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Theory Unit 4 > Intro To pharmacology > Flashcards

Intro To pharmacology Flashcards

1
Q

Controlled substances, schedules, or classifications

A

Determined by the drug enforcement agency (DEA) ,justice department, and then scheduled according to the controlled substance act.

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2
Q

How is a drug classified or scheduled?

A

Based on potential for abuse and physical, psychological dependence on the drug

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3
Q

Controlled substances required information

A

Name of patient receiving narcotic
Amount of narcotic used
The date and time the narcotic was given
The name of the physician prescribing the narcotic
Name of the nurse administering narcotic
A narcotic prepared and not used must be witnessed by another nurse, that it was destroyed
Documentation is done by both nurses in the narcotic record 

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4
Q

Requirements for narcotics in facilities

A

Kept in a locked cabinet or cart. Usually double locked.
Facility check on opioids at the beginning and ending of every shift and count whenever dispensing them by two nurses
Checked after administration of the opioid
Narcotics may be ordered routinely or PRN

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5
Q

What is pharmacology?

A

Exploration of substances that are used to heal and comfort the sick, and then other ways help us to live longer and healthier lives

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6
Q

Pharmacodynamics

A

Refers to the effects of drugs on the body or more scientifically the negative and positive bio chemical, or physiological changes that a drug creates

There are six categories of desired effects

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7
Q

Categories of medication

A

Curative
Prophylactic
Diagnostic
Palliative
Replacement
Destructive

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8
Q

Curative

A

treats, a problem

Examples are antibiotics or a diuretic

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9
Q

Prophylactic

A

Prevents a problem

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10
Q

Diagnostic

A

Helps diagnose a disease or condition

Examples are contrast dyes or barium enema

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11
Q

Palliative

A

Treat symptoms to make the patient more comfortable

Examples are pain, meds or inhalers

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12
Q

Destructive

A

Destroys, tumors, and or microbes

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13
Q

Drug class classifications

A

Classified by body systems by how the medication react to certain body systems, or relieves symptoms

Examples are anticoagulant

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14
Q

True, or false drugs can be part of more than one classification

A

True

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15
Q

What do the last syllables of generic medication indicate?

A

The last syllables indicate the class

Examples are OLOL, PRIL, TIDINE, PRAZOLE

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16
Q

Generic drug names

A

Assigned by the manufacturer that first developed the drug, name is lowercase, name can be used by anyone

This is the manufacturers name

Examples are acetaminophen

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17
Q

I drug brand or trade name

A

Copyrighted by the company that sells the drug
Uppercase

Example Tylenol

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18
Q

Pharmacokinetics

A

A drug cycle, or the process of how medication gets to the target site and what happens to the medication during the journey

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19
Q

Where is most absorption done in the body?

A

Muscles or G.I. track

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20
Q

What is absorption?

A

The process by which a substance moves into the bloodstream from the site where it is administered

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21
Q

True or false sub Q is less absorbing than intramuscular

A

True 

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22
Q

What factors very absorption rate

A

Route of administration: topical is the slowest
Ability to dissolve
Blood flow of the area
Body surface
Solubility of the med

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23
Q

Distribution

A

The delivery of a drug to the appropriate site after the drug has been absorbed into the bloodstream

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24
Q

Factors that affect drug distribution

A

Circulation
Membrane permeability
Plasma, protein binding

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25
Q

Circulation

A

The greater the blood supply, the greater the distribution-easier to move drug to the site

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26
Q

Membrane permeability

A

Drug must be able to cross the cell membrane in order to be distributed

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27
Q

Brain barrier vs. Placental barrier.

A

Fat soluble can cross this barrier

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28
Q

Plasma, protein binding

A

once the protein is in the circulation it attaches to plasma proteins, like albumin and decreases the amount of free drug available

Can create toxicity because it’s not getting binded

Liver problem or malnutrition

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29
Q

Metabolism

A

Is medication reaches the specific site bio transformation occurs under the influence of enzymes, that detoxify, degrade, and then biologically act of chemicals are removed.

The liver is the primary site for drug metabolism

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30
Q

What factors affect drug metabolism?

A

Age
Genetic
Disease state
Nutritional state

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31
Q

Excretion

A

The drug is excreted from the body after it is metabolized it exits the body through the kidneys, liver bowel, lungs, or exocrine glands, and respiratory

Kidneys are the main organ for excretion of drugs

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32
Q

Factors that affect the drug action

A

Developmental considerations-elderly, kids, does calculation by weight
Weight
Genetics and cultural factors differences in metabolizing medication’s, and or tolerance of medication
Psychological factors -state of mind placebo
Pathology -disease, kidney or liver
Environment-noise nutritional state
Timing of administration -empty stomach, food, diuretics

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33
Q

Drug affects are classified as

A

Local or systemic

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34
Q

Therapeutic effect

A

The concentration of a drug in the blood serum that produces the desired effect without side effects or toxicity

Intended or desired, physiological response of medication

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35
Q

Therapeutic range

A

Range between the minimum effect, concentration MEC and toxicity concentration

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36
Q

Side effects

A

Most drugs have additional effects be on the therapeutic effect on the body. These are generally mild.

Examples are nausea or constipation

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37
Q

Adverse drug affects

A

Severe side effects that lead to harm or death these are unpredictable

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38
Q

Toxic affects

A

Occurs when there is a prolonged intake of a medication, or when the medicine accumulates in the body

Example respiratory depression with narcotics opioids

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39
Q

Idiosyncratic effect

A

Abnormal or peculiar response to a drug that may manifest itself by over response, under response, or different from the expected outcome

Such as an allergic reaction

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40
Q

Symptoms of drug allergy

A

Uticaria— hives
Eczema
Pruritus— itching
Rhinitis
Wheezing
Anaphylactic shock

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41
Q

Anaphylactic reaction

A

Respiratory distress
Severe bronchial spasm
Airways close
Cardiovascular shock or collapse

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42
Q

Treatment for anaphylactic shock, or drug allergy

A

Antihistamine or epinephrine

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43
Q

Drug interactions

A

Agonist
Synergist
Antagonist 

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44
Q

Agonist

A

When a drug is taken with another drug, so the two can work together

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45
Q

Synergist

A

A greater effect than that of each drug alone

Example, ginseng, and Coumadin

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46
Q

Antagonist

A

When two drugs are taken together, the effect of each is lessened

Example is antibiotics and birth control

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47
Q

Half-life

A

The time it takes the body to eliminate half the blood concentration level of the drug

The time interval required to reduce the amount of the drug in the body by 50%

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48
Q

Loading dose

A

A larger than normal, initial dose of a drug to achieve therapeutic affect as quickly as possible

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49
Q

Serum drug level

A

Serum level can be monitored by drawing a serum blood level after the drug has been administered and has had time to absorb in the body

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50
Q

Onset

A

Medication effect first begins

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51
Q

Peak

A

Medication is at its highest concentration or at its peak affect

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52
Q

Duration

A

How long medication effects last

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53
Q

trough

A

The lowest serum concentration of a medication before the next medication dose is administer

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54
Q

Teratogenetic drug

A

Pass placenta barrier
Drug known to cause birth defects
Examples are Accutane for acne and alcohol

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55
Q

Three checks

A

Always check the medication label with the mar during the three checks

1.When the nurse reaches for the medication
2. Before pouring or opening the medication.
3. When replacing the medication, punch, card or medication, bottle back or before opening the unit at bedside

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56
Q

10 rights

A

Right client
Right medication
Right dose
Right time,frequency
Right route
Right documentation
Right client education
Right to refuse
Right assessment
Write evaluation

First five rights are always done with the three checks

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57
Q

Right client

A

Most important nursing intervention* used every time medication is given*

Check ID band
Patient states name and birthdate
Photo ID

NEVER USE ROOM NUMBER

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58
Q

Right medication

A

Read the medication label and compare it to the MAR three times:

—— before removing the container
—— just before opening and pouring medication
—— immediately prior to administration

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59
Q

Right dose

A

Compared to average dosages
Metric dosages, containing decimal are of particular concern
Split or crush medication given with pudding or applesauce

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60
Q

Right time

A

Administer medication‘s in long-term care one hour before or one hour after designated time

Administer medication in acute care. 30 minutes before or 30 minutes after the designated time.

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61
Q

Military time

A

000 one for one minute after midnight

2359 for one minute before midnight

No duplication in numbers

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62
Q

Right route

A

Oral
Parenteral or intramuscular
Topical
Rectal

63
Q

Right documentation

A

When medication administered, must be documented immediately
Never record before administration
MAR‘s or immediate reference for medication administration
MAR’s must be maintained up to the minute

64
Q

Right client education

A

Inform client about the medication, the purpose, and what to expect how to take it and what to report

65
Q

Individualized education

A

What does the client already know?
What do they need to know?
What do they want to know?

66
Q

Right to refuse

A

Respect the right to refuse

Explain the consequences, inform the provider and document the refusal

67
Q

Write evaluation

A

Follow up with the client to verify therapeutic effect as well as adverse effect

68
Q

Maintaining a safe environment

A

Wash your hands before beginning medication administration
Good lighting
Don’t leave meds, unattended
Nurse who prepares the med gives the med

69
Q

Administering medication’s

A

Check for allergies
Check compatibility of medication
Prepare one med at a time
Identify patient
Remain with patient to ensure the med is taken
If one is refused or dropped, positive identification can be made, and the drug recorded or replaced
Never leave medication at bedside
Record the medication was given right after administering

70
Q

Medication distribution system

A

Stock supply
Individual supply
Unit dose
Automated medication, dispensing system

71
Q

Stock supply

A

For all residence

72
Q

Individual supply

A

Per client

73
Q

Unit dose

A

One dose

74
Q

Are automated medication dispensing system

A

Computerized medication system

Barcoded medication cart

75
Q

Medication orders include:

A

Patients full name
Date and time order is written
Name of drug to be administered -generic
Dose of drug
Route by which drug is to be administered
Time in frequency
Signature of provider

76
Q

Types of medication orders

A

Standing order
PRN order
Single one time order
Stat order
Now order
Routine order

77
Q

Standing order

A

Protocol nurse has permission to do certain things with medication

78
Q

PRN order

A

As needed

79
Q

Single order

A

Given only once

80
Q

Stat order

A

Given immediately

81
Q

Now order

A

To be given with a 90 minutes

82
Q

Routine order

A

scheduled on a daily basis

83
Q

Actions for medication errors

A

Report as soon as discovered
Institute necessary remedial measures immediately
Determine reason for error
Institute corrective policy procedure to prevent reoccurrence

84
Q

Preventing medication errors

A

The two biggest factors in medication errors are distraction and fatigue
Use extreme caution when administering medication
Always use 10 rights
Routine should not be routine

85
Q

Medication errors are one of the most common allegations in nursing liability

A
86
Q

Patient education

A

Start teaching as soon as the patient is admitted
Education is key to success at home
Teach to the patience level of understanding
Verbal instruction is complemented by written instruction
Teach back to us, demonstrates their understanding of our teachings

87
Q

Placement of zero

A

Prevents overlooking, decimal point 

88
Q

 How do you round medication orders?

A

To the nearest 10th

89
Q

Metric system

A

Logically organized

Safest to use

Widely used

90
Q

Household measurements

A

Least accurate system

Commonly known

often used for teaching

91
Q

Advantages of oral medication

A

Safe

Inexpensive

Easy and convenient

92
Q

Disadvantages of oral medication

A

Oral medication’s have high variable absorption

Inactivation can occur in the G.I. track or buy first pass effect

Clients must be cooperative and conscious

93
Q

Solid forms of oral medication

A

Tablets

Capsule

Powders

Lozenges

94
Q

Liquid form of oral medication’s

A

Elixirs

Syrups

Suspensions or shakes

95
Q

How do you pour a liquid med?

A

Palm. The label.

Read at bottom of meniscus

Eye level

Wipe lip of bottle

96
Q

Sublingual

A

Under the tongue

97
Q

Buccal

A

Between the cheek and the gum

98
Q

Translingual

A

Top of tongue

99
Q

What does sublingual buccal and translingual bypass

A

The stomach and liver

100
Q

Oral medication procedure general guidelines

A

Check for patient allergies

Check expiration dates on package

Prepare meds for only one patient

Do not open wrapper until at bedside

Hold medication‘s that need assessment

Offer fluids

If medicine falls anywhere, but the patient bedside is contaminated

Remain with patient until swallowed

Do not leave med at bedside

Document in the MAR

Follow up 30 to 60 minutes after doses given 

101
Q

Rectal suppository administration

A

Suppositories can be for local or systemic affect

Wear gloves

Position patient in left Sims

Suppositories in place for as long as it can be tolerated at least five minutes

102
Q

Administering medication through a internal feeding tube

A

Gastrostomy

Jejunostomy

103
Q

Gastrostomy

A

Into the stomach

104
Q

Jejunostomy

A

G.I. track

Small intestine

105
Q

NG tube nasal gastric

A

Inserted in the nose

106
Q

Administering meds via external feeding tube

A

Check for placement of tube by aspiration method

Aspirate 20 to 30 mLs of stomach Content or intestinal Contant

Check pH content

Flush tube with 15 to 30 mils of water

Medication should be liquid or may need to be crushed or added to water

Flush tube with 30 to 60 ML’s of water

Extended release should not be given via G-tube

Keep track of how liquid is instilled on the I/O

** if continuous feeding discontinue feeding prior to medication administration by 30 minutes**

107
Q

Stomach contents

A

Greenish brown

pH of, 1 to 5

108
Q

Intestinal continents

A

Yellowish green

PH of 6+

109
Q

Criteria for choosing equipment for injection

A

Route of administration

Viscosity of a solution

Quantity to be administered

Body size

Type of medication

110
Q

Needleless systems

A

Prevents needlestick injuries

Sheathed and plastic guard

Retractable needle

Blunt cannulas

111
Q

Prefilled cartridges

A

Provide a single dose of medication

Cartridges fit in a reusable holder, called a Tubex or carpuject

112
Q

Five types of insulin

A

Rapid acting insulin

Short acting insulin

Intermediate insulin

Long acting insulin

Insulin mixture

113
Q

How are insulins administered?

A

Always subcutaneous

114
Q

Regular insulin

A

It is clear, fast acting, and is the only one that can be given IV

115
Q

NPH

A

It’s cloudy, and you need to roll it

116
Q

Lantus

A

Long acting, and it cannot be mixed

117
Q

Insulin mixtures

A

They are premixed and contain to insulins

118
Q

Sliding scale for insulin

A

Doctors order insulin ranges based on blood sugar readings

This dose is given in addition to the routine insulin orders

119
Q

What is insulin?

A

It is a hormonal, meant to take up sugars and raise levels

120
Q

Reconstitution of medication

A

Salute

Solvent or diluent

Solution

121
Q

Solute

A

A powder or liquid concentrates to be diluted or dissolved

122
Q

Solvent or diluent

A

Liquid added to a solution

123
Q

Solution

A

Is the liquid that results when the solvent dissolves in the solute

124
Q

What is reconstitution?

A

The technique of adding a diluent to a powder drug 

125
Q

Intradermal=ID

A

Gauge— 25 to 27

Links — 1/2 to 5/8 inch

Angle— 5 to 15°

Sites — upper chest, upper back inner forearm

126
Q

Subcutaneous=SQ

A

Gauge— 25 to 27

Length— 3/8 to 5/8 inch

Angle— 45 to 90° angle

Sites— outer upper arm, middle of back love, handles, and lower stomach 

127
Q

Intramuscular=IM

A

Gauge— 18 to 25

Length— 5/8 to 1 1/2 inch

Angle— 90° angle

Sites— ventrogluteal, vastus lateralis, deltoid

128
Q

Intradermal injections

A

TB testing
Allergy testing
Longest absorption time
Inner surface of forearm

129
Q

Subcutaneous injection

A

Injecting medication into the adipose fat tissue
Pinch of the skin and insert the needle at a 90° angle
If the person is thin, insert at 45°

130
Q

Heparin and Lovenox

A

No sub Q
Do not massage
Rotate site
Adminis. 2 inches from umbilicus(heprin)
—-administer anterior lateral posterior lateral abdomen Lovenox love handles

131
Q

Antidote for heparin and Lovenox

A

Protamine sulfate

132
Q

When choosing an IM site

A

4 mils can be given to adults in larger muscles

1 to 2 mills in a single site for children and elderly

133
Q

Primary sites for intramuscular injections

A

Ventral gluteal

Vastus lateralis

Deltoid 

134
Q

Vastus lateralis

A

One hand breath above the patella

One handbreadth below the greater trochanter

Locate the midline of the thighs lateral middle third

135
Q

Deltoid

A

Locate the acromion process

Count 2 to 3 finger widths below the acromion process 

Locate the axillary fold

Imagine an upside down triangle and inject into the center

136
Q

Z track method

A

Prevents seepage of the medication
———-vitamin B and iron
Reduces pain and discomfort of certain I am injections
Ventral, gluteal site preferred
Paul skin approximately one to one and a half inches laterally
Holds skin tight
Inject with darting motion
Release skin

137
Q

What does inject slowly mean?

A

One mL for every 10 seconds

138
Q

Documenting on the MAR after administering a med

A

Date
Time
Medication
Dose
Route
Site
Patient name
Nurses signature

139
Q

1 L =

A

1000 mL

140
Q

1 g =

A

1000 mg

141
Q

1 kg =

A

1000 g

2.2 pounds.

142
Q

1 mg=

A

1000 mcg

143
Q

30 cc

A

1 ounce

2 tablespoons

144
Q

1 teaspoon

A

5 mL

145
Q

1 cup

A

8 ounces

240 mL

146
Q

2 cups

A

1 pint

147
Q

2 pints

A

1 quart

148
Q

4 quarts

A

1 gallon

149
Q

1 pound

A

16 ounces

150
Q

1 foot

A

12 inches

151
Q

1 inch

A

2.54 cm.

152
Q

Need Fahrenheit

A

Take Celsius X 1.8+32.

153
Q

Need Celsius

A

Take Fahrenheit -32÷1.8

Theory Unit 4 (1 decks)

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