week 1 Flashcards
What is pharmacology
the branch of medicine concerned with the uses, effects, and modes of action of drugs.
What are the three names for drugs
Trade, Generic, Chemical
Pharmaceutics
science of dosage form design, rate at which drug dissolution occurs, and the delivery of the medication
Three types of dosage forms:
enteral, parental, and topical
Enteral
any oral medication
parental
medication that is given with injection
four types of injection
intradermal ID - just under the dermis
subcutaneous SQ- into fat layer just below the skin
intramuscular IM - into deep muscle layer
Intravenous IV- directly into blood stream
Topical dosage
applied on body surface
Enteric coated
oral coated tablets - cannot be cut in half. breaks down in lower GI
Capsule form oral medication description
encase in capsule, designed for sustained or extended release of granules. slow delivery
Chewable tablets start breaking down in
the mouth.
Sublingual
Under the tongue
liquid, syrups, and elixirs
already dissolved medication, absorbed more quickly than solid dosage form
Fastest to slowest absorption oral dosage forms
Liquid
suspension solutions
powders
capsules
tablets
coated
enteric-coated
Transdermal patch
adhesive medicated patch. handle with gloves
What is the difference between local and systemic rash?
Local means rash is located just on one part of the body, ie rash on arm. Systemic rash would be broken out all over your body, meaning it is in the blood stream.
Rectal suppositories (PR)
Excellent for pt who is vomiting or has difficulty swallowing. infant or small children especially
Why is it important to push IV meds slowly?
Pushing IV medication too fast can cause altered mental status - renal capacity must be taken into consideration.
When giving meds –
do not take shortcuts or work arounds.
Eye drops (GTT) or eye ointment (oint)
lean slightly back, make sure barrel doesn’t touch eye.
Ear drops (gtt)
pull lobe up or down to expose canal.
Inhaler (inh)
A canister containing medicine in aerosol form. delivered directly to lungs- bronchodilators.
Pharmacokinetics
The study of what happens to a drug from the time it is put into the body until it has left the body
Absorption is determined by
onset of drug action
Bioavailability
The portion of the drug that reaches the systemic circulation.
What drugs are altered by the first pass effect?
Oral drugs
What is the first pass effect?
When a drug is metabolized by the liver before it reaches the systemic circulation - some of the active drug will be inactivated before it reaches the general circulation.
The bioavailability of drugs administered orally
have less than 100% bioavailability
Drugs administered via IV have ___ bioavailability
100% bioavailability.
Food in the stomach can influence oral medication’s ___
absorption
how does milk in the stomach effect oral medication?
Milk binds with molecules of some drugs, so the drug can never be absorbed.
How does fruit juice effect absorption of oral medication?
Juices (orange, grape) can enhance absorption, making it stronger or be absorbed faster than intended
Distribution
the transport of a drug by the bloodstream to its site of action
3 major factors for drug distribution
Blood flow to tissue,
ability of drug to exit the vascular system
Ability of the drug to enter the cell
Protein Binding
some drugs binds to protein in the bloodstream. it can allow part of the drug to be stored and released as needed.
however if two drugs compete for protein binding sites, one of the drugs will be displaced. this can result in higher levels of freely circulating drug molecules
Metabolism considerations
also known as biotransformation
metabolism capabilities of the liver vary from pt to pt. Age, genetics, disease, concurrent use of other meds
excretion
refers to the elimination of a drug from the body.
requires adequate function of the circulatory system, and organs of excretion
Kidneys via urine
liver via bile into feces
lungs via exhaled air
saliva, tears, and sweat
Onset, peak, and elimination
When a drug begins to work, hits the peak of effectiveness, and is then excreted. k
half life
from peak level to elimination. some drugs have longer or shorter half life than others
pharmacodynamics
study of what a drug does to the body. once drug is at the site, it can modify the rate and which the cells or tissues function. a drug cannot make a cell or tissue perform a function it was not designed to perform
what is mechanism of action
how a drug achieves its response
what is drug effect
the goal of drug therapy
positive change in faulty physiological system
adverse drug reaction
reaction to a drug that is undesired, and may or may not be expected.
- side effects
-allergic (immune) response
- idiosyncratic reaction
-drug interactions
-interactions with food or other drugs like OTC’s
Contraindication
preexisting condition that precludes the use of a particular drug under all but the most desperate circumstances
precaution
pre-existing condition that significantly increases the risk of adverse effect
Black box warning
FDA’s strongest warning.
indicates the medication has serious or life-threatening adverse effects.
notifies physicians, pharmacists, and nurses that they are responsible to screen pt closely for drug appropriateness prior to giving drugs. should assess pt more frequently after administering.
Pharmacotherapeutics
Clinical treatment through the use of drugs
source of individual variations for pharmacotherapeutics
physiologic - age, weight, gender
pathologic - kidney and liver function
genetic variables - can alter metabolism
drug interactions
how do you know the kidney and liver function so you can know how a drug might be metabolized in a certain pt?
Lab values - complete blood pannel and basic metabolic panel
Lifespan considerations in pharmacotherapeutics
age has significant impact on the effect of medications
ESPECIALLY in peds or gery pts.
organ immaturity in infants
peds does is based on mg/kg of body weight
physiological changes of aging patients
Most important job for nurse before administering meds
Preadministration assessment
list of current meds
history of allergies
vitals signs and phys exam
lab values - renal, liver, metablolism
The rights of medication administration
DDTRPD
right Drug
right Dose
right Time
right Route
right Pt
right Documentation
Additional rights:
RRR
right Reason
right to Refuse
right to Response
For any med order to be complete it must include
NDRF
Name
Dose
Route
Frequency
call prescriber for clarification if missing one of these
Older adults are ____ likely to experience ADE (adverse drug effects
more
Pediatric patients are at ___ for side effects and ADEs due to pharmacokinetic differences in body systems
increased risk
Geriatric patients are ___ times more likely to hospitalized due to secondary ADE’s
seven
What is prophylaxis
a drug given prior to a procedure proactively. like antibiotics given before surgery to get ahead of potential infection
what is palliative care
medical care that relieves pain
