Vocab
Peak and trough level
Peak- highest level drawn at midpoint
Trough- lowest, drawn before next dose
enteral vs parenteral
GI vs non-GI
Breastfeeding tips while on meds
Flo will assess these general things before giving meds
allergies, rights of med admin, any specific med data (BP before BP meds), any route issues (compatibility)
why med response is different in newborns
organ maturity is not fully developed
Half-life
time it takes for 1/2 of the drug to be excreted
First pass- what organ and which routes are affected?
Liver tax
Affected: enteral
Think: Is SL affected?
Key components to patient education
Ability, readiness, and then practice
Flo know this is the major concern with herbals
Interactions/safety
Pregnancy category C
Caution. Possible adverse effects in animals, not enough research in humans
Therapeutic window
drug must be in this concentration for it to be effective
Think: what do we do if it is narrow?
Excretion is affected by
GI motility, kidney health, fluid status (anything that affects filtration in the kidney)
Major concern for over the counter meds
mask symptoms of a more severe problem
Flo know these 6 rights of med administration
patient, dose, route, time, med, documentation
Pregnancy category D
Evidence of risk in humans, only use for a compelling reason
Subjective vs objective data
Subjective- patient says
Objective- nurse observes
Think: What is the med list?
Absorption is affected by
route, GI pH, food in GI, lipid solubility, blood flow
Included in informed consent for meds
what, how it works and is made, side effects, and unknowns (if research)
Flo does this when taking a verbal or phone order
Repeat back, double check med and dose (spell if necessary), check indication
Reasons why patients may be nonadherent with medications
cost, fear, route, side effects, complicated to take, lack of education
Polypharmacy
So many meds at once, usually a concern in the elderly
IM vs SQ vs ID
where do they go? which is slowest?
IM- muscle
SQ- Fat (slowest bc of blood flow)
ID- under skin
Signs of an allergic reaction
difficulty breathing, wheezing, facial swelling, hives, feeling of doom
Flo know a RX must contain these to be complete
name, dose, timing and route
Changes in older adults related to absorption, distribution, metabolism and excretion (In general, individuals may vary)
absorption- decreased
distribution- decreased protein available, decreased body fat (lipid solubility)
metabolism- decreased liver function
excretion- slowed