Lecture 2 Nursing 100

Question 1

Absorption (Parenteral Routes)

Answer 1

must be absorbed to exert action; usually liquid; fewer barriers than through GI tract

Question 2

ID Injection

Answer 2

Intradermal Injection

between skin layers; slow absorption; allergen skin testing; bleb is bump; slowest absorption

Question 3

Subcutaneous injection

Answer 3

45 degree angle or less; can go to 90 degress for fat people; massage (increases blood flow and absorption); below epidermis layer; less than or euql to 1 mL; 20 min faster absorbed

Question 4

IM Injection

Answer 4

Intramuscular Injection
Into a specific muscle (deltoid is fastest)
faster absorption than SQ; length of needle depends; at least 3 mL;

Question 5

Rate of Absorption (IM Injection)

Answer 5

depends on type of solution; clear- one substance = immediate effect;

suspension: cystalline particles= cloudy;
emulsion: oil-like base= prolonged absorption; can hurt: give in gluteal

Question 6

Intrathecal Injection

Answer 6

Into cerbrospinal fluid
Administered by MD only
Must be specific for intrathecal use b/c it goes to the brain

Question 7

Intraarticular injection

Answer 7

Into synovial joint fluid
adminstered by MD only
local effect
ex: cortisone, antibiotic

Question 8

IV Injection

Answer 8

Intravenous Injection
no absorption necessary
immediate systemic response
dilute soln properly
check compatibility w/ stuff in IV bag
CLEAR ONLY

Question 9

Topical application

Answer 9

absorbed slowly
hairless AND unshaven
also! eye drops aka gtt

Question 10

Ointment and Cream

Answer 10

Local effect; slow onset and sustained effect (hrs to weeks)

Question 11

Opthalmic drops

Answer 11

aka gtt
local absorption only
need to reapply q 2-4 hrs
acclude tear duct, have gloves, drop in lower lid (inner canthas)

Question 12

Ear drops

Answer 12

local effect only

Question 13

Postauricular patch or disk

Answer 13

behind ear; slow absorption

Question 14

Nasal instillation

Answer 14

mostly local effect by some absorption b/c of blood; some systemic effects

Question 15

Inhalation application

Answer 15

local effect to bronchial tree; some systemic effect; rapid absorption and effect

Question 16

MDI

Answer 16

Metered dose inhaler

spacer- goes w/ inhaler; long tube to dilute air- wait 1 min b/t puffs

Question 17

Spariva

Answer 17

put pill in holder, close (pierces) & have patient breathe in powder

Question 18

Advair

Answer 18

rinse mouth after! OR gum damage :(

Question 19

Checking Absorption

Answer 19

trough- right before next dose
peak- right after dose
check: bioavailability, after drug adminstered, blood lvls for Rx

Question 20

Loading Dose (Bolus)

Answer 20

increase dosage to go into therapeutic stage quicker

ex: herapin, digoxin

Question 21

Distribution of Drugs (depends on; adversely affected by)

Answer 21

Occurs after absorbed
depends on: blood flow, drugs affinity to lipid or aqueous tissue, protein binding
Adversely affected by: abscesses, excudates, glands, tumors

Question 22

Protein binding of drugs

Answer 22

2 drugs: purples and green (more protein bound)
more of the purple drugs flows to target site
if all sites on protein are bound, green will knock off purples

Question 23

Metabolism of drugs

Answer 23

body’s ability to change drug form; mostly in liver; creates metabolites; most water soluble for kidneys; some lipid soluble for biliary system (feces); affected by physiologic, genetic, environmental, developmental stage

Question 24

metabolites

Answer 24

mostly water soluble (excreted through kidney) active- create change

Question 25

biliary system

Answer 25

bile, etc, to L.I. some lipid soluble drugs pass this way

Question 26

Excretion of drugs

Answer 26

usually by kidneys; some by biliary system; very little physiologically: lungs, exocrine glands

Question 27

Artificial means of excretion if kidney dysfunction

Answer 27

hemodialysis: artificial kidney

peritoneal dialysis: liquid goes in 30 min- drain; :// q 6-8 hrs

Question 28

Drug Half-Life

Answer 28

determined via blood
time in body
1/2 drug gone (eliminated)
predicts frequency of dose and accumulation

Question 29

Pharmacodynamics (action and effect)

Answer 29

drug produces biochemical or physiologically changes

action: cellular level
ex: insulin transports glucose into a cell
effect: response resulting from an action; change in total body function
ex: lowering of blood glucose lvls

Question 30

Agonist

Answer 30

attracted to receptor; go to target site

Question 31

Antagonist

Answer 31

competes with agonist for receptor; prevents action and effect of agonist; usually stronger (antidotes)

Question 32

Ceiling effect

Answer 32

max response and no further affect

Question 33

Dose response curve

Answer 33

low dose= low response
high dose = high response
may ont correlate with dose-response
may reach max response

Question 34

Adverse Drug Effects (3 kinds)

Answer 34

desired, predictable, and anticipated
ex: benedryl for cold symptoms; ordered for sleep
unpredictable, unexplainable, or life threatening
toxic effects- tissue damage- reversible or irreversible

Question 35

Unpredictable Adverse Reactions (Idiosyncratic)

Answer 35

unexpected; opposite for desire

ex: Ritalin in children

Question 36

Allergic response

Answer 36

hypersensitivity
antigen-antibody response
defense mechanism to foreign proteins
usually after previous sensitization

Question 37

iatrogenic effect

Answer 37

Adverse reaction that mimic pathologic disorder
ASA (aspirin) = GI distress
Propranolol (lowers BP) = asthma
gentamicin = deafness

Question 38

Pediatric considerations

Answer 38

Immature organs; faster metabolism; adjust dose for weight and age; less gastric acid (high pH); low BP, >% water in body; less protein binding, GFR, excretion

Question 39

Geriatric considerations

Answer 39

Less organ (f) r/t aging; more chronic illness= more chance of adverse/interaction; see many doctors; less protein, less water in body; GI more alkaline (higher pH- increase pH affects absorption); less GI motility, cardiac output, liver (f)