Chapter 35-Medications Flashcards
Medication
a substance administered for the diagnosis, cure, treatment, relief of a symptom, or prevention of disease
drug
a chemical compound taken for disease prevention, diagnosis, cure, or relief or to affect the structure or function of the body
Prescription
the written direction for the preparation and administration of a drug
Generic Name
a drug name not protected by trademark and usually describing the chemical structure of the drug
-assigned by the United states Adopted Names(USAN)council
Brand name aka Trade name
the name given by the drug manufacturer
Official Name
the name under which a drug is listed in one of the official publications (e.g., the United States Pharmacopeia)
Pharmacology
the scientific study of the actions of drugs on living animals and humans
Pharmacy
the art of preparing, compounding, and dispensing drugs; also refers to the place where drugs are prepared and dispensed
Pharmacist
a person licensed to prepare and dispense drugs and prescriptions
Pharmacopoeia
a book containing a list of drug products used in medicine, including their descriptions and formulas
Types of drug preparation
Page 842 table 35-1
-aerosol spray or foam elixir syrup cream lotion tablet capsule suppository caplet (not all listed)
Food, drug and cosmetic act 1938
- implemeted by FDA
- Requires that label be accurate and that all drugs be tested for harmful effects
Durkham-Humphrey Amendment (1952)
-clearly differentiates drugs that can be sold without a prescription, and those that can be sold only with a rx, and those that cannt be refilled without a new rx
Kefauver-Harris Amendment (1962)
Requires proff of safety and efficacy of a drug for approval
Comprehensive Drug abuse prevention and control act (1970)
controlled substance act
-categorizes controlled substances and limits how often a prescription can be filled, established govt funded programs to prevent drug dependence
Therapeutic effect (desired effect)
the primary effect intended of a drug; reason the drug is prescribed
side effect
the secondary effect of a drug that is unintended; usually predictable and may be either harmless or potentially harmful
adverse effect
more severe side effects which may justify the discontinuation of a drug
drug toxicity
the quality of a drug that exerts a deleterious effect on an organism or tissue, results from overdosage, ingestion of drug intended for external use
Drug allergy
an immunologic reaction to a drug
Therapeutic actions of drugs
page 844 table 35-3
- palliative (releives symptoms of disease, but does not affect disease itself)
- curative (cures a disease or condition)
- supportive (supports a body function until other treatments or the body’s response can take over)
- substitutive (replaces body fluids or substances)
- chemotherapeutic (destroys malignant cells)
- restorative (returns the body to health)
Anaphylactic reaction
a severe allergic reaction usually occurs immediately after the administration of the drug
Drug tolerance
a condition in which successive increases in the dosage of a drug are required to maintain a given therapeutic effect
Cumulative effect
the increasing response to repeated doses of a drug that occurs when the rate of administration exceeds the rate of metabolism or excretion
Idiosyncratic effect
a different, unexpected or individual effect from the normal one usually expected from a medication; the occurrence of unpredictable and unexplainable symptoms
drug interaction
the beneficial or harmful interaction of one drug with another drug
Potentiating effect
the increased effect of one or both drugs
Inhibiting effect
the decreased effect of one or both drugs
synergistic effect
occurs when two different drugs increase the action of one or another drug ie:codeine and aspirin both analgesics
latrogenic disease
disease cause unintentionally by medical therapy
Drug abuse
excessive intake of a substance either continually or periodically
drug dependence
inability to keep the intake of a drug or substance under control
Drug habituation
a mild form of psychologic dependence on a drug
Physiological dependence
tissues require the substance for normal functions
psychological dependence
is an emotional reliance on a drug to maintain a sense of well being
illicit drugs
-aka street drugs
sold illegally
-2 types; unavalable for purchase(heorin)
and available for purchase with rx, sold illegally
Onset of action
the time after administration when the body initially responds to the drug
Peak plasma level
the highest plasma level achieved by a single dose when the elimination rate equals the rate of absorption
drug half-life (elimination half dose)
the time required for the elimination process to reduce the concentration of the drug to one half what it was at initial administration
Plateau
a maintained concentration of a drug in the plasma during a series of scheduled doses
Pharmacodynamics
the process by which a drug alters cell physiology
Receptor
the drugs specific target, usually a protein located on the surface of a cell membrane or within the cell
agonist
a drug produces the same type of response as physiological or endogenouis substance
antagonist
a drug that inhibits cell function by occupying receptor sites
Pharmacokinetics
the study of the absorption, distribution, biotransformation, and excretion of drugs
absorption
the process by which a drug passes into the bloodstream
Distribution
the transportation of a drug from its site of absorption to its site of action
biotransformation
process by which a drug is converted to a less active form; also called detoxification
excretion
elimination of a waste product produced by the body cells from the body
Factors affecting medication action
Developmental factors (pregnancy, infants, older adults, children, etc)
-Sex (related to body fat and hormonal differences)
-Cultural, ethnic, and genetic factors
-Diet (nutrients affect meds, ex, vitamin K counteracts coumadin)
-Environment (temp affects vasoconstriction/dilation, behovior, mood, busy, noise, etc)
-Psychological factors (expectations affect response to meds)
-Illness and disease (drug action altered in clients with circulatory, liver, or kidney dysfunction)
-Time of administration (affects relative speed with which they act. some meds best taken with foods, some without.)
0
oral
referring to the mouth
-most convenient
-usually least expensive
safe-doesnt break sin barrier
otic
referring to the ear
opthalmic
referring to the eye
sublingual
under the tongue
-more potent than oral
buccal
pertaining to the cheek
rectal
- can be used when drug has a bad taste or odor
- drug released at slow steady rate
vaginal
provides a local effect
topical
few side effects
Parenteral
drug administration occurring outside the alimentary tract; injected into the body through some route other than the alimentary canal (e.g., intramuscularly)
intraspinal(intrathecal)
into the spinal cord
epidural
into the epidural space
topical
applied externally (e.g., to the skin or mucous membranes)
stat order
common medication order which indicates that the medication is to be given immediately and only once
single order
common medication order which “one-time order” is for medication to be given once at a specified time
standing order
a written document about policies, rules, regulations, or orders regarding client care; give nurses the authority to carry out specific actions under certain circumstances
prn order
as needed order, permits the nurse to give a medication when, in the nurse’s judgment, the client requires it
essential part of medication order
- Full name of the client
- Date and time the order is written
- Name of the drug to be administered
- Dosage of the drug
- Frequency of administration
- Route of administration
- Signature of the person writing the order
Parts of a prescription
-descriptive info about client, name, address, age dob
-date rx written
-the rx symbol
-med name, dosage, strength
-route of admin
-dispensing instructions
-direc of adminstration
-refills
dr signature
minim
the basic unit of measure in the apothecary system, equal to 0.0616 mL
Medication reconciliation
a method to ensure that clients recieve the appropriate medications and dosages. Three important areas for medication reconciliation to occur are
1) on admission
2) during shift reports, transfers, and with new medication administration records.
3) at discharge
Ten rights of med admin
1) right medication
2) right time
3) right route
4) right client
5) right client
6) right client education
7) right documention
8) right to refuse
9) right assessment
10) right evaluation
Nasogastric Tube
a tube is inserted by way of the nasopharynx and is placed into the client’s stomach for the purpose of feeding the client or to remove gastric secretions
Administering subcutaneous injection
1-3ml syringe. #25 gauge or smaller needle. 3/8 or 5/8 inch long needle. 45 or 90 degree angle. DO NOT aspirate, especially w/ heparin. Aspirating with insulin is not recommened. DO NOT massage site after injection
pinch or spread skin.
Administering intramusclular injection
1-3mL 1-1.5-inches #21 or #22 ventrogluteal site preferred dorsogluteal site should NOT be used, too risky Inject using z track method 90-degree angle quick darting motion aspirate for 5-10 seconds inject med slowly, 10 seconds per milliliter After injection wait 10 seconds Apply gentle pressure at the site Not necessary to massage, may cause leakage.
Vastus Lateralis site
Recommended site for IM injections for infants 1 year and younger.
- Middle third of outside (lateral) of thigh.
- No major blood vessels or nerves in the area, is desirable for infants whose gluteal muscles are poorly developed
