Ch.61 Introduction to Pharmacology (BN)

Question 1

Explain how the Controlled Substances Act regulates the storage of, and accountability for, specific medications.

Describe the proper procedure for monitoring these schedule drugs in the healthcare facility.

Answer 1

• The DEA regulates the manufacture, prescription, and distribution of psychoactive medications, including narcotics, depressants, stimulants, and hallucinogens.
• There are five classifications, or “schedules,” of controlled substances. The degree of control depends on the medication’s actions, which range from:
  
  • Schedule I (high potential for abuse) to
  • Schedule V (relatively low potential for abuse).
• In a healthcare facility or pharmacy, controlled substances must be kept in a double-locked area.
  
  • The keys must be in a licensed nurse’s possession at all times or access must be controlled electronically.
• Only licensed nurses are allowed to access schedule drugs.
• The client’s name, medication name, dose, time of administration, and signature or personal identification number (PIN) of the licensed nurse who administered it must be recorded.
• Schedule drugs must be documented in the client’s record within 5 min of administration.
• Most acute care facilities use some sort of computerized dispensing unit.
  
  • This unit dispenses and keeps records of controlled substances and other medications.
  • Medications are accessible only with the entry of a PIN assigned to each individual nurse or by fingerprint identification.

Question 2

Describe specific client rights, related to prescribe medications.

Answer 2

• Clients have the right to know the name, action, and possible side effects of their medications.
• They also have the right to refuse medications, unless a court order is in place. (If clients are endangering themselves or others or are considered a “medical emergency,” medications may be given against their will.)
• Clients also have the right to request the generic form of prescribed medications, if available.
  
  • Generic forms of medications are often less expensive than their brand name counterparts.

Question 3

List sources of drug information for nurses.

Answer 3

• The Physicians’ Desk Reference (PDR): This recognized source contains extensive information concerning therapeutic dosages, expected therapeutic effects, possible side effects, contraindications, drug interactions, and FDA pregnancy categories (levels of danger to a fetus).
• Facts & Comparisons: It lists medications under the following classifications: nutritional products, blood modifiers, hormones, diuretics, cardiovascular drugs, autonomic drugs, central nervous system drugs, gastrointestinal drugs, anti-infectives, and biologicals.
• The United States Pharmacopeia/National Formulary (USP-NF): is a book containing national standards for drugs, chemicals, and dietary supplements marketed in the United States.
• Lippincott’s Nursing Drug Guide
• Nursing Drug reference
• Handbook of Drugs for Nurse Practice:
  
  • They incorporate nursing considerations, in addition to mechanisms of action, uses, contraindications, precautions, dosages, preparations, interactions, pharmacokinetics (actions of drugs), side effects, and treatment of overdose.
  • They also emphasize client and family teaching.

Question 4

Define the terms chemical, generic, official, and trade/brand names of medications. State which medication names are most commonly used.

Answer 4

• Chemical Name: describes the medication’s chemical composition.
• Generic Name: is often similar to the chemical name and is assigned by the medication’s first manufacturer.
• Official Name: is the name identified in the USP-NF or in Health Canada’s publications .
• Trade/brand names of medications: is the copyrighted name assigned by the company manufacturing the medication and is usually followed by the symbol ® .
• If more than one company makes the same medication, it will have the same generic name, but different trade names.
  
  • For this reason, many healthcare providers order medications using only the generic name.

Question 5

Describe dosage formats for oral medications.

Answer 5

Administration of drugs by swallowing or instillatiojn thorgouh entereal tube

Solid:

• Scored Tablet (Can be cut in half)
• Enteric-coated tablet: (Slow breakdown; to small intestine) DO NOT CRUSH
• Modified Realease: Sustained/extended continous release

Liquid:

• Syrup
• Exlier
• Suspension (Thick)

Measured by

• Calibrated Cups: Pouring at eye level
• Droppers
• Syringes
• Dosing Spoon

Question 6

List and describe routes of medication administration.

Answer 6

• Oral: Administered by mouth
• Topical: Applied to the skin or mucous membranes
• Inhalant: Inhaled or breathed in
• Injectabled: Given via a needle
• Transdermal: Applied to and absorbed through the skin

Question 7

Discuss factors influencing medication dosage.

Answer 7

• Age
• Gender
• Weight
• Client’s Condition
• Disposition and Psychological State
• Method of Administration
• Distribution
• Environmental Factors
• Time of Administration
• Elimination

Question 8

Differentiate between prescribed and over-the-counter medications.

Answer 8

• A prescription (medication order) is an electronic, written, or verbal formula for preparing and giving a medication.
  
  • As stated before, specific healthcare providers are licensed to prescribe medications.
  • A legend drug is a medicine that under federal law cannot be dispensed without a prescription from a licensed practitioner.
• Medications that can be purchased without a prescription are called over-the-counter ( OTC ) drugs.

Question 9

List required components of a prescription.

Answer 9

• Client’s full name
• Date and time of day
• Name of drug
• Dosage/amount of drug
• Time/Frequency
• Method/Route
• Primary Health Care Provider’s Signature (Written of electronic)

Question 10

A ____________ or medication is a medicinal agent that modifies body functions.

Answer 10

Drug

Question 11

__________ is the science that deals with the origin, nature, chemistry, effects, and uses of medication.

Answer 11

Pharmacology

Question 12

Liquid medications for topical use include instillations and __________.

Answer 12

Irrigations

Question 13

An oral __________ is a medicated tablet that dissolves in the mouth.

Answer 13

Troche

Question 14

When medications are absorbed via the oral mucosa or __________, they bypass the gastrointestinal tract.

Answer 14

Skin

Question 15

Identify the object in the figure.

Answer 15

The object in the image is a computerized medication dispensing cabinet.

Question 16

Explain its purpose and how it is used.

Answer 16

• A computerized medication dispensing cabinet dispenses and keeps records of controlled substances and other medications.
• Medications are only accessible with the entry of a personal identification number (PIN) assigned to each individual nurse.
• In this way, there is a computerized record of each medication removed from the machine, as well as the client for whom it was signed out, the nurse, the time and date, and the amount of medication remaining.

Question 17

Describes the medication’s chemical composition

Answer 17

Chemical name

Question 18

Similar to the chemical name and assigned by the medication’s first manufacturer.

Answer 18

Generic Name

Question 19

Name identified in the USP or NF or, in Canada, on Health Canada’s publications

Answer 19

Official name

Question 20

Copyrighted name assigned by the company manufacturing the medication and usually followed by the symbol ®

Answer 20

Trade Name

Question 21

What is the purpose of medication references?

Answer 21

• Medication references are valuable tools for learning about the classification, use, abuse, desired actions, recommended dosage, and adverse actions of medications.
• These books incorporate nursing considerations, treatments of overdose, and client and family teaching.

Question 22

List three medications references commonly used by nurses.

Answer 22

Medication references commonly used by nurses include:

• The Nursing Drug Reference
• The Handbook of Drugs for Nursing Practice
• The Nurse’s Drug Looseleaf

Question 23

Which are the different routes of administration of a medication?

Answer 23

The different routes of administration of medications are:

• Oral (administered by mouth)
• Topical (applied to the skin or mucous membranes)
• Inhalant (inhaled or breathed in)
• Injectable (given via a needle)
• Transdermal (applied to and absorbed through the skin).

Question 24

What are the different modes of administration of semisolid medications?

Answer 24

Semisolid medications are usually administered by the rectal, vaginal, or urethral routes or administered topically.

Question 25

Who is a registered pharmacist?

Answer 25

A registered pharmacist (RPh) is a healthcare professional who is licensed to prepare and dispense medications on the order of a licensed practitioner of medicine.

Question 26

A nurse is caring for a client who has been prescribed a medication by the healthcare provider.

What should the nurse know about the medication before administering it to the client?

Answer 26

The nurse should know the generic and common trade name, classification, use, recommended dosage, desired effects, possible adverse or untoward effects, and route of administration of any medication administered.

Question 27

A nurse is caring for a client who has been prescribed a medication by the healthcare provider.

Which details should the nurse know about the client before administering any medication to them?

Answer 27

• The nurse should ensure that the client does not have any allergy or previous adverse reaction to the medication.
• The nurse should obtain a detailed medication history of the client from his family and pharmacy.

Question 28

A client admitted to the healthcare facility asks the nurse to administer the generic form of a medication prescribed to the client.

What are the clients rights related to administration of medication?

Answer 28

• Clients have the right to request administration of the generic form of prescribed medications, if available, because they are often less expensive than their brand name counterparts.
• Clients have the right to know the name, action, and possible side effects of medications administered to them.

Question 29

A nurse is required to know all about the medications that are being administered to the client.

What should the nurse do if in doubt regarding a medication?

Answer 29

• If in doubt regarding a medication, the nurse should refer to the drug reference books.
• The nursing units of most healthcare facilities contain a copy of the Physician’s Desk Reference (PDR).
• This book is a valuable tool for learning about the classification, use, abuse, desired actions, recommended dosage, and adverse actions of medications.
• It incorporates nursing considerations in addition to mechanisms of action, uses, contraindications, precautions, dosages, preparations, interactions, pharmacokinetics, side effects, and treatments of overdose.
• This book also emphasizes client and family teaching.

Question 30

A client admitted to the healthcare facility asks the nurse to administer the generic form of a medication prescribed to the client.

What should the nurse do if the client refuses to take a medication?

Answer 30

• Clients have the right to refuse medications, unless a court order gives a physician the right to administer medications without the client’s consent.
• Clients may be given medications against their will if they are endangering themselves or others.