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Pharmacology > Pharm & the Nurse-Patient Relationship > Flashcards

Pharm & the Nurse-Patient Relationship Flashcards

1
Q

Medication Error Index

A

Categorization of medication errors according to the extent of the harm an error can cause.

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2
Q

Sentinel event

A

An event that results in an unexpected, serious, or fatal injury following the administration (or lack of administration) of a medication.

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3
Q

Medication reconciliation

A

The process of tracking medications as the patient proceeds from one health care provider to another, in an attempt to reduce duplication, omissions, dosing errors or drug interactions.

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4
Q

E-prescribing

A

The transmission of prescription-related information through electronic transmission to a pharmacy or health care provider.

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5
Q

What type of drugs are less likely to cross the placenta?

A

Drugs that are water soluble, ionized, or bound to plasma proteins.

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6
Q

How do increased levels of progesterone in pregnant women affect the absorption of oral drugs?

A

Increased progesterone levels can delay gastric emptying, allowing a longer time for the absorption of oral drugs.

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7
Q

How do increased progesterone levels in pregnant women affect the absorption of inhaled drugs?

A

Progesterone increases tidal volume and pulmonary vasodilation, that may cause inhaled drugs to be absorbed to a greater extent.

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8
Q

How does increased blood volume in pregnant women affect drug distribution?

A

Causes dilution of drugs and decreases plasma protein concentrations, affecting drug distribution.

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9
Q

The metabolism in which drugs are increased during pregnancy?

A

Anticonvulsants. May need a higher dose during pregnancy

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10
Q

Why would doses of many medications need to be adjusted during the third trimester of pregnancy?

A

Blood flow through the Mother’s kidneys increases by over 50%, increasing drug excretion rates.

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11
Q

Teratogen

A

A substance, organism, or physical agent to which an embryo or fetus is exposed that produces a permanent abnormality in structure or function, causes growth retardation, or results in death.

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12
Q

Effects of teratogen exposure during Preimplantation period? (1-2 weeks)

A

All-or-none period. Exposure to a teratogen either causes the death of the embryo or has no effect.

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13
Q

Potential Effects of teratogen exposure during the Embryonic period (3-8 weeks)

A

Maximum sensitivity to teratogens due to rapid development of internal structures.
Structural malformation
Spontaneous abortion

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14
Q

Potential effects of teratogen exposure during the fetal period (9-40 weeks)

A

Period of maximize transfer of substances from the maternal circulation to the fetal blood
More likely to produce slowed growth or impaired organ function, rather than gross structural malformations

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15
Q

Why do medications have a prolonged duration of action during the fetal period?

A

Because the fetus lacks mature metabolic enzymes and efficient excretion mechanisms

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16
Q

Pregnancy drug risk category A

A

Adequate, well-controlled studies in pregnant women have not shown an increased risk of fetal abnormalities in any trimester of pregnancy

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17
Q

Pregnancy drug risk category B

A

No harm in animal studies but not enough human studies
OR
Adverse effect in animal studies but adequate human studies show no risk

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18
Q

Pregnancy drug risk category C

A 
Animal studies: adverse effect
Human: Inadequate studies
OR
Animal: No animal studies
Human: Inadequate studies
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19
Q

Pregnancy drug risk category D

A

Humans: Studies have demonstrated risk to a fetus

HOWEVER, the benefits of therapy may outweigh the potential risk.

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20
Q

Pregnancy drug risk category X

A

Animals & humans: Positive evidence of fetal abnormalities or risks.
No indication for use in pregnancy

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21
Q

What are 5 potential effects of Tobacco use during pregnancy or while trying to get pregnant?

A 
Difficulty getting pregnant
Increased risk of: Miscarriage
Premature delivery
Sudden infant death syndrom (SIDS)
Certain birth defects such as cleft lip or cleft palate
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22
Q

Infancy

A

The period from birth to 12 months

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23
Q

What is the preferred site for IM injections in an infant?

A

Vastus lateralis

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24
Q

What are the two preferred venous access sites for IV’s in infants?

A

The feet or scalp

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25
Q

Toddlerhood

A

Age period from 1-3 years

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26
Q

What is the preferred IM injection site for toddlers?

A

Vastus lateralis muscle

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27
Q

Preschool child

A

3-5 years old

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28
Q

When can the Ventrogluteal site begin to be used for IM injections?

A

After a child has walked for about a year

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29
Q

The scalp veins can no longer be used for IV access at what age?

A

3 years old. Peripheral veins are now used

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30
Q

What is one of the most common causes of iron poisoning in children?

A

Iron found in vitamins

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31
Q

Symptoms of iron poisoning

A

Nausea & vomiting
diarrhea
GI bleeding
Can progress to coma and death

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32
Q

School-age child (middle childhood years)

A

Between 6-12 years old

33
Q

Adolescence

A

13-16 years old

34
Q

The most common needs for the pharmacotherapy of teens

A

Skin problems, headaches, menstrual symptoms, eating disorders, contraception, alcohol and tobacco use, and sports-related injuries

35
Q

Young adulthood

A

18-40 years old

36
Q

Middle adulthood

A

40-65 years old

37
Q

Older adulthood

A

Over 65 years old

38
Q

At what stage of life are drug absorption, metabolic and excretion mechanisms at their peak?

A

Younger adults

39
Q

What health impairments begin to surface in late middle age?

A 
Cardiovascular disease
Hypertension
Obesity
Arthritis
Cancer
Anxiety
40
Q

Polypharmacy

A

The taking of multiple drugs concurrently. Common among older adults

41
Q

What are the principal complications of drug therapy in the older adult population?

A

Degeneration of organ systems
Multiple and severe illness
Polypharmacy
Unreliable compliance

42
Q

How does drug absorption change in older adults?

A

Slower due to diminished gastric motility and decreased blood flow to digestive organs.
Increased gastric PH slows dissolving and absorption of oral tablets and capsules

43
Q

How does increased body fat in older patients affect drug distribution?

A

Provides a larger storage compartment for lipid-soluble drugs and vitamins, which reduces plasma levels and therapeutic response

44
Q

How does the amount of body water present in older adults affect drug distribution?

A

Have less body water, making the effects of dehydration more dramatic and increasing the risk for drug toxicity

45
Q

How does the decline in lean body mass and total body water in older adults affect drug distribution?

A

Leads to an increased concentration of water-soluble drugs, because the drug is distributed in a smaller volume of water.

46
Q

How does the aging liver in older adults affect drug distribution?

A

Liver produces less albumin, resulting in decreased plasma protein-binding ability and increased levels of free drug in the bloodstream, increasing the potential for drug interactions.

47
Q

How does the aging cardiovascular system in older adults affect drug distribution?

A

Decreased cardiac output and less efficient blood circulation slow drug distribution.

48
Q

How does the aging liver in older adults affect drug metabolism?

A

Enzyme production in the liver decreases which reduces hepatic drug metabolism.
Leads to increase in half-life of many drugs (prolongs and intensifies drug response)
Reduces first-pass metabolism

49
Q

First-pass metabolism

A

Relates to the amount of a drug that is removed from the bloodstream during the first circulation through the liver after the drug is absorbed by the intestinal tract.

50
Q

How do the aging kidneys in older adults affect drug excretion?

A

Reduced renal blood flow, glomerular filtration rate, active tubular secretion, and nephron function.
Decreses drug excretion for drugs eliminated by kidneys.
Serum drug levels and potential for toxicity increase.

51
Q

Complementary and Alternative medicine (CAM)

A

Comprises an extremely diverse set of therapies and healing systems that are considered to be outside mainstream health care.

52
Q

Common characteristics in major CAM systems

A

Consider and focus on treating each person as a whole individual
Emphasize integration of mind and body
Promote disease prevention, self-care, and self-healing
Recognize role of spirituality in health and healing

53
Q

Herb

A

A botanical that does not contain any woody tissue such as stems or bark

54
Q

Dietary Supplement Health and Education Act (DSHEA) of 1994

A

Primary law in the United States regulating herb and dietary supplements.
Far less rigorous law that the Food, Drug, and Cosmetics act.

55
Q

Dietary supplements

A

Defined as products intended to enhance or supplement the diet, such as botanicals, vitamins, minerals, or other extracts or metabolites that are not already approved as drugs by the U.S. Food and Drug Administration (FDA)

56
Q

Specialty supplements

A

Nonherbal dietary products used to enhance a wide variety of body functions. More specific in their action than herbal products and are generally targeted for one or a smaller number of conditions

57
Q

Acquired immune deficiency syndrome (AIDS) cause and target

A

Human immunodeficiency virus (HIV)

Immune response

58
Q

Bubonic plague cause and target

A

Yersinia pestis, flea and rodent vectors

Immune response and respiratory system

59
Q

Cholera cause and target

A

Vibrio cholerae

Digestive tract

60
Q

Dengue fever and yellow fever cause and target

A 
Flavivirus
Entire body (fever)
61
Q

Ebola cause and target

A 
Zaire ebolavirus (filovirus)
Immune response and cardiovascular system
62
Q

Hepatitis B cause and target

A

Hepatitis B virus (HBV)

Liver

63
Q

Influenza (flu) cause and target

A

Haemophilus influenza, avian and swine vectors

Respiratory system

64
Q

Leprosy cause and target

A

Mycobacterium leprae

Skin, nervous system, muscular system

65
Q

Malaria cause and target

A

Plasmodium falciparum, female Anopheles mosquito vector

Blood disorder

66
Q

Measles cause and target

A

Rubeola virus

Lungs and meninges

67
Q

SARS (severe acute respiratory syndrome) cause and target

A 
SARS coronavirus (SARS CoV)
Respiratory system
68
Q

Smallpox cause and target

A

Variola virus

Skin, mucosa, lymphoid tissue

69
Q

Syphilis cause and target

A

Treponema pallidum

Genitalia, mucous membranes, central nervous system

70
Q

Tetanus (lockjaw) cause and target

A 
Clostridium tetani
Entire body (infections)
71
Q

Tuberculosis cause and target

A

Mycobacterium tuberculosis

Lungs

72
Q

Whooping cough cause and target

A

Bordetella pertussis

Respiratory system

73
Q

During the initial interview, what info is essential to obtain related to the patient’s current and past drug history?

A 
Rx meds
OTC meds
Herbal products
Dietary supplements
Any adverse effects
Allergic reactions
Tobacco/alcohol use
74
Q

What are 6 factors that affect how a drug crosses the placenta?

A 
Amount of drug available
Lipid solubility of the drug
Size of the drug molecules
Drug-protein binding
Ion trapping capability
Placental blood flow
75
Q

What 5 factors must be considered when determining the drug dose for a pediatric patient?

A 
Age
Height
Weight
Maturational state
Body surface area (BSA)
76
Q

How is the body weight method of pediatric drug dose calculated?

A

Based on milligrams per kilogram of weight, plus a unit of time

77
Q

Body surface area (BSA) method of pediatric drug dosing

A

Based on a nomogram, which plots the child’s height and weight. A line is drawn between each point; where the line intersects the surface area is the child’s BSA. The BSA is then used to calculate the drug dose.

78
Q

What are four common reasons for drug noncompliance in the older adult population?

A

Limited monetary resources
Emotional issues (fear of adverse effect, drug unnecessary)
Physical (visual and mobility impairments)
Misuse of drugs (taking too much or too little, not following schedule)

Pharmacology (6 decks)

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