💊- Pharmacology Terminology Test Flashcards
Misfeasance
Negligence
Wrong drug/wrong dose
Pharmacology
The study of medicine (drugs)
Nonfeasance
Omission
Omitting a drug dose
Malfeasance
Giving the correct drug via the wrong route
U.S pharmacopoeia
Established in 1820
Set of drug standards used in the United States
4 stages of drug approval
- Preclinical investigation
- Clinical investigation
- Review of NDA (new drug application)
- Postmarketing studies
Phase 1 of clinical investigation
To determine human dosage range based on healthy subjects and identify pharmacokinetics
(Safe dose to give to people)
Phase 2 of clinical investigation
To demonstrate safety and efficacy of drug in subjects with disease to be treated
(Does it work)
Phase 3 and 4 of clinical investigation
To demonstrate safety and efficacy of drug for well client population; to include long term data if a chronic regimen
(Gather info; side effects)
Is the preclinical investigation performed on humans or animals
Animals
What does IRB stand for and what do they do
Institutional review board ; to test drugs on humans
List 5 advantages of prescription drugs
- proper drug ordered
- amount and frequency controlled
- instructions on use and side effects
- can be monitored
- patient education
Disadvantages of prescription drugs
- maybe more expensive if you don’t have insurance
- people may not seek medical help due to cost or inconvenience
Over the counter drugs
Don’t require a physicians order and have a greater margin of safety
Advantages of OTC drugs
- easily obtained
- may be less expensive
Disadvantages of OTC drugs
- delay in professional diagnosis and treatment
- no monitoring of underlying condition
- symptoms maybe masked
- potential for overdose
- drug interactions
- polypharmacy
Therapeutic drug classification
Usefulness
Pharmacological drug classification
Mechanism of action
Prototype drug classification
An original; well understood drug by which others in its class are compared
Chemical name
Describes the drugs chemical structure
What the drug is made of
Generic name
Is the official nonproprietary name for the drug
Nonproprietary
Means the name is not owned by any drug company and is universally accepted
Brand (trade) name
Aka proprietary name
Is chosen by the drug company and is usually a registered trademark owned by that specific company
Schedule I drugs
Limited or no therapeutic use
Example: heroin, lsd, marijuana
Schedule II drugs
Used therapeutically with prescription, some are no longer used therapeutically
Example: Demerol, morphine, PCP, cocaine, hydrocodone, dilaudid (hydromorphone), oxycodone, etc
Schedule III drugs
Used therapeutically with prescription
Ex: anabolic steroids, codeine and hydrocodone with aspirin or Tylenol
Schedule IV drugs
Used therapeutically with prescription
Ex: darvon, talwin, Valium and Xanax
Schedule V drugs
Used therapeutically without prescription
Ex; OtC cough medicines with codeine
Pharmaceutics phase
The drug becomes a solution so that it can cross the biologic membrane
On the drug schedule scale the lower the number suggests what ?
The higher the risk of dependency
When drugs are administered parenterally by subQ IM or IV routes which phase in how drugs work is skipped
Pharmaceutic phase
Disintegration of the pharmaceutic phase
Drugs in solid form (tablet or capsule) must disintegrate into particles to dissolve
Dissolution of pharmaceutic phase
Small particles dissolve in the GI fluid before absorption
Rate limiting
Is the time it takes the drug to disintegrate and dissolve to become available for the body to absorb it
Pharmacokinetics
The process of drug movement to achieve drug action
What are the 4 parts of pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
Absorption
Movement of drug from site of administration to the target cells
Passive absorption
- mostly by diffusion
- drug does not require energy to move across the membrane
Active absorption
- requires a carrier such as an enzyme or protein
- moves drug against a concentration gradient
- energy is required
Pinocytosis
Type of absorption
Process by which cells carry a drug across their membrane by engulfing the drug particles
Distribution
How drugs are transported throughout the body/the process by which the drug becomes available to body fluids and body tissues
What 3 things influence drug distribution
Blood flow
Affinity to the tissue
Protein-binding effect
Metabolism
Process whereby drugs are made less or more active/process by which the body inactivates or biotransforms drugs
Excretion
The process by which drugs are removed from the body
Bioavailability
Is a subcategory of absorption
The percentage of the administered drug dose that reaches the systemic circulation
When does bioavailability occur in the oral route of drug administration
After absorption and first-pass metabolism
What is the percentage of bioavailability for the oral route
Always less than 100%
What is the percentage of bioavailability for the IV route
100%
What is the percentage of bioavailability for an oral drug that has a high first-pass hepatic metabolism
20% to 40%
To obtain the desired drug effect is it safe or unsafe to give an oral dose higher than drug dose for IV
Safe
What are the 5 factors that alter bioavailability
1 drug form
2 route of administration
3 GI mucosa and motility
4 food and other drugs
5 changes in liver metabolism caused by hepatic dysfunction or inadequate hepatic blood flow
First-pass effect
The process in which the drug passes to the liver first then to systemic circulation
How are drugs absorbed during first-pass effect
Absorbed in the intestinal lumen and then go to the liver via the portal vein
What are the 3 things that can happen to a drug while in the liver during the first-pass effect
- Some drugs are metabolized to an inactive form that is then excreted , reducing the amount of active drug
- Some drugs are metabolized to drug metabolite , which maybe equally or more active than the original drug
- Some don’t undergo metabolism at all
Drugs with a larger volume of drug distribution have a longer or shorter half-life ?
Have a longer half-life and stay in the body longer
Name 2 drugs that shouldn’t be given via mouth because of a high first-pass effect
Nitro and lidocaine
Protein binding effect
Drugs that need a protein receptor to get to target cells
Is the portion of the drug that is bound to protein active or inactive
Inactive ; because it is not available to receptors
Free drugs
(Drugs not bound to protein)
Are active and can cause a pharmacologic response
What can occur when 2 highly protein-bound drugs are given concurrently
They compete for protein binding sites, causing more free drug to be released into circulation
Leading to drug accumulation and possible toxicity
Prodrugs
Aka metabolites
Are drugs that break down into equal or more active substances
Where do prodrugs become active
In the liver
Half-life
Is the time it takes for one half of the drug concentration to be eliminated
What are 2 things that affect the half-life of a drug
Metabolism and elimination
How does liver or kidney disease affect the half-life of a drug
The half-life is prolonged and less drug is metabolized and eliminated
A drug has to go through several half-life’s before more than what percentage of the drug is eliminated
90%
Microsomial enzyme system
Drugs are broken down by the liver enzymes which are usually inactive forms of the drugs which are more easily excreted
Excretion
Is the process by which drugs are excreted from the body
Name 6 ways (other than the kidneys) that drugs are excreted from the body
Bile Feces Lungs Saliva Sweat Breast milk
Acidity of urine in excretion
Acidic urine promotes elimination of weak base drugs
Alkalinity of urine in excretion
Alkaline urine promotes elimination of weak acid drugs
How does kidney disease affect excretion
Drug excretion is slowed or impaired leading to drug accumulation and possible toxicity
Pharmacodynamics
Is the study of the way drugs affect the body / the process by which drugs Influence cell physiology
Dose response
The relationship between the minimal versus the maximal amount of drug dose needed to produce the maximal drug response
Maximum drug effect
All drugs have a maximal efficacy
Ex: no matter how much tramadol you give the pain relief provided by morphine is greater
Desired effects
The expected therapeutic response to a drug
Onset of action
The time it takes to reach the minimum effective concentration (MEC) after a drug is administered
When it reaches a therapeutic level
Peak action
Occurs when the drug reaches its highest blood or plasma concentration
Maximum effectiveness
Duration of action
The length of time the drug has a pharmacologic effect
How long the therapeutic effect lasts
Receptor theory
Drugs act through receptors by binding to the receptor to produce (initiate) a response or to block (prevent) a response
Drug-binding sites are primarily located where
On proteins
The better the drug drug fits at the receptor site , means what ?
The more biologically active the drug is
Nonspecific drug effect
Drugs that affect various cholinergic receptor SITES and have properties of nonspecificity
Name the 6 cholinergic receptor sites
Bladder ❤️ Blood vessels Stomach Bronchi Eyes
Nonselective drug effect
Drugs that affect various RECEPTORS and have properties of nonselectivity
Epinephrine acts on which 3 receptors
Alpha1
Beta1
Beta2
What are the 4 categories of drug action
- Stimulation or depression
- Replacement
- Inhibition or killing of organisms
- Irritation
Stimulation or depression related to drug action
Cell activity or function is increased or decreased
Replacement related to drug action
Replace essential body compounds
Ex: insulin
Inhibition or killing of organisms related to drug action
Interfere with bacterial cell growth
Irritation related to drug action
Laxatives irritate the inner wall of the colon, thus increasing peristalsis and defecation
The length of action of a drug depends on what
The half-life of that drug
Half-life is used to determine what
The dosing schedule
Drugs with a long half are usually given how many times a day
Once
Drugs with a short half-life are usually given how many times a day
Several
Potency
Aka strength
The amount of drug required to produce a given percentage of its maximal effect / amount of drug needed to elicit effect
Efficacy
The ability of the drug to produce a more intense response as its concentration is increased
Therapeutic index
Estimates the margin of safety of a drug through the use of a ratio that measures the effective (therapeutic) dose ED in 50% of people and the lethal dose LD in 50% of people
Therapeutic index
Estimates the margin of safety of a drug through the use of a ratio that measures the effective (therapeutic) dose ED in 50% of people and the lethal dose LD in 50% of people
In the therapeutic index , the closer the ratio is to 1 the greater the what ?
Danger of toxicity
In the therapeutic index , the closer the ratio is to 1 the greater the what ?
Danger of toxicity
Drugs with a low therapeutic index have a narrow or wide margin of safety ?
Narrow
Drugs with a low therapeutic index have a narrow or wide margin of safety ?
Narrow
Drugs with a high therapeutic index have a narrow or wide margin of safety
Wide and less danger of producing toxic effects
Drugs with a high therapeutic index have a narrow or wide margin of safety
Wide and less danger of producing toxic effects
If the therapeutic index is narrow does the plasma drug level need to be monitored more often or less often
More often
If the therapeutic index is narrow does the plasma drug level need to be monitored more often or less often
More often
Therapeutic range (window)
Concentration of a drug between the minimum effective concentration and the minimum toxic concentration
Therapeutic range (window)
Concentration of a drug between the minimum effective concentration and the minimum toxic concentration
Loading dose
- given when immediate drug response is needed to achieve a rapid response
- after a large initial dose, a prescribed dose per day is ordered
Loading dose
- given when immediate drug response is needed to achieve a rapid response
- after a large initial dose, a prescribed dose per day is ordered
Digitalization as associated with loading dose
Is the process by which the minimum effective concentration level for digoxin is achieved in the plasma in a short time
Digitalization as associated with loading dose
Is the process by which the minimum effective concentration level for digoxin is achieved in the plasma in a short time
Peak drug levels
Highest plasma concentration at a specific time
Indicates the rate of absorption
Peak drug levels
Highest plasma concentration at a specific time
Indicates the rate of absorption
Trough drug level
Is the lowest plasma concentration of a drug
Indicates the rate of elimination
Trough drug level
Is the lowest plasma concentration of a drug
Indicates the rate of elimination
When/why are peak and trough levels requested
For drugs that have a narrow therapeutic index and are considered toxic
When/why are peak and trough levels requested
For drugs that have a narrow therapeutic index and are considered toxic
Toxicity can occur if either the peak or trough level is too high or too low
Too high
Toxicity can occur if either the peak or trough level is too high or too low
Too high
If the peak is too low that means no what is achieved
Therapeutic effect
If the peak is too low that means no what is achieved
Therapeutic effect
If the drug is given orally the peak time might be ?
Between 1-3 hours after drug administration
If the drug is given orally the peak time might be ?
Between 1-3 hours after drug administration
If the drug is given IV the peak time might be
Occur within 10 minutes of being given
If the drug is given IV the peak time might be
Occur within 10 minutes of being given
When do you draw lab work to test trough level ? And what do levels (high/low) indicate
Immediately BEFORE drug is given
Too high= not being eliminated (toxicity)
Too low= need higher dose
When do you draw lab work to test trough level ? And what do levels (high/low) indicate
Immediately BEFORE drug is given
Too high= not being eliminated (toxicity)
Too low= need higher dose
When do you draw lab work to test peak level ? And what does that level (high/low) indicate ?
Draw labs AFTER drug is given
Too high= absorbed to fast (toxicity)
Too low= not absorbing well
When do you draw lab work to test peak level ? And what does that level (high/low) indicate ?
Draw labs AFTER drug is given
Too high= absorbed to fast (toxicity)
Too low= not absorbing well
Side effects
Are mild , undesired responses to a drug
Side effects
Are mild , undesired responses to a drug
Adverse effects
Are more serious side effects even at therapeutic levels
Adverse effects
Are more serious side effects even at therapeutic levels
What is one of the primary reasons patients stop taking their prescribed medications
The occurrence of side effects
What is one of the primary reasons patients stop taking their prescribed medications
The occurrence of side effects
Name 6 types of side/adverse effects
- allergic reactions (anaphylaxis)
- gi disturbances (nausea, vomiting, diarrhea)
- organ toxicity (hepatotoxicity)
- bone marrow (anemia, thrombocytopenia)
- CNS (drowsiness, hyperactivity)
- anticholinergic (tachycardia, dry mouth, blurred vision, constipation, etc)
Name 6 types of side/adverse effects
- allergic reactions (anaphylaxis)
- gi disturbances (nausea, vomiting, diarrhea)
- organ toxicity (hepatotoxicity)
- bone marrow (anemia, thrombocytopenia)
- CNS (drowsiness, hyperactivity)
- anticholinergic (tachycardia, dry mouth, blurred vision, constipation, etc)
Tolerance
Decreased responsiveness over the course of therapy
Ex: drug tolerance to narcotics can result in decreased pain relief for the patient
Tolerance
Decreased responsiveness over the course of therapy
Ex: drug tolerance to narcotics can result in decreased pain relief for the patient
Tachyphaxis
A rapid decrease in response to the drug “acute tolerance”
Tachyphaxis
A rapid decrease in response to the drug “acute tolerance”
Placebo effect
A psychological benefit from a compound that may not have the chemical structure of a drug effect
Placebo effect
A psychological benefit from a compound that may not have the chemical structure of a drug effect
In a clinical trial is it ok not to tell a patient they may be given a placebo
No
In a clinical trial is it ok not to tell a patient they may be given a placebo
No
Drug interactions
An altered or modified action or effect of a drug as a result of interaction with one or multiple drugs
Drug interactions
An altered or modified action or effect of a drug as a result of interaction with one or multiple drugs
Additive drug effect
When two drugs with similar action are administered
Ex: alcohol and sedatives / diuretic and a beta blocker
Additive drug effect
When two drugs with similar action are administered
Ex: alcohol and sedatives / diuretic and a beta blocker
Synergistic drug effect or potentiation
One drug enhances the effects of the other
Ex: mixing alcohol and sedative-hypnotic can increase CNS depression
Synergistic drug effect or potentiation
One drug enhances the effects of the other
Ex: mixing alcohol and sedative-hypnotic can increase CNS depression
Antagonistic drug effect
When two drugs that have opposite effects are administered together , each drug cancels the effect of the other
(Actions of both drugs are nullified)
Antagonistic drug effect
When two drugs that have opposite effects are administered together , each drug cancels the effect of the other
(Actions of both drugs are nullified)
Displacement drug effect
One drug displaces another from a receptor or from a protein molecule
Ex: narcan displaces morphine
Displacement drug effect
One drug displaces another from a receptor or from a protein molecule
Ex: narcan displaces morphine
Incompatibility drug interaction
Mixing drugs may cause one to precipitate, or form solid particles rather than remain in solution
Incompatibility drug interaction
Mixing drugs may cause one to precipitate, or form solid particles rather than remain in solution
Photosensitivity drug interaction
Reaction caused by exposure to sunlight
Photosensitivity drug interaction
Reaction caused by exposure to sunlight
Idiosyncratic reaction
Is an unexpected response
Idiosyncratic reaction
Is an unexpected response
what is goal 1 of the national safety administration
To improve the accuracy of patient identification
what is goal 1 of the national safety administration
To improve the accuracy of patient identification
What is goal 3 of the national safety administration
Improve the safety of using medications
What is goal 3 of the national safety administration
Improve the safety of using medications
What is goal 4 of the national safety administration
Label all medications, medication containers and other solutions on and off the sterile field in perioperative and other procedural settings
Medication containers include: syringes, medicine cups and basins
What is goal 4 of the national safety administration
Label all medications, medication containers and other solutions on and off the sterile field in perioperative and other procedural settings
Medication containers include: syringes, medicine cups and basins
What is goal 5 of the national safety administration
Reduce the likelihood of patient harm associated with the use of anticoagulant therapy
What is goal 5 of the national safety administration
Reduce the likelihood of patient harm associated with the use of anticoagulant therapy
More than how many medication errors occur in hospitals every year
100,000
More than how many medication errors occur in hospitals every year
100,000
Name 6 places where drug errors can occur
During:
Prescribing Dispensing/preparing Administration Documenting/transcribing Monitoring Other
Name 6 places where drug errors can occur
During:
Prescribing Dispensing/preparing Administration Documenting/transcribing Monitoring Other
What are the 5 rights of drug administration
Right client Right drug Right dose Right time Right route
What are the 5 rights of drug administration
Right client Right drug Right dose Right time Right route
What are the 5 rights of safe drug administration
Right assessment Right documentation Right to education Right evaluation Right to refuse
What are the 5 rights of safe drug administration
Right assessment Right documentation Right to education Right evaluation Right to refuse
Name the 3 times the drug label should be read to avoid drug error
- With the MAR when removing from the drawer
- When preparing, pouring, or opening
- Before administering
Name the 3 times the drug label should be read to avoid drug error
- With the MAR when removing from the drawer
- When preparing, pouring, or opening
- Before administering
Name the 6 nurses rights when administering medications
- To complete and clear order
- To have correct drug, route and dose dispensed
- To have access to information
- To have policies to guide safe drug administration
- To administer drugs safely and to identify system problems
- To stop, think and be vigilant
Name the 6 nurses rights when administering medications
- To complete and clear order
- To have correct drug, route and dose dispensed
- To have access to information
- To have policies to guide safe drug administration
- To administer drugs safely and to identify system problems
- To stop, think and be vigilant
Name 5 abbreviations that are on the Do Not Use list
- cc (write mL)
- D/C (write discontinue)
- hs (write bedtime)
- qod (write every other day)
- sq (write subq)
Name 5 abbreviations that are on the Do Not Use list
- cc (write mL)
- D/C (write discontinue)
- hs (write bedtime)
- qod (write every other day)
- sq (write subq)
List the 7 methods for proper disposal of medications
- follow specific information on drug label or insert
- dont flush drugs down toilet unless instructed
- remove all identifying info on container
- transfer drug from original container to undesirable substance (I.e kitty litter)
- return drugs to community “drug take back” program
- remove all identifying information on container
- consult pharmacist
List the 7 methods for proper disposal of medications
- follow specific information on drug label or insert
- dont flush drugs down toilet unless instructed
- remove all identifying info on container
- transfer drug from original container to undesirable substance (I.e kitty litter)
- return drugs to community “drug take back” program
- remove all identifying information on container
- consult pharmacist
Name 4 things to check for in a counterfeit drug
Color
Texture
Shape
Taste
Name 4 things to check for in a counterfeit drug
Color
Texture
Shape
Taste
What drugs can NOT be crushed
Extended release/sustained release and enteric coated drugs
What drugs can NOT be crushed
Extended release/sustained release and enteric coated drugs
High alert medications
Must be trained to administer
Medication errors have more serious consequences for the patient
High alert medications
Must be trained to administer
Medication errors have more serious consequences for the patient
Tall man letters
Are a safety strategy to reduce confusion between similar sounding drugs
Tall man letters
Are a safety strategy to reduce confusion between similar sounding drugs
Name 7 components of a drug order
- date and time written
- drug name
- drug dosage/preparation
- route of administration
- frequency and duration of administration
- special instructions
- prescribers signature
Name 7 components of a drug order
- date and time written
- drug name
- drug dosage/preparation
- route of administration
- frequency and duration of administration
- special instructions
- prescribers signature
Preparation as it relates to a medication order
Is the drug form
Preparation as it relates to a medication order
Is the drug form
What are the 3 main routes that drugs are administered
Oral
Parenteral
Topical
What are the 3 main routes that drugs are administered
Oral
Parenteral
Topical
Unit dose
- one dose of medication per package
- any medication not used from package is discarded
Unit dose
- one dose of medication per package
- any medication not used from package is discarded
Multidose
- multiple doses of medication per package
- may be for one patient or many patients
- watch the expiration date
Oral route of administration
Medication is absorbed in the stomach or small intestine
Parenteral route of administration
- medication is given by injection
- may be given IV or IM or subQ
Topical route of administration
- medication is applied to mucous membranes or skin
- may be given by transdermal patch, inhalation, mouth (but not swallowed) rectum or vagina
Is it ok to apply a new transdermal patch over one already attached to the skin
No ! Must remove previous transdermal patch before placing a new one
what is the proper way to administer a topical ear drop to a patient aged 3 and under
Pulling the auricle (ear) down and back
What is the proper way to administer a topical ear drop on a patient who is aged 3 or older
By pulling the auricle (ear) up and back
Nebulizers
Small machine that vaporizes a liquid drug into a fine mist that can be inhaled
Parenteral medications
Are medications administered via injection to bypass the first pass effect of the liver
Name the 6 parenteral routes to administer drugs
Intradermal Subcutaneous Intramuscular Intraosseous Intravenous
At what angle should the needle be held to administer an intradermal injection
10 - 15 degree angle
Ex: TB testing
At what angle should the needle be held to administer a subcutaneous drug injection
** should be administered at fatty tissue sites ; stomach, upper arm, thigh)**
45 - 90 degrees
(45 degrees for those with little subq tissue)
At what angle should the needle be held to administer an intramuscular drug injection
90 degree angle
What is the most preferred site for intramuscular drug injections
Ventrogluteal
Intraosseous
Drill hole in leg to give medicine in bone of leg
The higher the numbered gauge of a needle indicates what ?
The smaller the needle
Intradermal wheal
Is a blister or blew created just under the skin when medicine is administered via intradermal injection
Name the 4 common intramuscular injection sites
Ventrogluteal (most common)
Dorsogluteal (old way, not recommended)
Deltoid
Vastus lateralis
The deltoid site can take up to how many mL of medication via the intramuscular route
Up to 1 mL
The ventrogluteal site can take up to how many mL of medication via the intramuscular route
Up to 3 mL
Z-track injection
Pull the skin to one side and hold; insert needle
Holding skin to side, inject medication
Withdraw needle and release skin
technique prevents medication from entering the subcutaneous tissue
Name the 4 most common sites for intravenous administration
Radial vein
Median cubital
Cephalic vein
Basilic vein
Kilo
Thousands
Mili
One thousandths
Centi
One hundreth
1 g equals how many mg ?
1000 mg
1 L equals how many mL ?
1000 mL
When converting larger units (G) to smaller units (mg) do you move the decimal point to the right or the left ?
To the RIGHT for each degree of magnitude
Ex: 1.000g = 1000mg
When converting smaller units (mg) to larger units (G) do you move the decimal point to the left or to the right ?
Move to the LEFT
Ex: 1000.mg = 1g
1 medium glass is equivalent to how many ounces
8 oz
1 ounce (oz) is equivalent to how many tablespoons
2 tablespoons (Tbsp)
1 tablespoon (tbsp) is equivalent to how many teaspoons
3 teaspoons (tsp)
1 teaspoon (t) is equivalent to how many drops (ggts)
60 drops (ggts)
1 teaspoon (tsp) is equivalent to how many mL ?
5 mL
On a drug label which name is written in large letters and which name is written in smaller letters
LARGE letters is the BRAND name
Small letters is the generic name
3-mL syringe carry out to what place value
The hundredths
1-mL syringe carry out to what place value
The thousandths
Normal range of potassium
3.5 - 5.3 mEq/L
What are the function of potassium
Promotes glycogen storage in the liver
Regulates osmolality of cellular fluids and plays role in acid-base balance
What are the signs and symptoms of hyperkalemia
⤴️ k+
Cardiac dysrhythmia (tachycardia/bradycardia)
Paresthesia of face, hands, tongue and feet
Nausea/diarrhea/cramping
Metabolic acidosis
Signs and symptoms of hypokalemia
⤵️K+
Fatigue , muscle weakness , anorexia
Nausea/vomiting
Decreased bowel motility
Confusion
Cardiac arrest
Quadricep weakness
Paresthesia
Abnormal sensation such as burning, prickling or formication (tactile hallucination of sensation of tiny insects crawling over the skin)
Normal range for sodium
135 to 145 mEq/L
Signs and symptoms of hyponatremia
Due to water in cells: muscle weakness, ⤵️ deep tendon reflex, headaches, seizures, pale skin, hypotension, dry mucous membranes
Due to hypovolemia: tachycardia and ⤵️ BP
Signs and symptoms of hypernatremia
Due to water loss: fluid volume deficit
Na+ gain: fluid volume excess
Dry, sticky mucous membranes , flushed dry skin , agitation , ⤴️ temp , dry tongue , muscle twitching and thirst
Hypotonic IV fluid
- 45% normal saline
- 5% dextrose and water
Allows water to move INTO the cell causing the cell to BURST
Hypertonic IV fluid
3% saline
5% dextrose and 0.45% normal saline
Pulls water OUT OF the cell causing it to SHRINK
Isotonic IV fluid
5% dextrose in water
0.9% sodium chloride (normal saline)
Lactated ringers
Ringers solution
What is normal saline
0.9% sodium chloride
Absorption as related to pediatric pharmacokinetics
As children grow the absorption of medications becomes more effective . Less developed absorption in neonates and infants MUST BE CONSIDERED IN DOSAGE AND ADMINISTRATION
How does body fluid composition affect distribution in pediatric pharmacokinetics
Neonates and infants are 70% water
Allows for greater volume of fluid in which to distribute medication and a lower concentration of the drug
requires HIGHER DOSES of water soluble drugs to achieve therapeutic levels
How does body tissue composition affect distribution in pediatric pharmacokinetics
Neonates and infants have less body fat than older children
Requires LESS fat soluble medications than adults
How does protein-binding capability affect distribution in pediatric pharmacokinetics
Infants and neonates have less albumin and fewer protein receptor sites than older patients
LESS dosage needed
How does The blood brain barrier affect distribution as related to pediatric pharmacokinetics
Infants blood brain parties are immature , allowing medications to pass easily into nervous system tissue and increase likelihood of toxicity
Pediatric pharmacokinetics related to metabolism
Metabolism occurs more rapidly
HIGHER dosage needed due to first pass effect
Pediatric pharmacokinetics related to excretion
Immature kidney function slows excretion
(⤵️ renal blood flow, GFR, renal tubular function)
LESS CONCENTRATION needed
Polypharmacy
Is the administration of many drugs together
Absorption related to geriatric pharmacokinetics
Generally slower
⤴️ gastric ph , slowed motility , ⤵️ blood flow and ⤵️ first pass effect
Generally amount of an oral dose that is absorbed is not affected by age
Affects of Body fluid composition in geriatric pharmacokinetics
Decreased amount of body water
LESS DOSE required
Body tissue composition related to geriatric pharmacokinetics
Increased body fat
requires MORE drug dose to obtain desired effects
Protein binding compatibility in geriatric pharmacokinetics
Loss of protein-binding sites for drugs
Requires LESS amount of protein bound drugs to prevent excess Dee drug in circulation decreasing toxicity
Metabolism in geriatric pharmacokinetics
Liver dysfunction caused by aging , decreases the livers ability to metabolize
Requires LESS of a dose
Excretion in geriatric pharmacokinetics
Decreased kidney and liver function equals decreased rate of excretion
Requiring LESS drug to
What tests are administered to test the function of the liver
Liver function tests LFT’s
What tests are administered to test the function of the kidneys
BUN , serum creatinine and creatinine clearance
What is TPN and when does it become necessary
Total parenteral nutrition
Becomes necessary when the GI tract is incapacitated due to uncontrolled vomiting, malabsorption or intestinal obstruction
What is Enteral nutrition
Nutrition that is given directly into the GI tract
Name 3 complications of enteral nutrition feelings
Dehydration
Aspiration
Diarrhea
List 5 complications associated with TPN
Air embolism
Pneumothorax, hemothorax
Hyperglycemia or hypoglycemia
higher risk for sepsis
Fluid overload
List the 4 fat soluble vitamins
Vitamin K A D E
List the 2 water soluble vitamins
Vitamin B and C
Which types of vitamins can become toxic if taken in excessive amounts
Vitamin A and D
Fat soluble
List 3 signs of vitamin A deficiency
Dry skin
Poor tooth development
Night blindness
List 2 signs of vitamin D deficiency
Rickets (children)
Osteomalacia (adults)
List 2 signs of vitamin D deficiency
Rickets (children)
Osteomalacia (adults)
What is a sign of vitamin E deficiency
Breakdown of RBCs
What is a sign of vitamin E deficiency
Breakdown of RBCs
List 2 signs of vitamin K deficiency
Increased clotting times
Spontaneous hemorrhage
List 2 signs of vitamin K deficiency
Increased clotting times
Spontaneous hemorrhage
List 9 signs of vitamin b complex deficiency
Sensory disturbances
Retarded growth
Fatigue
Anorexia
Visual defects
Neuritis
Convulsions
Anemia
Dermatitis
List 9 signs of vitamin b complex deficiency
Sensory disturbances
Retarded growth
Fatigue
Anorexia
Visual defects
Neuritis
Convulsions
Anemia
Dermatitis
List 4 signs of vitamin C deficiency
Poor wound healing
Bleeding gums
Scurvy
Predisposition to infection
List 4 signs of vitamin C deficiency
Poor wound healing
Bleeding gums
Scurvy
Predisposition to infection
List 7 signs of folic acid deficiency
Alopecia
Anorexia
Fatigue
⤵️ WBC and clotting factors
Anemia
Depression
Blood dyscrasias (abnormal blood component quantity)
List 7 signs of folic acid deficiency
Alopecia
Anorexia
Fatigue
⤵️ WBC and clotting factors
Anemia
Depression
Blood dyscrasias (abnormal blood component quantity)
List 4 signs of vitamin B12 deficiency
GI disorders
Poor growth
Anemia
Disturbance of intrinsic factor and intestinal absorption
List 4 signs of vitamin B12 deficiency
GI disorders
Poor growth
Anemia
Disturbance of intrinsic factor and intestinal absorption
Name 7 populations in need of increased vitamin usage
- those with rapid body growth
- those who are pregnant or breastfeeding
- those who are malnourished
- those who are debilitated (cancer,AIDS)
- inadequate absorption (chrohns disease)
- inability to use vitamins
- fad or restrictive diets
