Pharm ch 1 - 3 Flashcards
assessment
objective (concrete data, test results), subjective (complaints) and human needs statement ( Diaphoresis is the medical term used to describe excessive, abnormal sweating in relation to your environment and activity level)
planning phase
outcomes are objective, measurable, and realistic
Outcomes are
objective, measurable, and realistic with an established time frame for their achievement.
PO
by mouth
redox
an addition of H or removal of O
ADE
adverse drug event
ADR
adverse drug reaction
neonate
between birth and 1 month of age
infant
between 1 and 12 months
child
between 1 and 12 years of age
younger than 38 weeks gestation
premature
younger than 1 month
neonate
prescribing cascade
give potassium to counteract potassium loss from diuretics
Outcomes are
objective, measurable, and realistic with an established time frame for their achievement.
The ninth right is that of the right of the patient to
refuse
Knowledge of the drug’s indication allows the nurse, prescriber, members of the health care team, patient and/or family members to
understand what is being treated.
If there is a medication error
complete an incident report with the entire event, surrounding circumstances, therapeutic response, adverse effects, and notification of the prescriber described in detail. However, do not record completion of an incident report in the medical record.
following information needed:
following information: date and time of medication administration, name of medication, dose, route, and site of administration
Other factors must be considered in determining the right time, such as
multiple-drug therapy, drug-drug or drug-food compatibility, scheduling of diagnostic studies, bioavailability of the drug
Include in your three checks…
the frequency of the ordered medication, the time to be administered, and when the last dose of medication was given
Always confirm that the dosage amount is appropriate for the patient’s
age and size
Grounded theory was used to identify the
essence of medication safety.
If a verbal order is given, the prescriber must
sign the order within 24 hours or as per guidelines within a health care setting
Statements of interventions include
frequency, specific instructions, and any other relevant information
The study of natural (versus synthetic) drug sources (i.e., plants, animals, minerals) is called
pharmacognosy (nature is cognizant)
The study of the adverse effects of drugs and other chemicals on living systems is known as
toxicology
Pharmacotherapeutics (also called therapeutics) focuses on the
clinical use of drugs to prevent and treat diseases. It defines the principles of drug actions
Pharmacokinetics is the study of what the (kinetic energy is dope)
body does to the drug.
Pharmacodynamics involves (dynamic between drug and receptor)
drug-receptor relationship
Pharmaceutics is the study of
various dosage forms influence the way in which the drug affects the body
Drugs can be classified by their
structure (e.g., beta-adrenergic blockers) or by their therapeutic use (e.g., antibiotics, antihypertensives, antidepressants).
Pharmacology includes the following several subspecialty areas:
pharmaceutics, pharmacokinetics, pharmacodynamics, pharmacogenomics (pharmacogenetics), pharmacoeconomics, pharmacotherapeutics, pharmacognosy, and toxicology
Oral dosage forms rely on
gastric and intestinal enzymes and pH environments to break the medication down into particles that are small enough to be absorbed into the circulation
Topical
Aerosols, ointments, creams, pastes, powders, solutions, foams, gels, transdermal patches, inhalers, rectal and vaginal suppositories
Parenteral
Injectable forms, solutions, suspensions, emulsions, powders for reconstitution
Enteral
Tablets, capsules, oral soluble wafers, pills, timed-release capsules, timed-release tablets, elixirs, suspensions, syrups, emulsions, solutions, lozenges or troches, rectal suppositories, sublingual or buccal tablets
Dosage form determines the
rate at which drug dissolution (dissolving of solid dosage forms and their absorption, e.g., from the gastrointestinal [GI] tract) occurs
Metabolism is also referred to as
biotransformation. It involves the biochemical alteration of a drug into an inactive metabolite, a more soluble compound, a more potent active metabolite (as in the conversion of an inactive prodrug to its active form), or a less active metabolite
Typically a drug that is highly water-soluble (hydrophilic) will have a smaller volume of
distribution and high blood concentrations. In contrast, fat-soluble drugs (lipophilic) have a larger volume of distribution and low blood concentrations
A theoretical volume, called the volume of distribution, is sometimes used to describe the
various areas in which drugs may be distributed. These areas, or compartments, may be the blood (intravascular space), total body water, body fat, or other body tissues and organs.
A drug-drug interaction occurs when the
presence of one drug decreases or increases the actions of another drug that is administered concurrently (i.e., given at the same time).
Only drug molecules that are not bound to plasma proteins can
freely distribute to extravascular tissue (outside the blood vessels) to reach their site of action.
Areas of rapid distribution include the (BLK H)
heart, liver, kidneys, and brain
Transdermal drug delivery through adhesive patches is an elaborate topical route of drug administration that is commonly used for (transdermal has a system)
systemic drug effects
All topical routes of drug administration avoid
first-pass effects of the liver, with the exception of rectal administration.
Muscles have a greater blood supply than does the skin; therefore drugs injected intramuscularly are
absorbed faster than drugs injected subcutaneously
Injections into the fatty subcutaneous tissues under the dermal layer of skin are referred to
subcutaneous injections
The time until onset of action for the PO form is
30 to 60 minutes; for the IV form, this time is 5 minutes.
Intramuscular injections are indicated/used with drugs that are poorly soluble which are often given in
“depot” preparation form and are then absorbed over a prolonged period
Medications given by the parenteral route have the advantage of
bypassing the first-pass effect of the liver.
Intraarterial, intrathecal, or intraarticular injections are usually given by
physicians
The parenteral route is the f
fastest route by which a drug can be absorbed, followed by the enteral and topical routes
Drug absorption may be altered in patients who have had
portions of the small intestine removed because of disease. This is known as short bowel syndrome
Taking an enteric-coated medication with a large amount of food may cause it to be
dissolved by acidic stomach contents and thus reduce intestinal drug absorption and negate the coating’s stomach-protective properties.
Once the drug is in the liver
hepatic enzyme systems metabolize it, and the remaining active ingredients are passed into the general circulation.
three basic routes of administration
enteral (GI tract), parenteral, and topical.
First-pass effect reduces the bioavailability of the drug to
less than 100%.
If a large proportion of a drug is chemically changed into inactive metabolites in the liver, then
a much smaller amount of drug will pass into the circulation (i.e., will be bioavailable). Such a drug is said to have a high first-pass effect
Bioavailability is the term used to express the
extent of drug absorption
Absorption is the
movement of a drug from its site of administration into the bloodstream for distribution to the tissues
Specifically, the combined processes of pharmacokinetics include
drug absorption into, distribution and metabolism within, and excretion from the body represent.