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Patient Care 2 > Pharmaceuticals & Medication Administration > Flashcards

Pharmaceuticals & Medication Administration Flashcards

1
Q

Classifications of Medications

A
  • OTC analgesics (over the counter)
  • controlled medications
  • narcotics
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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
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3
Q

Trade/Brand name

A
  • name given to a drug manufactured by a specific company
  • starts with a CAPITAL letter
  • ex: Glucophage
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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
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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)
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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
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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
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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**
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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
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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
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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
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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)
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13
Q

First-pass effect

A

The partial absorption of a drug before it reaches systemic circulation (ex: vascular system)

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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

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15
Q

Distribution

A

How the drug travels through the blood stream and outwards to the target tissue and site of action

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16
Q

3 factors that affect distribution

A
  1. Regional blood flow: amount of blood supplied to that organ/area
  2. Cardiac output: amount of blood pumped by the heart per minute
  3. Drug reservoirs: drug accumulations bound by specific sites (fat/bone tissue and plasma). Drugs must cross barrier to be effective
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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)
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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
  1. Oxidation, hydrolysis or reduction: gaining an election to decrease positive valence
  2. 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
  1. Control pain
  2. Cure disease
  3. Alleviate symptoms of a disease (managing Parkinson’s)
  4. 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
  1. Contrast agents name and strength
  2. Volume administered
  3. Route administered
  4. Date and time of administration
  5. 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
  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
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

Patient Care 2 (7 decks)

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