Week 1 Flashcards
4 Key things to know about a medication
- Properties of an ideal drug
- Therapeutic objective
- Factors determining intensity of drug response
- Therapeutics
3 most important properties of an ideal drug
- Effectiveness
- Safety
- Selectivity
Other properties of ideal drugs
Reversible action
Predictability
Ease of administration
Freedom from drug interactions
Low cost
Chemical stability
Simple generic name
Therapeutic index
Achieve therapeutic effect without reaching toxic effect
Provide maximum benefit with minimum harm
Factors that determine intensity of drug response
Administration
Pharmacokinetics
Pharmacodynamics
Sources of individual variation
4 Major Pharmacokinetic processes
Drug absorption
Drug distribution
Drug metabolism
Drug excretion
10 Rights of Pharmacology in Nursing
Right drug
Right patient
Right responsibility
Right dose
Right time
Right assessment
Right documentation
Right evaluation
Right of patient to education
Right of patient to refuse care
CNO best practice regarding medication administration
Authority
Safety
Competence
Pharmacology in patient care
Pre administration assessment
Dosage and administration
Evaluating and promoting therapeutic effects
Minimizing adverse effects
Minimizing adverse interactions
Making PRN decisions
Managing toxicity
Pharmacology in patient education
Drug name and therapeutic category
Dosage size
Dosing schedule
Route and technique of administration
Expected therapeutic response and when it should develop
Non drug measure to enhance therapeutic response
Duration of treatment
Method of storage
Symptoms of adverse effects
Major adverse interactions
Whom to contact in emergencies
Nursing Process
Asessment
Diagnosis
Planning
Intervention
Evaluation
Pre administration assessment
Baseline data to evaluate therapeutic and adverse effects
Identify high risk patients
Assess patients capacity for self care
Types of nursing diagnosis
Problem focused
Risk
Health promotion
Syndrome
Possible
Planning
Define goals
Set priorities
Identify specific interventions
Drug administration
Interventions to enhance therapeutic effect and minimize adverse effects
Patient education
Establish objective criteria for evaluation
Implementation
Drug administration
Patient education
Interventions to promote therapeutic effects and minimize adverse effects
Evaluation
Therapeutic responses
Adverse drug reactions and interactions
Adherence to prescribed regimen
Satisfaction with treatment
Canadian Regulatory Framework
Acts
Regulations
Guidelines
Policies
Act - provide legal authority to health Canada to regulate and oversee development and marketing of drugs
Regulation - legally enforceable interpretations of the act
Guidelines - not legally binding and allow flexibility in interpretation, general details, how to interpret and meet regulations
Policies - expand or modify interpretation of regulations
Steps to new drug development
Randomized control trial
Preclinical testing
Clinical testing (4 phases)
***limited info for women and children, fail to detect all adverse effects
Should nurses use generic or brand names?
Generic - more complicated than trade names but a single drug has multiple trade names with different active ingredients
OTC drugs must have
A valid DIN to meet requirements for safety, quality and effectiveness
Ingredients list
Must be licensed and able to provide documents for evidence
Is pharmacokinetics specific to drug classes or general processes
General processes
What is pharmacokinetics
The movement of drugs through the body (metabolism and excretion)
The principles of ADME
Absorption- how does it get it
Metabolism- how is it broken down
Distribution- where will it go
Excretion- how does it leave
Factors affecting drug absorption
Rate of dissolution
Surface area
Blood flow
Lipid solubility
PH partitioning
IV and advantages and disadvantages
Advantages
- rapid onset, use of irritant drugs
Disadvantages
- high cost, difficult and inconvenient, irreversibility, infection, fluid overload, embolism
Intramuscular advantages, disadvantages, and barriers to absorption
Advantages
- poorly soluble drugs, depot prep
Disadvantage
- discomfort, nerve damage and bleeding risk
Barrier to absorption: capillary wall
Oral advantages, disadvantages, and barriers to absorption
Advantages
- easy and convenient, self med, safer then injections, potentially reversible, minimal risks
Disadvantage
- absorption highly variable, inactivation of certain drugs
Barriers: epithelial cells in GI tract and capillary walls
P-Glycoprotein
Transmembrane protein
Transports drugs out of cells
(Into bile, urine, maternal blood)
To penetrate cell membranes, a drug must be _____?
Lipid soluble (lipophilic)
Rank the absorption or different oral administrations
I. Tablets (dissolve in stomach)
2. Enteric coated (dissolve in intestine)
3. Sustained release (slowly throughout the day)
