drug if there is a reason to believe it will be harmful, performing correct techniques and precations, monitoring client response and document drug effects |
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Term
| Drug Information Resources |
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Definition
-The United States Pharmacopoeia (USP)
-National Formulary (NF)
-Pharmacists
-Nursing drug handbooks
-Physician's Desk Reference (PDR)
-Package Inserts
-Electronic databases and internet |
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Term
| Legalities of med administration |
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Definition
| protect public health and safety, laws govern testing, production, distribution, prescription and the administration of drugs. Health care agencies establish policies to comply with Federal law. |
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Term
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Definition
2 nurses at change of shift count and record.
Stored using a double lock system.
Written renewal orders are required every 72 hours for narcotics and Schedule II and III drugs. |
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Term
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Definition
Schedule I (highest potential for abuse
Schedule II
Schedule III
Schedule IV
Schedule V (lowest risk of abuse) |
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Term
| 2 Ways to obtain legal drugs |
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Definition
Prescription (Rx) - order written authorizing patient to receive medication. Prescriptions taken to pharmacy whereby the pharmacist dispenses the drug.
Over the Counter (OTC) - patient treats self and doesn't need a prescribers order. Buys medications where ever they are available |
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Term
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Definition
Chemical Structure: Steroid
Mode of Action: Antacid
Physiologic Action: diuretic
Therapeutic Action: antihypertensive |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| daily, units, morphine sulfate |
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Term
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Definition
Proprietary, Trade or Brand Name - Demerol
Generic Name - meperidine
Chemical Name - N-methyl 4 carboxypiperidine hydrochloride |
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Term
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Definition
| A variety of drug forms provides some flexibility in the administration of drugs. Ex. capsules, elixir, tablets, gel caps, chewable tablets, powders |
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Term
Drug Dispensing
3 Examples |
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Definition
Obtained from pharmacy dept.
Individual client supply-unit dose
Dispensing systems |
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Term
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Definition
Right patient
Right medication
Right dose
Right route
Right time
Right documentation |
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Term
| Guidelines for administering meds |
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Definition
1 patient at a time, check chart for original prescriber order, Check MAR for a list of meds/times to be given,
bring meds to bedside with MAR, ID client arm band and ID number, 3 checks |
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Term
| Steps for med administration |
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Definition
1. ID med to be given
2. Educate patient and family on the risks and benefits of drug.
3. Administer drug.
4. Record in MAR
5. Monitor patient for response, side effects and adverse reactions |
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