Exam 1 Flashcards
Medication Error
Any preventable event that may cause or lead to inappropriate med use or patient harm
Rights of Drug Administration
- Right Drug
- Right Dose
- Right Time
- Right Route
- Right Patient
- Right Documentation
- Right to refuse
- Right Reason
- Right Reaction
Chemical Name
Describes the drug’s chemical composition and molecular structure
Generic Name
Given by the U.S. Adopted Names Council; nonproprietary name
Trade Name
Drug has a registered trademark- use of drug name is restricted by patent owner; proprietary name
Pharmacokinetics
Study of what the body does to a drug
(Absorption, Distribution, Metabolism, Excretion)
Toxicology
Science of adverse effects of drugs and other chemicals on living organisms
Pharmacognosy
Study of natural vs. synthetic drug sources
Pharmacoeconomics
Study of economic factors influencing the cost of drug therapy, cost-benefit analysis
Enteral Route
Drug absorbed into systemic circulation through the oral or gastric mucosa or small intestine
(EX: oral, sublingual, buccal, rectal)
Parenteral Route
EX: IV, IM, subcutaneous, intradermal, intraarterial, intrathecal, intraarticular
Topical Route
EX: Skin, eyes, ears, nose, mouth, lungs (inhalation), rectum (local effects), vagina
Bioavailability
The extent of drug absorption
First Past Effect
Large portion of the drug is broken down by the liver into inactive metabolites
Distribution
Transport of the drug by blood to site of action
(Albumin is the most common blood protein)
Metabolism
How the body breaks down the drug
Excretion
Elimination of the drug from the body
-renal
-biliary
-bowel
Half-Life
Time required for half of the given drug to be removed from the body
Steady State
Amount of drug removed = amount of drug absorbed
Peak Level
Highest blood level of drug
Trough Level
Lowest blood level of drug
Toxicity
Occurs if peak is too high
Pharmacotherapeutics
Clinical use of drugs to prevent and treat diseases
Tolerance
Decreased response to repeated drug dosages
Dependence
Physiologic or psychological need for a drug
Psychological Dependence
“Addiction”
-Obsessive desire for euphoric effects of drug
When can med errors occur?
-Prescribing
-Administering
-Dispensing
-Monitoring
Adverse reactions to medications:
-Pharmacologic reaction
-Hypersensitivity reaction (allergy)
-Idiosyncratic reaction: rare and unpredictable reactions
-Drug interaction
Drug therapy during pregnancy:
-Drugs cross the placenta via diffusion
-Factors impacting safety: drug properties, fetal gestational age, maternal factors
What trimester is drug transfer to the fetus most likely to occur in?
Third trimester
Neonatal and Pediatric Considerations
-Absorption: gastric pH less acidic until 1-2; gastric emptying slowed; IM absorption faster and irregular
-Distribution: lower fat content, decreased protein binding, immature BBB
-Metabolism: immature liver, older children may have higher metabolism
-Excretion: immature kidneys
Factors affecting pediatric drug doses:
-Skin is thin and permeable
-Stomach lacks acid to kill bacteria
-Lungs have weaker mucous barriers
-Body temp. not well regulated
-Easy dehydration
-Immature liver and kidneys
-MUST DETERMINE DOSAGE BY WEIGHT IN KG
Factors affecting older adults and drugs:
-Decline in organ function
-Drug therapy more likely to result in adverse effects and toxicity
-High use of medications
-Polypharmacy
-Noncompliance
-Nonadherence
-Sensory and motor deficits
Older Adult Considerations:
-Absorption: gastric pH less acidic, gastric emptying and movement slowed, blood flow to GI tract reduced, absorptive surface reduced
-Distribution: increased fat content, decreased proteins by liver, decreased drug binding
-Metabolism: decreased liver blood flow and breakdown
-Excretion: decreased filtration rate and fewer nephrons, drugs cleared less efficiently
Adverse Drug Events
Composed of both medication errors and adverse drug responses (allergic reactions and idiosyncratic reactions)
Drugs commonly involved in med errors:
CNS drugs, anticoagulants, chemotherapy drugs
Near Miss
Event/situation did not produce patient injury but only due to chance
Types of Med Errors:
- No error, although circumstances/events occurred that could have led to one
- Med error that causes harm
- Med error that causes no harm
- Med error that results in death
Med error Prevention:
-Check med orders 3 times before administration
-Rights of med admin
-Assessment
-2 patient identifiers
-Do NOT administer if you did not prepare the meds yourself
-minimize verbal/telephone orders
-Don’t assume or use unapproved shorthand
-Use generic names
-Mandatory second nurse verifications for high risk meds/patients
-Minimize interruptions
Reporting Errors:
-Report to prescriber and nursing management
-Document error per policy
-Factual information only
When should medication reconciliation be done?
Admission, status change, patient transfer within/between facilities or providers, discharge
Tylenol affects the _______
Liver
Ibuprofen affects the __________
Kidneys
Over the Counter Drugs
Nonprescription drugs used for short-term treatment of common minor illnesses
Criteria for OTC Drugs:
- Indication for use: the consumer must be able to easily diagnose and monitor themselves for effectiveness; benefits must outweigh the risks
- Safety: drugs must have limited interaction with other drugs, low potential for abuse, and high therapeutic index
- Practicality: drugs must be easy to use and monitor