Ch. 34 Medication Administration Flashcards
chemical name
is a scientific name that describes chemical structure of a drug
Chemical name: N-acetyl-para-aminophenol
Brand name
“trade name”
is developed by the drug company is patented and trademarked. Names that are easy to remember or are catchy are chosen. Once the patent runs out, generics can be made
Brand name: Tylenol
generic name
is assigned by Health Canada. Generic names are usually less complicated and are easier to remember than chemical names. Each drug has only one generic name.
Generic: acetaminophen
Enteric-coated tablet
Coated tablet that does not dissolve in stomach; coatings dissolve in intestine, where medication is absorbed
Suppository
vaginal or rectal, melts at body temperature, shaped like a bullet to aid in insertion.
elixir
water and alcohol often sweetened;
syrup
medication in sugary, sticky solution
suspension
small drug particles and must be well shaken before use
DIN
8 digit Drug Identification Number
Pharmacokinetics
The study of how medications enter the body, reach the site of action, metabolize, and exit
Absorption
The passage of medication molecules into the blood from the site of administration
distribution
Transportation of drugs throughout body to target tissue
metabolism
Process by which structure (and function) of drugs, nutrients, vitamins, and minerals is altered.
Metabolism usually makes drug more excretable
excretion
Removal of drug from the body. The rate of excretion influences concentration of drug in blood
Main source is kidneys
blood-brain barrier
doesn’t allow certain medications through. Only lipid-soluble drugs able to cross; this safety barrier can prevent some therapeutic drugs from entering the brain
biotransformation
The drug metabolism process is also called biotransformation. In this process, the body chemically changes a drug molecule, which results in functional changes to the drug.
occurs when enzymes detoxify, degrade, and remove active chemicals.
Most biotransformation occurs in the liver.
May convert into another compound that produces increased therapeutic action
May convert into a toxic substance
Therapeutic effects
the reason the medication is prescribed is to have a specific action…. Its expected and predictable the desired effect
Side effects
Unintended secondary effect, but is still predictable, may be harmless or serious the undesired effect
Side effects are less severe than adverse effects (mild headache vs severe headache)
Adverse effects
Severe, negative response to medication and may be unexpected. Health Protection Branch is a voluntary reporting system. Any adverse effects should be reported there. Pt
Toxic effects
Medication accumulation in the bloodstream or there is impaired metabolism, excretion, the effect of too much drug in the body
Idiosyncratic reactions
any unpredictable effect that is specific to the patient: may be over or under reaction
adverse effects that cannot be explained by the known mechanisms of action of the offending agent, do not occur at any dose in most patients, and develop mostly unpredictably in susceptible individuals only.
Allergic reactions
are related to the immune system – unpredictable may be mild with things such at urticaria. Med allergies develop after repeated exposures. The medication acts as an antigen and triggers the immune response. Antibiotics are the most common class to cause allergic reactions
Anaphylactic reactions
emergency, life threatening. Sudden constriction of bronchial muscles, edema of the pharynx and larynx, severe wheezing, shortness of breath and circulatory collapse. Immediate treatment necessary.
Interactions
are events in which one medication modifies the action of another.
Synergistic effect
occurs when the combined effect of two medications is greater than the effect of the medications given separately.
Onset
time it takes for a medication to produce a response
Peak concentration
the highest effective concentration reached after medication is administered
Trough concentration
minimum blood serum concentration before next scheduled dose
Serum half-life
time for serum medication concentration to be halved
after 4 half lives more than 90% of the drug is excreted
Duration
time period the medication is in the therapeutic range
Plateau
blood serum concentration reached and maintained
Oral route
PRO: preferred as it is convenient, easy, comfortable, cheap and easy for the patient. Safest as drug can be recovered from the stomach in case of an error. It has a large surface area for absorption.
CON: Is not preferred if pt has nausea or vomiting, reduced GI motility or if pt is unable to swallow, positioning, gastric suction
Sublingual
placed under the tongue. Is not to be swallowed. No food or drinks or talking until completely dissolved, rich blood supply, excellent absorption, rapid onset
Buccal
placed against the cheek until dissolved through mucous membrane. Can cause irritation so pt needs to switch sides. Do not eat or drink. Lozenges
Parenteral
involves injecting medication into a body tissue. Provides a fast response and better absorption. Useful if oral not available. IV can provide stable blood concentration across time. Disadvantages are that is carries risk of infections, the drug cannot be withdrawn if an error is made and it frightens some people
Intraocular
medicated disc inserted into patient’s eye. There is a soft layers enclosing the medication. The disc can stay in the eye for up to a week
Topical
Refers to administration of drugs onto the surface of the skin or of membranous linings of eye, ear, nose, respiratory tract, urinary tract, vagina and rectum
Inhalation route:
has a very rapid onset due to rich vascular network and large surface area. (why some illegal drugs are used this way) may have local or systemic effects
Direct treatment of upper respiratory and pulmonary diseases
Routine order
carried out until the prescriber cancels it by writing a new order or until a prescribed number of days have elapsed
ex. Tylenol 500mg PO OD will get Tylenol 500mg once daily at 8am every day
PRN order
(“as-needed”): given when the patient requires it
pro re nata
(may be single, stat, or now) only given when the person requires it. There are usually specific parameters for giving it…. PRN morphine sulphate 5 mg subcutaneously q3–4 h prn for incisional pain. If pt has a headache or just generalized pain, you don’t give it. There is a minimum of 3 hours between doses. Documentation must be completed to indicate giving a PRN, the rationale and its effectiveness.
Single (one-time) order
Medication is ordered for 1 administration only. May be an anti-anxiety medication before a procedure. Maybe someone is retaining fluid and 1 dose of Lasix is given.
STAT order
given immediately – pt needs it immediately, emergency… insulin may be ordered this way for high blood sugar, salbutamol for respiratory distress, textbook mentions Apresoline which is for high blood pressure
NOW order
have up to 90 minutes to administer the medication. Not life threatening, but still urgent. Dose of IV antibiotics
Prescriptions
more detailed than a medication order.
Omission
missed medication or missed assessment prior to giving e.g. taking BP prior to administering BP medication, or not taking blood glucose prior to administering insulin
Polypharmacy
when a person takes two or more medications to treat the same illness, usually in older persons and increases risk of adverse effect and drug-drug interactions and drug-food interactions
Rational Polypharmacy
taking several medications to treat a health conditions
- the provider is aware of the multiple medications or is the one prescribing the multiple meds
Irrational polypharmacy
when taking more medications than needed; can be from seeing multiple health providers or not taking a thorough health history so not knowing all the medications a pt is on before prescribing a new one
Nonadherence
- deliberately not taking medication correctly.
- May not take it at all or take a double dose.
- Always ask questions with non-adherence. Generally people don’t take their medications because they are expensive, they feel the medication is not effective, or there is unwanted side effects or adverse effects.
