Pharmaceuticals & Medication Administration Flashcards
1
Q
Classifications of Medications
A
- OTC analgesics (over the counter)
- controlled medications
- narcotics
2
Q
Generic (chemical) name
A
- name given to a drug when it becomes commercially available (derived from more complex chemical name)
- starts with a small letter
- ex: metformin
3
Q
Trade/Brand name
A
- name given to a drug manufactured by a specific company
- starts with a CAPITAL letter
- ex: Glucophage
4
Q
What information is found on a drug information sheet?
A
- trade name
- generic name
- chemical composition
- chemical strength
- usual dose
- indications and contradictions
- reported side effects
- physicians will order meds either by the generic name or trade name
5
Q
Drug regulation
A
- meds governed in Canada by Food and Drug Act
- no meds administered without an order either written or verbal by a physician
- narcotic drugs controlled by Canadian Narcotic Act
- always check med expiry dates (once per week)
6
Q
Narcotics
A
- have the symbol N following the name of the drug (indicates it has ADDICTIVE qualities)
- always kept in locked cupboard with “narcotics control” book to document usage
- strict records must be kept
- name and quantity of each narcotic is regularly checked
7
Q
What must be included when a narcotic is given to a patient?
A
- full name of pt
- date
- name of ordering position
- time
- exact dose administered and wastage dose
8
Q
Controlled Drugs
A
- non-narcotic drugs that are POTENTIALLY addictive and may have a potential of abuse
- have the letter C with a circle around it –>© following the name of the drug
- regulation and documentation similar to narcotics and records are kept in a “controlled drugs” book
- there are 5 different controlled substance schedules indicating the potential of addiction
- *the lower the number, the higher the abdication potential**
9
Q
Drug Reactions (people process drugs based on…)
A
- age, sex and nutritional status
- physical condition and body weight
- immune status, existing pathological conditions
- ethnicity
- time of day, state of mind
- environmental conditions
10
Q
Pharmacokinetics
A
- the study of how drugs enter the body, are absorbed, metabolized and exit the body
1. Absorption
2. Distribution
3. Metabolism
4. Excretion
11
Q
Absorption
A
- process by which a drug enters systemic circulation in order to produce a desired effect
- drug must be made of the same components as intended absorption site (pill for GI tract)
- drugs taken orally are absorbed into small intestine
- drugs taken orally in liquid form are processed quicker than tablets or capsules
12
Q
absorption rate depends on…
A
- surface area
- blood flow
- concentration: drugs move from high concentration to low concentration areas
- compatibility: some drugs counteract each other (no absorption)
13
Q
First-pass effect
A
The partial absorption of a drug before it reaches systemic circulation (ex: vascular system)
14
Q
Oral Medications
A
Often given in larger doses due to the travel of the drug through the gastric and hepatic systems
-oral meds are absorbed through the mucosal lining of the GI tract
15
Q
Distribution
A
How the drug travels through the blood stream and outwards to the target tissue and site of action
16
Q
3 factors that affect distribution
A
- Regional blood flow: amount of blood supplied to that organ/area
- Cardiac output: amount of blood pumped by the heart per minute
- Drug reservoirs: drug accumulations bound by specific sites (fat/bone tissue and plasma). Drugs must cross barrier to be effective
17
Q
Metabolism
A
- also called biotransformation
- chemically changes drugs into a metabolite to be excreted into the body
- don’t want permanent effects
- the LIVER is the most responsible for metabolism (also: kidneys, lungs, plasma and intestinal mucosa)
18
Q
Factors affecting metabolism
A
- age
- time of day
- overall health/nutrition
- emotional/mental status
- other drugs present
- genetic variations and disease processes/states
19
Q
Drug chemical reactions
A
- Oxidation, hydrolysis or reduction: gaining an election to decrease positive valence
- Conjugation: transforms drug from a lipid soluble (crosses biological membranes) to a water soluble (excreted through biliary tract).
20
Q
Excretion
A
- happens mainly in the KIDNEYS (which can only excrete water soluble substances)
- route depends on chemical makeup of the drug
- other sites of drug excretion are through: biliary tract and feeces
- some can be excreted through breast milk (IV contrast agents)
21
Q
Blood brain barrier
A
- protects the brain from most ions and large molecular compounds from blood to brain
- a drug in the blood will diffuse into tissue everywhere EXCEPT the brain (because of the BBB)
22
Q
Effects of Medications
A
- therapeutic: prescription/over the counter meds to treat illness or injury
- side: unwanted, but expected
- idiosyncratic: abnormal reaction, unexpected, opposite effect
- adverse: undesirable/unwanted consequence, unexpected
- toxic: dangerous reaction caused by allergy or other response
- nephrotoxic: damages kidney tissues due to drug toxicity
- dependency: physical craving of drug may or may not be accompanied by physiological dependency
- withdrawal: symptoms experienced by an addict (sweating, anxiety, nervousness)
- teratogenic: causes congenital anomalies or birth defects (meds for morning sickness used in the ’60s that caused babies to have missing limbs and flippers)
- carcinogenic: substance or organism known to potentially cause cancer
23
Q
Intent of Drug Therapy
A
- Control pain
- Cure disease
- Alleviate symptoms of a disease (managing Parkinson’s)
- Diagnose a disease
* target area which a drug is intended is called a drug receptor
24
Q
Adverse drug reactions (2)
A
- side effect: an action or effect of a drug other than that desired, something that is expected to occur (nausea, headache)
- adverse reaction: any undesirable or unwanted consequence of a diagnostic or therapeutic procedure, something NOT expected to occur (anaphylactic shock)
25
Measuring drugs
- metric system
- mL and cc (1mL=1cc)
- x-ray techs DO NOT prescribe drugs
26
charting medications
1. Contrast agents name and strength
2. Volume administered
3. Route administered
4. Date and time of administration
5. Signature or approved identification
27
Stat order
Patient to receive meds immediately (verbal order from physician)
28
PRN order
Pro re nata, when necessary
29
Standing order
-specific meds Gwen under certain conditions
-order signed by requesting physician (antibiotics before and after a biopsy)
Consider:
-effect of drug
-dosage of drug (amount)
-when the drug should be given (post procedure)
-condition of the patient
30
Drug errors
You are responsible for your OWN actions
- notify radiologist of any error(s) immediately
- DOCUMENTATION (incident report)
- never borrow meds from the crash cart
31
Six Rights of Drug Administration
1. The right DOSE
2. The right MEDICATION
3. The right PATIENT
4. The right TIME
5. The right ROUTE
6. The right DOCUMENTATION
32
Routes of Drug administration
- topical
- enteral (oral and rectal)
- sublingual
- buccal
- parenteral
*route depends on whether meds are fast or slow acting (oral is slow)
33
Topical
- medication administered to the surface of the skin
- local effect (calamine lotion for poison ivy)
- transdermal (applied in paste form or adhesive disks and medicine is more widely distributed (fentanyl patches for pain control)
34
Enteral
- applies to meds administered directly into the GI tract via oral or rectal routes
* Oral is the most common:
- swallowed by patient
- absorbed through stomach and small bowel
- can be liquid or solid
- most cost effective
- for larger doses when slower absorption and longer duration of drug activity is required
35
Retcal Medications
- unreliable (patient may have bowel movement)
- placed into rectum
- given when patients are nauseated (cant keep anything down) or unable to take drug my mouth (children, confused patients)
36
Sublingual and Buccal
- a variation of the topical route (meds come in contact with the mucosal membranes of the oral cavity)
- even though they are placed in the mouth they are not considered oral
- absorbed into the blood through oral mucosa
- effects are immediately available without being absorbed into the stomach
* sublingual: placed under the tongue
* buccal: placed inside the cheek
37
Parenteral
- injections are injected directly into the body to bypass the GI tract
* administration options are:
- intravenous
- intradermal
- subcutaneous
- intra-arterial
- intrathecal
- intra-articular
38
Intravenous
- injected directly into the vein
- most immediate result
- cannot change it once it is injected
- required surgical aseptic technique
- invasive procedure, therefore, informed consent required
39
Intradermal
- between the layers of the skin
- usually anterior surface of the forearm
- small quantities and a small needle (26g) injected at a 30˚ angle
40
Subcutaneous
- injected under the skin below the epidermis
- injected at a 45˚ angle using a 23-25 needle
- painful for the patient
- done on upper arm or outer thigh
41
Intramuscular
- injected into muscle tissue
- larger amounts can be given because muscle tissue absorbs some meds (veins have no absorptions)
- 22g needle injected at a 90˚ angle
- deltoid or gluteal muscles (arm/buttocks)
- pain in muscle can last for days
- slower release
42
Intra-arterial
- injected directly into an artery
| - used to achieve a high local concentration of a drug for pain relief or treatment of neoplasms
43
Intrathecal
-injection into spinal subarachnoid space, past the BBB, directly where the CSF is
44
Intravenous-articular
-injected within the joint directly
