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N221 exam 1 and 2 > principles pf drug classification I > Flashcards

principles pf drug classification I Flashcards

1
Q

nurses should always with meds

A

understand before administration
know usual dose
know route
side effects and adverse reactions
major med interactions
and apply nursing process at all times

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2
Q

side effect vs adverse effect

A

SE: expected
AR: unexpected

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3
Q

nursing process example
pain

A

assess: pain, RR, HR
plan: for meds
Diagnosis: pain
implement: pain meds
evaluate: pain scale

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4
Q

rights to meds

A

right:
drug
dose
time
route
patient

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5
Q

caveat to the rights to meds

A

use clinical reasoning to determine if the med should or not be administered

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6
Q

generic name verse trade name

A

generic: all lower case
acetaminophen

trade: upper case first letter
Tylenol
Advil

HCPs should always use the generic name when writing prescriptions

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7
Q

precription or legend drug

A

requires a prescription in order to get

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8
Q

non-prescription or over the counter (OTC) drug

A

dont need prescription
usually at lower dose than prescription drugs
(200 tylenol vs 800mg prescription tylenol)

see doctor if med dose does not work. do not take more than instructed

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9
Q

4 main sources of drugs

A

plants (digitalis, colchicine)

animals/humans (insulin from pigs) (epi)

minerals/mineral products (iron, iodine, zinc)

synthetic/ chemical substances (made in lab)

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10
Q

what is similar per class

A

-class name
-mechanism of action
-SE/AR
-contraindications
-precautions
-significant med interactions
-specific nursing action to be taken before, during, and after administration

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11
Q

resources for drug info

A

us pharmacopia: highlightd info to reduce drug risks

PDR physicians desk reference: drug inserts/pics does snot contain nursing info

nursing drug books: condensed PDR toward nursing

Apps: get updated

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12
Q

on going education

A

-should always continue to learn for .edu or .org
-empolyer must give updated med info
-nurse is responsible for being up to date
-ignorance to new info will not help in court
-use multiple sources

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13
Q

what are nurses responisble for with their education

A

staying current in all areas of practice

liable for their actions and omissions of their duties and duties delegated to others

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14
Q

history of meds

A

prior to 1906 meds were not regulated

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15
Q

1906 the pure food and drug act

A

passed to protect from mislabeled drugs

designated us pharmacopeia and the national formulary as official standards of publications

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16
Q

1914 harrison narcotic act

A

first federal law aimed at curbing drug addiction

established the word narcotics

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17
Q

1938 federal food, drug, and cosmetic act

A

Prevented new drugs from being marketed before being tested for safety

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18
Q

1952 durham-humphrey amendment

A

Specified how legend, or prescription, drugs and refills could be ordered and dispensed

Also recognized OTC meds

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19
Q

1962 kefauver-harris amendment

A

Required proof of both safety and efficacy of a new drug before it could be approved

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20
Q

1971 controlled substance act

A

Increase research, prvent abuse, provide rehabilitation

Improved handling of controlled substances

Classifies meds according to their potential for addiction

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21
Q

1973 The drug enforcement administration (DEA)

A

dea became sole legal drug enforement agency in the us

federal offense to give someone your prescription

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22
Q

1983 Orphan Drug Act

A

authorized the FDA to provide grant money to encourage research for rare chronic diseases

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23
Q

scheduled medication: how meds are rated for addiction

A

1: not prescribed, its very addictive (lsd, heroin)

2:
3:
4:

5: lowest for addiction

24
Q

properties of meds

A

most meds do not cause new fuction on tissues or organs

only modify or change existing function

usually have multiple side effects

25
Q

pharmaceutics

A

how drug works in body from start to finish

26
Q

dissolution

A

the process which a drug goes into a solution (blood) and becomes available for absorption in body

iv is most rapid

27
Q

pharmacokinetics

A

study of the absorption, distribution, biotransformation, and excretion of meds in body

28
Q

absorption

A

process of moving the drug molecules from the entry site into circulation

29
Q

variables that affect absorption

A

the cell membrane: the thickness different in different locations

the vascular bed within the surface can increase or decrease absorption time depending on how vascular it is

30
Q

solubility (absorption)

A

more soluble the drug the more rapid it is absorbed ad affects the patient

meds mixed with oils absorb slower than ones mixed with water which allows weekly injections because it last longer due to it being slower.

31
Q

drug concentration (absorption)

A

higher the concentration the more rapidly it is absorbed

some meds are given higher dose at first and lower doses after to keep an affect. this is called “loading or primary dose” and the smaller dose referred to as “maintenance dose”

32
Q

loading or priming dose vs maintenance dose

A

loading or priming dose: first higher dose you give (2 laperomide for diarrhea)

maintenance dose: smaller dose proceding the loading dose to keep the affects (1 laperomide for every stool after)

33
Q

route effects absorption

A

enteral route: gi tract (most common and safest because dosage can be retrieved)

absorption in gi can take place in:
oral
gastric absorption
small intestine
rectal absorption (super vascular)

34
Q

oral administation

A

30-45 min

sublingual effects take a few seconds to minutes

enteric coated protect the stomach making the pill absorbed later in the tract

35
Q

rectal administration

A

insert with gloves and lube

insert past internal sphincter muscle or itll get pushed out

can have instant results due to the rectums vascularity

36
Q

parenteral route (injections)

A

SQ: connective tissue or fat
IM
IV: immediate response
intrathecal: directly into the CSF
epidural: slower than intrathecal (into the epidural space of spine)
intraarticular (synovial fluid, joint)
intraosseous (into bone marrow)
intraperitoneal
intrapleural

37
Q

topical route

A

slow

can use patchs:
dont place on broken skin, wipe old patch skin before placing

eye drops: hold eye duct when applying

nasal: highly vascular

38
Q

distribution

A

once absorbed the med is distributed through body by blood circulation

cardiac output effects distribution: faster it beats faster its distributed

39
Q

drug reservoirs (distribution)

A

allows a drug to accumulate by binding to tissues in the body

binds to plasma proteins or tissue

40
Q

palma protein binding

A

attaches to protein which limit amount of free drug floatin in circulation

this limits the distribution of the drug and limits action of med on action side

hypoabluminemia: if pt has this then lower the dose or it will become toxic

41
Q

tissue binding

A

lipid-soluble meds have a high attraction to adipose (fat) tissue

not much circulation to adipose tissue making it good for storage but slow to bind and distribute

42
Q

barriers to med distribution

A

blood-brain barrier

placental barrier

43
Q

metabolism / biotransformation

A

hepatic first pass effect

44
Q

hepatic first-pass effect

A

most po meds are circulated through the liver and the microsomal enzmatic action

this causes a significant amound of med action to be decreased (med is broken down by liver)

high HFP=less drug in system
low HFP=more drug in system

this is why you may give a 4mg in iv but 50mg po because you have to account for the med thatll be broken down by the liver

45
Q

excretion

A

med continue to act until it is biotransformed or excreted

major sites for med excretion:

-kidneys: most important route
-GI tract: feces
-Lungs: breath
-Sweat and salivary glands
-mammr glands: breast milk
-hemogialysis: used for drug overdoses. manually filter -blood (bad kidneys)

46
Q

pharmacodynamics

A

effect a med has on the body

47
Q

biologic half-life

A

amount of time it takes for a drug to diminish its amount in the body by 50%

med is completely remove by 5 half-lifes

ex: if half life is 4 hours then itll be completely gone in 20 hours

48
Q

therapeutic index

A

ratio between the toxic (lethal) level and the therapeutic (effective) level

49
Q

side effects

A

predictable
inconveniences in most cases (insomnia, gi upset)

50
Q

Adverse reactions

A

unpredictable
can be mild to fatal
always monitor for adverse drug reactions

51
Q

adverse med reactions

A

toxicity: blood levels too high

idiosyncratic effect: uncommon response due to a genetic predisposition

latrogenic disease: disease produced by medication

teratogenic effect: medication induced birth defect

carcinogenic effect: cancer causing medications

paradoxical reaction: the opposite of what you expect to happen (benadryl instead of making you sleepy makes you awake)

52
Q

allergic reactions

A

seen with second known exposure

body makes antibodies to the first exposure and reacts on the second one.

can be fatal

53
Q

medication and the aging

A

metabolism slows and effects distribution, absorption and elimination

psychological sharpness can be slowed effecting it as well

increase in adipose tissue will slow absorption and may lead to overdoses due to increased storage of meds

54
Q

things that effect individuals response to medications

A

kidney failue
liver failure
genetics
diet
patient behavior (understanding, willing to follow info, and psychological illnesses)

55
Q

OTC meds

A

usually lower dose

get med history of all OTC meds, home remedies and others to help you understand their treatments

N221 exam 1 and 2 (11 decks)

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