Pharmacology Basics

Question 1

What are the six rules before administering medication that must be present?

Answer 1

1. Patient name
2. Date of order
3. Drug(s) need to be named
4. Dosage amount and frequency
5. Root of administration
6. Signature from prescriber

Question 2

What part of the nursing process do the ten rights fall under?

Answer 2

Implementation

Question 3

Describe the difference between critical thinking and critical reasoning

Answer 3

Thinking - providing best possible patient care using best practice informed by evidence

Reasoning - Critical thinking leads to critical reasoning. Analyzing and understanding patient issues, making timely and effective patient-centred decisions, and it is holistic

Question 4

List the 10 rights of drug administration

Answer 4

1. Drug
2. Dose
3. Time
4. Route
5. Patient
6. Reason
7. Documentation
8. Evaluation/assessment
9. Education
10. To refuse

Question 5

What is the magic window for a time critical medication? What constitutes a time critical medication? What happens if it is not given in this window?

Answer 5

30 minutes either way

q4h or more frequent

When we pass this, the patient will not have the therapeutic response to the medication as needed (i.e., can develop antibiotic resistance)

Question 6

What is the non-critical magic window?

Answer 6

1 hour either way

Question 7

Define pharmaceutics

Answer 7

Study of how various dosage forms influence the way in which a drug affects the body

i.e., pill, tablet, liquid, controlled release, sustained release, crushable

Question 8

Define pharmacokinetics

Answer 8

Study of what the body does to the drug (absorption, distribution, metabolism, and excretion)

Question 9

Define absorption

Answer 9

the drug moves from its site of administration into the blood stream

Question 10

Define distribution

Answer 10

transport of the blood by the blood stream to the site of action

Question 11

Would dosage of an oral medication or IV medication be higher? Why?

Answer 11

Oral because they work through the liver and some may be lost/excreted

Question 12

Define metabolism

Answer 12

medication is broken down into its active components

Question 13

Define excretion. What organs excrete medications?

Answer 13

ensure that the kidneys are excreting what they should be to ensure the patient is not going into toxicity

Excreted through the kidneys, skin, lungs, and GI tract/colon

Question 14

Define pharmacodynamics

Answer 14

Relationship between drug concentrations and pharmacological response (mechanism of action) - how does the drug work?

Question 15

Define pharmacotherapeutics

Answer 15

Clinical use of drugs to prevent or treat (acute, maintenance, supplemental, palliative, supportive, prophylactic & empirical)

Question 16

Match the following medications to the purpose

Supportive, Acute, Prophylactic/empirical, Supplemental, Maintenance, Palliative

Insulin, Electrolytes, BP medications, Vaccines, Analagesics, Vasopressors

Answer 16

Acute - Vasopressors
Maintenance - BP medications
Supplemental - Insulin
Palliative - Analgesics
Supportive - Electrolytes
Prophylactic/empirical - Vaccines

Question 17

Define the difference between an adverse event and reaction

Answer 17

Event - any undesirable occurrence involving medications

Reaction - anaphylaxis or hypersensitivity to a drug administered

Question 18

Are adverse events or reactions more common?

Answer 18

Events

Question 19

What is an idiosyncratic reaction?

Answer 19

Rare, not understood completely, occur unexpectedly, evidence suggests a genetic component

Question 20

What is teratogenic reaction?

Answer 20

negatively impacts the developing fetus (i.e., thalidomide)

Question 21

What is carcinogenic reaction?

Answer 21

medications that can cause cancer (i.e., immunotherapy or hormone therapy can cause structural differences to DNA)

Question 22

Describe phase one of new drug development. How many people are involved?

Answer 22

trial in a clinical setting, small numbers of individuals (<100), lasts a couple of days to a couple weeks, and they are healthy individuals

Question 23

What phase of a new drug trial is pharmacokinetics being tracked?

Answer 23

Phase one

Question 24

Describe phase two of new drug development. How many people are involved?

Answer 24

100-300 individuals who have the disease, clinical trial, adverse reaction and events are monitored

Question 25

Describe phase three of new drug development. How many people are involved?

Answer 25

larger numbers (1000-3000), reaching out to medical research centre

Question 26

What phase is placebo introduced in new drug development?

Answer 26

Phase 3

Question 27

Describe phase four of new drug development. How long is the drug followed for?

Answer 27

medication is deemed safe, distributed by pharmaceutical companies that follow the medication for two years

Question 28

List and describe the three classes of recalls

Answer 28

Class I - serious issues or reasonable probability of adverse effects/death - Medication will be terminated completely

Class II - adverse events are temporary or reversible - will have a black box warning but won’t be pulled

Class III - Not much will happen, but a warning label – onus is on the person taking the medication to read warning guide

Question 29

Describe some considerations for older adults in pharmacology

Answer 29

Decline in total organ function, lower GI absorption function, take four times more over the counter medication than any other group, often on four to five prescription medications and two over the counter (medications could interact with one another), most common medications used by older adults are statins, unintentional self-medication errors can occur (writing too small, timing errors, dosing errors), may be taking natural products, issues with polypharmacy (have seen many health professionals and have been prescribed multiple different drugs because the professionals don’t check what they are currently already taking), prescribing cascade (one prescription often leads to multiple others to supplement issues/changes with the initial medication needing to be prescribed), non-adherence