MEDICATION Flashcards
Substance administer for diagnosis, cure, treatment, or relief of symptom for prevention of disease.
Medication
Same as medication but also refers to illicitly obtained substance
Drug
Written direction for preparation and administration of a drug
Prescription
Name used throughout the drug’s lifetime
Generic Name
Given by drug manufacturer
Identifies it as property of that company
Trade (brand) name
Name by which drug is listed in official publications
Official Name
Name by which a chemist knows it
Describes constituents of the drug precisely
Chemical Name
Study of effect of drugs on living organisms
Pharmacology
Prepares, makes, and dispenses drugs as ordered
Pharmacy
Person who prepares, makes, and dispenses drugs as ordered
Pharmacist
DRUG STANDARDS
- Drugs can be made from plants, minerals, or animals, or be produced synthetically.
- Standards ensure drugs are pure and of uniform strength, uniform quality.
- U.S Pharmacopeia described drug sources, properties, tests done, storage methods, assay category, normal dosages
.
Legal Aspects of Administering Medications
- Nursing practice acts
- Recognizing limits of own knowledge and skill
- Take responsibility for actions
- Question any order that appears reasonable
- Refuse to give medication until order is clarified
Controlled substances
- Kept under lock
- special inventory forms
- documentation requirements
- procedures for discarding
- end-of-shift counts of controlled substances
- Ordered by physicians (sometimes nurse practitioners, physician assistants depending on state laws and agency policies)
- Can be made through written, verbal, or telephone orders
- Abbreviation, acronyms, and symbols
Medication orders
- Carried out until the specified period of time or until it is discontinued by another order.
- Indefinitely, such as multiple vitamins daily
- specified number, such as KCl BID x 2 days
Standing order
Carried out at once or immediately (e.g Paracetamol 300mg IV STAT)
Stat order
Carried out for one time only (e.s. seconal 100 mg HS before sugery)
Single order
Carried out as needed/as the patient requires (Such as Paracetamol 300 mg IV PRN for temp of 37.8 or above)
PRN order
Essential parts of a medication order
- fullname of client
- Date and time order is written
- Name of drug to be administered
- Dosage of drug
- Frequency of administration
- Route of administration
- Signatre of person writing the order
Parts of prescription
- Desc info about the client: name, age, and address
- Date on which the prescription was written
- The Rx symbol, meaning “Take thou”
- Medication name, dosage, and strength
- Route of administration
- Dispensing instructions for the pharmacist for example “Dispense 30 capsules”
- Refill and/or special labelling for example, “Refill x1”
- Prescriber’s signature
Communicating medication orders
- written on chart, provided by phone or verbally
- copied to kardex or MAR, or on computer printout
IF an order seems inappropriate
- contact primary care provider
- Document in notes when PCP called, what was communicated, how PCP responded
- Or, document attempts to reach and reason for withholding drug
- If medication given, document client condition before and after dose
- If needed, document factual information on incident report
The primary effects intended, that is the reason drug is prescribed, also called desired effect
Therapeutic effect
Unintended, usually predictable; may be harmless or harmful; also called secondary effect
Side effect
- More severe side effect; may justify discontinuation of a drug
Adverse effect
- Results from overdose, ingestion of external-use drug, or buildup of drug in blood
Drug toxicity
- Immunologic reaction to drug; can be mild to severe reactions (Anaphylactic reaction, anaphylaxis)
Drug allergy
- a severe allergic reaction which usually occurs immediately following administration of drug
Anaphylactic reaction
- Unusually low physiological response (can be due to repeated administration of drug or chemically related substance).
- Requires increases in the dosage to maintain a given therapeutic effect
Drug tolerance
Increased effect resulting from rate of dosage being higher than rate of excretion
Cumulative effect
- Unexpected; may be individual to client. Can be overresponse, under response, different response than expected, unpredictable or unexplained responses.
Idiosyncratic effect
- One drug alters effect of other drug(s).
- Effects of one drug are modified by the prior or concurrent administration of another drug, thereby increasing or decreasing the pharmacological action.
Drug interaction
One or both drugs is increased.
Potentiating effect
Two of same types of drugs increase action of each other.
Additive
Two different drugs increase action of one or another.
Synergistic
Effect of one or both drugs is decreased.
Inhibiting effect
Disease unintentionally caused by medical or drug therapy
Iatrogenic disease
- Conjoint effect of two drugs is less than the drugs acting separately.
Summation
Drug Antagonism
- The combined effect of two drugs produces a result that equals the sum of the individual effects of each agent.
Summation
The combined effects of drugs is greater than the sum of each individual agent acting independently.
Synergism
- Inappropriate intake of a substance, either continually or periodically
Drug Abuse
A person’s reliance to take a drug or substance. Intense physical or emotional disturbance is produced if the drug is withdrawn.
Drug dependence
It is due to biochemical changes in body tissues, especially in the nervous system. Also called physical dependence.
Addiction
- It is the emotional reliance on drug to maintain a sense of well-being accompanied by feelings of need or cravings for the drug. Also called psychological dependence.
Habituation
Therapeutic actions of drugs
- Palliative
- Curative
- Supportive
- Substitutive
- Chemotherapeutic
- Restorative
- Relieves the symptoms of a disease but not affect the disease itself. e.g. antineoplastic agents for cancer.
Palliative
- Treats the disease condition. e.g. antibiotic for infection.
Curative
- Sustains body functions until other treatment of the body’s response can take over. e.g. Mannitol to reduce ICP (intracranial pressure) in a client for surgery due to brain tumor.
Supportive
- Replaces body fluids or substances. e.g. insulin injection for diabetes mellitus.
Substitutive
- Destroys malignant cells. e.g. Cyclophosphamide for cancer of the prostate gland.
Chemotherapeutic
- Returns the body to health. e.g. multivitamins for elderly clients.
Restorative
General Properties of Drugs
- Drugs do not confer any new function on a tissue or organ in the body. They only modify existing functions.
- Drugs in general exert multiple actions rather than single effect. Therefore, no drug is free from side effect.
- Drug interaction results from physiochemical interaction between the drug and a functionally important molecule in the body.
Action of drugs on the body
Half-life: Time interval required for body’s elimination processes to reduce the concentration of the drug in the body by one-half
Onset of action: The time after administration when the body initially responds to the drug
Peak plasm level: the highest plasma level achieved by a single dose when the elimination rate of the drug equals the absorption rate
Plateau: a maintained concentration of a drug in the plasma during a series of scheduled
.
Mechanism of drug action and relationships between drug concentration and the body’s responses
Pharmacodynamics
Drug’s target
Receptor
Same response as endogenous substance
Agonist
Drug that inhibits cell function by occupying receptor’s site
Antagonist
- Study of absorption, distribution, biotransformation, and excretion of drugs
Pharmacokinetics
- Process by which drug passes into bloodstream
- Rate is variable
- Depends on food, acid medium
- Drug bypassed if injected
Absorption
Factors affecting drug absorption
- Blood flow
- Pain
- Stress
- Food
- Exercise
- Nature of absorbing surface
- Solubility of the drug
- pH
- Drug concentration
- Dosage form
- Blood brain barrier
- Placental barrier
- Obesity
- Receptor combination
.
- Transportation of a drug from its site of absorption to its site of action
- Factors affecting drug distribution
- Volume distribution
- Barriers to drug distribution
Distribution
- Process by which a drug is converted to a less active form
- The liver is the principal site of drug metabolism.
- Oral medications: go directly to the liver via the portal circulation before entering
- Many medications become entirely inactivated by the liver the first time they go through it.
Biotransformation
products of Biotransformation process
Metabolites
Protein binding
Plasma
Factors that affect drug metabolism
* Age
* Nutrition
* Insufficient amounts of major body hormones
.
- Process by which metabolites are eliminated
- Most important route of excretion for most drug is kidneys in a form of urine.
Excretion
Factors that affect excretion
- Renal excretion
- Drugs that can affect elimination of other drug
- Blood concentration levels
- Half life.
Factors affecting medication action
DEVELOPMENTAL FACTORS
— Risks during pregnancy
— Infants require smaller dosages.
— Older adults experience decreased gastric motility
GENDER
— More drug research done on men
CULTURAL, ETHNIC, AND GENETIC FACTOR
— Pharmacogenetics
— Ethnopharmacology - Study the effect of racial, ethnic responses to prescribed medication
DIET
— Nutrients can affect action of a medication
ENVIRONMENT
— Especially affects drugs used to alter behavior and mood
PSYCHOLOGICAL FACTORS
— Expectations
ILLNESS AND DISEASE
— Action altered in clients with circulatory, liver, or kidney dysfunction
TIME OF ADMINISTRATION
— Some drugs absorbed more quickly if stomach is empty, some when stomach is full.
Systems of measurement
- Metric System
- Apothecary System
- Household System
Devised by the french; Logically organized into units of 10
e.g gram (g), meter (m)
Metric System
Older than metric system; as much as possible do not use unfamiliar to many
e.g grain (gr) minim (m) pint (pt)
Apothecary System
e.g drop(gtt), teaspoon or tablespoon (tsp), cups and glasses
Household System
