29 Medication Flashcards
2 drug classifications
1 pharmaceutical class 2 therapeutic class
pharmaceutical class
refers to:
1 mechanism of action [MOA]
2 physiologic effect [PE]
3 chemical structure [CS]
therapeutic class
refers to clinical indication of drug or therapeutic action
ex) analgesic, antibiotic, antihypertensive
pharmacoKINETICS
effects of body on drugs
types of pharmacokinetics
1 absorption
2 distribution
3 metabolism
4 excretion
pharmacoDYNAMICS
effects of drugs on body
- drugs turn on, turn off, promote, or block responses
- can also alter cell structure/environment
types of adverse effects
- allergic rxn
- drug tolerance
- toxic effect
- idiosyncratic effect
- drug interactions: antagonist/synergist
factors affecting drug action
- dvlptl consideration
- weight
- gender
- genetic/cultural
- psychological
- pathology
- environment
- timing of administration
therapeutic range
concentration of drug in the blood serum that produces the desired effect wo toxicity
through level
point when the drug is at its lowest concentration
-indicates rate of elimination
half life
amount of time it takes for 50% of blood concentration of drug to be eliminated fr body
you need a needle for……
parenteral (outside the intestines)
NonParenteral Medications
1 Oral 2 Topical 3 Suppositories 4 Ophthalmic 5 Otic 6 Nasal 7 Inhalation
score pills
pill w grooves to indicate pill may be split
enteric coated
barrier prevents gastric acids in stomach fr dissolving/degrading drugs
DO NOT CUT
extended release, sustained release, time-release, controlled release
coated to dissolve more slowly
capsules
easier to swallow
-CANNOT OPEN TO ADMINISTER
sublingual vs buccal
sublingual goes under tongue
buccal goes bw cheek + gums
DO NOT PROVIDE WATER
elixer vs suspension vs syrup
elixir: alcohol + syrup + water + med
syrup: syrup + water + med
suspension: med + suspension (must shake)
ophthalmic
lean back, block duct, pull undereye, drop into under eye
Liniment
liquid or semi-liquid thats applied to skin w friction + rubbing
Lotion
- meant for external application w/o friction
- less viscous than liniments
- works best w less grease on skin
Oil
contains oil base
Intradermal
administered into dermis right below the epidermis
- 5-15 degrees
- used for sensitivity test + localized anesthesia
which has the longest absorption time out of all parenteral routes?
intradermal injection
how much is the usual intradermal dosage?
0.5mL
usually a small amount
ng tube reasons
1 for suction
2 feeding
Interference
one drug interferes w METABOLISM of another
-leads to build-up of meds and maybe toxicity
additive effects
drugs w SIMILAR PHARMACOLOGIC action
—1+1=2
synergistic effects
drugs w different sites or mechanisms of action
- –GREATER effects when taken together
- —1+1=4
ethnopharmacology
study of indigenous plants
bioavailability
portion of drug that reaches systemic circulation
pharmacogenetics
difference in responses of patients may result fr genetic differences
ex) patient may not have a certain enzyme needed to break down a med
Certain ethnic groups/races have more variation in therapeutic dose/adverse effects than others… example
ACE inhibitors are found to be less effective on black patients
routine order
carried out as specified until it is canceled by another order
standing order
specified set of written orders for ALL hospitalized patients
–for practitioners whose practices are limited to a particular clinical area
PRN order
as needed
—when requested or required
7 parts of medication order
1 pt. name + 2ndry IDer 2 date + time order was written 3 drug name 4 dosage 5 route 6 frequency 7 provider signature + title
11 medication RIGHTS
1 drug 2 patient 3 dosage 4 route 5 time 6 reason 7 assessment 8 documentation 9 response 10 to education 11 to refuse
narcotic dispersal recording requirements
1 patient name 2 amount of substance used 3 hour it was given 4 name of prescriber 5 name of nurse/administer
when wasting a controlled substance, what is required?
a second nurse to witness the disposal
crushing/chewing extended-release meds can result w…
potentially toxic peaks and low troughs
how much water do you flush tubes with before/after providing medication?
15-30 mL for adults
5-10 for kids
route of admin on equipment size
IM=longer needle
viscosity on equipment size
more viscous=needle w larger lumen
quantity on equipment
larger amt=larger syringe
body size on equipment size
large body=larger needle
what type of clean technique does parenteral injections require?
surgical asepsis
ampule
- glass flask w SINGLE DOSE
- requires a FILTER NEEDLE
how long do vials usually last for once opened?
usually 24 hrs to prevent microbes
vial procedures
wipe w alcohol, insert air (same amt as needed), label w date + time
basal insulin
-covers body’s basal metabolic needs
basal insulin examples
- glargine
- detemir
- NPH
prandial/preprandial insulin
to prevent postpandrial (after meal) hyperglycemia
prandial/preprandial insulin examples
- lispro
- aspart
which insulins CANNOT be mixed with other insulins
glargine + detemir
U100 contains…
100 units per mL
TB test or allergy test usually uses which injection?
intradermal injections
what is the max amount to inject subQ
usually no more than 1 mL
subcutaneous injections
- into adipose, under epidermis + dermis
- slow + sustained rt of absorption
- 45-90 degree
recommended IM sites for infants/toddlers?
vastus lateralis
recommended IM sites for adults?
ventrogluteal + deltoids
recommended IM sites for children?
vastus lateralis or deltoids
recommended IM sites for irritating medication?
ventrogluteal
amt usually injected in IM
1-5 mL
3 ways IV can be administered
1 infusion solution (slow)
2 bolus/push (usually over 2 min)
3 intermittent infusion (prescribed intervals like every 4 hours)
contraindications for suppositories
patients who has recent rectal/prostate surgery
- thrombocytopenia
- neutropenic
- at risk for cardiac arrythmias
steps after med error
1 check patient for adverse effects
2 notify nurse mgmt + provider
3 report incident
enteral vs parenteral vs nonparenteral
E: anything placed directly into the digestive tract: NG-tube, J-tube, PEG tube.
P: INJECTED in the body anywhere other than the mouth or alimentary canal
NP: oral medications (pills, capsules, syrups), topical medications (ointments, patches like nitro), and suppositories (vaginal and rectal)
Enteral Route is part of….
NONparenteral
