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NURS 212 > Ch 8 > Flashcards

Ch 8 Flashcards

1
Q

Pharmacokinetics

A

how the drug is absorbed,
distributed, metabolized and excreted

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2
Q

Pharacodynamics

A

how the body is affected by the drug at the
cellular level and in relation to the target organ).

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3
Q

Absorbtion

A

refers to the passage of a medication from its site of introduction,
usually the gastrointestinal tract, into the general circulation.

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4
Q

Absorption of oral meds can be affected by

A

can be affected by
diminished gastric acid, increased gastric pH, delayed gastric
emptying and the presence of other substances (e.g., food,
nutrients, medication additives).

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5
Q

Elimination/serum half-life

A

is the time required to decrease the drug concentration by one half
of its original value.

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6
Q

It takes ______ half times to reach steadystate
concentrations after a drug is initiated or to completely
eliminate a drug from the body after a drug is discontinued.

A

5

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7
Q

The clearance rate

A

measures the volume of blood from
which the drug is eliminated per unit of time

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8
Q

Can herbs be taken along with medications without worry of any potential intereaction

A

No

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9
Q

How could oldr adult bod ycomposition affect the effects of medications?

A

decreased
body water and lean tissue and increased body fat)
can affect substances according to their degree of fat or water
solubility. Consequently, medications that are distributed
primarily in body water or lean body mass may reach higher
serum concentrations in older adults and their effects may be
more intense. Similarly, the serum concentration of highly
fat-soluble substances can increase, so the immediate therapeutic
effects are diminished, but the overall effects are prolonged
or erratic.

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10
Q

Polypharamacy

A

typically
refers to the use of more medications than are clinically indicated.

(Many drugs)

Not about the number, about the appropriateness & combination of meds

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11
Q

Medication nonadherence

A

refers to medication-taking patterns
that differ from the prescribed pattern, including missed
doses, failure to fill prescriptions, or medications taken too
frequently or at inappropriate times.

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12
Q

prescribing cascade

A

an adverse drug reaction
is misinterpreted as a new medical condition, a drug is
prescribed for this condition, another adverse drug effect occurs,
the patient is again treated for the perceived additional
medical condition, and the sequence perpetuates new adverse
events.

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13
Q

Ac

A

before meal

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14
Q

Pc

A

After meal

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15
Q

Hs

A

At bedtime

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16
Q

Qd

A

Every day

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17
Q

PO

A

Per oral

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18
Q

Absorption medication affect by

A

Reduced gastric acid, increased gastric pH, delayed gastric emptying, and the presence of other substances

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19
Q

Age-related physiological changes that affect the action of medications in older adults

A

Decline in renal function (eGFR) - older adults have slower GFR
Hepatic blood flow declines
Decreases muscle mass and water content
Low serum albumin (protein)
Altered receptor sensitivity

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20
Q

What affects medication-taking behaviour

A

Motivation
Knowledge abt med
Cultural and psychosocial influences
Physical ability to remove the substance from the container and administer it
Ability to swallow oral preparations
Additional skills related to administering nasally, transdermally, SC and other routes

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21
Q

Considerations of polypharmacy

A

All meds have side-effects

Older adults are more likely to experience stronger side-effects

Always consider wether the benefit outweighs the risk

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22
Q

Side-effects and medication

A

Every med has side-effects, they are just not necessarily common

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23
Q

Narcotics do what

A

Slow respiratory rate

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24
Q

Functional consequences associated with medications in older adults

A

Disease or polypharmacy may alter the
therapeutic effects of a medication

Adverse effects

Anticholinergic Adverse Effects

Altered mental status

Antipsychotics in people with dementia

Tardive Dyskinesia and Drug-Induced
Parkinsonism

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25
Q

Factors that increase older adults risk for adverse events

A

Higher number of medications
* Malnourishment or dehydration
* Multiple comorbidities
* An illness that interferes with cardiac, renal or
hepatic function
* Cognitive impairment
* History of medication allergies or adverse effects
* Fever that can alter the action of certain
medications
* Recent change in health
* Certain medications: anticoagulants/
antiplatelets, antidiabetics, NSAIDs, CNS drugs

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26
Q

Antipsychotics should not be given to

A

Dementia

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27
Q

Anticholinergics

A

Drugs blocking action of AcH, inhibiting the parasympathetic NS

Higher specificity to older adults (Often not reccomended if better option available)

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28
Q

Morbidity

A

Illness

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29
Q

cardiac, renal or
hepatic function in

A

Main metabolizing organs

30
Q

Exzmples of anticholinergics

A

OTC cough, cold flu and sleep problems
Treatment for older adults (antihistamines, antidepressants antipsychotics CV agents, antiparkinsonians)
Safer alternatives usually exist and should be advocated for

31
Q

Anti-psychotics

A

Increasingly used in LTC facilites
US restricted by FDA to prescribe ONLY for psychotic symptoms

32
Q

Tardive dyskenisia

A
  • Rhythmic involuntary movements of the trunk, extremities, jaw, lips, mouth or
    tongue.

Can begin 3-6 months after initiation of antipsychotic use and persist after medication is discontinued

33
Q

Drug induced parkinsonism

A

Parkinson-like symptoms such as shaking,
involuntary or poorly controlled movement.
* Condition can be easily misdiagnosed as
Parkinsonism and patients are started on
new medications

34
Q

BEERS

A

A list of medications known to increase
the risk of delirium and other adverse
reactions in older adult

should not be
prescribed for older adults unless there is
a greater benefit
-risk ratio for a particular
situation, and then should only be used
for the shortest possible duration.

35
Q

When are meds safest and most therapeutic

A

Prescribed and regularly reviewed

36
Q

Goals of assment

A

Determine effectiveness of existing
regimen

Identify any factors that interfere with the
current regimen

Notice risk for adverse effects

Detect adverse medication effects

Identify teaching needs regarding medications

37
Q

Scope of Medication
Assessment

A

Prescription and OTC medications (all routes)
taken regularly

Medications taken “as needed” or PRN

Vitamins, minerals, and dietary supplements

Herb and Folk remedies and complementary/
alternative modalities

Alcohol, substances

Smoking/inhaling

38
Q

Medication reconciliation

A

Identifying medications at any transition in
care

View all the medications

Address ability to get prescriptions filled

Address issues that affect adherence

Allow the client to ask questions

39
Q

Nursing intervention

A

Recommend all odler adulrs have a list of what the are currently taking

Snesure clients and caregivers understand the appropriate use of “as needed” (PRNP meds)

Encourage use of decices and systems to improve medication adherances

40
Q

What info should we know when gathering med history from patient

A

Current medications (including herbal, OTCs, and PRNS)
Dose/freq
Why?
Working?
Side effects/concerns

41
Q

Qs pertinent to med administration

A

Age, weight, BMI
All medical diagnoses
Prevailing symptoms and reason for hospitalization/care, ongoing lab draws
Known drug allergies? (describe)
Previous drug reactions? (describe)
Any difficulty swallowing pills? Other concerns?
Smoker?
Provider managing medications _

42
Q

What must be know ABOUT the medication before adminsitering

A

What drug is ordered?
Drug name (generic and trade) and classification
Intended or proposed use
Effects on the body
Contraindications
Special considerations
Side effects
Why the medication has been prescribed
How the med is to be administered including dosage ranges

43
Q

10 Rights

A

Drug
Client
Dose
Route
Time of delivery and frequency
Documentation
History and assessment
Drug approach and right to refuse
Drug- drug interaction and evaluation
Right education and information

44
Q

3 checks of drug admin occur

A

When preparing it
When removing the drug
Immediately before administering

45
Q

What is the first check of the med

A

Comparing the physians order to the MAR

46
Q

ac

A

Before meal

47
Q

pc

A

After meal

48
Q

gtt

A

Drop

49
Q

Hs

A

At bedtime

50
Q

Standing order

A

To be completed on a regular basis

51
Q

Nursing actions when preparing to administer drug

A

Wash hands, assemble supplies
Calculate dose (safe range?)
Brief patient assessment
- Administer drug accurately
10 rights, 3 checks
aseptic or sterile techniques
talk to patient

52
Q

Enteric coating

A

Coating diesinged to hold the tablet together when it is in the stomach and break down in none acidic conditions in the intestines

53
Q

SR vs IR

A

Sustained/timed release vs immediate release

SR means a drug can be taken less frequently and is administered slower and steadier

54
Q

Why would a drug be enteric coated

A

Protect stomach from drug
Protect drug from the stomach
Relase drug after the stomach

55
Q

First pass effect

A

a phenomenon in which a drug gets metabolized at a specific location in the body that results in a reduced concentration of the active drug upon reaching its site of action or the systemic circulation.

56
Q

Disadvtages of oral route

A

First pass effect
Slower release
Pt must be able to swallow

57
Q

Reccomendations ofr adinstering meds by NG

A

Use liquids where possible
Tablets to be crushed or dissolved

58
Q

Topical drugs include

A

Drugs applied to the skin
Drugs applied into body cavities
Inhaled drugs

59
Q

Topical meds side affects?

A

Low side effects because amounts reaching general circulation are minimal

60
Q

Parental route

A

Needle into the skin layers sc tissue, muscles or veins
SC
IM
IV
`

61
Q

Preventing med errors

A

Neveruse trailing 0s (2.0)
Always use leading )s (0.25)

62
Q

What should patients know about medication usage

A

What it’s for
If it interacts with anything else
How to monitor oneself

63
Q

How are drugs categorized

A

Based on their target body tissue use and/or their action

64
Q

Significant info to know about a drug

A

Indication ( What it’s for)
Most COMMON side effect + any lethal side effect
Mot important nursing implications (administration or monitoring need-to-do)
Most needed patient education

65
Q

If an older adult is having any unusual sign of confusion or diorientation, where should our first culprit be

A

Adverse drug affect

66
Q

Important fact about older adults recieveing medications

A

Older adults face an increased risk of adverse medication effects.

67
Q

What age related change relates to slower drug clearance

A

Reducae heaptic blood flow

68
Q

Does diet affect an older adults ability to receive medication

A

Not usually

69
Q

What are medication on the BEERS criterea for?

A

catalogues medications that cause side effects in older adults due to the
physiologic changes of agin

70
Q
A

NURS 212 (21 decks)

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