Intro To Pharmacology Flashcards by Lysza Sabanal

Each drug has its own characteristics

▫️therapeutic application
▫️interaction
▫️side effects
▫️mechanism of action

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Drugs elicit different responses depending on individual factors:

▫️age 
▫️sex
▫️body mass
▫️health status
▫️genetics

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Medication incidents are a common cause of morbidity and preventable death:

▫️can cause serious illness
▫️increase patient length of stay
▫️increase in health care cost
▫️affect reputation of facility
▫️rarely, can result in death

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One study showed that nurses intercepted _____% of all med errors made by others.

86%

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Before drug administration, what are nurse legal responsibilities?

▫️practice within your scope as a RPN
▫️CNO - College of Nurses of Ontario Standards
▫️be knowledgeable
-never give medication that you haven’t researched
-you are responsible for the drugs that you administer
▫️monitoring -nursing process
▫️client education
▫️advocacy
▫️documentation
▫️ethical practice (clients right, reporting errors)

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This documentation outlines the nurse’s responsibilities related to medication & medication administration

CNO Standard of Medication Practice

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Prior to medication administration and practice, nurses use their______?

knowledge, skills, and judgement in the assessment of the client.

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Nurse accountability in medication practice?

PLANNING

Nurses are accountable for ensuring the accuracy, appropriateness, & completeness of a clients plan of care in regards to medication orders and for communicating concerns about the treatment plan to other members of the health care team.

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Nurses prepare and administer medication(s) to clients in a ____, ____, and ______.

safe
effective
ethical manner

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CNA ➡️ Code of Ethics

e.g. providing _____, ______, ______, & _____

safe, compassionate, competent and ethical care

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Nurses responsible for when giving medication:

▫️administering them only to people for whom they are prescribed
▫️ recording each dose given on agency narcotic sheets and on the patient’s medication administration record
▫️maintaining an accurate inventory
▫️ reporting discrepancies to the proper authorities

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What are the different ways drugs enter the body?

▫️orally
▫️ears
▫️eyes
▫️IV
▫️topical 
▫️inhaled
▫️buccal
▫️sublingual

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A drug that reverse the effect

Antidote

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Subcutaneous. ____ml? _____ syringe gauge

▫️1.5 to 2 mL
▫️ 23-25 gauge
▫️don’t aspirate when you give subq
▫️we don’t massage, can cause bruising

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🔸 Intramuscular (IM)
max.vol. ___? landmark? areas to inject?
what med.given?

🔘2-3mL IM max
🔘landmark properly in body that has fats, important to landmark bcoz they could hit nerves
🔘 site: ventrogluteal (adults); dorsogluteal (children)
🔘we do not aspirate anymore w/ IM injection
🔘meds given: vaccines

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simply puffer (nebulizer) it goes directly to site of action. We don’t see lots of side effects. We want to bronco_____ the bronchioles.

▫️bronchodilate

absorption is rapid from IM sites bcoz muscle tissue has an abundant supply

The higher the blood supply, the greater the absorption. i.e. kidney, ❤️, lungs, brain.

smallest blood supply is BONE

people with bone cancer is hard to treat, same with skin cancer bcoz not much blood flowing in the skin.

Lipid soluble drug has super fast onset of action. Can enter our brain and spinal cord.
ex. General anesthetic, anti-anxiety, caffeine

Do you think kidney can excrete lipid soluble? It has to be change to water soluble

Water soluble that can affect brain & spinal cord (can’t go to site of brain & spinal cord)

What factors affect drug absorption?

When you have empty stomach, the drug absorbs faster. Yet, for patient who has GI problem, they need to have food in their stomach but distribution of drug could be slower.

Distribution involves the transport of drug molecules within the body:

▫️blood supply
▫️blood brain barrier
▫️protein binding

Area of body that has slow distribution of blood supply:

▫️fat tissue
▫️bone
▫️skin

Blood brain barrier (BBB)

▫️selectively permeable membrane that is designed to protect the brain.

Lipid can cross the BBB. If someone has meningitis and doctor will order a water soluble drug, you will have to question it.

Drugs that crosses BBB:
▫️anti-anxiety
▫️sedative
▫️general anesthetic (lipid soluble)

Side effects:
▫️drowsiness
▫️

Always ask pt on child bearing years, if pregnant.

Drugs cross placenta barrier:
▫️cocaine
▫️caffeine
▫️alcohol

🔸very few drugs that can cross FBB

Significance of protein binding 🔘monitor your client’s serum albumin level ▫️low albumin levels can lead to drug toxicity

Drugs that are highly bound to plasma proteins or stored in other tissues have a longer duration of action ▫️Zithromax

conditions affecting plasma protein binding:

▫️healthy individual has more plasma protein that can bind with drugs. ▫️malnourished has minimal plasma protein that drugs can bind

Decreased drug metabolism ▫️infants (immature hepatic enzyme system) ▫️impaired hepatic blood flow (including the elderly) ▫️severe hepatic or CV disease ▫️low serum albumin ▫️drug-drug interactions (both drugs are competing for the same metabolizing enzymes)

🔺infants has impaired/immature hepatic enzyme system 🔺severe hepatic (liver system) affect drug to be metabolized 🔺HPB or LBP can affect drug distribution 🔺some drug compete i.e. antibiotics and birth control, antibiotic wins out the day. 🔺with child bearing age on antibiotic, always ask and use other birth barrier like condom

___________ ? ▫️only occurs when medication are given orally ▫️drug via the oral route is absorbed in the GI tract and travels to the liver via portal circulation where it is extensively metabolized in the liver. ▫️as a result of this only a portion of the drug dose reached the systemic circulation

First Pass Effect

Primary site of excretion is_____.

Kidney Other site include: ▫️bowel, lung, skin, bile, sweat, saliva and breast milk.

Factors that influence excretion: ▫️decreased renal function ▫️Age

those very young and very old undergo kidney function test before they will be given a certain medication 🔺if we don’t excrete drug properly can lead t toxicity

▫️a lab measurement of the amount of drug in the blood stream at a particular point in time ▫️used with drugs that have a narrow therapeutic ▫️when suspect a drug overdose ▫️to assess adherence to the prescribed therapy

Serum Blood Levels

Terms used to describe the drug effects -reactions of the body to the drug

1. Onset of action - the time after administration when the body initially responds to the drug 2. Peak effect - the time required for a drug to reach its maximum therapeutic response. 3. Duration of action - the length of time that the drug concentration is sufficient (w/o more doses) for the drug to elicit a therapeutic response. 🔸how long has the drug will take a therapeutic response🔸

_____ is the time required for the serum concentration of a drug to decrease by 50%

🔸Serum half-life, also called elimination half-life 🗯the higher the half-life the less frequent we give medication. the lower the half-life, the frequent the dosing.

What is the goal of therapy?

Use of drug for therapeutic purpose

It’s a result from excessive amounts of a drug whether received in a single dose or multiple doses.

Drug overdose

The study of movement of drugs throughout body from introduction to excretion. Four properties: absorption, distribution, metabolism, and excretion

Pharmacokinetics

Alteration of the drug structure. Enzyme-mediated.

Metabolism (aka- bio transformation)

Branch of pharmacology concerned with mechanisms of drug action and the relationships between drug concentration and responses to the body.

Pharmacodynamic