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Pharm Exam 1 > Lesson 3 > Flashcards

Lesson 3 Flashcards

1
Q

Oral Forms

A
  • powder
  • tablet
  • capsule
  • lozenge or troche
  • liquid
  • suspension
  • emulsion
  • elixir
  • syrup
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2
Q

tablet

A
  • some are scored

- enteric coated dissolves in small intestine (do not crush)

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3
Q

capsule

A
  • gelatin shell
  • some contain powder or liquid
  • time release
  • do not crush
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4
Q

suspension

A

liquid form of drug particles suspended, not dissolved

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5
Q

emulsion

A

liquid form in oils and fats in water

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6
Q

elixir

A

liquid formulation with alcohol base

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7
Q

syrup

A

sweet liquid formulation

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8
Q

Routes

A
  • oral
  • sublingual
  • buccal
  • NG
  • instillation
  • topical
  • inhalation
  • parenteral
  • rectal
  • vaginal
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9
Q

Do not crush

A
  • enteric coated tablets

- Time release capsules

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10
Q

Process for administering medication via the oral route

A
  1. wash hands, clean gloves
  2. assess for contraindications to oral route
  3. pt sitting upright with chin flexed
  4. open packaged meds at bedside
  5. perform needed assessment (s)
  6. administer critical meds first
  7. if help needed, place cup to lips, giving one med at a time
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11
Q

Measuring liquid medication

A
  • cup on flat surface

- move down to eye level

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12
Q

Advantages to NG/Enteric Tube Route

A
  • if pt cannot swallow
  • unconscious
  • avoids use of injection
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13
Q

Disadvantages to NG/Enteric Tube Route

A
  • discomfort of tube
  • risk of aspiration
  • can get occluded
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14
Q

Drug forms with NG Tube

A

can be crushed: liquids and orals

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15
Q

What forms can you NOT use in a NG tube

A
  • enteric coated

- time release

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16
Q

How to read the meniscus

A

locate the lowest fluid mark

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17
Q

Meds given through NG tube should…

A

be administered separately

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18
Q

Dilute NG crushed pills in…

A

30 ML of sterile water before administering

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19
Q

How to verify placement of NG tube

A

air, aspirate, pH testing

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20
Q

HOB after meds/feeding…

A

remain in fowlers position preferably 45 degrees or higher

-never less than 30 degrees

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21
Q

Apply topical meds using…

A

gloves to clean skin

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22
Q

liniments

A

liquid or lotion, made with oil for rubbing on body to relieve pain

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23
Q

with topical meds no…

A

double dipping or sharing

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24
Q

hydration equals..

A

increased absorption

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25
Q

thin skin equals..

A

increased absorption

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26
Q

larger area of application equals..

A

increased absorption

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27
Q

Advantages of dermal patches

A
  • systemic effect
  • constant, even release of med over long period
  • absorption slow
  • consistent blood levels
  • easy application
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28
Q

Disadvantages of dermal patches

A
  • skin sensitivity

- difficulty with adherence of adhesives

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29
Q

Topical Drug Forms

A
  • cream
  • ointments
  • paste
  • lotions
  • liniments
  • powder
  • dermal patches
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30
Q

creams

A
  • semisolid

- nongreasy emulsion

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31
Q

ointments

A

-oil base semisolid

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32
Q

paste

A

stiffer than ointment

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33
Q

lotions

A
  • aqueous preparations

- suspended particles

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34
Q

liniments

A

liquid containing alcohol, oil, or soapy emollient

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35
Q

Instillation Drug Forms

A
  • eyes
  • ears
  • nose
36
Q

Eye drug forms

A
  • drops

- ointments

37
Q

Ear drug forms

A

-drops

38
Q

Nose drug forms

A
  • drops

- sprays

39
Q

Vagina drug forms

A
  • cream
  • suppositories
  • douche
40
Q

Rectum drug forms

A
  • suppositories

- enema

41
Q

Spacers

A

enhance the delivery of medications from the MDI

42
Q

Metered-dose inhaler

A

handheld devices that deliver medication to the lower respiratory tract

43
Q

Some MDIs have…

A

a counter to indicate the number of inhalations used

44
Q

For MDIs that do not have a counter..

A

the most accurate way to determine the number is for the patient to count and record the number of inhalations used

-often not practical

45
Q

Inhalation route

A
  • spray or mist
  • gas
  • powder
46
Q

spray or mist

A
  • nebulizer

- inhaler (w or w/out spacer)

47
Q

gas

A

general anesthesia

48
Q

powder

A

powder placed in spinhaler

49
Q

Advantages of parenteral route

A
  • more rapid absorption and effect compared to other routes
  • bypasses GI tract
  • bypasses first pass (liver)
50
Q

Disadvantages of parenteral route

A
  • risk of local tissues, nerves, bone damage

- risk for administering drug into vascular system

51
Q

When parenteral route is selected…

A
  • pt cannot take oral meds
  • drug is not suitable for GI tract
  • faster effect is desired
52
Q

Parenteral Drug Routes

A
  • intravenous
  • intramuscular
  • subQ
  • intradermal
  • intraspinal
  • epidural
  • intracardiac
  • intraosseous
  • intraarterial
  • intracapsular
  • intraperitoneal
  • intrapleural
53
Q

Parenteral drug forms

A
  • solutions

- powders

54
Q

Solutions

A

drugs suspected in sterile medium such as sterile water or in an oil medium

55
Q

Powders

A

must be reconstituted with suitable sterile solvent such as sterile water

56
Q

Intradermal needle length and gauge

A

25-27 gauge

3/8 to 5/8 inch

57
Q

subcutaneous needle length and gauge

A

25-27 gauge

1/2 to 5/8 inch

58
Q

intramuscular needle length and gauge

A

18-23 gauge
1 to 1 1/2 inche

18 for blood products

59
Q

intradermal injection sites

A
  1. ventral mid-forearm
  2. clavicular area on chest
  3. scapular area on back
60
Q

what to know about subcutaneous injection sites

A
  • chosen for adequate fat-pad size
  • sites should be rotated to avoid overuse
  • larger amount of medication may have to be divided and administered at two sites or else the medication route may change
61
Q

what to know about intradermal injection sites

A

chosen so that inflammatory reaction can be observed

62
Q

subcutaneous injection sites

A
  • upper arm
  • thigh
  • stomach
  • mid back
  • above buttocks, love handles
63
Q

what to know about intramuscular injection sites

A

chosen for adequate muscle size and minimal major nerves and blood vessels in the area

64
Q

IM injection sites

A
  1. ventrogluteal (preferred for adults and toddlers - walking)
  2. dorsogluteal (not preferred due to sciatic nerve)
  3. deltoid
  4. vastus lateralis
65
Q

Intravenous

A

-peripheral veins

66
Q

adult IV

A

20-21g 1 to 1 1/2 inch

67
Q

infant IV

A

24g 1 inch

68
Q

children IV

A

22g 1 inch

69
Q

Insulin action

A

lowers blood sugar by stimulating glucose uptake in the skeletal muscle and fat

-inhibits hepatic glucose production

70
Q

insulin types

A
  • clear (regular or crystalline)

- cloudy (NPH)

71
Q

protamine

A

what makes the insulin cloudy

-used to prolong the action of insulin in the body

72
Q

which insulin can be given both IV and SubQ

A

only clear (reg)

73
Q

types of insulin

A
  • rapid
  • fast
  • intermediate
  • long
  • commercial premixed
74
Q

Intradermal injection

A

bleb

-inject medication slowly to form a wheal (blister or bleb)

75
Q

rapid-acting insulin

A
  • humalog
  • Aspart
  • Apidra
76
Q

fast-acting insulin

A

Humulin R
Regular
Novolin R

77
Q

intermediate-acting insulin

A
  • NPH
  • Humulin N
  • Novolin N
78
Q

long-acting insulin

A
  • Levemir

- Lantus

79
Q

commercial premixed insulin

A

mix of fast and intermediate-acting insulins

80
Q

Do not mix which insulin

A

Lantus or Levemir with any other insulin

81
Q

Preparing for injection

A
  • check order
  • check pertinent patient info
  • expiration date
  • contaminants
  • label checks
  • dosage strength/concentration
  • total amount in vial or ampule
  • DO THE MATH, check calculations with another nurse
82
Q

Reducing risk of infection

A
  • prevent contamination of solution
  • prevent syringe and needle contamination
  • site selection
  • skin prep
83
Q

Skin prep

A
  • wash with soap and water if soiled
  • clean 2 in diameter X 15 seconds using alcohol swab using inner to outer circular motion
  • allow to dry
84
Q

Minimizing injection discomfort

A
  • sharp needle
  • how much volume is being admin?
  • select appropriate site
  • apply vapocoolant or topical anesthetic if indicated
  • position to relax muscles
  • hold syringe already
  • inject medication slowly (1 ML per 10 seconds)
  • wait 10 second, withdraw quickly and smoothly
85
Q

angle for IM injection

A

90

86
Q

angle for subQ

A

45 or 90

87
Q

angle for intradermal

A

15

Pharm Exam 1 (5 decks)

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