Medications and disease management Flashcards by Caleb Stephens

What is Admixture?

The preparation of an intravenous (IV) medication that requires a mixture of medications

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What are Adverse effects?

Drug effects that are unexpected and unwanted and are usually reported in only a few patients

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What is an Antagonistic effect?

The action of one drug preventing the action of another drug or preventing the action of a messenger on a receptor site in the body

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What is Clarity?

Clear and free of visible particulate matter

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What is Coring?

Breaking off small pieces of the rubber stopper on vials and allowing them to enter the solution or IV fluid

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What is Hypertonic?

Any solution containing a higher concentration of dissolved substances than red blood cells

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What is Hypotonic?

Any solution containing a concentration of dissolved substances less than red blood cells

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What is Isotonic?

Any solution containing a concentration of dissolved substances, such as salts, that are the same as the concentration found in human red blood cells

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What is Osmolarity?

Number of dissolved particles in a solution per liter of solution

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What is Osmosis?

Movement of a solvent (water) across a cell membrane from a lower osmolality to a higher osmolality

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What is pH?

Degree of alkalinity or acidity of a solution. Acidity is usually between 0 and 6, while alkalinity is between 8 and 14. Neutral pH is around 7.

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What is Precipitation?

Solid material or deposits that are separated from a solution often caused by reactions between drugs or drugs and certain fluids

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What is Reconstitution?

Process of adding a diluent to a powder form of a medication

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What is a Synergistic effect?

The action of two drugs working together to produce effects

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What is a Therapeutic effect?

The intended effect of a drug

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What is Tonicity?

The osmolarity of a solution or the effect of the concentration of dissolved particles in the solution.

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Target cells have special places where drugs go to allow a specific action to take place. These places are known as ____

receptor sites

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Distribution allows the drug to reach its ____ and exert its action

target cells

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Receptor sites are sometimes referred to as a “lock and key” mechanism, which describes the interactions of the drug at the receptor sites on the ____

target cell

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The primary enzyme system responsible for metabolism is the ____ P450

cytochrome P450

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If too little of a dose is administered, it can be ____, which means it is not enough to be effective

subtherapeutic

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Adverse drug reactions (ADRs) should be reported to the ____ (FDA)

US Food and Drug Administration

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A special FDA program to report ADRs for vaccines is called the ____ (VAERS)

Vaccine Adverse Event Reporting System

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If the liver does not function properly because of impairment caused by a disease or a decrease in function because of deteriorating body functions (the aging process), drugs may not be ____ properly

metabolized

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Sometimes a ____ dose could be required because of the impairment of vital organs

smaller dose

What is a Neonate?

A kid up to 1 month after birth

Neonates and infants have smaller skeletal structures, and this can affect the absorption of medication just as much. Since there is limited physical activity in these patients, there is a decrease in blood flow to the muscles. This causes slower absorption of the medication and increases the risk of muscle and nerve damage with any ____ injection, since the medication is not absorbed into the bloodstream as quickly as with an adult

IM injection

Several factors, such as ____ and ____, influence how much of a drug reaches its organ or area of the body

blood flow and metabolism

Various organs, such as the ____ and ____, have the largest blood supply

liver and kidneys

The adult brain has a protective barrier called the ____, which protects it from water-soluble substances

blood brain barrier

Drugs must have a certain degree of ____ or ____ solubility to penetrate this barrier and get to the brain

lipid- or fat-solubility

If a lipid-soluble drug is administered to a pediatric patient, there is decreased distribution of the drug to the organs and body tissues because of the lower percentage of ____ in the body

fat

The liver and the kidneys are not fully developed in pediatric patients. This causes metabolism and excretion to occur more slowly than in adults and allows the drug to stay in their body ____

longer

Since a drug stays in the child’s body longer, this can lead to a build-up of the drug, causing ____

toxicity

____, a preservative in bacteriostatic water for injection, which is used regularly to dilute some powder forms of IV medication, has been associated with toxicity in neonates

benzyl alcohol

Cardiac output decreases significantly with age, which affects the amount of ____ that the kidneys and liver receive

blood

Drug distribution is greatly affected in the aging adult because the percentage of lean body mass or muscle and the total percentage of body water are lower than in the ____

younger adult

Since the amount of body fat increases with age, ____ soluble drugs are widely distributed in those organs that contain the most adipose tissue. This causes the drug to be diverted from the kidneys and liver, where the metabolism and excretion processes should take place. This slows the elimination of the drug from the body and causes it to have a longer half-life and toxicity because of the increased levels of medication in the bloodstream

lipid- (fat-)

What is an Agonist effect?

When one medication increases the action of another

Injectable medications have to be in an aqueous solution form to allow them to be injected into the body. They may be packaged as a solution and require preparation using a ____ to withdraw the desired amount; or, they may be packaged as a ____, which requires dilution with a specific fluid called a diluent

syringe diluent

The injectable medications will either be transferred to an ____, usually in a plastic bag, drawn up in a ____ for IV push, or be manufactured as a ____

IV solution container of fluid syringe ready-to-use premixed product

What are ampules?

heat-sealed glass containers

Other common reference sources to use for IV medications include Drug Facts and Comparisons 2014, the Physicians’ Desk Reference, and the Handbook on Injectable Drugs by ____

Lawrence A. Trissell

____ and the ____ contain the most current drug information

Drug Facts and Comparisons and the Handbook on Injectable Drugs

The Handbook for Injectable Drugs is used mostly in the ____ setting because it provides comprehensive compatibility information in chart form, such as to which fluids a medication can be added, storage requirements, stability, and preparation directions

hospital setting

Once the medication is diluted if necessary, the next step is choosing a proper IV solution to which the medication can be added. This can be found in literature, such as the package insert, ____ on Injectable Drugs

Trissel’s Handbook

Always note any interactions with certain types of containers, such as ____ or ____

plastic or aluminum

The fluid inside the red blood cell contains dissolved substances, such as sugars and salts. The cell membrane is designed to allow fluid to pass freely from one membrane to another but not the ____

substances

____ fluids have the same osmolarity as normal body fluid. These solutions are the closest to the red blood cells because the concentration of the salt and other substances are the same as those found in red blood cells

Isotonic fluids

Both 5% dextrose and 0.9% sodium chloride are examples of ____ fluids

isotonic fluids

If the solution contains a concentration of dissolved substances less than red blood cells, it is known as hypotonic. This means fluid will move into the cells and cause ____

swelling

If the solution contains a higher concentration than the red blood cells, it is hypertonic and cells can ____ because of the movement of fluids out of the cells

shrink

Medications that are added to the fluid are known as ____, whereas the final product is known as the ____

additives admixture

____ injection (glucose) is primarily used as a carbohydrate for nutrition and as a source of fluid. It is usually given in 5% concentration

Dextrose injection

____ is used as a source of fluid and electrolytes. It is usually given in 0.9%.

Sodium chloride

____ solution for injection contains primary electrolytes found in plasma and is used for fluid replacement or as a source of electrolytes

Lactated Ringer’s

What is the abbreviation for 5% Dextrose?

D5W

What is the abbreviation for 0.9% Sodium chloride?

NS (normal saline)

What is the abbreviation for Lactated Ringer’s solution?

What is the abbreviation for 10% Dextrose?

D10W

What is the abbreviation for 0.45% Sodium chloride (normal saline)?

1/2NS

What is the abbreviation for 5% Dextrose and 0.9% sodium chloride?

D5NS

What is the abbreviation for 5% Dextrose and 0.45% sodium chloride?

D51/2NS

What is the abbreviation for 5% Dextrose and 0.2% sodium chloride?

D51/4NS

What is the abbreviation for Lactated Ringer’s solution and 5% dextrose

D5LR

Often there are drugs that cannot be combined safely with a particular IV fluid for various reasons. There may be a physical change (such as color or clarity) or a formation of particles called particulate matter. These IV admixtures are known as ____ and must not be given to the patient

incompatible

When preparing IV admixtures, carefully inspect the completed product visually and look for any obvious changes. Any leaks, tears, or changes in the bag of fluid should be observed while still in the hood. Look for the following characteristics:

* Particles floating, such as rubber from the stopper of the vial (known as coring) * Any color changes * Haze or turbidity * Solid particles or filaments formed (particulate matter).

Always refer to medication information concerning compatibility. Color changes or particulate matter does not always form immediately. It may take ____ for this to happen, and in that amount of time the IV may be delivered to the patient for administration.

hours

metronidazole (Flagyl) should be kept at room temperature because refrigeration causes ____ to form

precipitate

Some drugs must not be exposed to ____ and should be protected by a light-blocking protective bag or cover because the medication will be destroyed or degraded

light

Once a vial of ____ is reconstituted and added to a bag of 0.9% sodium chloride, the admixture is only good for 7 days

cefazolin

Some drugs will interact with certain metals, such as cisplatin (a chemotherapy drug) and ____

aluminum

If the fluid and medication to be added have conflicting pH values, this may cause the drug to either ____ or form a ____

degrade or form a precipitate

What are some common Parenteral Medications Types?

Antibiotic therapy, Fluid replacement, Antineoplastic (Chemotherapy), Nutrition, Pain management, Biologics, & Trauma (emergency)