Ch. 34 Medication Administration

Question 1

chemical name

Answer 1

is a scientific name that describes chemical structure of a drug
Chemical name: N-acetyl-para-aminophenol

Question 2

Brand name

Answer 2

“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

Question 3

generic name

Answer 3

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

Question 4

Enteric-coated tablet

Answer 4

Coated tablet that does not dissolve in stomach; coatings dissolve in intestine, where medication is absorbed

Question 5

Suppository

Answer 5

vaginal or rectal, melts at body temperature, shaped like a bullet to aid in insertion.

Question 6

elixir

Answer 6

water and alcohol often sweetened;

Question 7

syrup

Answer 7

medication in sugary, sticky solution

Question 8

suspension

Answer 8

small drug particles and must be well shaken before use

Question 9

DIN

Answer 9

8 digit Drug Identification Number

Question 10

Pharmacokinetics

Answer 10

The study of how medications enter the body, reach the site of action, metabolize, and exit

Question 11

Absorption

Answer 11

The passage of medication molecules into the blood from the site of administration

Question 12

distribution

Answer 12

Transportation of drugs throughout body to target tissue

Question 13

metabolism

Answer 13

Process by which structure (and function) of drugs, nutrients, vitamins, and minerals is altered.
Metabolism usually makes drug more excretable

Question 14

excretion

Answer 14

Removal of drug from the body. The rate of excretion influences concentration of drug in blood
Main source is kidneys

Question 15

blood-brain barrier

Answer 15

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

Question 16

biotransformation

Answer 16

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

Question 17

Therapeutic effects

Answer 17

the reason the medication is prescribed is to have a specific action…. Its expected and predictable the desired effect

Question 18

Side effects

Answer 18

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)

Question 19

Adverse effects

Answer 19

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

Question 20

Toxic effects

Answer 20

Medication accumulation in the bloodstream or there is impaired metabolism, excretion, the effect of too much drug in the body

Question 21

Idiosyncratic reactions

Answer 21

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.

Question 22

Allergic reactions

Answer 22

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

Question 23

Anaphylactic reactions

Answer 23

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.

Question 24

Interactions

Answer 24

are events in which one medication modifies the action of another.

Question 25

Synergistic effect

Answer 25

occurs when the combined effect of two medications is greater than the effect of the medications given separately.

Question 26

Onset

Answer 26

time it takes for a medication to produce a response

Question 27

Peak concentration

Answer 27

the highest effective concentration reached after medication is administered

Question 28

Trough concentration

Answer 28

minimum blood serum concentration before next scheduled dose

Question 29

Serum half-life

Answer 29

time for serum medication concentration to be halved

after 4 half lives more than 90% of the drug is excreted

Question 30

Duration

Answer 30

time period the medication is in the therapeutic range

Question 31

Plateau

Answer 31

blood serum concentration reached and maintained

Question 32

Oral route

Answer 32

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

Question 33

Sublingual

Answer 33

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

Question 34

Buccal

Answer 34

placed against the cheek until dissolved through mucous membrane. Can cause irritation so pt needs to switch sides. Do not eat or drink. Lozenges

Question 35

Parenteral

Answer 35

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

Question 36

Intraocular

Answer 36

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

Question 37

Topical

Answer 37

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

Question 38

Inhalation route:

Answer 38

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

Question 39

Routine order

Answer 39

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

Question 40

PRN order

Answer 40

(“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.

Question 41

Single (one-time) order

Answer 41

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.

Question 42

STAT order

Answer 42

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

Question 43

NOW order

Answer 43

have up to 90 minutes to administer the medication. Not life threatening, but still urgent. Dose of IV antibiotics

Question 44

Prescriptions

Answer 44

more detailed than a medication order.

Question 45

Omission

Answer 45

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

Question 46

Polypharmacy

Answer 46

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

Question 47

Rational Polypharmacy

Answer 47

taking several medications to treat a health conditions

- the provider is aware of the multiple medications or is the one prescribing the multiple meds

Question 48

Irrational polypharmacy

Answer 48

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

Question 49

Nonadherence

Answer 49

• 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.