Medication Administration Flashcards
What is pharmacology ?
The study of drugs and their effect on the body
Nurses must have ____________ about the drugs being administered to _____________ care for their patients.
Sufficient knowledge….. safely
Know the difference between a trade name and a generic name
Generic name identifies the drugs active ingredient while a trade name is the brand name selected by the pharmaceutical company
What is pharmacodynamics ?
What drugs do to the body
What is pharmacokinetics ?
What the body does to drugs - this is the study of drug movement through the body
Pharmacodynamics and pharmacokinetics leads to the
individualized patient response
What are the four processes of pharmacokinetics (ADME)
Drug Absorption Drug Distribution Drug Metabolism Drug Excretion
Discuss Absoption
process by which a drug is transferred from its site of entry into the body to the bloodstream May be slowed due to: ICF (increased or decreased?) Gastric pH (increased or decreased?) Gastric blood flow and motility (increased or decreased?) Metabolism and drug absorption (increased or decreased?)
What is a loading dose ?
A larger than normal dose
What is a maintenance dose ?
A lower dose that becomes the usual or daily dosage
Discuss distribution
Distribution occurs after the drug has been absorbed into the bloodstream and the drug is distributed throughout the body, becoming available to body fluids and body tissues Considerations: Changes in circulation Membrane permeability Body temperature Tissue structure Dehydration and hypoalbuminemia decrease drug distribution
What does distribution depend on ?
Blood flow to the tissues, the drugs ability to leave the bloodstream, and the drugs ability to enter the cells
Metabolism (aka biotransformation)
Change of a drug from its original form to a new form
What is the primary site of drug metabolism ?
The liver. Other tissues, such as those of the GI tract, lungs, kidney and skin also have a role in drug metabolism
Drug Excretion
Kidneys excrete most drugs - although changes associated with aging, disease or other factors that impair the functioning of the kidneys can decrease their ability to excrete drugs. In this case, the drug package must list specific implications
At what level do drugs act to achieve their desired effect?
The cellular level
What is pharmacodynamics ?
The process by which drugs alter cell physiology and affect the body
Drugs turn _____, turn _________, promote or _______ responses that are part of the body’s processes.
on; off; block
What are adverse drug effects ?
Undesirable effects other than the intended therapeutic effect of a drug. These can occur at any drug dosage or drug concentration
Effects of aging on medication use ?
Age related changes affect pharmacokinetics and pharmacodynamics, and there is an increased risk for adverse reactions
What is an early sign of an adverse reaction?
Delirium and mental dysfunction
Questions to ask regarding necessity and effectiveness of drugs
* Ensure drugs are selectively and cautiously used* Why is the drug ordered? Is the smallest possible dosage ordered? Is the patient allergic to the drug? Can this drug interact with other drugs, herbs, nutritional supplements? Are there any special instructions accompanying the drug’s administration? Is the most effective route of administration being used?
Safety considerations for Aspirin
Observe for bleeding
Safety considerations for Acetaminophen
monitor daily dose due to liver
Safety considerations for analgesics
Older adults may present differently regarding pain Start low and go slow Titrate and watch for adverse reactions (all meds)
Considerations for Anticoagulants
Anticoagulants (Heparin & Coumadin are common) High risk for bleeding Vitamin K (antidote) Monitor blood levels
Considerations for Antacid
Avoid other meds for 2 hours (prevents absorption interference)
Considerations for NSAIDs
Toxic levels accumulate easier at lower doses in older adults.
What is polypharmacy ?
The simultaneous use of multiple drugs to treat a disease or condition
What are some of the most common polypharmacy drugs
Cardiovascular agents, antihypertensives, analgesics, antiarthritic agents, sedatives, laxatives, and antacids.