Basic Concepts
What is the difference between a generic name and a brand (trade) name?
The generic name is the official, universal, nonproprietary name (e.g., acetaminophen), whereas the brand name is the trademarked, proprietary name chosen by the manufacturing company (e.g., Tylenol)
What does the ethical principle of "Justice" require in clinical research?
The fair and equitable selection of subjects, ensuring that studies reflect diverse social, racial, and ethnic groups so that no single group bears an unfair burden of the research
What are the two most crucial unit conversions to memorize for medication math?
1 gram (g) equals 1,000 milligrams (mg), and 1 kilogram (kg) equals 2.2 pounds (lb)
What is the purpose of pharmacogenetics?
It is the study of how a patient's unique genetic factors influence their response to drugs, allowing providers to personalize treatment, improve safety, and reduce adverse effects
What is the standard protocol for identifying the "Right Patient"?
Ask the patient to state their full name and birth date, and compare this information directly with their identification band and the Medication Administration Record (MAR)
Why are the abbreviations "qd" and "U" on the Joint Commission's "Do Not Use" list?
They frequently cause misinterpretation errors. Nurses must write out the words "daily" and "unit" instead
How does the principle of "Beneficence" apply to medical research and clinical trials?
It requires researchers to maximize potential benefits while strictly minimizing physical, psychological, and social risks to the subjects (evaluating the risk-benefit ratio)
What is the vital safety rule for using zeroes when documenting medication dosages?
use leading zeros, never use following zeroes
How do agonists and antagonists differ in pharmacodynamics?
Agonists activate receptors to produce a desired response, while antagonists block receptors to prevent a response
What are the six rights of medication administration?
Right patient, right drug, right dose, right time, right route, right documentation
What strategy is used to prevent mix-ups between look-alike and sound-alike drug names?
"Tall-man" lettering, which capitalizes the distinct parts of the words (e.g., CeleXA vs. CeleBREX)
What does the ethical principle of "Respect for Persons" (Autonomy) dictate?
Patients must be treated as independent individuals with the right to make their own choices about their care, including accepting or refusing treatment, without coercion
A provider orders 0.5 g of amoxicillin. The capsules available are 250 mg. How many capsules do you administer?
2 capsules
what are the four phases of pharmacokinetics?
absorption, distribution, metabolism, and excretion (ADME)
How many times must a nurse check a drug label against the MAR to avoid errors?
Three times: (1) when removing the drug from the dispensing cabinet, (2) while preparing the drug, and (3) immediately before administering it to the patient
What is the clinical difference between a drug's peak and trough levels?
The peak is the highest level of the drug in the blood showing absorption, while the trough is the lowest level, measured just before the next dose to ensure the drug is clearing properly.
What is the nurse's exact role during the Informed Consent process for a clinical trial?
The nurse acts as a patient advocate and witness, ensuring the patient is alert, comprehends the information, and signs voluntarily. It is the specific role of the healthcare provider—not the nurse—to explain the study and answer the patient's medical questions
Which diagnostic labs evaluate the kidneys' ability to excrete drugs safely?
Blood urea nitrogen (BUN), creatinine (CR), and estimated glomerular filtration rate (eGFR)
A patient receiving a centrally acting analgesic reports that their pain is suddenly no longer controlled, even though this is only the second time they have received the medication. The nurse recognizes this acute, rapid decrease in drug response as which of the following? A) Drug tolerance B) The placebo effect C) Tachyphylaxis D) A secondary physiologic effect
C) Tachyphylaxis
What makes "high-alert" medications (like insulin and heparin) unique during administration?
Because small errors with these drugs can cause severe harm, they must be independently double-checked and documented by two nurses before administration
What happens during the distribution phase if a patient has low albumin or takes two highly protein-bound drugs simultaneously?
The drugs compete for active sites which creates a lot more of a "free" drug, which can lead to toxicity.
A patient enrolled in a Phase III clinical drug trial tells the nurse, "I don't want to take this experimental medication anymore because the nausea is intolerable, but I am afraid the hospital will refuse to treat my condition if I quit the study." What is the best and most appropriate response by the nurse? A) "Because you signed the informed consent document, you are obligated to finish the trial, but we can manage your nausea." B) "You have the right to withdraw from the study at any time without any penalty or loss of your regular medical benefits." C) "I will call the health care provider so they can re-evaluate your risk-benefit ratio." D) "If you stop the trial now, it will invalidate the research results and violate the ethical principle of justice."
B) "You have the right to withdraw from the study at any time without any penalty or loss of your regular medical benefits."
Which specific diagnostic labs evaluate the liver's ability to metabolize drugs?
Aspartate transaminase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP)
A patient with a documented genetic polymorphism resulting in two variant alleles for the CYP2D6 liver enzyme is prescribed codeine for post-operative pain. As a designated "poor metabolizer," what clinical outcome should the nurse anticipate? A) The patient will experience immediate, profound respiratory depression and toxicity. B) The patient will not achieve adequate pain relief. C) The codeine will be excreted unchanged by the kidneys without passing through the liver. D) The patient will require a significantly lower dose to avoid adverse reactions.
B) The patient will not achieve adequate pain relief.
What does the FDA's acronym "SAFER" stand for regarding over-the-counter (OTC) medicines?
Speak up, Ask questions, Find the facts, Evaluate your choices, and Read label