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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
pharmaceutics
how drug works in body from start to finish
26
dissolution
the process which a drug goes into a solution (blood) and becomes available for absorption in body iv is most rapid
27
pharmacokinetics
study of the absorption, distribution, biotransformation, and excretion of meds in body
28
absorption
process of moving the drug molecules from the entry site into circulation
29
variables that affect absorption
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
solubility (absorption)
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
drug concentration (absorption)
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
loading or priming dose vs maintenance dose
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
route effects absorption
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
oral administation
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
rectal administration
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
parenteral route (injections)
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
topical route
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
distribution
once absorbed the med is distributed through body by blood circulation cardiac output effects distribution: faster it beats faster its distributed
39
drug reservoirs (distribution)
allows a drug to accumulate by binding to tissues in the body binds to plasma proteins or tissue
40
palma protein binding
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
tissue binding
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
barriers to med distribution
blood-brain barrier placental barrier
43
metabolism / biotransformation
hepatic first pass effect
44
hepatic first-pass effect
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
excretion
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
pharmacodynamics
effect a med has on the body
47
biologic half-life
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
therapeutic index
ratio between the toxic (lethal) level and the therapeutic (effective) level
49
side effects
predictable inconveniences in most cases (insomnia, gi upset)
50
Adverse reactions
unpredictable can be mild to fatal always monitor for adverse drug reactions
51
adverse med reactions
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
allergic reactions
seen with second known exposure body makes antibodies to the first exposure and reacts on the second one. can be fatal
53
medication and the aging
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
things that effect individuals response to medications
kidney failue liver failure genetics diet patient behavior (understanding, willing to follow info, and psychological illnesses)
55
OTC meds
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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