Ch. 23 Administering Medications Flashcards
Pharmacology
The science of drug effects. It deals with all drugs used in society, legal and illegal, prescription and nonprescription, and “street” drugs.
Drug
A chemical that interacts with a living organism and alters its activity.
Chemical name (of a drug)
The exact description of the drug’s chemical composition and molecular structure.
Ex: 2-(p-isobutylphenyl) propionic acid
Generic (nonproprietary) name
Similar to the chemical name, but simpler. It’s also the official name assigned by the United States Adopted Name (USAN) Council.
Ex: ibuprofen is both a generic and official name.
Brand (trade or proprietary name)
Name given to a drug by a manufacturer so that it is easily recognizable. Different manufacturers of the same medication may give the medication different brand names.
EX: Advil, Nuprin, and Motrin
Prescription Drugs
Require a written order from a healthcare provider who is licensed by the state to prescribe or dispense drugs.
Nonprescription or over-the-counter (OTC)
Drugs that may be purchased without a prescription and are assumed to be safe for the general population if consumers follow the manufacturer’s directions.
United States Pharmacopoeia (USP)
Directory of drugs approved by the FDA lists the physical and chemical composition of each drug.
National Formulary (United States)
Identifies the therapeutic value of drugs as well as their formulas and prescriptions.
Nursing Drug Handbooks
Serve as a quick resource for information (e.g., dosage, side effects) and nursing interventions associated with a drug
Physician’s Desk Reference (PDR)
Book commercially compiled by the pharmaceutical companies, lists manufactures’ prescribing information and is a standard resource for professionals prescribing and administering medication. It is updated annually and is the same information found in drug packet inserts.
Pharmacology Texts
Provides more information about physiology and pathophysiology, and provides broader information, than the drug formulary or a handbook.
Pharmacists
A clinical pharmacist can assist you with medication-related concerns (e.g. dosage calculations, compatibility, admixture administration, and adverse reactions)
Medication Package Inserts
Insert packaged with most medications that provides information identical to that found in the drug formulary.
Medicinal products NOT regulated by the FDA
Herbal remedies and some naturopathic supplements that are considered “food products”
Controlled Substances
Drugs considered to have either limited medical use or high potential for abuse or addiction.
It is illegal to possess a controlled substance w/o a valid prescription.
Double locking
Process in which locked drawers are within a second locked area
Stock supply or Bulk Quantity
Medications used most frequently, that are labeled, and in a central location (e.g. acetaminophen elixir and cough syrups).
Cost-effective
PRN
“give according to patient need”
Unit dose
The prescribed amount of drug the patient receives at a single time.
Automated dispensing system
Computerized system similar to a unit-dose system.
Pharmacokinetics
Refers to the absorption, distribution, metabolism, and excretion of a drug.
Absorption
Refers to the movement of the drug from the site of administration into the bloodstream.
-Absorption determines when a drug becomes available to exert its action; thus absorption influences metabolism and excretion
Factors that affect drug absorption:
- Route of administration
- Solubility of the drug
- Effects of pH and Ionization
- Blood flow to the area
Local effects
Effect of drug occurs at the site of application
Systemic Effect
Drug must be absorbed into the bloodstream before it can be distributed to a distant location
Capsule
A gelatinous container that holds the liquid, powder, or oil form of the drug. When swallowed, the gelatin container dissolves in the gastric juices.
Pill
This term is rarely used now. Tablet is the preferred term
Tablet
A powdered drug is compressed into a hard, compact form that is easy to swallow and then breaks into a fine powder in the stomach. It is the most common oral preparation.
Time-released tablet or capsule
A tablet or capsule formulated so that it does not dissolve all at once, but gradually releases medication over a few hours
Elixir
A liquid containing water and about 25% alcohol that is sweetened with volatile oils; not as sticky or as sweet as syrups
Extract
A very concentrated form of a drug made from animals or vegetables; may be a syrupy liquid or a powder
Fluid extract
An alcohol-based solution of a drug from a vegetable source; the most concentrated of the fluid preparations
Spirits
A concentrated alcohol-based solution of a volatile (easily evaporated) substance or oil; contains larger amounts of the substance than can be dissolved in water
Advantages of Oral Route
- Convenient
- Sterility is not needed for oral use
- Economical
- Noninvasive, low-risk procedure
- Easy to administer, good for self-administration
- Capsule can mask unpleasant taste of a drug
- Capsule can be time-released
Disadvantages of Oral Route
- Unpleasant taste may cause noncompliance
- May irritate gastric mucosa
- Patient must be conscious
- Digestive juices may destroy drug
- Cannot use if patient has nausea and vomiting or decreased gastric motility
- Cannot use if patient has difficulty swallowing
- Potential for aspiration
- May be harmful to teeth
- Onset of action is slow
Solubility
The ability of a medication to be transformed into a liquid form that can be absorbed into the bloodstream
Enteric-coated
Drugs that have an acid-insoluble coating to keep them form dissolving in the stomach; they disintegrate in the alkaline secretions of the small intestine
Enteral Route
Drug is given directly into the stomach or intestine (e.g. through a nasogastric or gastrostomy tube
Syrup
An aqueous solution of sugar, used to disguise unpleasant taste of drugs
Tincture
An alcohol or water-and-alcohol solution made by extracting potent plants: may also be used externally
(e.g. tincture of iodine)
Powder
Finely ground drug, usually mixed with a liquid before ingesting
Solution
Drugs dissolved in a liquid carrier
Suspension
Drug that are suspended (not completely dissolved) in a liquid. Aqueous suspensions are suspended in water. Never used for IV or intra-arterial routes
Sublingual Route
Drug is held under the tongue and absorbed across the sublingual mucous membrane
Lipid-soluble lozenges (troche)
A flat, rounded preparation that dissolves when held in the mouth.
Buccal/Transmucosal Administration
Medication is held against the mucous membrane of cheek until it is dissolves
Topical: Instillations
Drug is placed into a body cavity (e.g. urinary bladder, rectum, vagina, ears, nose, eyes)
Inhalation Route
A device that breaks the drug into finely dispersed particles, which are breathed into the respiratory passages.
Aerosols
Liquids in very fine particles that can be inhaled into the lungs; they are sprayed under air pressure
Intravenous route
Drug is injected directly into the vein, either by bolus or slow infusion
Intramuscular
drug is injected into the muscle mass
Subcutaneous Route
Drug is ingested into the subcutaneous tissue under the skin
Primary solutions
Drugs dissolved in a liquid carrier
Intradermal Route
Drug is injected under the skin, into the dermis. Most commonly used for diagnostic testing or screening or for injecting local anesthetic
Intraspinal
Injection of drug into the spinal canal
Intrathecal
Injection of drug into the subarachnoid space around the spinal cord
Epidural
Injection of drug for regional anesthesia
Water-soluble drugs
Drugs must be water soluble in order to dissolve in the aqueous contents of the GI tract
Lipid-soluble drugs
Drugs that can penetrate lipid-rich cell membranes and enter the cell
pH
- Relative acidity or alkalinity
- Acidic medication (e.g. aspirin) that are more readily absorbed in the stomach than basic (alkaline) medications (sodium bicarbonate) which are readily absorbed in the alkaline small intestine
Ionized
Electrically charged
