Lessons in Drug 'dealing'
Definition of Agonist and Antagonist
drugs that produce effects similar to those produced by naturally occuring hormones, neurotransmitters and other substances.
Bind to receptors to produce effects similar to those produced naturally
An antagonist drug is a substance that blocks or reverses the effects of another substance. Antagonists bind to receptors, preventing them from producing a desired response.
What medication would the nurse expect if peaked T waves are reported on ECG?
sodium polystyrene sulfonate
IV regular insulin, D50 and Calcium gluconate
Define Pharmacokinetics
movement of drug through body. includes absorption, distribution, metabolism and excretion
What is the mechanism of action of epoetin alfa?
Epoetin alfa is the prototype recombinant form of human erythropoietin that helps the body produce more RBCs.
What would be the indication? What are signs and symptoms?
What are side effects of chemotherapy in general?
Thrush/Stomatitis
BMS
GI
how can we treat these?
Fertility/alopecia
What is the mechanism of action and adverse effects of filgrastim?
Filgrastim stimulates white blood cell production
What is the therapeutic expectation?
Adverse effects of filgrastim are drowsiness, fatigue, flulike symptoms, nausea, and bone pain.
What drug route has the fastest bioavailability and why?
Intravenous. They have 100% bioavailability also as they bypass first pass effect.
What are hypotonic fluids, what is their mechanism of action and what are indications?
D5W and 0.45% NS
Pulls fluid from intravascular space and pushes into cells and tissues.
Indications: Hypernatremia or severe celluar dehydration states (DKA and HHS)
What would the nurse watch for as a complication of this medication?
What are medication administration recommendations for Pediatric and Elderly Clients? And why?
Start Low and Go slow.
In older adults (65 years and older), physiologic changes may alter all pharmacokinetic processes. In the liver, blood flow and metabolizing enzymes are decreased. Thus, many drugs are metabolized more slowly, have a longer action, and are more likely to accumulate with chronic administration. In peds, these processes are underdeveloped
How is pernicious anemia treated?
Administer of cyanocobalamin (vitamin B12)
What is an adverse effects of tamoxifen?
Tamoxifen is an antineoplastic medication that may increase risk of blood clots.
endometrial cancer
What would be the indication for epoetin alpha?
anemia, chemotherapy induced pancytopenia
What would be signs and symptoms of this?
Define Prophylactic medication administration
Prophylactic meaning “prevent’ is the term used to define giving antibiotics to prevent post-surgical infection
What are the signs and symptoms of complications of isotonic fluid administration?
Signs of fluid overload as in?
What would an elevated creatinine level indicate in a client? What would the nurse be concerned about with medication administration?
What is kidney dysfuction. As medication excreted via the kidneys, drugs are cleared less effectively in the presence of impaired renal function leading to a toxic level.
What are nursing considerations with the administration of iron dextran?
Iron Dextran has 0.3% of fatal anaphylaxis with administration so a test dose should always be given. After an hour if no reaction occurs then the remaining medication can be administered slowly IV.
If given as injection should be given into a deep large muscle mass using the Z-track method.
What is a sign of toxicity of vincristine?
Peripheral neuropathy is the major dose-limiting toxicity associated with vincristine. Nearly all clients exhibit signs and symptoms of sensory or motor nerve injury such as decreased reflexes, weakness, paresthesia, and sensory loss.
What is the antidote for iron toxicity?
deferoxamine
What are the 10 rights of Medication Administration?
The ten rights of medication administration include: the right drug; right dose; right patient; right route; right time; right reason; right documentation; right patient education; right evaluation; and right to refuse the medication.
What is a contraindication of lactated ringers?
What is alkalosis.
LR can change the pH level of a client. LR produces a metabolic alkalinizing effect.
What medical condition is most commonly associated with this contraindication?
what does TI mean
Theraputic index
What does it tell us?
What are client teaching topics regarding epoetin alfa?
Take iron supplement
Medication is ineffective without adequate body iron stores and bone marrow function.
Take your blood pressure
Go to dr appts
What are the adverse effects of this drug? Why? Who is more at risk? What lab should be checked before administration?
What are nursing considerations with chemotherapy administration?
wear protective clothing
2 pairs of chemo gloves and gown
avoid during first 84 days of pregnancy
Double flush toilets
Vesicant
Why do some chemotherapy patients have trouble eating?
cytotoxic effects to gi system
N,V-how do we treat?
Stomatitis, thrush. How do we treat?
Why do we check a trough level and when do we draw it?
Drugs with narrow T1. Drug plasma level prior to the next dose of medication
What medical conditions would a nurse anticipate giving magnesium replacement?
Indications for magnesium replacement mostly commonly are due to malnutrtion in alcoholism. clients with kidney disease, diabetes (DKA), and gastrointestinal disease also can have magnesium deficiency.
anticonvulsant in deficency, preeclampsia, tololytic drug (premature labor), torsades de point, short term treatment of constipation,
What can a nurse do to promote medication administration safety?
question inaccurate orders, calculate drugs appropriately, follow the 10 rights, use a quiet zone, limit interruptions, follow all hospital policies and protocols, complete med reconcilations accuratley.
What would be teaching points for a client prescribed iron sulfate orally?
Iron causes stool to turn black and can stain teeth. Many forms can look like candy to children so should be stored appropriately. Clients with iron deficiency anemia should be reminded of the importance of maintaining routine appointments to have their blood counts and iron stores measured.
What are side effects of cyclophosphamide and cisplatin?
Alkylating drugs have risk for bone marrow suppression, nausea, vomiting, diarrhea,
nephrotoxicity and ototoxicity and peripheral neuropathy.
What are the indications for an albumin infusion?
third spacing, hypotension, plasma expansion, increased colloid oncotic pressure