Med Admin Flashcards
what is the pure food and drug act
in 1906 it established official standards for listing or labeling dangerous and addictive ingredients; set standardsfor proper labeling of medications
What is the comprehensive drug abuse and control act
Classified drugs by abuse potential and medical usefulness; regulated manufacture, distribution, and sale of controlled substances; provided for treatment and rehabilitation for drug abuse and dependence
what is the orphan drug act?
in 1983 it provided tax credits to companies to develop drugs used to treat rare diseases
what is the food and drug administration act
in 1988 it established the FDA within the department of health and human services
What are controlled substances?
-drugs considered to have either limited medical use or high potential for abuse or addiction.
- It is illegal to possess w/o a prescription under the 1970 comprehensive drug abuse and control act.
- must be double-locked, counted and verified at specific times.
- includes narcotics & anti-anxiety meds
U.S. drug legislation controls
- sets official drug standards
- defines prescription drugs
- regulates controlled substances
- improves safety
- requires proof of efficacy
Nurse practice acts…
identify nursing responsibilities for administration and client monitoring
What are the four types of systems for medication storage?
Stock supply
Unit dose
Automated dispensing system
Self-administration
what are the features of stock supply?
- bulk quantities
- central location
- not client-specific
- cost effective
- potential for measurement error w/each dose
what are the features of unit dose systems?
- individually packaged
- client-specific drawers
- 24-hour supply
- safest method of due to double-check between pharm and nurse
- saves time
what are the features of automated dispenser systems?
- password-accessible locked cart
- computerized tracking
- can combine stock and unit doses
-meds available on the unit so new orders do not have to go through pharmacy and are immediately available
what are the features of self-administration systems?
- individual containers
- kept at client’s bedside
- promotes independence
- allows for evaluation of pt effectiveness at admin. their own meds
what is pharmacokinetics?
refers to what happens to the drug in the body (absorption, distribution, metabolism and excretion).
These determine the intensity and duration of a drug’s actions
What factors affect drug absorption?
depends on the
- route of administration
- form of the drug
- drug solubility
- effects of pH
- blood flow to the area
- pain
- stress
- hunger
- fasting
- food
- exercise
For a drug to have a systemic effect it must
be absorbed into the bloodstream before it can be distributed to a distant location
What does solubility of medication refer to
the ability of a medication to be transformed into a liquid form that can be absorbed into the bloodstream
An enteric-coated drug cannot
be decomposed by gastric secretions; thus the medication is not diluted before it reaches the intestines.
Timed-release (sustained release) meds dissolve
slowly, releasing small amounts for absorption over several hours.
oral preparations must be
water soluble so that they can dissolve in the aqueous contents of the GI tract
Liquids are absorbed
faster than tabs or caps b/c they are already dissolved
Drugs must be _____ ______ in order to cross cell membranes
lipid soluble (at least somewhat)
How does acidity affect absorption of meds?
Higher acidity in the stomach (and med) aids in the transportation of meds across the mucous membrane.
Ionized molecules in meds …
are lipid insoluble and thus, cannot pass easily through cell membranes
How does blood flow affect absorption?
Area where blood flow to the tissue is greatest have rapid absorption of meds
How does pain affect absorption?
can slow gastric emptying time, thus increasing absorption time
How does stress affect absorption?
can slow gastric emptying time, thus increasing absorption time
How does hunger affect absorption?
reduces absorption rates
How does fasting affect absorption rates?
reduces absorption rates (typically the longer the fasting, the slower the absorption)
How does food affect absorption rates?
can either increase or decrease depending on the drug. Usually decreases
How does exercise affect absorption rates?
decreases blood flow to the GI tract and thus decreases absorption rates
What is distribution?
transportation of a drug in body fluids (usually bloodstream) to the various tissues and organs of the body.
What factors affect distribution?
- local blood flow
- membrane permeability
- protein-binding capacity
How does local blood flow affect distribution
increased vascularity/circulation increases absorption rates.
Therefore vasodilation increases absorption and vasoconstriction decreases absorption
How does membrane permeability affect distribution?
some membranes can act as barriers (i.e. blood-brain barrier)
How does protein-binding capacity affect distribution
Only free, unbound molecules can produce pharmacological effects; THEREFORE, the greater the protein-binding capacity, the lower the distribution.
What is metabolism in med admin?
aka biotransformation, is the chemical inactivation/conversion of a drug
Metabolism mainly takes place in the
liver
If liver function decreases the drug will be eliminated…
more slowly
What is the first-pass effect?
The inactivation of an oral medication after absorption through the GI tract and circulation through the liver before reaching systemic circulation.
How does disease status affect metabolism?
It can affect the speed of metabolism. For instance, elixirs that are high in sugars being given to a diabetic will be absorbed very slowly.
In order to bypass the first-pass effect, what routes of administration could be substituted for oral meds?
sublingual or IV bypass the GI tract.
How can drugs be excreted?
through the kidneys liver and GI tract lungs exocrine glands
Factors affecting excretion are
organ function, especially the kidneys, liver and lungs.
kidney failure will change the excretion and buildup in the body. Can cause toxicity or allow meds to exit the body too soon.
