Pharm Basics Flashcards
Category ___ medications have the highest potential for abuse
1
Examples of Category 1 medications
Heroin, LSD
Category ___ medications have a lower risk of abuse, but still a potential for abuse
5
Example of category 5 medication
Cough medication with codeine
Category ___ is the safest during pregnancy
A
Category ___ is the most dangerous during pregnancy
X
What are the 5 core rights of medication administration?
Right: person, medication, dose, route, and time
How the medication gets from the site of administration into the bloodstream
Absorption
How a medication gets from the bloodstream to the site of action
Distribution
The inactivation of medications by enzymes
Metabolism
The elimination of medications from the body
Excretion
Metabolism mainly occurs in the _________ and excretion mainly occurs in the _________
Liver; Kidneys
Comparison of the minimum effective concentration (MEC) to toxic drug levels
Therapeutic index (TI)
The amount of time it takes for a medication to be reduced by 50% in the body
Half life
Medications that activates receptors in the body
Agonists
Medications that block receptors in the body
Antagonists
Medications that act as agonists on some receptors and antagonists other receptors
Agonist-antagonist
Which medication is safer: a medication with a high therapeutic index or a medication with a low therapeutic index?
Medication with a high therapeutic index
T or F: drugs with a longer half life have a greater risk for toxicity
True
List 3 examples of time-critical medications
Antibiotics, anticoagulants, insulin
Time-critical medications should be administered within _____ of scheduled time
30 min (can be 30 min before or 30 min after)
Non-time critical medications can be administered within _____ of scheduled time
2 hours
A non-time critical medication that is administered multiple times a day (bid, tid, etc.) can be administered within _____ of scheduled time
1 hour
What are the most common PRN medications?
Pain and nausea medications
Best practice for taking telephone orders
Have a second RN listen in on the call, write down the prescription and repeat it back, make sure the provider signs the prescription within 24 hours
The process by the nurse compiles and complete and updated list of medications that the patient has been taking at home and compare it to the providers orders to prevent medication errors
Medication reconcilation
When should medication reconciliation be performed?
During transitions of care
What three herbs can increase the risk for bleeding when taken with medications such as warfarin, aspirin, and NSAIDs?
garlic, ginger, and ginkgo biloba
Which herb can increase the risk for serotonin syndrome when taken with a serotonin reuptake inhibitor such as SSRIs and SNRIs?
St. John’s Wort
Symptoms of serotonin syndrome
Fever, tachycardia, diaphoresis, N/V, muscle rigidity
What supplement is sometimes used for insomnia, anxiety, and other disorders but may increase the risk for sedation when taken with a CNS depressant?
Valerian
Foods that contain _________ can cause a hypertensive crisis in patients taking an MAOI such as phenelzine
Tyramines
Examples of foods that are rich in tyramines
Bananas, avocados, salami, pepperoni, aged cheese, chocolate, red wine
What food-drug interaction can increase the risk for toxicity with many medications such as Antihypertensives, statins, and mental health medications?
Grapefruit juice
Alcohol potential interactions
Increased risk for drowsiness when taking with CNS depressant (antihistamine), increased risk for hepatotoxicity when taken with certain meds such as antituberculosis
_____ can decrease the absorption of iron supplements and certain antibiotics such as tetracycline
Dairy
Increased intake of __________ rich foods can decrease the effectiveness of warfarin
Vitamin K (however, note that a decrease in vitamin K while taking warfarin can increase risk for bleeding; teach patient to maintain consistent intake of vitamin K)
Increased _________ can decrease the absorption of levodopa
Protein
Increased _________ intake can lead to increased risk of hyperkalemia when taken with certain Antihypertensives agents such ACE inhibitors or spironolactone
Potassium
Antidote for acetaminophen
Acetylcysteine
Antidote for benzodiazepines
Flumazenil
Antidote for opioids
Naloxone
Antidote for digoxin
Digoxin immune fab (Digibind)
Antidote for heparin
Protamine sulfate
Antidote for warfarin
Vitamin K
Antidote for magnesium
Calcium gluconate
Antibiotic patient teaching
- Take the ENTIRE course
- report significant side effects to provider
- some antibiotics may require periodic lab testing throughout therapy
- certain antibiotics (such as tetracyclines) can decrease effectiveness of oral contraception (use an alternate form of protection)
- certain antibiotics can cause photosensitivity (increased risk for burns) so educated patient to avoid sun exposure and wear sunscreen!
List some of the medication classes that can cause anticholinergic effects
Inhaled/nasal anticholinergics, atropine, antihistamines, tricyclic antidepressants, antipsychotic agents, Benztropine, oxybutynin
__________ medications block the effect of acetylcholine
Anticholinergic
Anticholinergic side effects
Blurred vision (can’t see), urinary retention (can’t pee), dry mouth (can’t spit), constipation (can’t shit), tachycardia, photosensitivity, hyperthermia
Anticholinergic nursing care
Monitor urine output, monitor temperature
Anticholinergic patient education
Increase fluid and fiber intake, suck on hard candy for dry mouth, wear sunglasses for photosensitivity, avoid heat
List medications that place patient at increased risk for bleeding
Heparin/enoxaparin, warfarin, factor Xa inhibitors, platelet aggregation inhibitors, thrombin inhibitors, thrombolytics, antineoplastics
S/S that indication a patient is having bleeding
Coffee ground emesis, black tarry stools, hematuria, oozing at gumline, bruising
Bleeding precaution nursing care
Limit venipunctures and IM injections, if injection is unavoidable use smallest needle possible, implement fall precautions
Bleeding precautions patient education
Use soft-bristled toothbrush and electric razor, seek immediate medical attention following any kind of head trauma
Medications that cause immunosuppression and increased risk for infection
Corticosteroids, atypical antipsychotic agents, DMARDs, antineoplastic agents
Immunosuppression/infection precautions nursing care
Implement isolation/neutropenic precautions (private room w/ dedicated equipment, no live flowers/plants, screen visitors for illness), notify provider for s/s of infection, monitor WBCC and temperature
Immunosuppression/infection precautions patient education
Avoid crowded areas/contact with people with illness, frequent and thorough hand hygiene, avoid gardening and cat litter, cook foods thoroughly to prevent foodborne illness
