final revision slide Flashcards
6 rights of medication error
- right patient
- right drug
- right dose
- right time
- right route of administration
- right documentation
4 additional rights incl:
right assessment
right education
right evaluation
right to refuse
what are the 3 checks to avoid medication error
- Check drug against IMR when removing it from medication drawer, refrigerator or controlled drugs
- Check the drug when preparing it, pouring it, taking it out, of the container or connecting the IV tubing to the bag
- Check the drug before administration
4 steps to take once error is detected
- check patient for any change of condition/ vital signs
- inform immediate superior
- inform doctor
- write and incident report
impact of medication error
patient may suffer morbidity or death which may carry legal implications.
patient may have to stay longer in hospital which results in an increase in healthcare cost and even time separated from family
nurse or doctor making the error may suffer self doubt and embarrassment
nurse or doctor making the error may face disciplinary inquiry
the hospital may suffer negative reputation for being unsafe
purpose of incident report after a medication error
- verify the client’s safety was safeguarded
- serve as a tool to improve drug administration
therapeutic response of most drugs depends on the __________ in the plasma.
concentration
the plasma concentration curve, give an indication of _________________ values
pharmacokinetics
definition of mimimum effective conc in drug plasma curve
amount of drug required to produce a therapeutic effect
definition of minimum effective conc in drug plasma curve
amount of drug required to produce a therapeutic effect
definition of therapeutic range in drug plasma curve
the range at which the drug produces its desired effect
definition of onset of action
represents the amount of time it takes to produce a therapeutic effect after drug administration
definition of onset of action (drug plasma conc)
represents the amount of time it takes to produce a therapeutic effect after drug administration
definition of area under the curve
the area under the plasma drug conc-time curves reflects the actual body exposure to drug after administration of a dose of the drug
definition duration of drug action
-plasma half life. ( T1/2)
Defined as time required for the plasma concentration of a drug to decrease by half. The plasma conc of a drug is halved after one elimination half-life.
for a drug with short-half life, the drug must be given ______ frequently
more
for a drug with a long-half life, the drug must be given _______ frequently
less
clinical implications of duration of drug action:
half-life determines the duration of drug action.
the half-life of a drug depends on its clearance and volume of distribution. the elimination half-life is considered to be independent of the amount of drug in the body.
definition of loading dose
higher amount given to ‘prime’ bloodstream
plateau reached faster and quickly produces therapeutic response
important when it is critical to raise the drug plasma quickly.
definition of maintenance dose
smaller doses to keep concentration within therapeutic
therapeutic index definition
TI is a measure of the safety of a drug. It is he ratio between a drug’s therapeutic benefits and its toxic effects.
therapeutic index
median lethal dose/ median effective dose
median lethal dose
the amount of drug that will be lethal in 50% of a group of animals
median effective dose
the amount of a drug required to produce a response in 50% of the subjects to whom the drug is given
example of medicine with low TI
warfarin, anti-epileptics, digoxin, vancomycin
larger the difference between the lethal dose and effective dose, the ______ (greater/smaller) the T.I thus the ______ (safer/toxic) the drug
greater, safer
smaller the difference between the lethal dose and effective dose the ________ (smaller/ greater) the TI , thus more ______ the drug
smaller, toxic
definition of potency
refers to the measure of how much a drug is required in order to produce a particular effect
definition of efficacy
refers to the magnitude of maximal response that can be produced by the drugs . (the higher the peak, the higher the efficacy)
convert 1 mg to g
0.001 g
convert 1 mg to mcg
1000 mcg
convert 1 kg to g
1000g
convert 1g to mg
1000 mg
convert 1L to mL
1000mL
convert 1mcL to L
0.000001L
convert 1mL to L
0.001 L
general formula for oral tablet / parenteral drug calc
number of tablets = prescribed dose (what u want) / tablet strength (what u have avail in the ward )
general formula for oral mixture
mixture volume =
[ prescribed dose / unit strength] x volume
general formula for iv drip rate
rate (drops/ min ) = [(total vol (mL) x drops/ mL)]/ [no of hours to run x 60 ]
general formula for iv drip rate
rate (drops/ min ) = [(total vol (mL) x drops/ mL)]/ [no of hours to run x 60 ]
proprietary drugs are also known as
brand name, trade name or commercial
generic drugs are also known as
non-proprietary, approved name or official name
trade name is assigned by ________________________. Basically to identify it from other companies that manufacture the same chemical/ drug.
assigned by pharmaceutical company that manufactured the product
generic name is assigned by the __________________
U.S Adopted Name Council
the term _____ suggests ownership and the pharmaceutical companies’ exclusive rights (also known as _________) for naming and marketing a drug for a fixed number of years after the new drug application is approved. this exclusive rights allows the drug company to ________________________
proprietary, patent ,
recoup the cost of research and development of the drug
difference between proprietary and generic drug
- generic drug have identical doses as the trade drug, but their formulations or inert ingredients may differ
- this difference may change the bioavailability of the drug
- cost, higher (P) lower (GD)
- strength of drug , SAME
definition of bioavailability
bioavailability is defined as the rate and extent to which the active ingredient is absorbed from the drug product and then becomes available at the site of the drug action to produce the desired effects
pharmacokinetic considerations in elderly patients
- decreased body water
- increased body fat as % of body mass
- increased blood pressure with left ventricular hypertrophy
- decreased liver function
- decreased bone density
pharmacokinetic considerations in paediatric patients (absorption)
- intestinal mobility
- gastric acid secretion and pH
- intestinal motility
- surface area of GIT
pharmacokinetic considerations in paediatric patients (distribution)
- children have higher % of water in body composition which can affect distribution of drugs
- higher doses of water-soluble drug may be needed
- less effective BBB in infants
pharmacokinetics consideration in paediatric patients (metabolism)
- hepatic metabolism is reduced in young children
pharmacokinetics consideration in paediatric patients (metabolism)
- drugs have a longer half-life in children due to slower drug to slower drug clearance and excretion.
