Lecture 1&2 Pharmacology, the Nurses Role In Medication Administration Flashcards
What program does the FDA encourage for health care professionals to report a medication, product or medical event that causes serious harm to patients?
MedWatch program
Who regulates medication and nursing practice?
Nurse Practice Acts (NPA)
Are government control often more restrictive than health care agency policies?
No, healthcare agency policies are.
Chemical ( med. names)
Provides the exact description of medication’s composition, exact composition and molecular structure. (N-acetyl-para-aminophenol)
Trade (med. name)
Also known as brand or proprietary name. This is the name under which a manufacturer markets the medication (Tylenol)
Generic (med. name)
The manufacturer who first develops the drug assigns the name, and it is then listed in the U.S. Pharmacopeia. (Acetaminophen)
Medication Classification
Indicates the effect of a medication on a body system
-Symptoms the medication relieves or desired effect.
Medication forms
Solid, liquid, other oral forms (topical, parenteral)
- compositions of a medication enhances its absorption and metabolism
Solid forms of medication
-Caplet (shaped like capsule, coated for ease of swallowing)
-Capsule
-Tablet
-Enteric-coated tablet (coated tablet that dissolves in intestine)
Liquid forms of medication
- Elixir:
Clear fluid containing water and/or alcohol - Extract:
Syrup or dried form of pharmacologically active medication, usually made by evaporating solution - Aqueous solution:
Substance dissolved in water and syrups - Aqueous suspension:
Finely dissolved medication particles dispersed in liquid medium; when suspension is left standing, particles settle to bottom of container - Syrup:
Medication dissolved in a concentrated sugar solution - Tincture:
Alcohol extract from plant or vegetable
Other Oral Forms and Terms Associated with Oral Preparations
- Troche (lozenge):
Flat, round tablets that dissolve in mouth to release medication; not meant for ingestion - Aerosol:
Aqueous medication sprayed and absorbed in mouth and upper airway; not meant for ingestion
-Sustained Release:
Tablet or capsule that contains small particles of a medication coated with material that requires a varying amount of time to dissolve
Medication Forms Commonly Prepared for Administration by Topical Route
- Ointment (Salve or cream): Semisolid, externally applied preparation, usually containing one or more medications
- Liniment:
Usually contains alcohol, oil, or soapy emollient applied to skin - Lotion:
Semiliquid suspension that usually protects, cools, or cleanses skin - Paste:
Medication preparation that is thicker than ointment; absorbed through skin more slowly than ointment; often used for skin protection - Transdermal disk or patch: Medicated disk or patch absorbed through skin slowly over long period of time (e.g., 24 hours)
Medication Forms Commonly Prepared for Administration by Parenteral Route
- Solution:
Sterile preparation that contains water with one or more dissolved compounds - Powder:
Sterile particles of medication that are dissolved in a sterile liquid (e.g., water, normal saline) before administration
Medication Forms Commonly Prepared for Instillation Into Body Cavities
- Intraocular disk:
Small, flexible oval (similar to contact lens) consisting of two soft, outer layers and a middle layer containing medication; slowly releases medication when moistened by ocular fluid - Suppository:
Solid dosage form mixed with gelatin and shaped in form of pellet for insertion into body cavity (rectum or vagina); melts when it reaches body temperature, releasing medication for absorption
Pharmacokinetics
The study of how medications enter the body, reach their site of action, metabolize, and exit the body. (Alter physiological functions)
(We use pharmacokinetics when timing medication administration, selecting the route of administration, and evaluating a patient’s response.
Four processes for Pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
Where are medications absorbed/distributed in the patient’s body?
Cells, tissues, or a specific organ + alter physiological functions
Absorption
Occurs when medication molecules pass into the blood from the site of medication administration.
You are caring for a patient who has diabetes complicated by kidney disease. You need to make a detailed assessment when administering medications because this patient may experience problems with:
A. absorption.
B. biotransformation.
C. distribution.
D. excretion.
Answer: D
Rationale:
The kidneys are the main organs for medication excretion. If a patient’s renal function declines, the kidneys cannot excrete medications adequately.
What is the rate of absorption when applying medication to the skin?
Absorption is slower because of the physical makeup of the skin.
Factors that influence absorption:
- Route of administration
- Ability of a medication to dissolve
- Blood flow to the site of administration
- Body surface area
- Lipid solubility
Absorption rate of mucous membrane and respiratory tract
Quick rate of absorption
-the tissues contain many blood vessels
What is the administration route of oral medication?
It is slow because its passing through the GI tract.
What medication has the most rapid response of absorption?
Intravenous injection/administration
-medication are available immediately when they enter the systemic circulation
What occurs after Absorption?
Distribution occurs within the body to the tissues, organs and specific site of action.
How does blood supply of the site of administration determine how quickly the body can absorb a drug?
The richer the blood supply to the site of administration, the faster a medication is absorbed.
When medication comes into contact with a larger surface, does it absorb slower or faster?
Faster
-Majority of medications are absorbed in the small intestine rather the large intestine.
Why do highly lipid soluable medications absorb quickly?
Because cell membranes have a lipid layer, allowing the medication to cross cell membranes easily and can be quickly absorbed.
What does the speed of distribution depend on? (Circulation)
Vascularity of various tissue and organs
-Once the medication has entered into the bloodstream, it is carried throughout the tissues and organs of the body.
Distribution depends on…
- Physical and chemical properties of the medication
-Physiology of the person taking it: Circulation, Membrane permeability, protein binding
Membrane permeability
Protein binding
The degree to which medications bind to serum proteins such as albumin affects their distribution.
How are medications metabolized?
Into a less-potent or an inactive form
-easier to excrete
What are older adults/patients with liver disease or malnutrition at risk for when taking medication?
They have an increase risk of medication activity, toxicity or both because these conditions decrease albumin in the bloodstream
-Most medications binds to albumin (a type of protein) to some extent and then cannot be pharmacologically active.
How is a medication unbound or “free”?
Part of the medication that aren’t bound to protein are the active form of medication.
Where does most biotransformation occur?
Liver
Biotransformation
occurs under the influence of enzymes that detoxify, break down, and remove biologically active chemicals
Why is the liver important in metabolism?
The liver has a specialized structure that oxidizes and transforms many toxic substances.
- the liver degrades many harmful chemicals before they are distributed to the tissues.
What other parts of the body does biotransformation occur, other than liver?
Lungs, kidneys, Blood and Intestines
What are patients at risk for if their organs that metabolize medications are not functioning correctly?
Medication toxicity
-If any of these organs are not working properly, medications won’t be broken down as effectively, which can lead to a build-up of the drug in the body, increasing the risk of toxicity.
Metabolism
How the body breaks down the medication, usually in the liver, into active or inactive forms.
- Medications are changed into less potent or inactive forms through a process called biotransformation.
Distribution
How the medication travels through the body to reach cells, tissue, or organs
Excretion
How the medication is eliminated from the body, primarily through the kidneys.
Impairment of what two organs can increase the risk of medication toxicity?
Liver (Metabolism) and kidney (Excretion) function
What is the main organ for excretion?
Kidney
Which type of medications are excreted through the lungs?
Anesthetic gases and alcohol
Why should certain medications not be taken during pregnancy?
Some may pass through the placental barrier or mammary glands.
