Medication and Pharmacology Flashcards
List and explain the “rights” of medication administration
The right client The right medication The right reason The right dose The right frequency The right route The right site The right time
What is the trade name of a medication
○ Trade name OR proprietary name:A brand name drug is a medication sold by a pharmaceutical company under a trademark-protected name (TM) stands for trade mark and follows each medication trade name, manufactureres chose trade names that are easy to pronounce, spell and remember to make it easier for the everyday person
What is the generic name of a medication?
○ Generic name OR non-proprietary name:is given by the manufacturer that first developd the medication. Acetominophine is the generic name for Tylenol. the generic name becomes the official name uner which the medication is listed in official publications
What is the official name of a medication?
Official name:the title under which a drug is listed in theUnited States Pharmacopeia(USP) or theNational Formulary(NF)
What information is required on a medication label?
- the name and address of the dispenser
- the serial number of the prescription
- the date of the prescription (date of filling or refilling)
- the name of the prescriber
- the name of the patient
- the directions for use , includingprecautions(if any)
- the name of the drug and strength(if any)
- a caution note (if any)
What are the components of a complete medication order?
- Medication name;
- Strength of medication (if one is required);
- Dosage of medication to be administered;
- Route of administration;
- Specific directions for use, including frequency of administration; and,
- PRN or “as needed” orders must also clearly state the reason for administration
List the nursing responsibilities in administering medication
- know which med isprescribed,therapeuticand non-therapeuticeffects, and any nursing implications associated with the med.
- responsible for performing a physicalassessment (ie. monitoring andinterpretingBP before admin. a hypertensive medication)
- determine whether a medication is safe to administer based on assessment
- know why the client needs the med
- know know if the client needssupervision during admin. or necessary education about the drug and its effects
- always monitor the effect of the drug after admin and report any reaction to prescriber
What “three checks” are required when preparing medication?
- Check the order (prescribed amount)[Check when you take it out of the chart.]
- Check the contents from the dispenser [Check it before you pour it in.]
- Check the order again to verify what you are administering[Check it before you put it back.]
Tablet:
a solid dosage form containing a medicinal substance with or without a suitable diluent
Lozenges:
A small medicinal tablet, originally of this shape, taken for sore throats and dissolved in the mouth: “throat lozenges”
Capsule:
an enclosing structure, as a soluble container enclosing a dose of medicine
Caplet:
A smooth, coated, oval-shaped medicine tablet intended to be tamper-resistant
Enteric Coated
designating a special coating applied to tablets or capsules that prevents release and absorption of active ingredients until they reach the intestine
Syrup:
a concentrated solution of a sugar, such as sucrose, in water or other aqueous liquid, sometimes with a medicinal agent added; usually used as a flavored vehicle for drugs.
Elixir:
a clear, sweetened, alcohol-containing, usually hydroalcoholicliquid containing flavoring substances and sometimes active medicinal ingredients
Suspension:
a liquid preparation consisting of solid particles dispersed throughout a liquid phase in which they are not soluble.
Suspended Release:
allowing a twofold or greater reduction in frequency of administration of a drug in comparison with the frequency required by a conventional dosage form.
When is it appropriate to “crush” a medication and which medications should never be crushed?
- pt cannot swallow
As long as it isn’t a slow release or an enteric coated
The nurse should know what medications can or cannot be crushed.
When is it appropriate to halve a tablet or caplet?
Only when it is scored
What are some different routes to administer medication?
Oral Sublingual Oral inhalers Eye drops and ointment Ear drops Nose Drops & Nasal Sprays/Inhalers Transdermal products and patches Topical
Describe responsibility in relation to telephone orders:
Telephone or verbal orders may be accepted only by a licensed nurse, registered pharmacist or qualified staff
responsible for medication administration.
The order is to be dated and signed by the person receiving the order and signed by the prescribing practitioner within 15 days of when the order is received. It is important that the employee understands that a copy of an order, including a telephone order, is always kept in the resident’s record.
Describes resident’s rights regarding medications, i.e., refusal, privacy, respect
- Respect – How the resident is addressed; The resident should not be interrupted while eating for the
administration of medications such as oral inhalers and eye drops. The resident should not be awakened to
administer a medication that could be scheduled or administered at other times; Explain to the resident the
procedure that the employee is about to perform; Answer questions the resident may have about the medication. - Refusal – The resident has a right to refuse medications. A resident should never be forced to take a
medication. The facility should have a policy and procedure to be followed when residents refuse medications.
The policy and procedure is to ensure the physician is notified timely (based on the resident’s mental and physical
condition and the medication). - Privacy – Knock on closed doors before entering; Do not administer medications when the resident is
receiving personal care or in the bathroom; Administration of injections outside the resident’s room is not
acceptable if the resident receiving the injection or other residents present are offended by this; Administration of
medications requiring privacy, e.g., vaginal and rectal administrations, dressing changes and treatments requiring
removal of clothing. - Chemical Restraint Medications, especially psychotropics, are not to be administered for staff convenience.
Describe what constitutes a medication error and actions to take when a medication error is made or detected
A medication error occurs when a medication is not administered as prescribed.
Examples of medication errors include: omissions; administration of a medication not prescribed by the prescribing practitioner; wrong dosage; wrong time, wrong route; crushing a medication that shouldn’t be crushed; and documentation errors. T
Define Drug:
Any chemical that can affect living processes
What is Pharmacology?
Study of drugs and their interactions with living systems
What is Clinical Pharmacology?
Study of drugs in humans (includes the study of drugs in PATIENTS as well as in healthy volunteers—during new drug development)
What is Therapeutics? AKA Pharmacological Therapeutics?
is the use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy.Alternatively,therapeuticscan be defined simply as themedical use of drugs.
What are the properties of an ideal drug?
- Effectiveness:it elicits the responses for which it is given.
- Safety:A drug that cannot produce harmful effects—even if administered in very high doses or long term
- Selectivity:It elicits only the response for which it is given
Name the Four major pharmacokinetic processes:
Drug Absorption
Drug Distribution
Drug Metabolism
Drug Excretion
Compare the different routes of parenteral medication
- Percutaneous: Skin
- Transdermal:Skin
- Intradermal: into the dermis..TB skin test
- Subcutaneous: into the subcutaneous fat.
- Intramuscular: Into the muscle
- Intravenous: into blood stream–fastest
- Intra-Articular: Into the joint
- Intraosseous: Into the bone
- Epidural: Into the spinal space
- Spinal:Into the spine
pharmacokinetic processe
Define absorption:
movement of a drug from its site of administration into the blood
pharmacokinetic processes
Define distribution:
movement of drugs throughout the body
pharmacokinetic processes
Define metabolism
enzymatic alteration of drug structure
pharmacokinetic processes
Define excretion
Removal of drugs from the body
List factors affecting drug absorption.
• Rate of Dissolution
○ Rate it dissolves; fast or slow onset
• Surface Area
○ Lungs have wide surface area
○ Skin has large surface area, will absorb faster
• Blood Flow
○ Abscess has poor blood flow, harder to absorb
• Lipid Solubility
○ highly lipid-soluble drugs are absorbed more
rapidly than drugs with low solubility.
• pH Partitioning
○ ASA, non iodized, absorbed quicker
What factors determine drug distribution?
• Blood Flow to Tissues
○ Bone does not have blood supply like muscle,
so drug cannot penetrate well
• Exiting the Vascular System
○ typical capillary beds
○ blood-brain barrier
○ Protein binding
- Albumin, drug binds to albumin will not be
active and cannot leave (Ex)
- Others will not bind as closely to Albumin
proteins and will be free-flowing in the
blood stream
○ Placental barrier
• Ability of a drug to enter cells
What is the primary site of metabolism?
Liver
What are the sites of drug excretion?
- Urine
- Bile
- Sweat
- Saliva
- Breast Milk
- Expired Air
- KIDNEY!!!!
Define Drug Half-Life
the time required for the amount of drug in the body to decrease by 50%.
Define Drug Therapeutic level
Range of a drug lies between the MEC (Minimum effective concentration) and the toxic concentration
Define Toxic Level
Toxicity occurs when plasma drug levels climb too high.The plasma level at which toxic effects begging is termed the toxic concentration.
What is therapeutic action?
Intended or desired physiological response of a medication
What is adverse effect?
unintended, undesirable, and often unpredictable effects. Ex drop in BP, respiratory issues with morphine.
What are side effects
predictable and often unavoidable secondary effects produced at a usual therapeutic drug dose Ex dizziness
What is an allergic reaction?
unpredictable responses to a medication.
What is drug incompatibility?
Cannot give together
What is Toxicity?
adverse drug reactions due to excessive dosing
Define Tolerance
decreased physiological response that occurs after repeated administration of a medication (prolonged use)
What is a physical dependance?
physiological adaptation to a medication that manifests itself by intense physical disturbance when the medication is withdrawn
What is additive effect?
2 drugs work better together than separately.
what is a teratogens
Harmful or fatal to fetuses
What is a carcinogen?
Cancer-Causing
What is Idiosyncratic Effects
Uncommon effect
What is Iatrogenic Hazards:
Physician causing, ex: morphine given to pt, which drops blood pressure and results in dizziness. From this dizziness, the pt. has a fall. This is considered Iatrogenic Hazard.
Discuss how drug interaction can occur
- Can occur whenever a patient takes 2 or more drugs
* Some interactions are both intended and desired ( or not)
What are some outcomes when drugs interact?
- One drug may intensify the effects of the other
- One drug may reduce the effects of the other
- The combination may produce a new response not seen with either drug alone
8 Rights
- Client
- medication
- reason
- dose
- frequency
- route
- site
- time
Advantages & Disadvantages of Intravenous IV
Advantages: -rapid onset, ideal for emergencies -precise control over drug levels -permits use of large fluid volumes -permits use of irritant drugs Disadvantages: -Irreversible -Expensive -Difficult to do -Risk of fluid overload, infection, and embolism -Drug must be water soluble
Advantages & disadvantages of Intramuscular (IM) & Subcutaneous
Advantages: -Permits use of poorly soluble drugs Permits use of depot preparations Disadvantages: -Possible discomfort -Inconvenient -Potential for injury
Advantages & disadvantages of Oral (PO)
Advantages:
-Easy
-Convenient
-Inexpensive
-Ideal for self-medication
-Potentially reversible, and safer than parenteral routes
Disadvantages:
-Variability
-Inactivation of some drugs by gastric acid and digestive enzymes
-Possible nausea and vomiting from local irritation
-Patient must be conscious and cooperative
What are the enteral routes of administration?
Oral
Rectal
Nasogastric
percutaneous endoscopic gastrostomy (PEG)
percutaneous endoscopic jejunostomy (PEJ)
What are the parental routes of administration?
Intradermal Subcutaneous Intramuscular Intravenous Intra-articular Intraosseous Epidural Spinal
How do drugs pass through a cell membrane?
Channels and pores
Lipid solubility
Ionization
What are the 4 components of pharmacokinetics?
Absorption
Distribution
Metabolism
Excretion
Name some factors that affect absorption
Rate of dissolution Surface area Blood flow Lipid solubility pH partitioning
Name the routes of excretion?
Kidneys
Breast milk
Bile
Lungs
What are some drug regulations in Canada?
Food and Drug Regulations Prescription drugs Nonprescription (OTC) drugs Restricted drugs Orphan drugs Controlled Drugs and Substances Act
Name the stages of a new drug development
Preclinical stage: range 1 – 3 years
Begins with discovery, synthesis, and purification of the drug
Clinical stage: range 2 – 10 years
Phase 1: 20 - 100 subjects treated for 4-6 weeks
Phase 2: larger population of several hundred
Phase 3: larger population to assure statistical significance
New Drug Application Review: 2 months – 7 years
Post marketing Surveillance
Who can prescribe in Ontario?
Physicians RN’s in the extended class Dentists Chiropodists Midwives Optometrists Pharmacists
College of Nurses Practice Standard: Medication (2008)
“Administering a medication is one component of a continual process that goes beyond the task of giving a medication to a client. Nurses must apply their knowledge about the client and the medication when assessing, planning, implementing and evaluating the process. The College advocates for the same nurse performing all administration steps to minimize the chance of error and clarify individual accountability”
Name the rights of medication
The right client The right medication The right reason The right dose The right frequency The right route The right site The right time
Define Medication Error
Any preventable event that may cause or lead to inappropriate medication use or client harm while the medication is in the control of the health care professional, client or consumer.
Name the types of Medication Errors
Commission
Omission
Near miss
Name some reasons that Medication Errors occur
Verbal/telephone orders Poor communication within the health care team Poor handwriting Inappropriate abbreviations Improper drug selection Drug interactions/polypharmacy Look alike/sound alike drugs (Morphine & Hydromorphone) Hectic work environment Fatigue
Name some way to prevent Medication Errors
Use knowledge, skill and judgment
Have knowledge of high alert medication
Have access to current medication information
Use agency approved abbreviations
Use workplace independent double checks systems
