UNIT 1 Flashcards
is a vital component of nursing roles each day it is common for nurses to make critical decisions regarding the safety appropriateness and effectiveness of the medication administered to their patients.
Safe medications administration
Examples of decisions that nurses make during patient care include:
- Is my patient’s heart rate within the correct range to receive this beta blocker medication?
- Does my patient have adequate renal function prior to administering this dose of antibiotic?
- Is this pain medication effective in controlling patient discomfort?
In order to make safe medication administration of decisions, the nurse must have a _____, ____, _____ and ____ can be strongly connected to the use of medications in a patient’s treatment plant so before a student nurse reviews of medication order
strong understanding of pharmacology; symptoms management; physical recovery; individual well-being
so before a student nurse reviews of medication order:
- Checks a medication administration record.
- Removes a medication from an expensing machine
- It is important to have a foundational understanding on how medication work within the human body
- chemical substance used in the treatment, cure, prevention or diagnosis of disease
- used otherwise enhanced physical or mental well-being
Drug
maybe classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition each drug can be classified into one or more drug classes
drug
is a group of medications with certain similarities so there are three dominant methods used to classify them
Drug class
specific changes that they can cost in your body.
The mechanism of action
how your body responds to them
Physiologic affects
what they are made of.
The chemical structure
T or F
Actually, there are multiple categories not all drugs fit nearly into a single category. Some drugs are good together under one method but not another. Others belong in multiple classes even within the same system
True because for example, finasteride which treats enlarge prostate and regrows hair.
it is an approved drug for hyperthyroidism (traits low thyroid function) but is often used off-label to treat depression.
lemotroxine
is to make sure you use the drug safely and get the greatest possible benefit. Every time you take a drug your body chemistry changes.
The aim of drug classification
are meant to help but they sometimes cause harmful effects so if you take multiple drugs, they may chain each other’s effectiveness. They can also make side effects or more severe. But your healthcare team can understand what to expect to it and that includes the risk and which other drugs you can switch to.
Medications
also have identified drug-drug interactions and the potential of drug resistance.
Classification
The action of one drug can make another drug less effective, they may change the way your body absorbs or uses the drug. When classified the mechanism of action and interaction that affects one job will usually affect others in the same classes
Drug to drug interaction
work by blocking stomach acid but they also deplete stomach acids you need to break down protein inhibitor (a class of HIV drugs) so taking this drug together makes the HIV drug less able to control the infection
Antacids
It is important to use caution when combining drugs that affect the same organ system so your liver uses an enzyme called ___ to process drugs out of your system, if you take to drugs metabolized by it your liver may not be able to clear them effectively, they can build up leading to toxicity or what we called overdose by classifying a job by its ____, healthcare providers can be can avoid this interactions
cyp3a4; cyp3a4 action
drugs like ___, and ___ or _____ that are metabolized by the kidneys taking them together can lead to toxicity and even kidney failure.
methotrexate and Advil or the ibuprofen
starting with the mildest possible drugs, you then work up until you find what is effective that’s because milder drugs have fewer side effects this over means taking the over the counter drugs or the OTC if they’re not effective you may move up to a prescription drug so guidelines for healthcare provider often list preferred classes and alternate process proven the prepared one’s that don’t work.
Treatment staging
1976- WHO created a system called anatomical therapeutic chemical
(ATC) Anatomical Therapeutic Chemical Classification system
(ATC) Anatomical Therapeutic Chemical Classification system LEVELS
LEVEL 1 describes the organ system treated
LEVEL 2 describes the therapeutic effect
LEVEL 3 describes the mechanism of action
LEVEL 4 describes general chemical properties
LEVEL 5 describes chemical components
1820 - it’s goal is to ensure prescription and ATC drugs approved in the US meet quality standards so those that do go on the national formulary issued by the US or the food and drug administration. Among it may function. The USP was tasked by the US congress to classify the drugs.
`(USP)United States Pharmacopeia
importance of Drug classification
they help protect you from severe side effects and drug interactions.
-they help ensure the body can break down and use medication
-they help guide many treatment decisions
-highly characterized material suitable to test the identity, strength, purity of substances from pharmaceutical use and products
-empowered by FDA to ensure safety
Drug standards and drug information
It describes the relationship between the dose of the drug given to a patient and the activity of that drug in treatment the patients disorder
3 Basic Areas of Pharmacology
is the study of how various dosage forms Influence the way in which the drug affects the body
Pharmaceutics
is the study of what the body does to the drug, it involves the process of absorption, distribution, metabolism and excretion.
Pharmacokinetics
is the study of what does the drug does to the body, involves drug receptor relationship.
Pharmacodynamics
3 phases of drug activity
- Pharmaceutical phase
- Pharmacokinetics phase
- Pharmacodynamics phase
Disintegration of the dosage forms dissolution of drug in the body
Pharmaceutical phase
II. Pharmacokinetics phase
- Absorption
- Distribution
- Metabolism
- Excretion
III. Pharmacodynamics phase
Drug receptor interaction
sunod-sunod na phase ng drug activity (lahat-lahat)
DOSE OF FORMULATED DRUG -> ADMINISTRATION -> I. Pharmaceutical phase -> DRUG AVAILABLE FOR ABSORPTION ->II. Pharmacokinetics phase -> DRUG AVAILABLE FOR ACTION -> III. Pharmacodynamics phase -> EFFECT
ratio that compares the drug concentration at which the drug becomes toxic and concentration at which the drug is effective
Therapeutic index and Drug safety
T or F
The larger the therapeutic index the more dangerous the drug is,
F. It is safer because if the therapeutic index is small, the difference between the two concentration is very small then the drug must be dosed carefully and the person receiving the drug should be monitored closely for any signs
also known as DRUG SAFETY is the signs and activities related to the detection, assessment, understanding and prevention of adverse effects of any possible drug related problem from WHO.
Pharmacovigilance
It describes a drug effect which increases in proportion to increasing drug dose a graded response to a drug is seeing an individual and increases with those graded dose-response graphs plot the responses to a drug against its concentration how.
Graded dose response
denotes the amount of drug needed to produce a given effect in a graded dose response measurement the effect usually chosen is 50% of the maximal effect and the concentration or those causing this protein effects.
Potency and efficacy
___ determined mainly by the affinity of the receptor for the drug and the number of receptors available so efficacy often called ___ is the greatest effect or the E-max
potency; MAXIMAL EFFICACY
can produce if a dose is taken to a highest tolerated level efficacy is determined mainly by the nature of the drug and the receptor and its associated affecter system.
Agonist
are proteins so either inside in a cell or in a surface which receives a signal
In a normal physiology this is a chemical signal where a protein ligand binds into protein receptor
Cellular Receptor and Drug Action.
Receptor 4 main classes
Ligand - gated ion channels
Tyrosine kinase coupled
Intracellular steroid
G-protein coupled - GPCR
is a macromolecule in the membrane or inside the cell that is specifically or chemically bind a ligand or a drug.
Receptor
determine the degree of affinity of ligand to receptor so ligand to receptor so ligands or the drugs that attracted the receptor may be classified as agonist or antagonist.
The strength of the chemical bonds, the covalent, ionic, hydrogen, hydrophobic
T or F
The binding of the drug receptor depends on the types of chemicals bond that can be established between drug and receptor.
T
produce the biological response as a result of receptor ligand interaction therefore agonist possesses efficacy
Agonist
do not provoke any biological response activity after binding to its receptor
Antagonist
MOST ABUNDANT TYPE OF RECEPTORS
G-PROTEIN COUPLED RECEPTOR (FAMILY OF 100)
is the process in which a pharmaceutical substance is released from the formulation it is delivered in, this must occur before the drug can be absorbed into the body
Liberation
is the process in which a pharmaceutical substance enters the blood circulation in the body so the pharmacokinetic parameters for absorption includes absorption rate, constant absorption trait over amount of drug remaining to be absorbed.
Absorption
pharmacokinetic parameters for absorption
absorption includes absorption rate, constant absorption trait over amount of drug remaining to be absorbed
is amount of drug absorbed over the drug dose
Bioavailability
Factors that affects absorption of drugs
Two absorption process
Passive diffusion
Active transport
ABSORPTION PROCESS
major processes through which the drugs are absorbed into the body which does not require energy
Passive diffusion -
ABSORPTION PROCESS
process that uses energy to actively move a molecule across a cell membrane
. Active transport
process in which a pharmaceutical substance is dispersed through the fluids and tissues in the body the pharmacokinetic parameters for distribution includes: 1. Apparent volume of distribution is equal to amount of drug in the body over the drug concentration in the plasma 2. Unbound fraction which is equal to unbound drug concentration in the plasma over the total drop of concentration in the plasma.
Distribution
is the process in which a process in which the pharmaceutical substance is transformed into other substances they called it METABOLITES in the body to the pharmacokinetic parameters from the metabolism includes
Metabolism
pharmacokinetic parameters from the metabolism includes
Metabolic clearance or drug metabolism rate over the drop concentration in the plasma
This is the most rapid cellular response to receptor activation and
-composed of multiple peptide subunits and each contains four membrane spanning domains
Transmembrane ion-channels receptors
-the intracellular membrane in enzymic active, mga catalyc receptor or is bound to specific enzymes
Transmembrane receptors with cytosolic domain
not associated with cell membranes
-in general their protein molecules consists from three main domains: HSP90, DNA, Ligand-binding domains
Intracellular receptors
mostly lipid, soluble, and passively fast membrane
ligand
4 MAIN COMPONENTS OF PHARMACOKINETICS (LADME)
Liberation, Absorption, Distribution, metabolism, excretion
this is the process in which the pharmaceutical substance is removed from the body in rare cases some drugs may never be completely excreted from the body
Excretion
FACTORS INFLUENCING RESPONSES TO DRUGS
- weight
-age
-gender
-physiological factors
-pathological factors
-genetic factors
-immunological factors
-psychological factors
-environmental factors
-cumulation effects
-interaction
examples of physiological factors
dirunal rhythm, electrolyte balance, acid-base balance, hydration
examples of pathological factors
disease, hepatic dysfunction, renal dysfunction, gastrointestinal dysfunction, vascular disorders, low blood pressure
examples of psychological factors
placebo effect, health beliefs, compliance
examples of environmental factors
temperature, light, noise, drug tolerance
- one drug prevents or enhances the absorption of another drug
Ex. tetracycline cannot be absorbed if the client recently took calcium supplement calcium products and still present on the GI tract
In the absorption size
drugs compete for the protein bonding sites one drug prevents the other drug to transported to reactive tissue
Ex. methotrexate a chemotherapeutic drug if taken with aspirins will be excreted a lot because aspirin is more competitive for the size
Upon distribution
Drugs can enhance or block the metabolism of other drug
Ex. Warfarin biotransformation will be increased when taken with (drug unknown) this means that the clients will need higher doses in order to achieve the side effect
During biotransformation
Drugs compete for excretion therefore leading to accumulation and toxic effects of the drugs list excreted
Ex. quinidine or the digoxin when taken together affect the excretion of digoxin, this leads to increased serum level of digoxin of the client because digoxin cannot be excreted
During excretion
Drugs can be antagonist to another drug meaning it can oppose the effect of one another which leads to a no therapeutic effect
Ex. antihypertensive drugs effect is negated if taken with antihistamine or anti-allergy because antihistamines elevate blood pressure also antidiabetic medications which lowers blood sugar shall not be taken with the (unknown) because it also lowers blood sugar but with little to no control that will lead to loss of blood sugar control.
The Action Site
There is some food that increase acid productions therefore speeding the breakdown of drugs that will ultimately prevent absorption and distribution
Ex. Tetracycline shall not be taken with iron and calcium. Grapefruit juice affect liver enzymes for up to 48 hours this will increase or decrease the serum level of drugs
Drug food interaction
Some of the laboratory result may increase or decrease is caused by drugs and not the body’s own reaction or response
Ex. dalteparin used to prevent deep vein thrombosis after abdominal surgery may cause increase level of the liver enzymes aspirate amino transferase and alanine aminotransferase with no injury to liver cell or hepatitis.
Drug laboratory interactions
drug alternate therapy interaction can occur in ff:
- In the absorption size
- Upon distributin
- During biotransformation
- During excretion
- The action site
- drug food interaction
- drug laboratory interactions
An act instituting the comprehensive dangerous act of 2002 repealing republic act no. 6425 otherwise known as the “Dangerous Drugs of 1972” as amended, providing funds therefore and for other purposes this act is known as the cited as the comprehensive dangerous drugs act of 2002.
Republic act no. 9165 (June 7, 2002)
can be safe and effective alternatives to their counterparts and often as a reduced dose, by fb low, generic medications must have some chemically active ingredient in the same those
Ex. they must be a bio equivalent however the excipients of the substance that holds the active chemical ingredients into peel form such as top or the flavoring can be different, some patients do not tolerate these differences in excipients very well.
When prescribing a medication, the provider must indicate the generic substitution. Nurses are often pivotal in completing paperwork on the patient’s behalf, if the brand-new medication is more effective or better tolerated by a particular patient so when studying medication, it is important to know medication by their generic name.
Generic Drugs
A drug or other substances that is tightly controlled by the government because it may be abused or cause addiction. The control applied to the way the substance is made, used, handled, stored and distributed.
Controlled substances
Controlled substances include:
Opioid
Stimulants
Depressants
Hallucinogens
Anabolic steroids
Controlled substances with no medical use such as:
Morphine
Valium
Ritalin
are pharmaceutical agents developed with medical conditions which because there are so rare so would not be profitable to produce without government assistance, the conditions are referred based on orphan diseases so orphan drugs are produced to treat orphan diseases.
orphan drugs
medications do not require a prescription so you can buy them at a pharmaceutical store, they can be brought to store and may be used by multiple individuals. OTC medications are also regulated so the FDA, some prescription medications are available for purchases as OTC in smaller doses
ex. diphenhydramine or Benadryl is commonly prescribed as 50 mg every 6 hours and the prescription strength is 50 mg however it can be purchased OTC in 25 mg doses or less for children.
Over the counter drugs
Ex. paracetamol
