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
Q
Measuring drugs
A
- metric system
- mL and cc (1mL=1cc)
- x-ray techs DO NOT prescribe drugs
26
Q
charting medications
A
- Contrast agents name and strength
- Volume administered
- Route administered
- Date and time of administration
- Signature or approved identification
27
Q
Stat order
A
Patient to receive meds immediately (verbal order from physician)
28
Q
PRN order
A
Pro re nata, when necessary
29
Q
Standing order
A
-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
Q
Drug errors
A
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
Q
Six Rights of Drug Administration
A
- The right DOSE
- The right MEDICATION
- The right PATIENT
- The right TIME
- The right ROUTE
- The right DOCUMENTATION
32
Q
Routes of Drug administration
A
- topical
- enteral (oral and rectal)
- sublingual
- buccal
- parenteral
*route depends on whether meds are fast or slow acting (oral is slow)
33
Q
Topical
A
- 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
Q
Enteral
A
- 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
Q
Retcal Medications
A
- 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
Q
Sublingual and Buccal
A
- 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
Q
Parenteral
A
- injections are injected directly into the body to bypass the GI tract
- administration options are:
- intravenous
- intradermal
- subcutaneous
- intra-arterial
- intrathecal
- intra-articular
38
Q
Intravenous
A
- 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
Q
Intradermal
A
- 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
Q
Subcutaneous
A
- 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
Q
Intramuscular
A
- 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
Q
Intra-arterial
A
- injected directly into an artery
- used to achieve a high local concentration of a drug for pain relief or treatment of neoplasms
43
Q
Intrathecal
A
-injection into spinal subarachnoid space, past the BBB, directly where the CSF is
44
Q
Intravenous-articular
A
-injected within the joint directly
