Medication Administration Flashcards
What is the chemical name?
first name given, describes the chemical components and molecular structure– rarely used in medical practice
What is the generic name?
shortened chemical names given by first manufacturer, ex. Ibuprophen
What is the trade/brand name?
name given by manufacturer for marketing, ex. tylenol
What is the generic drug?
copies of brand name drugs and contain the same medicinal ingredients as brand name drugs
What is a drug classification?
it indicates the effect of medication on the body, the symptoms it relieves, or it’s desired effect– some meds are in more than one classification
Define pharmacokinetics
the study of how meds enter the body, reach their site of action, metabolize, and exit the body
Define the first pass effect
a phenomenon for oral medications in which a med gets metabolized at a specific location in the body resulting in a reduced concentration of the active drug reaching its site of action
Define bioavailability
the amount of med available to reach the target cells after metabolism to produce its intended effect– is affected by the first pass effect
What are the four processes that encompass the pharmacokinetics of a medication?
absorption, distribution, metabolism, and excretion
What has an effect on the production of albumin and why is that important?
Albumin is a serum protein produced by the liver. Most medications bind to protein when they enter the body but those that bind to albumin cannot produce their intended effects. Patients with liver failure don’t produce as much albumin so they are at a higher risk for drug toxicity.
What is metabolism?
the breakdown of medication into an inactive/less active form– drug toxicity can result when the patient is unable to metabolize effectively
What is the main route of med excretion?
through the kidneys, so if there is decreased renal function then there is a risk for med toxicity
Define therapeutic effect
the intended or desired physiological response of a medication (the reason it is prescribed)
Define side effect
the unintended secondary effect, usually predictable, and is either harmless or potentially harmful– it is a common reason for why patients will decide to stop taking a medication
Define adverse effect
a severe negative response to a medication prompting immediate discontinuation of the medication
Define toxic effect
the development of toxicity following prolonged intake of the medication or after a medication accumulated in the blood due to either impaired metabolism or impaired excretion
Define idiosyncratic reaction
the unpredictable effects which occur when a patient over or under reacts to a medication or has a different reaction than what is expected– ex. giving benadryl to adults makes them sleepy but giving it to children can cause excitement
Define medication interactions
when one med modifies the action of another medication– either increasing, decreasing, or effecting the pharmacokinetics
Define polypharmacy
the use of multiple drugs or more than are medically necessary– occurs frequently in older adults
Define synergistic effect
occurs when the combined effect of two medications or a med and a substance is greater than the effects of the medications given separately– ex. grapefruit and statins– can result in potentially dangerous levels of the drug in your body, but sometimes the interaction is desired
What are the time intervals of medication action?
Onset– when med starts to produce therapeutic response
Peak– med reaches max therapeutic response, highest serum concentration, after peaking the serum med concentration fall progressively
Trough– point at which lowest amount of drug is detected in serum
Duration– length of time drug exhibits therapeutic response
When does a patient receive a successive dose of medication?
when the medication reaches half-life
What is an order?
a written direction given by a nurse practitioner, physician, or regulated prescriber regarding treatment or medication– nurses can transcribe medication when given orally but NURSING STUDENTS CAN NOT
Define routine orders
orders that are carried out until the prescriber discontinues/cancels it, writes a new order, or the order has elapsed due to time or doses in order– this is the most common form of order
Define stat orders
an order that is to be given immediately and only one dose– usually in emergencies
Define single orders
also referred to as “one-time orders”, it is an order for just one dose to be given one time– usually in relation to surgeries, such as a preop med
The difference between single order and stat order is that the single order is written beforehand/predicted, and the stat order is emergency
Define standing orders
an order conditioned upon the occurrence of certain events; it allows other medical professions (like nurses) to use if the patient hits all of the necessary criteria
Define PRN orders
these are “as needed” orders, they are prescribed but the nurse uses their judgement on if/when/how much of the medication should be given
Define med reconciliation
the process of creating the most accurate list possible of all medications, including OTC by comparing the patient list with the health care providers orders– used to prevent any adverse drug events
What are the 3 rights that are not listed during med administration but still apply everytime?
the right to refuse, right of client education, and right to evaluation (evaluating the effects after the med has been administered)
What are the 3 A’s?
Arm band, Allergies, and Assessment
In what order should you administer meds?
from top to bottom on the MAR unless the client is likely to refuse meds half-way through then start with the highest priority meds and work your way down
When should you NOT crush a med?
if they are enteric/gel coated, long/sustained acting, SL or buccal, contents of caps
What is the Health Products and Food Branch (HPFB)?
a branch of the federal government that regualtes the manufacture and sale of all health products and drugs within Canada– they assess the safety, efficacy and quality of a drug and authorizes it
What is the Food and Drug act?
an act that regulates prescribing standards of composition, strength, potency, purity, quality or other property of any article of food, drug, cosmetic or device
What is the College of Registered Nurses of Manitoba (CRNM)?
a governing body that establishes regulations that guide nursing practice related to safe medication administration
– they developed the standards of practices that serve as a legal reference to describe reasonable and prudent nursing practice
What is negligence?
nursing conduct that does not meet a standard of care established by law– courts define nursing negligence as failure to use degree of skill or learning ordinarily used under the same of similar circumstances by other nurses
What is a med error?
any preventable event that oculd cause or lead to a client either receiving inappropriate med therapy or failing to receive an appropriate med therapy
-most common med errors by nursing students are omission, improper dose, wrong time, extra dose, and wrong patient
Med safety can be compromised by..?
interruptions, miscalculations, fatige, increased workload and lack of knowledge
What does safe PRN medication include?
-assessment of client to determine what drug, dose, route, is appropriate
-check when the last dose was given
-timely documentation on MAR and progress notes of assessment finding and rationale for giving drug
-follow up documentation of effectiveness of drug
What are the special requirements for narcotics and controlled substances?
-only be dispensed with prescription
-be stored in locked cabinets
-documented
-wastage witnessed
What are the forms of dermatologic medication?
ointments, pastes, creams, lotions, powders, sprays, and patches
What are transdermal medications?
a form of dermatologic medication that administers sustained action meds via a multi layered film containing the drug and an adhesive later– can be worn for 12 hours to a week depending on the medication
Where can a transdermal patch be applied?
only on clean, intact, hairless skin on the chest, back, abdomen, anterior thigh, buttocks, side, or upper arms– do NOT apply on distal extremities, breast tissue, areas with rash or scar tissue or to areas that have excessive movement, wrinkling, or friction
MUST be removed before a new one is put on!!
What is an ophthalmic medication?
medication for the eyes in liquid, ointment, or gel and administered via installation or irrigation
What is an otic medication?
medication for the external auditory canal via instillation or irrigation
What are the factors influencing drug action in older adults?
-absorption
-protein binding sites
-metabolism
-nephrons, GFR
