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NURS 200 > NURS 200 Midterm > Flashcards

NURS 200 Midterm Flashcards

1
Q

Medication Trade Name

A

brand name, often more expensive (ex. tylenol)

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2
Q

Medication Chemical name

A

exact elements (ex. C8H9NO2)

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3
Q

Medication Generic Name

A

medication with the exact same active ingredient as the brand-name drug (ex. acetaminophen)

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4
Q

Absorption of meds

A
  • done in stomach and SI
  • how long it takes drug to get from admin site to BS
  • depends on size, lipid solubility, degree of ionization, interactions with food or other meds, liquid is faster than tablets, food decreases absorption rate
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5
Q

Distribution of meds

A
  • done in bloodstream
  • how agents are transported throughout the body
  • depends on the formation of drug-protein complexes and special barriers (BBB, FPB)
  • rapid distribution occurs in highly vascularized sites like the heart, liver, kidneys, brain
  • slower: muscle, skin
  • slowest: bone, fat
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6
Q

Metabolism of meds

A
  • mostly in liver
  • also known as biotransformation
  • chemical conversion to a form that is more likely to be excreted
  • increased drug metabolism can cause diminished pharmacologic effects
  • delayed drug metabolism can cause accumulation of drugs in body to lethal levels, prolonged drug action
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7
Q

Excretion of meds

A
  • in kidneys and LI
  • removal of drugs from the body
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8
Q

4 processes of pharmacokinetics

A

Absorption, metabolism, distribution, excretion

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9
Q

Drug plasma concentration

A
  • the concentration of drugs in the bloodstream
  • determines their duration of action
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10
Q

Therapeutic response

A

depends on their concentration in the plasma
therapeutic range = toxic concentration - minimum effective concentration

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11
Q

Half-life

A

length of time required for a med to decrease concentration in the plasma by 1/2 after administration

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12
Q

Duration of action

A

length of time a drug concentration remains in the therapeutic range

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13
Q

Loading and maintenance dose

A

loading dose: higher amount of drug often given only once or twice to “prime” the BS with a level sufficient to quickly induce3 a therapeutic response

maintenance dose: this is given intermittently before plasma levels drop to 0 to keep the plasma drug concentration in the therapeutic range

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14
Q

Therapeutic index

A
  • ratio of the lethal dose and minimal dose at which therapeutic effects occur
  • higher index = larger difference b/w the LD50 (lethal) and ED50 (effective) = safer
  • “it would take an error of the therapeutic index value times the average dose to be lethal”
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15
Q

Potency

A

required dose to produce a therapeutic effect
- if a drug is more potent, it will produce a therapeutic effect at a lower dose

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16
Q

Efficacy

A
  • magnitude of max response that can be produced by a drug
  • greater intensity of drug response
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17
Q

Cellular receptors and drug actions

A

cell signalling: perceive and respond to info from their environment through receptors
- meds bind to receptors to initiate their effects
- many receptors are cell surface proteins
- receptor ligands are molecules that activate or inhibit receptors

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18
Q

Type of Drug Receptor Interactions

A

agonists - produce same response as endogenous
antagonists - occupy a receptor and prevents endogenous reactions
partial agonist - med that produces a weaker or less efficacious response than an agonist

19
Q

side effects

A
  • predictable drug effects
  • may occur even at therapeutic doses
  • less serious than adverse effects
  • tolerable
20
Q

adverse effects

A
  • undesirable & potentially harmful action caused by med
  • minimized through: getting med hx, prevention of med errors, questioning unusual orders, pt education on adverse effects
21
Q

drug allergies

A

6-10% of all adverse drug effects

22
Q

idiosyncratic response

A

adverse drug effect producing unusual & unexpected symptoms not related to pharmacological action, not allergies bc they are not immune related, often caused by genetic differences among clients (mutations)

23
Q

drugs that have the ability to induce cancer

A
  1. antineoplastic
  2. hormones and hormone antagonists
  3. immunosuppressants
24
Q

drugs that have the ability to cause birth defects

A

Teratogenic

25
Q

pros to PO med

A

non-invasive, cheaper, can be longer lasting, can be pumped out

26
Q

pros to sublingual and buccal

A

rich BS, excellent absorptive surface, faster than oral, bypasses first pass effect, should be given after oral meds

27
Q

Elixirs, Syrups, and Suspension

A

Elixirs - drugs in a water and alcohol solution

Syrups - drugs in a sticky solution

Suspension - finely divided drug particles dispersed in liquid. must shake.

28
Q

What amounts can be injected into intradermal, SC, and IM?

A

intradermal - 0.1-0.2mls
SC - 1.5-2mls
IM - 2-3mls

29
Q

Common classes of meds involved in ME (medication errors)

A
  • antibiotics
  • anticoagulants
  • antidiabetic agents
  • antineoplastic (anticancer) agents
  • CV agents
  • CNS-active agents (ex. opiates, anesthetics)
  • vaccines
30
Q

Top 5 High alert meds

A
  • insulin
  • opioids and narcotics
  • injectable KCl
  • IV anticoagulants
  • NaCl solution above 0.9%
31
Q

how to prevent med errors

A
  • 3 checks
  • minimize verbal/telephone orders
  • use 1 mg instead of 1.0 mg which can look like 10
  • contact for clarification of illegible writing
32
Q

what routes skip the first pass effect?

A

parenteral, topical, mucosal

33
Q

do enteral meds go through the first pass effect?

A

yes

34
Q

steady state serum levels

A

amount of drug eliminated is equal to amount administered with each dose

35
Q

Examples of drug toxicity categories

A
  • nephrotoxicity
  • neurotoxicity
  • hepatotoxicity (ex. tylenol)
  • dermatological
  • bone marrow
  • cardiotoxicity
  • skeletal muscle and tendon
36
Q

What is an immunosuppressant

A

Inhibit immune system for organ transplants or severe cases of autoimmune diseases

37
Q

Action of Immunosuppressants

A

prototype drug: cyclosporine inhibits helper T cells

38
Q

Adverse effects of immunosuppressants

A
  • 75% of pts experience reduced urine flow
  • Since it is toxic to bone marrow, you may see complications such as decreased RBC, WBC, and platelet count
  • tremors, HTN, elevated hepatic enzymes
39
Q

What to monitor when someone is receiving immunosuppressants

A

Assess presence of metastatic cancer, active infection, renal or liver disease, pregnancy, skin integrity, temperature
- greatest risk is infection
- safe diet: careful with raw foods, unpasteurized products, mold, dirty water

40
Q

What does acetylcholine do?

A

Stimulates the next nerve cell as impulses move along a nerve from neuron to neuron or at the neural muscular junction stimulating muscle stimulation

41
Q

Why are cholinergics rarely used?

A

Side effects - SLUDGE
excess Salivation
Excess of lacrimation (crying)
Urinary incontinence
Diarrhea
Gastrointestinal cramps
Emesis

42
Q

most common BP medication

A

Beta-blockers

43
Q

Where and what are the receptors of the SNS

A

Adrenergic receptors are at the end of the postganglionic sympathetic neurons

NURS 200 (2 decks)

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