Individual Variations
Is used in health care to describe the interaction between one's psychological development and one's social environment.
What is psychosocial. Is part of a holistic model that includes the examination of the patients' social roles, environmental stressors, culture, values, and family, all of which contribute to health and wellness. Psychosocial also includes the spiritual nature of a person, known as psycho-social-spiritual. pg 127
Was passed in 1997, which gave financial incentives for pharmaceutical companies to conduct pediatric research in pharmacology.
What is the Food and Drug Administration (FDA) Modernization Act. This was done in response to the fact that very little drug information was specifically targeted for the pediatric patient. Drug trials with pediatric patients were virtually unheard of, an data regarding pharmacokinetics and adverse effects of most drugs were not well documented in this population. pg 104
This influence can cause non-compliance with medications due to adverse side effects such as impotence, gynecomastia, and increased hair growth
What is Gender
Rationale: Men and women respond differently to medications for simple fact of their gender. Examples include antihypertensives causing impotence in men and increased hair growth in women (Adams & Urban, 2016).
The categories of drugs that should be avoided during pregnancy is what?
What are Category D and X: May cause birth defect. (Adam, M. & Urban, C., 2016). Pharmacology, Connections to Nursing Practice (3rd ed.). New jersey: Pearson.
This is the major reason for polypharmacy in older adults.
What is increase in comorbities. Comorbidities oftern result in the need for multiple drugs and although it is not unique to older pts, it is prevelant most prevalent in this age group. The higher number of drugs taken by the patient, the greater risks of adverse effects and drug interactions. Also consider OTC drugs, herbal products, and dietary supplements. (pg. 117)
Implies that people have a biologic and genetic similarities. is important
What is Ethnicity. An ethnic group is a community of people who share a common ancestry and similar genetic heritage. It is important aspect of patient care that directly relate to pharmacotherapy. It can influence the occurrence of specific drug effects and patient outcomes. pg 127
This chewable vitamin is destructive to tooth enamel and increases the risk of cavities unless a child’s teeth are brushed immediately after chewing and swallowing a vitamin supplement.
What is Vitamin C? While citric acid (vitamin C) tends to make the teeth feel “clean,” it provides that sensation because the acid strips the teeth of enamel. Chewable vitamins may also contain sugar, which is another reason to brush a child’s teeth after taking a vitamin (Consumer Med Safety.org)
This influence brings about variations in drug response when a mutation occurs in the DNA that encodes certain proteins.
What is Genetic
Rationale: Genetic influences deal with mutations and proteins that create genetic polymorphisms, which is two or more versions of the same protein, causing different responses to medications related to absorption, excretion, metabolism, and distribution (Adams & Urban, 2016).
What opioids are NOT contraindicated during pregnancy?
What are Codeine and morphine: are acceptable in occasional doses. (Adam, M. & Urban, C., 2016). Pharmacology, Connections to Nursing Practice (3rd ed.). New jersey: Pearson.
When providing a Sulfonylurea to a diabetic patient, this is the main nursing consideration.
What is hypoglycemia. Sulfonylurea stimulates insulin release—pg. 1121
Is a set of beliefs, values, and norms that provide meaning for an individual or group.
What is culture. People within a culture have common ritual, religious beliefs, languages and certain expectations of behavior. It is important aspect of patient care that directly relate to pharmacotherapy. It can influence the occurrence of specific drug effects and patient outcomes. pg 127
This is the most important factor when determining your child’s dose of commonly used pain medicines or fever reducers, including acetaminophen and ibuprofen.
What is your child's weight? The correct dose of most children’s medicine is based on the child’s weight. For both acetaminophen and ibuprofen, for example, the manufacturers provide dosing directions for both the child’s weight and age. However, both manufacturers note that using the child’s weight to select the dose is preferred; if the weight is not available, then the manufacturers suggest selecting the dose according to the child’s age. (Consumer Med Safety.org)
These types of groups are included in many clinical trials related to individual response to drugs.
What is ethical and/or cultural groups
Rationale: Research has confirmed that there is a biologic basis for variations or difference in metabolic response to drubs among various cultural and ethnic groups (Adams & Urban, 2016).
A dose of hydralazine IV was given to control the blood pressure of a woman diagnosed with preeclampsia. If the medication was given at 0800, the next assessment of blood pressure should occur at this time.
What is 8:03. The vasodilator hydralazine is given to control blood pressure. If IV has been given, monitor the maternal and fetal heart rates and the mothers blood pressure every 2 to 3 minutes after the initial dose and every 10 to 15 minutes thereafter. (Clayton, B., & Willihnanz, M., (2016) Study Guide for Basic Pharmacology for Nurses, 17th Edition. St, Louis, Missouri: Elsevier)
The nurse takes into consideration that as adipose tissue replaces muscle mass in the older adult, a person taking this type of drug such as diazepam (Valium) several times a day would exhibit a hangover effect.
What is a Fat-Soluble Drug. Fat-soluble drugs become stored in the adipose tissue for extended periods of time and lead to lower plasma levels and increased drug concentration in the tissues. The longer a drug remains in the tissues, the more significant the response to the drug will be and the greater the potential for adverse effects. pg. 119)
Two or more versions of the same protein in DNA.
What is Genetic Polymorphism. Humans of all races and cultures share remarkable DNA similarities:99.8% of our DNA sequences are identical. The remaining 0.2% may result in significant differences in a patients ability to handle medications. Some of these differences arise when a mutation occurs in the DNA that encodes for a certain protein ex: hepatic CYP 450 enzymes pg 129
This pain medicine should never be given to babies or children less than 12 years old or adolescents who have or who are recovering from chicken pox, the flu, or another viral illness.
What is aspirin (including "baby" aspirin)? The use of aspirin (a salicylate) or aspirin-containing medicines in children and teens who have or are recovering from a viral illness has been linked to Reye’s syndrome. This is a rare but serious illness that can harm the brain and liver, and sometimes cause death. Cases of the syndrome are few in the US since doctors started advising parents not to give children and teens aspirin. (Consumer Med Safety.org)
Patients have this “right” related to their medications due to religious or other cultural objections.
What is refusal
Rationale: One of the “rights” of medication administration is refusal. Patients have the right to refuse their medications due to religious or other objections. An example of this is a refusal to accept blood or blood product by a Jehovah’s Witness member because of religious beliefs (Adams & Urban, 2016).
What is the name of the drug given to a mother-to-be for preterm labor to help develop baby’s lungs and reduce infant respiratory distress disorder.
What is Corticosteroid. (Adam, M. & Urban, C., 2016). Pharmacology, Connections to Nursing Practice (3rd ed.). New jersey: Pearson.
The nurse cautions the older adult who is taking warfarin (Coumadin) that, with age-related reduced plasma protein levels, the risk of an adverse reaction is high because Coumadin is known to bind to this.
What is protein. Coumadin is a protein-bound drug. Because of declining liver function, plasma levels are reduced up to 13% in older adults. This decrease results in fewer binder sites for certain drugs and higher concentration of free drugs, which may lead to toxicity. (pg. 119).
The study of specific genetic variations that alter patients' responses to medications.
What is Pharmacogenetics. Pharmacogenomics is a related term that is more general in scope, referring to the network of genes that govern a person's response to drug therapy. Both attempt to identify genetic differences in metabolism or receptor target that affect individual drug responses, with the ultimate goal of improving safety and effectiveness of drug therapy pg 130
According to the U.S. Food and Drug Administration (FDA), you should never give a child younger than this an OTC cough and/or cold medicine.
What is less than 4 years old? FDA warns parents to avoid use of cough and cold medicines in children less than 4 years old. In 2008, drug companies voluntarily removed over-the-counter (OTC) cough and cold products for infants and children less than 4 years old due to safety concerns. The safety concerns were based on reports of seizures, rapid heart rates, loss of consciousness, and occasionally death in young children who took cough and cold medicines. Later in 2008, all companies relabeled cough and cold medicines to say that the products should not be used in children less than 4 years of age. The FDA is still reviewing the safety of OTC cough and cold medicines for children between 4 and 11 years old. So use these products with care in all young children, and follow the direction in the Drug Facts part of the product label. (Consumer Med Safety.org)
This increase or decreases based on gene mutation, forming abnormal enzymes and causing a patient to potentially require a higher, lower, or completely different form of medication.
What is metabolism
Rationale: When a patient has genetic polymorphisms present in their DNA related to drug metabolizing enzymes, certain medications may not metabolize properly, enhancing effect or causing toxicity (Adams & Urban, 2016).
Excretion of drugs during pregnancy is enhanced by this and therefore it important to adjust doses of many medications during pregnancy. What is increased?
What is renal plasma flow during the first two trimesters, which increases renal elimination of drugs. (Adam, M. & Urban, C., 2016). Pharmacology, Connections to Nursing Practice (3rd ed.). New jersey: Pearson.
The nurse knows that she has to frequently assesses the older adult who is on a psychotropic drug for an overdose because this has become inefficient and it makes them become more hypersensitive.
What is inefficient blood-brain barrier. Elderly pts can become hypersensitive. Adverse effects can often manifest as reduced cognitive function, drowsiness, confusion and even hallucinations and psychoses. (pg.119)