Pharmacokinetics
Pharmacodynamics
General
Safety
Drug orders
Concept relevant to Pharmacokinetics
Administration
100
Name the 2 absorption drug effects?
Local- at the site- inhaler, SL, buccal
Systemic- in bloodstream- PO, IV,
100
What is the supportive drug effect?
Supportive- supports integrity of body function ex. Tylenol for fever
Palliative- relieves s/s of disease with no effect on disease itself- Ex morphine
Substitutive- replace either body fluids or chemical ex- Synthroid
Chemotherapeutic? destroys disease producing microorganisms- Ex Chemo, Abx
Restorative- return the body to or maintain optimal level Ex Vitamins
100
Differentiate between chemical, generic and brand name of a drug?
Chemical= chemical composition
Generic= nonproprietary name
Brand= proprietary name, drug company registered trademark
100
Name types of technology that prevents errors
Barcode of medication, Smart pumps, Automated dispensing cabinets, Computerized prescriber order entry
100
Acetaminophen 650 p.o. every 6 hours prn temperature 101.5
Is drug order complete?
No, missing mg
100
What is potency?
Amount of drug needed to elicit a specific physiologic effect
Drug response
Therapeutic effect
Maximal efficacy
100
The nurse checks the mediation at least how many times prior to administrtaion?
3 Before you pour, after you pour and at the bedside
200
What is biotransformation?
Change or break down of medication into a less active/potent form or inactive form
Done by liver enzymes- First Pass effect PO meds
200
A physiological drug effect which is unintended but is predictable. Primary reason patients stop a mediation
Side effect
Primary or Secondary (ex diphenhydramine)
200
How many control substance categories are there and define?
5, I High potential for abuse, unsafe/illegal (ectasy, LSD, Heroin)
II- high abuse potential, severe dependence (Morphin, Ritalin, Oxycodone, Cocaine, Methadone)
III less potential for abuse, moderate dependence (Codeine, hydrocodone, anabolic steroids, testosterone)
IV- Low abuse, limited dependence (lorazepam, tramadol, temazepam- sleep nerve pills)
V Lower abuse, limited dependence Cough med, diarrheal meds iwth opiod
200
Give some examples of why errors occur?
Confusion of similar drug names, lack of knowledge, faulty communication, equipment error, drug calc error, Pt ID not checked, Nurse bypass safety protocols (2 RN insulin), Nurse fatigue, distraction or interruption
200
Atropine 5 mg IV Stat,
Is this order complete, and when do you give it
yes, Immediately
Now is within 90 minutes
200
Occurs when drug concentration is at its highest blood concentration?
Peak action
Onset of action- time needed for drug concentration to reach a high enough blood level to cause physiological effect
Duration of action-Length of time a drug exerts a pharmacologic effect-- HALF LIFE
Therapeutic range- relationship between therapeutic dose and toxic does- Narrow or wide index
200
Six Rights
Patient, drug, dose, route, time, documentation
300
Factors effect Absorption??
Route of administration, Drug solubility (XL, Enteric coated, lipid vs water soluble), Acid vs alkaline environment.
Stress, hunger, pain, fasting, presence or absence of food/stool, Food texture, fat content and temperature
300
Drug level exceeds therapeutic range and may cause a damaging effect to organs or tissues.
Toxic effect or Drug toxicity
300
Stock supply or unit dose?
Stock= Bulk quantity, central location, cost effective
Unit dose= individually packaged, client specific
300
Drugs that appear on these 2 lists are meds the nurse should use with precaution in the elderly?
High Alert Meds (heparin, insulin, hypnotics) and BEERS Criteria
Black Box Warning= strongest form of warning issued about a drug
300
After the nurse takes a telephone order from a healthcare provider the nurse has to preform what next?
Read back and verify the order R?V
300
When is a trough lever drawn?
30 to 60 minutes prior to next scheduled dose of medication
300
When should the nurse give a patient an oral medication?
Pt N&V, lack of gag reflex, Decrease LOC, Dysphagia until speech therapy evals (risk for aspiration), NPO status,
400
factors which effect excretion include:
Kidney function, Age, other drugs, urinary PH, half-life
400
3 Causes of drug toxicity
Overdosing, Accumulation of drug in tissues, Abnormal sensitivity or allergic response
400
Differentiate between prescription and OTC drug?
Prescribed require health care provider to write it
OTC- go to CVS Walgreens
400
DOPamine DOBUTamine
Tall man lettering
Look Alike Sound Alike Drug Names
400
Flagyl 10 mg po ac
When do you administer ibis medication?
Yes, give prior to meals
400
A drug is given once a day if it has a short or long half life?
Long
400
Principles of transdermal patch
Rotate sites, Date, initial and time patch, Do not cut. Remove old before apply new, Provides consistent blood level, Avoids GI upset, Clean area prior to application
Wash hands wear gloves
500
Factors effect distribution?
Circulatory system function, Membrane permeability (blood brain and placenta), protein binding sites, Free drug
500
Signs of anaphylactic shock
Wheezes, tachycardia, hypotension, rash/hives, cough, dyspnea, swollen eyes, lips or tongue, Edema of phyrnx and larnyx
500
Regulates medication before and after market
500
Identifies the most accurate medication list on admission, Compare patient's medication orders to home medications, Done to avoid errors, omission, dosing errors and drug interactions
Medication Reconcillation
500
Example of a scheduled BID mediation
1000 and 2200
0900 and 2100
500
A medication dose used when immediate drug response is desired, large, safe initial dose?
Loading dose
500
Name 4 herbs that decrease platelet aggregation potentially causing bleeding
Garlic, Ginkgo biloba, Ginger
Ginseng- watch with DM and hypoglycemia
Kava Kava- liver toxicity
Saw Palmetto- interfere with enlarged prostate meds
St John's Wart- watch for interaction with mental health drugs
Valerian- Mild sedative like valium