Intro To Pharmacology

Question 1

Each drug has its own characteristics

Answer 1

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

Question 2

Drugs elicit different responses depending on individual factors:

Answer 2

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

Question 3

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

Answer 3

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

Question 4

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

Answer 4

86%

Question 5

Before drug administration, what are nurse legal responsibilities?

Answer 5

▫️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)

Question 6

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

Answer 6

CNO Standard of Medication Practice

Question 7

Prior to medication administration and practice, nurses use their______?

Answer 7

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

Question 8

Nurse accountability in medication practice?

PLANNING

Answer 8

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.

Question 9

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

Answer 9

1. safe
2. effective
3. ethical manner

Question 10

CNA ➡️ Code of Ethics

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

Answer 10

safe, compassionate, competent and ethical care

Question 11

Nurses responsible for when giving medication:

Answer 11

▫️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

Question 12

What are the different ways drugs enter the body?

Answer 12

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

Question 13

A drug that reverse the effect

Answer 13

Antidote

Question 14

Subcutaneous. ____ml? _____ syringe gauge

Answer 14

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

Question 15

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

Answer 15

🔘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

Question 16

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

Answer 16

▫️bronchodilate

Question 17

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

Answer 17

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

Question 18

smallest blood supply is BONE

Answer 18

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

Question 19

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

Answer 19

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)

Question 20

What factors affect drug absorption?

Answer 20

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.

Question 21

Distribution involves the transport of drug molecules within the body:

Answer 21

▫️blood supply
▫️blood brain barrier
▫️protein binding

Question 22

Area of body that has slow distribution of blood supply:

Answer 22

▫️fat tissue
▫️bone
▫️skin

Question 23

Blood brain barrier (BBB)

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

Answer 23

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

Question 24

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

Side effects:
▫️drowsiness
▫️

Answer 24

Always ask pt on child bearing years, if pregnant.

Drugs cross placenta barrier:
▫️cocaine
▫️caffeine
▫️alcohol

🔸very few drugs that can cross FBB

Question 25

Significance of protein binding

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

Answer 25

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

Question 26

conditions affecting plasma protein binding:

Answer 26

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

Question 27

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)

Answer 27

🔺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

Question 28

___________ ?

▫️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

Answer 28

First Pass Effect

Question 29

Primary site of excretion is_____.

Answer 29

Kidney

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

Question 30

Factors that influence excretion:
▫️decreased renal function
▫️Age

Answer 30

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

Question 31

▫️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

Answer 31

Serum Blood Levels

Question 32

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

Answer 32

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🔸

Question 33

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

Answer 33

🔸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.

Question 34

What is the goal of therapy?

Answer 34

Use of drug for therapeutic purpose

Question 35

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

Answer 35

Drug overdose

Question 36

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

Answer 36

Pharmacokinetics

Question 37

Alteration of the drug structure. Enzyme-mediated.

Answer 37

Metabolism (aka- bio transformation)

Question 38

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

Answer 38

Pharmacodynamic