chapter 31: medication administration Flashcards
Federal Regulations
Pure Food and Drug Act
FDA
National Formulary
USP
Medwatch
Sate/ Local Govt
adhere to Fed standars
have some say over stuff not covered by Fed standards
regulate alc and tobacco
Health Care Agencies
Meet Fed and State policies
Usually stricter though - e.g. automatic stop of narcotics after certain amt of days
Nurse Practice Acts
define scope of nurses’ professional functions and responsibilities
Med names
3: chemical, generic, and trade/brand name
Capitalize key letters to keep from making a mistake
Pharmacokinetics
study of how meds enter the body, reach their site of action, metabolize, and exit body
Absorption
med molecules pass into blood from site of med administration
Fast to slow:
on skin
oral
mucous memrane / respiratory airway
subcutaneous
intramuscular
Intravenous
which absorbs faster:
liquids or tablets/capsules?
acidic or alkaline meds?
lipid- or water- soluble?
liquids
acidic
lipid
Factors affecting absorption
route
ability to dissolve
blood flow to site of admission
body surface area
lipid solubility
Factors affecting distribution
Circulation –> good blood flow = fast delivery
Membrane permeability –> e.g. BBB only permeable to fat soluble stuff
Protein binding –> most meds partially bind to albumin - the rest is active
Metabolism of drugs
biotransformation occurs thru enzymes that detoxify, break down, and remove active chems
Liver is main one, but lungs, kidney, blood, and intestines do it too
If these organs aren’t working, meds accumulate and become toxic
Excretion
through kidneys, liver, bowel, lungs, and exocrine glands
lungs excrete NO, alc, and anesthesia
exocrine glands secrete lipid soluble stuff
Meds that go through digestion reabsorbed in small intestine - slowed emptying increases effects
KIDNEYS ARE MAIN ONE —> stay hydrated
Therapeutic effect
expected, predicted physiological response caused by the med
Adverse effects: who’s at risk?
young
old
pregnant
multiple meds
overweight
underweight
renal or liver disease
Side effects
predictable and often unavoidable adverse effect
Toxic effects
develop after taking for long time or if it accumulates
death!
Naloxone is antidote for opioids
Idiosyncratic reaction
overreaction, underreaction, or unexpected response to a med
Allergic reactions
-body sees med as antigen and so releases antibodies to fight it
Anaphylactic rxns = constriction of bronchiolar muscles, edema of pharynx/larynx, severe wheezing and shortness of breath
Medication interactions
synergistic effect = increase effect of each other
e.g. alc has synergistic effect on antihistamines, antidepressants, barbiturates, and narcotic analgesics
Medication tolerance and medication dependance
need higher doses to produce same outcome: morphine, nitrates, alc
Dependance is psychological and/or physical
-physical if withdrawal happens
Minimum effective concentration (MEC)
minimum amt of med in plasma needed to make effects happen
safe therapeutic range
tried to attain this consistently
bt MEC and toxic concentration
Biological half life
time it takes for excretion processes to lower serum medication concentration by half
Time intervals to know when administering meds
- Onset of med action = time to take effect
- peak action = time to reach peak
- trough = min blood serum level before next dose
- duration of action = how long the therapeutic effect is working
- plateau = blood serum concentration reached and maintained after repeated fixed doses