Medication and Pharmacology Flashcards

1
Q

List and explain the “rights” of medication administration

A
The right client
The right medication
The right reason
The right dose
The right frequency
The right route
The right site
The right time
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2
Q

What is the trade name of a medication

A

○ 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

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3
Q

What is the generic name of a medication?

A

○ 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

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4
Q

What is the official name of a medication?

A

Official name:the title under which a drug is listed in theUnited States Pharmacopeia(USP) or theNational Formulary(NF)

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5
Q

What information is required on a medication label?

A
  1. the name and address of the dispenser
    1. the serial number of the prescription
    2. the date of the prescription (date of filling or refilling)
    3. the name of the prescriber
    4. the name of the patient
    5. the directions for use , includingprecautions(if any)
    6. the name of the drug and strength(if any)
      1. a caution note (if any)
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6
Q

What are the components of a complete medication order?

A
  1. Medication name;
  2. Strength of medication (if one is required);
  3. Dosage of medication to be administered;
  4. Route of administration;
  5. Specific directions for use, including frequency of administration; and,
  6. PRN or “as needed” orders must also clearly state the reason for administration
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7
Q

List the nursing responsibilities in administering medication

A
  • 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
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8
Q

What “three checks” are required when preparing medication?

A
  1. Check the order (prescribed amount)[Check when you take it out of the chart.]
  2. Check the contents from the dispenser [Check it before you pour it in.]
  3. Check the order again to verify what you are administering[Check it before you put it back.]
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9
Q

Tablet:

A

a solid dosage form containing a medicinal substance with or without a suitable diluent

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10
Q

Lozenges:

A

A small medicinal tablet, originally of this shape, taken for sore throats and dissolved in the mouth: “throat lozenges”

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11
Q

Capsule:

A

an enclosing structure, as a soluble container enclosing a dose of medicine

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12
Q

Caplet:

A

A smooth, coated, oval-shaped medicine tablet intended to be tamper-resistant

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13
Q

Enteric Coated

A

designating a special coating applied to tablets or capsules that prevents release and absorption of active ingredients until they reach the intestine

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14
Q

Syrup:

A

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.

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15
Q

Elixir:

A

a clear, sweetened, alcohol-containing, usually hydroalcoholicliquid containing flavoring substances and sometimes active medicinal ingredients

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16
Q

Suspension:

A

a liquid preparation consisting of solid particles dispersed throughout a liquid phase in which they are not soluble.

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17
Q

Suspended Release:

A

allowing a twofold or greater reduction in frequency of administration of a drug in comparison with the frequency required by a conventional dosage form.

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18
Q

When is it appropriate to “crush” a medication and which medications should never be crushed?

A
  • 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.

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19
Q

When is it appropriate to halve a tablet or caplet?

A

Only when it is scored

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20
Q

What are some different routes to administer medication?

A
Oral
Sublingual
Oral inhalers
Eye drops and ointment
Ear drops
Nose Drops & Nasal Sprays/Inhalers
Transdermal products and patches
Topical
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21
Q

Describe responsibility in relation to telephone orders:

A

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.

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22
Q

Describes resident’s rights regarding medications, i.e., refusal, privacy, respect

A
  1. 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.
  2. 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).
  3. 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.
  4. Chemical Restraint Medications, especially psychotropics, are not to be administered for staff convenience.
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23
Q

Describe what constitutes a medication error and actions to take when a medication error is made or detected

A

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

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24
Q

Define Drug:

A

Any chemical that can affect living processes

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25
What is Pharmacology?
Study of drugs and their interactions with living systems
26
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)
27
What is Therapeutics? AKA Pharmacological Therapeutics?
is the use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy.  Alternatively, therapeutics can be defined simply as the medical use of drugs.
28
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
29
Name the Four major pharmacokinetic processes:
Drug Absorption Drug Distribution Drug Metabolism Drug Excretion
30
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
31
pharmacokinetic processe | Define absorption:
movement of a drug from its site of administration into the blood
32
pharmacokinetic processes | Define distribution:
 movement of drugs throughout the body
33
pharmacokinetic processes | Define metabolism
enzymatic alteration of drug structure
34
pharmacokinetic processes | Define excretion
Removal of drugs from the body
35
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
36
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
37
What is the primary site of metabolism?
Liver
38
What are the sites of drug excretion?
* Urine * Bile * Sweat * Saliva * Breast Milk * Expired Air * KIDNEY!!!!
39
Define Drug Half-Life
the time required for the amount of drug in the body to decrease by 50%.
40
Define Drug Therapeutic level
Range of a drug lies between the MEC (Minimum effective concentration) and the toxic concentration
41
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.
42
What is therapeutic action?
Intended or desired physiological response of a medication
43
What is adverse effect?
unintended, undesirable, and often unpredictable effects. Ex drop in BP, respiratory issues with morphine.
44
What are side effects
predictable and often unavoidable secondary effects produced at a usual therapeutic drug dose Ex dizziness
45
What is an allergic reaction?
unpredictable responses to a medication.
46
What is drug incompatibility?
Cannot give together
47
What is Toxicity?
adverse drug reactions due to excessive dosing
48
Define Tolerance
decreased physiological response that occurs after repeated administration of a medication (prolonged use)
49
What is a physical dependance?
physiological adaptation to a medication that manifests itself by intense physical disturbance when the medication is withdrawn
50
What is additive effect?
2 drugs work better together than separately.
51
what is a teratogens
Harmful or fatal to fetuses
52
What is a carcinogen?
Cancer-Causing
53
What is Idiosyncratic Effects
Uncommon effect
54
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.
55
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)
56
What are some outcomes when drugs interact?
1. One drug may intensify the effects of the other 2. One drug may reduce the effects of the other 3. The combination may produce a new response not seen with either drug alone
57
8 Rights
* Client * medication * reason * dose * frequency * route * site * time
58
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 ```
59
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 ```
60
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
61
What are the enteral routes of administration?
Oral Rectal Nasogastric percutaneous endoscopic gastrostomy (PEG) percutaneous endoscopic jejunostomy (PEJ)
62
What are the parental routes of administration?
``` Intradermal Subcutaneous Intramuscular Intravenous Intra-articular Intraosseous Epidural Spinal ```
63
How do drugs pass through a cell membrane?
Channels and pores Lipid solubility Ionization
64
What are the 4 components of pharmacokinetics?
Absorption Distribution Metabolism Excretion
65
Name some factors that affect absorption
``` Rate of dissolution Surface area Blood flow Lipid solubility pH partitioning ```
66
Name the routes of excretion?
Kidneys Breast milk Bile Lungs
67
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 ```
68
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
69
Who can prescribe in Ontario?
``` Physicians RN’s in the extended class Dentists Chiropodists Midwives Optometrists Pharmacists ```
70
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”
71
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 ```
72
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.
73
Name the types of Medication Errors
Commission Omission Near miss
74
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 ```
75
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