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Pharmacology > 💊- Pharmacology Terminology Test > Flashcards

💊- Pharmacology Terminology Test Flashcards

1
Q

Misfeasance

A

Negligence

Wrong drug/wrong dose

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2
Q

Nonfeasance

A

Omission

Omitting a drug dose

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3
Q

Malfeasance

A

Giving the correct drug via the wrong route

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4
Q

U.S pharmacopoeia

A

Established in 1820

Set of drug standards used in the United States

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5
Q

4 stages of drug approval

A
  1. Preclinical investigation
  2. Clinical investigation
  3. Review of NDA (new drug application)
  4. Postmarketing studies
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6
Q

Phase 1 of clinical investigation

A

To determine human dosage range based on healthy subjects and identify pharmacokinetics

(Safe dose to give to people)

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7
Q

Phase 2 of clinical investigation

A

To demonstrate safety and efficacy of drug in subjects with disease to be treated

(Does it work)

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8
Q

Phase 3 and 4 of clinical investigation

A

To demonstrate safety and efficacy of drug for well client population; to include long term data if a chronic regimen

(Gather info; side effects)

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9
Q

Is the preclinical investigation performed on humans or animals

A

Animals

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10
Q

What does IRB stand for and what do they do

A

Institutional review board ; to test drugs on humans

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11
Q

List 5 advantages of prescription drugs

A
  • proper drug ordered
  • amount and frequency controlled
  • instructions on use and side effects
  • can be monitored
  • patient education
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12
Q

Disadvantages of prescription drugs

A
  • maybe more expensive if you don’t have insurance

- people may not seek medical help due to cost or inconvenience

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13
Q

Over the counter drugs

A

Don’t require a physicians order and have a greater margin of safety

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14
Q

Advantages of OTC drugs

A
  • easily obtained

- may be less expensive

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15
Q

Disadvantages of OTC drugs

A
  • delay in professional diagnosis and treatment
  • no monitoring of underlying condition
  • symptoms maybe masked
  • potential for overdose
  • drug interactions
  • polypharmacy
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16
Q

Therapeutic drug classification

A

Usefulness

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17
Q

Pharmacological drug classification

A

Mechanism of action

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18
Q

Prototype drug classification

A

An original; well understood drug by which others in its class are compared

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19
Q

Chemical name

A

Describes the drugs chemical structure

What the drug is made of

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20
Q

Generic name

A

Is the official nonproprietary name for the drug

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21
Q

Nonproprietary

A

Means the name is not owned by any drug company and is universally accepted

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22
Q

Brand (trade) name

A

Aka proprietary name

Is chosen by the drug company and is usually a registered trademark owned by that specific company

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23
Q

Schedule I drugs

A

Limited or no therapeutic use

Example: heroin, lsd, marijuana

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24
Q

Schedule II drugs

A

Used therapeutically with prescription, some are no longer used therapeutically

Example: Demerol, morphine, PCP, cocaine, hydrocodone, dilaudid (hydromorphone), oxycodone, etc

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25
Q

Schedule III drugs

A

Used therapeutically with prescription

Ex: anabolic steroids, codeine and hydrocodone with aspirin or Tylenol

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26
Q

Schedule IV drugs

A

Used therapeutically with prescription

Ex: darvon, talwin, Valium and Xanax

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27
Q

Schedule V drugs

A

Used therapeutically without prescription

Ex; OtC cough medicines with codeine

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28
Q

Pharmaceutics phase

A

The drug becomes a solution so that it can cross the biologic membrane

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29
Q

On the drug schedule scale the lower the number suggests what ?

A

The higher the risk of dependency

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30
Q

When drugs are administered parenterally by subQ IM or IV routes which phase in how drugs work is skipped

A

Pharmaceutic phase

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31
Q

Disintegration of the pharmaceutic phase

A

Drugs in solid form (tablet or capsule) must disintegrate into particles to dissolve

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32
Q

Dissolution of pharmaceutic phase

A

Small particles dissolve in the GI fluid before absorption

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33
Q

Rate limiting

A

Is the time it takes the drug to disintegrate and dissolve to become available for the body to absorb it

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34
Q

Pharmacokinetics

A

The process of drug movement to achieve drug action

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35
Q

What are the 4 parts of pharmacokinetics

A

Absorption
Distribution
Metabolism
Excretion

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36
Q

Absorption

A

Movement of drug from site of administration to the target cells

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37
Q

Passive absorption

A
  • mostly by diffusion

- drug does not require energy to move across the membrane

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38
Q

Active absorption

A
  • requires a carrier such as an enzyme or protein
  • moves drug against a concentration gradient
  • energy is required
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39
Q

Pinocytosis

A

Type of absorption

Process by which cells carry a drug across their membrane by engulfing the drug particles

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40
Q

Distribution

A

How drugs are transported throughout the body/the process by which the drug becomes available to body fluids and body tissues

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41
Q

What 3 things influence drug distribution

A

Blood flow

Affinity to the tissue

Protein-binding effect

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42
Q

Metabolism

A

Process whereby drugs are made less or more active/process by which the body inactivates or biotransforms drugs

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43
Q

Excretion

A

The process by which drugs are removed from the body

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44
Q

Bioavailability

A

Is a subcategory of absorption

The percentage of the administered drug dose that reaches the systemic circulation

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45
Q

When does bioavailability occur in the oral route of drug administration

A

After absorption and first-pass metabolism

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46
Q

What is the percentage of bioavailability for the oral route

A

Always less than 100%

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47
Q

What is the percentage of bioavailability for the IV route

A

100%

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48
Q

What is the percentage of bioavailability for an oral drug that has a high first-pass hepatic metabolism

A

20% to 40%

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49
Q

To obtain the desired drug effect is it safe or unsafe to give an oral dose higher than drug dose for IV

A

Safe

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50
Q

What are the 5 factors that alter bioavailability

A

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

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51
Q

First-pass effect

A

The process in which the drug passes to the liver first then to systemic circulation

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52
Q

How are drugs absorbed during first-pass effect

A

Absorbed in the intestinal lumen and then go to the liver via the portal vein

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53
Q

What are the 3 things that can happen to a drug while in the liver during the first-pass effect

A
  1. Some drugs are metabolized to an inactive form that is then excreted , reducing the amount of active drug
  2. Some drugs are metabolized to drug metabolite , which maybe equally or more active than the original drug
  3. Some don’t undergo metabolism at all
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54
Q

Drugs with a larger volume of drug distribution have a longer or shorter half-life ?

A

Have a longer half-life and stay in the body longer

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55
Q

Name 2 drugs that shouldn’t be given via mouth because of a high first-pass effect

A

Nitro and lidocaine

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56
Q

Protein binding effect

A

Drugs that need a protein receptor to get to target cells

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57
Q

Is the portion of the drug that is bound to protein active or inactive

A

Inactive ; because it is not available to receptors

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58
Q

Free drugs

A

(Drugs not bound to protein)

Are active and can cause a pharmacologic response

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59
Q

What can occur when 2 highly protein-bound drugs are given concurrently

A

They compete for protein binding sites, causing more free drug to be released into circulation

Leading to drug accumulation and possible toxicity

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60
Q

Prodrugs

A

Aka metabolites

Are drugs that break down into equal or more active substances

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61
Q

Where do prodrugs become active

A

In the liver

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62
Q

Half-life

A

Is the time it takes for one half of the drug concentration to be eliminated

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63
Q

What are 2 things that affect the half-life of a drug

A

Metabolism and elimination

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64
Q

How does liver or kidney disease affect the half-life of a drug

A

The half-life is prolonged and less drug is metabolized and eliminated

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65
Q

A drug has to go through several half-life’s before more than what percentage of the drug is eliminated

A

90%

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66
Q

Microsomial enzyme system

A

Drugs are broken down by the liver enzymes which are usually inactive forms of the drugs which are more easily excreted

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67
Q

Excretion

A

Is the process by which drugs are excreted from the body

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68
Q

Name 6 ways (other than the kidneys) that drugs are excreted from the body

A 
Bile 
Feces 
Lungs 
Saliva 
Sweat 
Breast milk
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69
Q

Acidity of urine in excretion

A

Acidic urine promotes elimination of weak base drugs

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70
Q

Alkalinity of urine in excretion

A

Alkaline urine promotes elimination of weak acid drugs

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71
Q

How does kidney disease affect excretion

A

Drug excretion is slowed or impaired leading to drug accumulation and possible toxicity

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72
Q

Pharmacodynamics

A

Is the study of the way drugs affect the body / the process by which drugs Influence cell physiology

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73
Q

Dose response

A

The relationship between the minimal versus the maximal amount of drug dose needed to produce the maximal drug response

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74
Q

Maximum drug effect

A

All drugs have a maximal efficacy

Ex: no matter how much tramadol you give the pain relief provided by morphine is greater

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75
Q

Desired effects

A

The expected therapeutic response to a drug

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76
Q

Onset of action

A

The time it takes to reach the minimum effective concentration (MEC) after a drug is administered

When it reaches a therapeutic level

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77
Q

Peak action

A

Occurs when the drug reaches its highest blood or plasma concentration

Maximum effectiveness

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78
Q

Duration of action

A

The length of time the drug has a pharmacologic effect

How long the therapeutic effect lasts

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79
Q

Receptor theory

A

Drugs act through receptors by binding to the receptor to produce (initiate) a response or to block (prevent) a response

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80
Q

Drug-binding sites are primarily located where

A

On proteins

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81
Q

The better the drug drug fits at the receptor site , means what ?

A

The more biologically active the drug is

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82
Q

Nonspecific drug effect

A

Drugs that affect various cholinergic receptor SITES and have properties of nonspecificity

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83
Q

Name the 6 cholinergic receptor sites

A 
Bladder 
❤️
Blood vessels 
Stomach 
Bronchi 
Eyes
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84
Q

Nonselective drug effect

A

Drugs that affect various RECEPTORS and have properties of nonselectivity

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85
Q

Epinephrine acts on which 3 receptors

A

Alpha1
Beta1
Beta2

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86
Q

What are the 4 categories of drug action

A
  1. Stimulation or depression
  2. Replacement
  3. Inhibition or killing of organisms
  4. Irritation
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87
Q

Stimulation or depression related to drug action

A

Cell activity or function is increased or decreased

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88
Q

Replacement related to drug action

A

Replace essential body compounds

Ex: insulin

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89
Q

Inhibition or killing of organisms related to drug action

A

Interfere with bacterial cell growth

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90
Q

Irritation related to drug action

A

Laxatives irritate the inner wall of the colon, thus increasing peristalsis and defecation

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91
Q

The length of action of a drug depends on what

A

The half-life of that drug

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92
Q

Half-life is used to determine what

A

The dosing schedule

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93
Q

Drugs with a long half are usually given how many times a day

A

Once

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94
Q

Drugs with a short half-life are usually given how many times a day

A

Several

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95
Q

Potency

A

Aka strength

The amount of drug required to produce a given percentage of its maximal effect / amount of drug needed to elicit effect

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96
Q

Efficacy

A

The ability of the drug to produce a more intense response as its concentration is increased

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97
Q

Therapeutic index

A

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

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98
Q

In the therapeutic index , the closer the ratio is to 1 the greater the what ?

A

Danger of toxicity

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99
Q

Drugs with a low therapeutic index have a narrow or wide margin of safety ?

A

Narrow

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100
Q

Drugs with a high therapeutic index have a narrow or wide margin of safety

A

Wide and less danger of producing toxic effects

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101
Q

If the therapeutic index is narrow does the plasma drug level need to be monitored more often or less often

A

More often

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102
Q

Therapeutic range (window)

A

Concentration of a drug between the minimum effective concentration and the minimum toxic concentration

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103
Q

Loading dose

A
  • given when immediate drug response is needed to achieve a rapid response
  • after a large initial dose, a prescribed dose per day is ordered
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104
Q

Digitalization as associated with loading dose

A

Is the process by which the minimum effective concentration level for digoxin is achieved in the plasma in a short time

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105
Q

Peak drug levels

A

Highest plasma concentration at a specific time

Indicates the rate of absorption

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106
Q

Trough drug level

A

Is the lowest plasma concentration of a drug

Indicates the rate of elimination

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107
Q

When/why are peak and trough levels requested

A

For drugs that have a narrow therapeutic index and are considered toxic

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108
Q

Toxicity can occur if either the peak or trough level is too high or too low

A

Too high

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109
Q

If the peak is too low that means no what is achieved

A

Therapeutic effect

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110
Q

If the drug is given orally the peak time might be ?

A

Between 1-3 hours after drug administration

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111
Q

If the drug is given IV the peak time might be

A

Occur within 10 minutes of being given

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112
Q

When do you draw lab work to test trough level ? And what do levels (high/low) indicate

A

Immediately BEFORE drug is given

Too high= not being eliminated (toxicity)

Too low= need higher dose

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113
Q

When do you draw lab work to test peak level ? And what does that level (high/low) indicate ?

A

Draw labs AFTER drug is given

Too high= absorbed to fast (toxicity)

Too low= not absorbing well

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114
Q

Side effects

A

Are mild , undesired responses to a drug

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115
Q

Adverse effects

A

Are more serious side effects even at therapeutic levels

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116
Q

What is one of the primary reasons patients stop taking their prescribed medications

A

The occurrence of side effects

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117
Q

Name 6 types of side/adverse effects

A
  1. allergic reactions (anaphylaxis)
  2. gi disturbances (nausea, vomiting, diarrhea)
  3. organ toxicity (hepatotoxicity)
  4. bone marrow (anemia, thrombocytopenia)
  5. CNS (drowsiness, hyperactivity)
  6. anticholinergic (tachycardia, dry mouth, blurred vision, constipation, etc)
118
Q

Tolerance

A

Decreased responsiveness over the course of therapy

Ex: drug tolerance to narcotics can result in decreased pain relief for the patient

119
Q

Tachyphaxis

A

A rapid decrease in response to the drug “acute tolerance”

120
Q

Placebo effect

A

A psychological benefit from a compound that may not have the chemical structure of a drug effect

121
Q

In a clinical trial is it ok not to tell a patient they may be given a placebo

A

No

122
Q

Drug interactions

A

An altered or modified action or effect of a drug as a result of interaction with one or multiple drugs

123
Q

Additive drug effect

A

When two drugs with similar action are administered

Ex: alcohol and sedatives / diuretic and a beta blocker

124
Q

Synergistic drug effect or potentiation

A

One drug enhances the effects of the other

Ex: mixing alcohol and sedative-hypnotic can increase CNS depression

125
Q

Antagonistic drug effect

A

When two drugs that have opposite effects are administered together , each drug cancels the effect of the other

(Actions of both drugs are nullified)

126
Q

Displacement drug effect

A

One drug displaces another from a receptor or from a protein molecule

Ex: narcan displaces morphine

127
Q

Incompatibility drug interaction

A

Mixing drugs may cause one to precipitate, or form solid particles rather than remain in solution

128
Q

Photosensitivity drug interaction

A

Reaction caused by exposure to sunlight

129
Q

Idiosyncratic reaction

A

Is an unexpected response

130
Q

what is goal 1 of the national safety administration

A

To improve the accuracy of patient identification

131
Q

What is goal 3 of the national safety administration

A

Improve the safety of using medications

132
Q

What is goal 4 of the national safety administration

A

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

133
Q

What is goal 5 of the national safety administration

A

Reduce the likelihood of patient harm associated with the use of anticoagulant therapy

134
Q

More than how many medication errors occur in hospitals every year

A

100,000

135
Q

Name 6 places where drug errors can occur

A

During:

Prescribing 
Dispensing/preparing 
Administration 
Documenting/transcribing 
Monitoring 
Other
136
Q

What are the 5 rights of drug administration

A 
Right client 
Right drug 
Right dose
Right time 
Right route
137
Q

What are the 5 rights of safe drug administration

A 
Right assessment 
Right documentation 
Right to education 
Right evaluation 
Right to refuse
138
Q

Name the 3 times the drug label should be read to avoid drug error

A
  1. With the MAR when removing from the drawer
  2. When preparing, pouring, or opening
  3. Before administering
139
Q

Name the 6 nurses rights when administering medications

A
  1. To complete and clear order
  2. To have correct drug, route and dose dispensed
  3. To have access to information
  4. To have policies to guide safe drug administration
  5. To administer drugs safely and to identify system problems
  6. To stop, think and be vigilant
140
Q

Name 5 abbreviations that are on the Do Not Use list

A
  • cc (write mL)
  • D/C (write discontinue)
  • hs (write bedtime)
  • qod (write every other day)
  • sq (write subq)
141
Q

List the 7 methods for proper disposal of medications

A
  1. follow specific information on drug label or insert
  2. dont flush drugs down toilet unless instructed
  3. remove all identifying info on container
  4. transfer drug from original container to undesirable substance (I.e kitty litter)
  5. return drugs to community “drug take back” program
  6. remove all identifying information on container
  7. consult pharmacist
142
Q

Name 4 things to check for in a counterfeit drug

A

Color
Texture
Shape
Taste

143
Q

What drugs can NOT be crushed

A

Extended release/sustained release and enteric coated drugs

144
Q

High alert medications

A

Must be trained to administer

Medication errors have more serious consequences for the patient

145
Q

Tall man letters

A

Are a safety strategy to reduce confusion between similar sounding drugs

146
Q

Name 7 components of a drug order

A
  1. date and time written
  2. drug name
  3. drug dosage/preparation
  4. route of administration
  5. frequency and duration of administration
  6. special instructions
  7. prescribers signature
147
Q

Preparation as it relates to a medication order

A

Is the drug form

148
Q

What are the 3 main routes that drugs are administered

A

Oral
Parenteral
Topical

149
Q

Unit dose

A
  • one dose of medication per package

- any medication not used from package is discarded

150
Q

Unit dose

A
  • one dose of medication per package

- any medication not used from package is discarded

151
Q

What are the 3 main routes that drugs are administered

A

Oral
Parenteral
Topical

152
Q

Preparation as it relates to a medication order

A

Is the drug form

153
Q

Name 7 components of a drug order

A
  1. date and time written
  2. drug name
  3. drug dosage/preparation
  4. route of administration
  5. frequency and duration of administration
  6. special instructions
  7. prescribers signature
154
Q

Tall man letters

A

Are a safety strategy to reduce confusion between similar sounding drugs

155
Q

High alert medications

A

Must be trained to administer

Medication errors have more serious consequences for the patient

156
Q

What drugs can NOT be crushed

A

Extended release/sustained release and enteric coated drugs

157
Q

Name 4 things to check for in a counterfeit drug

A

Color
Texture
Shape
Taste

158
Q

List the 7 methods for proper disposal of medications

A
  1. follow specific information on drug label or insert
  2. dont flush drugs down toilet unless instructed
  3. remove all identifying info on container
  4. transfer drug from original container to undesirable substance (I.e kitty litter)
  5. return drugs to community “drug take back” program
  6. remove all identifying information on container
  7. consult pharmacist
159
Q

Name 5 abbreviations that are on the Do Not Use list

A
  • cc (write mL)
  • D/C (write discontinue)
  • hs (write bedtime)
  • qod (write every other day)
  • sq (write subq)
160
Q

Name the 6 nurses rights when administering medications

A
  1. To complete and clear order
  2. To have correct drug, route and dose dispensed
  3. To have access to information
  4. To have policies to guide safe drug administration
  5. To administer drugs safely and to identify system problems
  6. To stop, think and be vigilant
161
Q

Name the 3 times the drug label should be read to avoid drug error

A
  1. With the MAR when removing from the drawer
  2. When preparing, pouring, or opening
  3. Before administering
162
Q

What are the 5 rights of safe drug administration

A 
Right assessment 
Right documentation 
Right to education 
Right evaluation 
Right to refuse
163
Q

What are the 5 rights of drug administration

A 
Right client 
Right drug 
Right dose
Right time 
Right route
164
Q

Name 6 places where drug errors can occur

A

During:

Prescribing 
Dispensing/preparing 
Administration 
Documenting/transcribing 
Monitoring 
Other
165
Q

More than how many medication errors occur in hospitals every year

A

100,000

166
Q

What is goal 5 of the national safety administration

A

Reduce the likelihood of patient harm associated with the use of anticoagulant therapy

167
Q

What is goal 4 of the national safety administration

A

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

168
Q

What is goal 3 of the national safety administration

A

Improve the safety of using medications

169
Q

what is goal 1 of the national safety administration

A

To improve the accuracy of patient identification

170
Q

Idiosyncratic reaction

A

Is an unexpected response

171
Q

Photosensitivity drug interaction

A

Reaction caused by exposure to sunlight

172
Q

Incompatibility drug interaction

A

Mixing drugs may cause one to precipitate, or form solid particles rather than remain in solution

173
Q

Displacement drug effect

A

One drug displaces another from a receptor or from a protein molecule

Ex: narcan displaces morphine

174
Q

Antagonistic drug effect

A

When two drugs that have opposite effects are administered together , each drug cancels the effect of the other

(Actions of both drugs are nullified)

175
Q

Synergistic drug effect or potentiation

A

One drug enhances the effects of the other

Ex: mixing alcohol and sedative-hypnotic can increase CNS depression

176
Q

Additive drug effect

A

When two drugs with similar action are administered

Ex: alcohol and sedatives / diuretic and a beta blocker

177
Q

Drug interactions

A

An altered or modified action or effect of a drug as a result of interaction with one or multiple drugs

178
Q

In a clinical trial is it ok not to tell a patient they may be given a placebo

A

No

179
Q

Placebo effect

A

A psychological benefit from a compound that may not have the chemical structure of a drug effect

180
Q

Tachyphaxis

A

A rapid decrease in response to the drug “acute tolerance”

181
Q

Tolerance

A

Decreased responsiveness over the course of therapy

Ex: drug tolerance to narcotics can result in decreased pain relief for the patient

182
Q

Name 6 types of side/adverse effects

A
  1. allergic reactions (anaphylaxis)
  2. gi disturbances (nausea, vomiting, diarrhea)
  3. organ toxicity (hepatotoxicity)
  4. bone marrow (anemia, thrombocytopenia)
  5. CNS (drowsiness, hyperactivity)
  6. anticholinergic (tachycardia, dry mouth, blurred vision, constipation, etc)
183
Q

What is one of the primary reasons patients stop taking their prescribed medications

A

The occurrence of side effects

184
Q

Adverse effects

A

Are more serious side effects even at therapeutic levels

185
Q

Side effects

A

Are mild , undesired responses to a drug

186
Q

When do you draw lab work to test peak level ? And what does that level (high/low) indicate ?

A

Draw labs AFTER drug is given

Too high= absorbed to fast (toxicity)

Too low= not absorbing well

187
Q

When do you draw lab work to test trough level ? And what do levels (high/low) indicate

A

Immediately BEFORE drug is given

Too high= not being eliminated (toxicity)

Too low= need higher dose

188
Q

If the drug is given IV the peak time might be

A

Occur within 10 minutes of being given

189
Q

If the drug is given orally the peak time might be ?

A

Between 1-3 hours after drug administration

190
Q

If the peak is too low that means no what is achieved

A

Therapeutic effect

191
Q

Toxicity can occur if either the peak or trough level is too high or too low

A

Too high

192
Q

When/why are peak and trough levels requested

A

For drugs that have a narrow therapeutic index and are considered toxic

193
Q

Trough drug level

A

Is the lowest plasma concentration of a drug

Indicates the rate of elimination

194
Q

Peak drug levels

A

Highest plasma concentration at a specific time

Indicates the rate of absorption

195
Q

Digitalization as associated with loading dose

A

Is the process by which the minimum effective concentration level for digoxin is achieved in the plasma in a short time

196
Q

Loading dose

A
  • given when immediate drug response is needed to achieve a rapid response
  • after a large initial dose, a prescribed dose per day is ordered
197
Q

Therapeutic range (window)

A

Concentration of a drug between the minimum effective concentration and the minimum toxic concentration

198
Q

If the therapeutic index is narrow does the plasma drug level need to be monitored more often or less often

A

More often

199
Q

Drugs with a high therapeutic index have a narrow or wide margin of safety

A

Wide and less danger of producing toxic effects

200
Q

Drugs with a low therapeutic index have a narrow or wide margin of safety ?

A

Narrow

201
Q

In the therapeutic index , the closer the ratio is to 1 the greater the what ?

A

Danger of toxicity

202
Q

Therapeutic index

A

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

203
Q

Multidose

A
  • multiple doses of medication per package
  • may be for one patient or many patients
  • watch the expiration date
204
Q

Oral route of administration

A

Medication is absorbed in the stomach or small intestine

205
Q

Parenteral route of administration

A
  • medication is given by injection

- may be given IV or IM or subQ

206
Q

Topical route of administration

A
  • medication is applied to mucous membranes or skin

- may be given by transdermal patch, inhalation, mouth (but not swallowed) rectum or vagina

207
Q

Is it ok to apply a new transdermal patch over one already attached to the skin

A

No ! Must remove previous transdermal patch before placing a new one

208
Q

what is the proper way to administer a topical ear drop to a patient aged 3 and under

A

Pulling the auricle (ear) down and back

209
Q

What is the proper way to administer a topical ear drop on a patient who is aged 3 or older

A

By pulling the auricle (ear) up and back

210
Q

Nebulizers

A

Small machine that vaporizes a liquid drug into a fine mist that can be inhaled

211
Q

Parenteral medications

A

Are medications administered via injection to bypass the first pass effect of the liver

212
Q

Name the 6 parenteral routes to administer drugs

A 
Intradermal
Subcutaneous 
Intramuscular 
Intraosseous 
Intravenous
213
Q

At what angle should the needle be held to administer an intradermal injection

A

10 - 15 degree angle

Ex: TB testing

214
Q

At what angle should the needle be held to administer a subcutaneous drug injection

A

** should be administered at fatty tissue sites ; stomach, upper arm, thigh)**

45 - 90 degrees
(45 degrees for those with little subq tissue)

215
Q

At what angle should the needle be held to administer an intramuscular drug injection

A

90 degree angle

216
Q

What is the most preferred site for intramuscular drug injections

A

Ventrogluteal

217
Q

Intraosseous

A

Drill hole in leg to give medicine in bone of leg

218
Q

The higher the numbered gauge of a needle indicates what ?

A

The smaller the needle

219
Q

Intradermal wheal

A

Is a blister or blew created just under the skin when medicine is administered via intradermal injection

220
Q

Name the 4 common intramuscular injection sites

A

Ventrogluteal (most common)

Dorsogluteal (old way, not recommended)

Deltoid

Vastus lateralis

221
Q

The deltoid site can take up to how many mL of medication via the intramuscular route

A

Up to 1 mL

222
Q

The ventrogluteal site can take up to how many mL of medication via the intramuscular route

A

Up to 3 mL

223
Q

Z-track injection

A

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

224
Q

Name the 4 most common sites for intravenous administration

A

Radial vein

Median cubital

Cephalic vein

Basilic vein

225
Q

Kilo

A

Thousands

226
Q

Mili

A

One thousandths

227
Q

Centi

A

One hundreth

228
Q

1 g equals how many mg ?

A

1000 mg

229
Q

1 L equals how many mL ?

A

1000 mL

230
Q

When converting larger units (G) to smaller units (mg) do you move the decimal point to the right or the left ?

A

To the RIGHT for each degree of magnitude

Ex: 1.000g = 1000mg

231
Q

When converting smaller units (mg) to larger units (G) do you move the decimal point to the left or to the right ?

A

Move to the LEFT

Ex: 1000.mg = 1g

232
Q

1 medium glass is equivalent to how many ounces

A

8 oz

233
Q

1 ounce (oz) is equivalent to how many tablespoons

A

2 tablespoons (Tbsp)

234
Q

1 tablespoon (tbsp) is equivalent to how many teaspoons

A

3 teaspoons (tsp)

235
Q

1 teaspoon (t) is equivalent to how many drops (ggts)

A

60 drops (ggts)

236
Q

1 teaspoon (tsp) is equivalent to how many mL ?

A

5 mL

237
Q

On a drug label which name is written in large letters and which name is written in smaller letters

A

LARGE letters is the BRAND name

Small letters is the generic name

238
Q

3-mL syringe carry out to what place value

A

The hundredths

239
Q

1-mL syringe carry out to what place value

A

The thousandths

240
Q

Normal range of potassium

A

3.5 - 5.3 mEq/L

241
Q

What are the function of potassium

A

Promotes glycogen storage in the liver

Regulates osmolality of cellular fluids and plays role in acid-base balance

242
Q

What are the signs and symptoms of hyperkalemia

⤴️ k+

A

Cardiac dysrhythmia (tachycardia/bradycardia)

Paresthesia of face, hands, tongue and feet

Nausea/diarrhea/cramping

Metabolic acidosis

243
Q

Signs and symptoms of hypokalemia

⤵️K+

A

Fatigue , muscle weakness , anorexia

Nausea/vomiting

Decreased bowel motility

Confusion

Cardiac arrest

Quadricep weakness

244
Q

Paresthesia

A

Abnormal sensation such as burning, prickling or formication (tactile hallucination of sensation of tiny insects crawling over the skin)

245
Q

Normal range for sodium

A

135 to 145 mEq/L

246
Q

Signs and symptoms of hyponatremia

A

Due to water in cells: muscle weakness, ⤵️ deep tendon reflex, headaches, seizures, pale skin, hypotension, dry mucous membranes

Due to hypovolemia: tachycardia and ⤵️ BP

247
Q

Signs and symptoms of hypernatremia

A

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

248
Q

Hypotonic IV fluid

A
  1. 45% normal saline
  2. 5% dextrose and water

Allows water to move INTO the cell causing the cell to BURST

249
Q

Hypertonic IV fluid

A

3% saline
5% dextrose and 0.45% normal saline

Pulls water OUT OF the cell causing it to SHRINK

250
Q

Isotonic IV fluid

A

5% dextrose in water
0.9% sodium chloride (normal saline)
Lactated ringers
Ringers solution

251
Q

What is normal saline

A

0.9% sodium chloride

252
Q

Absorption as related to pediatric pharmacokinetics

A

As children grow the absorption of medications becomes more effective . Less developed absorption in neonates and infants MUST BE CONSIDERED IN DOSAGE AND ADMINISTRATION

253
Q

How does body fluid composition affect distribution in pediatric pharmacokinetics

A

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

254
Q

How does body tissue composition affect distribution in pediatric pharmacokinetics

A

Neonates and infants have less body fat than older children

Requires LESS fat soluble medications than adults

255
Q

How does protein-binding capability affect distribution in pediatric pharmacokinetics

A

Infants and neonates have less albumin and fewer protein receptor sites than older patients

LESS dosage needed

256
Q

How does The blood brain barrier affect distribution as related to pediatric pharmacokinetics

A

Infants blood brain parties are immature , allowing medications to pass easily into nervous system tissue and increase likelihood of toxicity

257
Q

Pediatric pharmacokinetics related to metabolism

A

Metabolism occurs more rapidly

HIGHER dosage needed due to first pass effect

258
Q

Pediatric pharmacokinetics related to excretion

A

Immature kidney function slows excretion

(⤵️ renal blood flow, GFR, renal tubular function)

LESS CONCENTRATION needed

259
Q

Polypharmacy

A

Is the administration of many drugs together

260
Q

Absorption related to geriatric pharmacokinetics

A

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

261
Q

Affects of Body fluid composition in geriatric pharmacokinetics

A

Decreased amount of body water

LESS DOSE required

262
Q

Body tissue composition related to geriatric pharmacokinetics

A

Increased body fat

requires MORE drug dose to obtain desired effects

263
Q

Protein binding compatibility in geriatric pharmacokinetics

A

Loss of protein-binding sites for drugs

Requires LESS amount of protein bound drugs to prevent excess Dee drug in circulation decreasing toxicity

264
Q

Metabolism in geriatric pharmacokinetics

A

Liver dysfunction caused by aging , decreases the livers ability to metabolize

Requires LESS of a dose

265
Q

Excretion in geriatric pharmacokinetics

A

Decreased kidney and liver function equals decreased rate of excretion

Requiring LESS drug to

266
Q

What tests are administered to test the function of the liver

A

Liver function tests LFT’s

267
Q

What tests are administered to test the function of the kidneys

A

BUN , serum creatinine and creatinine clearance

268
Q

What is TPN and when does it become necessary

A

Total parenteral nutrition

Becomes necessary when the GI tract is incapacitated due to uncontrolled vomiting, malabsorption or intestinal obstruction

269
Q

What is Enteral nutrition

A

Nutrition that is given directly into the GI tract

270
Q

Name 3 complications of enteral nutrition feelings

A

Dehydration
Aspiration
Diarrhea

271
Q

List 5 complications associated with TPN

A

Air embolism

Pneumothorax, hemothorax

Hyperglycemia or hypoglycemia

higher risk for sepsis

Fluid overload

272
Q

List the 4 fat soluble vitamins

A

Vitamin K A D E

273
Q

List the 2 water soluble vitamins

A

Vitamin B and C

274
Q

Which types of vitamins can become toxic if taken in excessive amounts

A

Vitamin A and D

Fat soluble

275
Q

List 3 signs of vitamin A deficiency

A

Dry skin

Poor tooth development

Night blindness

276
Q

List 2 signs of vitamin D deficiency

A

Rickets (children)

Osteomalacia (adults)

277
Q

What is a sign of vitamin E deficiency

A

Breakdown of RBCs

278
Q

List 2 signs of vitamin K deficiency

A

Increased clotting times

Spontaneous hemorrhage

279
Q

List 9 signs of vitamin b complex deficiency

A

Sensory disturbances

Retarded growth

Fatigue

Anorexia

Visual defects

Neuritis

Convulsions

Anemia

Dermatitis

280
Q

List 4 signs of vitamin C deficiency

A

Poor wound healing

Bleeding gums

Scurvy

Predisposition to infection

281
Q

List 7 signs of folic acid deficiency

A

Alopecia

Anorexia

Fatigue

⤵️ WBC and clotting factors

Anemia

Depression

Blood dyscrasias (abnormal blood component quantity)

282
Q

List 4 signs of vitamin B12 deficiency

A

GI disorders

Poor growth

Anemia

Disturbance of intrinsic factor and intestinal absorption

283
Q

List 4 signs of vitamin B12 deficiency

A

GI disorders

Poor growth

Anemia

Disturbance of intrinsic factor and intestinal absorption

284
Q

List 7 signs of folic acid deficiency

A

Alopecia

Anorexia

Fatigue

⤵️ WBC and clotting factors

Anemia

Depression

Blood dyscrasias (abnormal blood component quantity)

285
Q

List 4 signs of vitamin C deficiency

A

Poor wound healing

Bleeding gums

Scurvy

Predisposition to infection

286
Q

List 9 signs of vitamin b complex deficiency

A

Sensory disturbances

Retarded growth

Fatigue

Anorexia

Visual defects

Neuritis

Convulsions

Anemia

Dermatitis

287
Q

List 2 signs of vitamin K deficiency

A

Increased clotting times

Spontaneous hemorrhage

288
Q

What is a sign of vitamin E deficiency

A

Breakdown of RBCs

289
Q

List 2 signs of vitamin D deficiency

A

Rickets (children)

Osteomalacia (adults)

290
Q

Name 7 populations in need of increased vitamin usage

A
  1. those with rapid body growth
  2. those who are pregnant or breastfeeding
  3. those who are malnourished
  4. those who are debilitated (cancer,AIDS)
  5. inadequate absorption (chrohns disease)
  6. inability to use vitamins
  7. fad or restrictive diets
291
Q

Pharmacology

A

The study of medicine (drugs)

Pharmacology (8 decks)

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