Med Admin Chapter 2&3 Flashcards
As needed or prn drug order
An order for a drug to be given on as needed basis, based on nurses judgement of patient safety/need
Black box warning
A special designation from the FDA that the drug has a higher than normal risk for causing serious and even life threatening problems in addition to its positive benefits for some people
What are federal laws?
Laws passed by Congress to make drugs as safe as possible for patients to take and to ensure that the drug does what it claims to do
Three drug categories in the U.S.
Controlled
Prescription
Over the counter
Define physical dependence
Physical symptoms -shaking, increased heart rate, pain, confusion, seizures
Define psychological dependence
Mental desire, anxiety, depression, anger
Examples abused Cocaine alcohol
The goal of all regulations and policies is to….?
Verify and account for all controlled substances
Providers who write the prescriptions are also called
Prescribers
A legal prescription order must contain
The patients name Date Name of drug Route of administration Dose Route of administration Dose Frequency Duration Signature of prescriber
Additional details about how to give the drug may be…
Take with meals, avoid milk products, do not refill, may cause drowsiness
Why are older patients at high risk for problems with prescriptions?
Poor eye sight, memory, hand to mouth coordination (poly pharmacy)
What do OTC drugs commonly treat
Minor problems, colds, allergies, headaches, minor burns, constipation, or upset stomach
Accidental over doses of common cold drugs in children because of confusion on the correct dosage of…..?
Benadryl/cold medication
A standing drug order
Indicates that the drug is to be given until discontinued. A renewal order must be written by the prescriber before drug may be continued
An emergency or stat drug order is
A one time order to be given at specific time
Diphenhydramine 50 mg I’v stat
A single drug order is?
A one time order to be given at specific time.
Cefazolin 1g iv at 10:00am before surgery
Nurses who give drugs to patients accept professional responsibility for
Giving drugs correctly, ethically, and legally
Schedule I drugs
High risk for abuse, no accepted use for treatment in US
Schedule I drugs consists of
Alpha-acetymethadol GHB Heroin Marijuana peyote
What are the nine rights of drug administration
Right patient Right drug Right dose Right route Right time Right documentation Right reason Right response Right to refuse
Drug errors can occur at any of the three points in drug administration process..
1) during drug preparation
2) bringing drug to patient
3) giving the drug to the patient
Categories of high alert drugs can be remembered by ?
PINCH
What does PINCH stand for
P- potassium I- insulin N- narcotics (opioids) C- cancer H- heparin
What is medical reconciliation?
Is the practice of comparing the patients drug orders to all of the drugs that the patient has been taking.
How can you destroy drugs?
Drug buster bottles
What is the Kardex and Electronic drug systems?
Is a pen and paper flip-filed system used for many years that has important patient information and doctors orders.
(The here and now)
What is the first step of drug error?
Immediately check the patient
What are the steps of drug errors
Check the patient
Notify health care provider promptly
Follow any order given by the provider to reduce the affect of the drug error
A legal prescription order must contain
1) patient full name
2) date
3) name of drug
4) route of administration
5) does
6) frequency
7) duration
8) signature of prescriber
Sch II DRUGS
More than 30 of them
Amphetamines, Cocaine, codeine, fentanyl, hydromorphine, (dilaudid) meperidine (Demerol) methadone, methylphenidate (Ritalin) morphine, oxycodone , pentobarbital
Sch III DRUGS INCLUDE
Acetaminophen, anabolic steroids, testosterone preparations xyrem
Sch Iv consists of
Diet drugs with propionic acid, lorazepam (Ativan), flurazepam (dalmane), diazepam (Valium) , midazolam (versed), alparazolam (Xanax), chlora hydrate, paraldehyde, pentaxocine, phenobarbital
Sch v drug
Cough meds, with small amounts of cosine and drugs for diahreah also contains small amounts of opioids such as diphenoxylate with atropine (lomotil)
All controlled substances ordered for a patient but not used during hospital stay are ?
Sent back to the pharmacy
24 hour tablets and er or xr are what?
Do not crush
who can write prescriptions for controlled substance?
Physicians, Dentists, Nurse practitioners,physician assistants, and sometime nurse mid wife’s
What are the most common abused prescription drugs?
narcotics (opioids), sleep medication, anxiety disorder medication
Older patients are high risk for problems with prescription drugs because of?
poor eyesight
memory
coordination
what are OTC drugs used to treat?
cold, allergies, headaches, minor burns, constipation, or upset stomach
What is prescriptive authority?
the authority to write an order or prescription for drugs
The prescriber must then co-sign the order within?
24 hours
What is medication reconciliation?
the practice of comparing the patients drug orders to all of the drugs the patient has been taking.
What is absorption?
drugs that enter the body and pass into the circulation to reach to reach the part of the body it needs to affect through diffusion, osmosis, and filtration
What is additive effect?
when two drugs are given together and either make one drug stronger or make the action of the two drugs more powerful
What is the adverse reaction?
severe symptoms or problems that can cause great harm
What is agonist?
drugs that work by activating or unlocking cell receptors causing the same actions as the body’s own chemicals
what is allergy?
An antigen-antibody response that can cause hives rashes, itching, or swelling
What is anaphylactic reaction?
A severe life threatening form of an allergic reaction
What is antagonist?
Drugs that attach at drug receptor site but do not activate or unlock the receptor
What is bio-equivalent?
drug products that are chemically the same or identical
What is Bio-transformation?
The transformation or alternating of a drug into either active or inactive chemicals after it has been absorbed
What is brand name?
The proprietary name that a manufacture gives to a specific drug known as a (trade name)
What is buccal?
drug placement against the cheek
What is chemical name?
The names of the chemicals that actually form the drug
What is the desired action?
The drug does what its suppose to do
What is distribution?
Movement of the drug in the body to reach its site of action by way of the blood and lymph
What are the drug interaction?
When one drug changes the action of another drug.
what is enternal (route)
giving a drug by way of the gastrointestinal system
oral, feeding tube, sublingual and rectally
What is first-pass (effect)?
after they are consumed, drugs are inactivated in liver before being distributed to other parts of the body
What is Generic name?
the most common drug name used by the manufacture in all countries. also known as non-proprietary name
What is half-life?
The time it takes the body to remove 50% of the drug from the body
What is hepatotoxic ?
adverse drug effects that can result in liver damage
what is hypersensitivity?
exaggerated response to a drug an allergy is an example
What is idiosyncratic response?
responses to a drug that are peculiar and unpredicted
What is intramuscular?
giving a drug by the way of an injection deep into the muscle
what is intravenous
giving a drug by way of an injection by the way of an injection into a vein or giving the drug into tubing that is connected to a catheter that is inserted into a vein
What is nephrotoxic
adverse drug effects that may cause damage to kidneys
What is parenteral (route)
giving a drug by the way of an injection or infusion underneath the skin
What is partial agonist?
drugs that attach to the receptor site but produce only a partial effect rather then full effect
What is percutaneous (route)
giving a drug by way of absorption through the skin.
Topical creams, patches, or devices under the skin
What is pharma-co-dynamics?
the effects of a drug on body function
what the drug does to the body
What is pharma-co-kinetics?
The metabolism of a drug within the body
what the body does to a drug
What is Pharma-co-therapeutics?
The use of drugs in the treatment of disease
What is pro-drug
drugs that must be metabolized before they are active?
What are receptor site?
small lock-like areas of cell membranes that control what substances either enter the cell of change its activity
What is side effect
mild but annoying response to the drug.
nausea and headache are common and usual side effects to many drugs
What is solubility?
The ability of drug to dissolve in body fluids
What is subcutaneuos?
drug placement into fatty tissue
What is sublingual?
drug placement under the tongue
What is synergistic effect?
the effect of two drugs taken at the same time is greater than the sum of the effects of each drug given alone
What is trade name?
the proprietary that a manufacturer gives to a specific drug. known as brand name.
