Exam 1 - Substance Abuse, Legal/Ethics, Medication Administration, Principals of Pharm Flashcards
Factors contributing to drug abuse
- Initial use (peer pressure, curiosity, etc)
- Reinforcement 2 ways: pleasure and reduce unpleasant experience
- Physical dependence
- Psychologic dependence
- Social factors
- Drug availability
- Vulnerability of the individual
Principles of Addiction Treatment
- No single treatment
- Lifelong process
- Multiple modalities needed
Scheduled Drugs
- Schedule I - high abuse, no medical use
- heroin, LSD
- Schedule II - high abuse, accepted uses
- morphine, cocaine, methadone, codeine
- Schedule III - less abuse, accepted uses
- acetaminophen with codeine, testosterone
- Schedule IV - lower abuse, accepted uses
- phenobarbital, diazepam
- Schedule V - low abuse
- Lomotil
Pregnancy Safety Categories
- Category A – studied in humans and found to pose no known risk to fetus
- Category B – studied in animals and found to pose no known risk to fetus, or evidence of risk in animal studies not confirmed by controlled trials in humans
- Category C - adverse effects on fetus in animal studies but no data in humans, or no data in humans or animals.
- Category D - positive evidence of human risk; potential benefit may indicate use
- Category X - positive evidence of human risk; DO NOT USE
When studying the impact a drug has on the body, the nurse is reviewing what?
A.The drug’s pharmacokinetics
B.The drug’s selectivity
C.The drug’s pharmacodynamics
D.The drug’s predictability
C.The drug’s pharmacodynamics
Pharmacodynamics can be thought of as the impact of drugs on the body. Pharmacokinetics describes the movement of drugs through the body. Selectivity is the ability of a drug to elicit only the response for which it is given. Predictability is the degree of certainty about how a patient will respond to a certain drug.
Pharmacotherapeutics
use of drugs in the prevention and treatment of disease
Nursing Process
- Assessment
- Diagnosis
- Planning
- Implementation
- Evaluation
Five “A”s of Tobacco Dependence
- Ask about tobacco use
- Advise to quit
- Assess willingness to attempt quitting
- Assist in cessation attempt
- Arrange follow-up
Intravenous administration advantages/disadvantages
Advantages
- Rapid onset.
- Precise control over over the amount of drug entering the blood.
- Suitability for use with large volumes of fluid.
- Suitability for irritant drugs
Disadvantages
- High Cost
- Difficulty
- Inconvenience
- Danger because of irreversibility
- Potential for fluid overload
- Infection
- Embolism
Pharmacokinetics
processes of absorption, distribution, biotransformation, and excretion of drugs
Why is it important for drugs to have ease of administration?
A.Fewer medication errors
B.Less risk of side effects
C.Greater chemical stability
D.Greater likelihood of reversibility
A.Fewer medication errors
Ease of administration increases convenience and adherence and can reduce administration errors. Ease of administration is not related to side effects, chemical stability, or reversibility.
Properties of Drugs
- Effectiveness
- Safety
- Selectivity
- Reversible Action
- Predictability
- Ease of Administration
- Freedom from Drug Interaction
- Low Cost
- Chemical Stability
- Possession of Simple Generic Name
A nurse doesn’t understand why a patient is to receive a prescribed med. What should they do?
Verify with the prescribing healthcare provider the reason for the medication, because nurses should not administer a medication unless they understand the reason for its use.
Absorption is enhanced by…
- Rapid drug dissolution.
- High lipid solubility of the drug.
- A large surface are for absorption
- High blood flow at the site of administration.
- High lipid solubility.
- A large difference between the pH of plasma and the pH at the site of administration.
Enteric-coated oral formulation release their content in ___________________________
the small intestine NOT the stomach like other oral drugs.
Addiction
disease process in which use results in physical, psychological or social harm to user, yet use continues
Marijuana - most commonly abused illegal substance
Action…?
Symptoms of Intoxication?
- CNS depressant and psychedelic effects
- Symptoms of intoxication:
- impaired memory and problem-solving
- decreased motivation
- May cause psychological dependence
- Long-term consequences are controversial
Mr. J had abdominal surgery yesterday and is stating that he has pain at his incision site. You administer morphine sulfate 2 mg IV. What step in the nursing process was this?
Implementation– administration of medication is part of the implementation step
Factors that Determine Drug Response
- Administration - dosage, route, timing of dose must be correct! Errors: wrong med, wrong dose, wrong route, wrong time
- Pharmacokinetics - determine how much med reaches intended site
- Pharmacodynamics - determine nature & intensity of response.
What kind of drug diffuses most rapidly? Why?
lipid-soluble drugs because the cell membrane is lipoid
Drug Half-Life
the time required for the amount of drug in the body to decrease by 50%
Ex: The half life of morphine is about 3 hours. Body stores of morphine will decrease 50% every 3 hours, so if there is 50 mg of morphine in the body, 25 mg. (or 50%) will be lost in 3 hours.
