Exam 1 Flashcards
What is pharmacokinetics?
what the body does to the drug?
What does the acronym ADME represent?
absorption
distribution
metabolism
excretion
What is disintegration?
break down of a drug into small particles
Which part of ADME describes how a drug is broken down?
metabolism
What part of ADME describes drug movement after administration?
absorption
What part of ADME describes where a medicine will go (movement to body tissues)?
distribution
What part of ADME describes how a medication will leave?
excretion
What is an important consideration for enteric-coated drugs?
Never crush them, as this will alter the absorption process
What happens to half-life during kidneys/liver dysfunction?
half-life increases
What is the primary site of metabolism for most drugs?
liver
Which route of drug absorption has the greatest bioavailability?
intravenous
What is dissolution?
combining of small drug particles with liquid to form a solution
What kind of drugs skip disintegration and dissolution?
liquid oral solution
Which populations generally have a more difficult time absorbing medications due to the alkaline pH of their gastric contents?
very young children and older adults
What kind of drugs are affected by the first pass effect?
orally administered
What is known as the percentage of a drug available for activity?
bioavailability
What are prodrugs?
inactive medications that become active once in the body
What is an agonist?
drug that binds to a receptor, causing a normal reaction
What is an antagonist?
blocks receptor site and prevents an action
What does selective mean?
binds to specific receptors
What is an adrenergic?
drug that mimics the sympathetic nervous system ex. norepinephrine
What does nonselective mean?
binds to all receptors
What are sympathetic responses of adrenergic agonists/sympathomimetics?
dilated pupils, dilated bronchioles, vessel constriction, bladder/uterine relaxation
When are adrenergic agonists often used?
for patients in shock (low BP)
What is the effect of epinephrine on Alpha 1 receptors?
vasoconstriction (this increases BP)
What is the effect of epinephrine on Beta 2 receptors?
bronchodilation
What is the effect of epinephrine on Beta 1 receptors?
increased HR
What lab would be especially important to monitor in individuals with diabetes after receiving epinephrine? Why?
blood glucose. It stimulates glycogenolysis
What medications can decrease the effect of epinephrine?
beta blockers
What are the side effects of epinephrine (an adrenergic agonist/sympathomimetic)?
hypertension, tachycardia, dizziness, headache, urinary retention, sweating, tremors, hyperglycemia
What are the adverse reactions of epinephrine (an adrenergic agonist/sympathomimetic?
Dysrhythmias, heart attack, paresthesia, oliguria, dyspnea, pulmonary edema numbness, extravasation (medication leaking from vein)
What are the nursing interventions for clients given epinephrine?
continuous bedside cardiac monitoring, BP and HR, monitor urine output, chest pain, blood glucose, and IV site (extravasation)
What drug is a Beta 2 agonist?
albuterol
What are the side effects of albuterol (a Beta 2 agonist)?
tremors, restlessness, nervousness and dizziness
What are adverse effects caused by albuterol?
reflex tachycardia, dysrhythmias,
What do adrenergic antagonists/sympatholytics do?
inhibit release of epinephrine and norepinephrine, reducing their effect (used to lower BP)
How can Beta blockers be recognized?
suffix -olol or -lol
What are the contraindications for nonselective Beta blockers (Propranolol, Sotalol, Timolol)? Why?
respiratory disorders (asthma, heart failure). bronchoconstriction can occur.
What drugs are in the Alpha 1 adrenergic ANTagonist class?
suffix -osin (Prazosin, alfuzosin, doxazosin, terazosin, tamsulosin)
What are examples of adrenergic agonists?
epinephrine, norepinephrine, amphetamine, ephedrine, and pseudoephedrine
What medications are Beta-2 agonists?
albuterol, levalbuterol, metaproterenol, and terbutaline,
What is tamsulosin used for?
used to treat BPH
What medications are selective Beta blockers (blocks only Beta 1-carioselective)?
metoprolol and atenolol
How should patients end use of selective Beta blockers? Why?
taper usage (end slowly). Could cause rebound myocardial excitation (MI) and hypertension
What specific symptoms should be monitored for patients on selective beta-blockers(metoprolol)?
activity intolerance, dyspnea, and edema
What patient education should be given for those prescribed Alpha 1 adrenergic blockers/antagonists (tamsulosin, prazosin)?
orthostatic hypotension, dizziness.
Patient should shift positions slowly and dangle legs off bed before standing up.
What mnemonic can be used to remember the effect of cholinergic agonists (metoclopramide, pilocarpine, bethanechol chloride)?
SLUDGES
S-salivation
L-lacrimation
U-urination
D-diarrhea
G- GI distress
E- emesis
S- sweating
A diabetic individual has recently been prescribed a Nonselective beta blocker (ex. propranolol), what education should the nurse give concerning hypoglycemia?
patient should avoid gauging their sugar (having a hypoglycemic episode) by their heart “racing,” as these meds lower HR, so this symptom of hypoglycemia is masked
Prior to administering metoprolol, what should the nurse assess? Why?
patient BP and HR, baseline EKG, blood glucose
-this is a Beta 1 adrenergic blocker, which lowers HR and BP
What medication should a patient taking prazosin avoid? Why?
phenylephrine (otc cold meds), because it stimulates an increase in BP, which is the opposite purpose of the prescribed prazosin
Scopolamine is often prescribed as a transdermal patch for what condition?
motion sickness
What patient education should be given for placement and use of a transdermal scopolamine patch?
place behind ear 4hrs before activity that causes motion sickness, and can be left for 3 days
What grocery product should be avoided in older individuals due to its impact on drug metabolism (especially calcium channel blockers)?
grapefruit juice
What is the enteral route?
administered orally
What is the first pass effect?
phenomenon by which drug passes through the liver (gets partially metabolized & becomes less active) before it reaches its site of action, reducing the % of active drug at specific site or in systemic circulation
What are pharmacodynamics?
what the drug does to the body; drug mechanism of action
Where are enteric coated tablets metabolized?
small intestine
What is known as the highest serum concentration of a drug within the body?
peak
What is known as the lowest serum concentration of a drug within the body?
trough
When should the peak of a medication administered via IV infusion be monitored?
30-60 mins after completion of the infusion
How should oral medications be administered for children?
oral syringe, slowly, in the cheek
what does the pregnancy category D mean?
risk to the fetus
Why are medication reconciliations important to perform?
prevent duplications, omissions, or drug interactions
Which pregnancy category is considered safe?
category A
Prior to administration, how many times should the nurse check that they are giving correct drug?
3 checks! (2 before entering room and 1 while scanning before giving)
What action should be taken if a patient refuses a medication?
document refusal, but educate on misinformation, explain risk of not taking medication, document explaining risk, and notify provider
What must be included on a medication order?
name of med, strength, dose, route, frequency, duration of administration, and special instructions
How should patient be positioned prior to giving oral meds?
high fowlers
What does pregnancy category C indicate?
human risk cannot be ruled out
How soon after oral administration should peak serum medication levels be checked?
2-3hrs after consumption
When should serum peak be checked for IM injection?
2-4hrs after injection
What effect do anticholinergics have on the body?
cant see, cant pee, cant spit, cant poop
A pt is prescribed scopolamine. It is most important for the nurse to assess the pt for a history of which condition?
Glaucoma
