Chapter 1_Introduction
Job of FDA
Regulates development and sale of drugs to ensure safety and reliability
Selective toxicity
Chemotherapeutic agents act on enzyme systems of foreign cells
May also destroy some normal cells, especially those that are fast growing
Adverse reaction
Undesired effects that may be unpleasant or dangerous
Nursing process
Decision making and problem solving process to provide efficient and effective care
Drawbacks to alternative therapies
Most of same problems OTCs have
Active ingredient not tested by FDA
Incidental ingredients unknown
Drug-alternative therapy interactions may occur
Pts don't always mention these therapies to HCP
Animal reproduction studies have shown an adverse effect on fetus
Pregnancy category C
Pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
Anaphylactic reaction
Antibodies react with specific sites, release histamines, immediate reaction of mucus membrane swelling and bronchoconstriction, respiratory distress, death
Parts of Nursing Process
Assessment
Diagnosis
Intervention
Evaluation
Off label medication
Used for an indication not approved by FDA
DEA
controls coding of drugs with abuse potential and enforcement of these codes
Half life
Time of peak effect
Superinfection
R/t destruction of body's normal flora generally grom abx use
S/s fever, diarrhea, vaginal d/c
Tx supportive care, antifungal meds, stop drug responsible
Patient
Drug
Storage
Route
Dose
Prep
Timing
Record of administration
When advertising drugs to consumers, federal guidelines mandate
Advertisement state:
indication
contraindications
adverse effects
precautions
OTC drug education
Could mask s/s of underlying disease, making diagnosis difficult
Taken with prescription meds could result in drug interactions and interfere with drug therapy
Not taken as directed could result in serious overdose
Critical Concentration
Amount of a drug needed to cause a therapeutic effect
Blood dyscrasia
Seen with anti-neoplastics and abx
Low WBC, infection, fever/chills, weakness, low h/H/platelets, bleeding
Patient and family education
Cornerstone of drug therapy
Increases compliance by patient
Responsibility of RN
Factors for high cost of health care
Consumer demand for "the best"
Practice of defensive medicine by HCP
Rising cost of health insurance to make sharholder profit
Law suits
Nurse's Responsibility re: medication therapy
Administer drug safely
Monitor and prevent med errors
Monitor therapeutic effects
Assess for adverse reactions
Intervene to make drug regimen more tolerable
Provide patient teaching
Dynamic equilibrium
Actual concentration that a drug reaches in body
Effected by ADME
Types of toxicity related to medications
Hepatotoxicity - fever, nausea, jaundice, change in color of urine/stool, alteration in bili/ast/alt/clotting times
Nephrotoxicity - high bun/crt, low HCT, fatigue, edema, rash, electrolyte imbalance
Comfort measures
Help patient cope with effects of drug therapy
Responsibility of RN
Promotes compliance by patient
RN's responsibility when administering off label medications
Know off label uses
Know when to question use of a drug before administration to reduce liability