Week 5-Medication Flashcards
Medication systems
Automated Dispensers
Self administration
Automated dispensers
Password accessible lock chart
Computer tracking
Can combine stock and unit doses
Self administration
Individual containers
Kept at client’s bedside
Pharmacological considerations
Pharmacokinetics
Pharmacodynamics
Pharmacokinetics
Movement of drug in the body
Pharmacodynamics
How does the drug affect the body
Absorption
Movement of drug into bloodstream
Factors affecting absorption
-route
-solubility of drug
-ph/ionization
-blood flow
Distribution
Drug transport to tissues and organs
Factors affe ting distribution
-local blood flow
-membrane permeability
-Protein-binding capacity
Factors affecting Metabolism
Biotransformation-chemical conversion of drug
Factors affecting metabolism
-liver function
-health/disease status
-first-pass effect: liver reduces potency of oral medications
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Route
Drug solubility
Ph and ionization
Blood flow to the area
Excretion
Elimination of the drug
Factors affecting excretion
-organ function, especially the kidneys, liver, and lungs
-exocrine glands
Pharmacokinetics concepts
Therapeutic range
Peak level
Through level
Half life
Therapeutic range
A window of Different levels of therapeutic concentration.
Peak level
Onset of action is minimum effective concentration.
When drug concentration in blood is at its highest it is at peak level.
Through level
Drug is at lowest concentration, usually right before dose is due
Half life
How long it takes for half the drug to be eliminated
Factors impacting pharmacokinetics
Age
Weight
Gender
Route
Pharmacodynamics
Primary effects
-Therapeutic effect
-intended
-desired
-why the drug was prescribed
Primary/therapeutic effects
Are predicted, intended, and desired. Reason drug was prescribed.
Types of primary/therapeutic effects
Palliative
Restorative
Palliative
Address signs and symptoms but not disease
Restorative
Targets disease
Secondary effects
Unintended
Non-therapeutic
Can be
-predictable
-harmless
-harmful
Types of secondary effects
Side effects
Adverse reactions
Toxic reactions
Allergic reactions
Side efffects
Unintended, often predictable, usually well tolerated. Occurs at prescribed dose. Can be immediate or delayed.
Adverse reactions
Harmful unintended, usually unpredictable to drug administered at normal dose
More severe than side effects and often require discontinuation of drug
FDA definition of severe adverse reaction
Life threatening
Require intervention to prevent death or serious illness
Lead to congenital anomaly, Disability, hosp., death
Health professionals must document serious adverse reactions according to agency policy and report it to FDA medeatch
Toxic Reactions
Dangerous effects to organ or tissue. Can be cause by:
Overdosing(more than prescribed amount)
-respiratory depression from excessive morphine
-hypoglycemia from too much insulin
Accumulation of drug in tissue(continuous use or incomplete metabolism/excretion)
Abnormal sensitivity or allergic response:
-digoxin can lead to hyperkalemia
Drugs most common in allergic reactions
Antibiotics, biological agents, diagnostic agents
Components of med order
Patient name
Date and time
Med
Dosage
Route
Frequency
Prescriber signature and credentials (DEA number)
Assessing medications
Before
During
After
Med history
Physical
Analysis/Nursing Diagnosis
Risk for Injury
Ineffective Health Management
How often to check meds before administering
Check 3 times
-before you pour
•check med label against MAR
-after you pour
•verify label against MAR
-At the bedside
• check med again
Six rights
Person
Med
Dosage
Route
Time
Doc.
Other right
Reason
To know
To refuse
Type of routes
PO(most common)
Topical
Respiratory inhalers
Parenteral
Types of PO meds
Tabs, caps
Liquid-children and adult. Rapid absorption.
Buccal-cheek, rapid absorption
Sublingual-under tongue
Enteral-patients sho cannot swallow or have feeding tubes. Give meds through NG
Topical
Local and sometimes systemic effects
-lotions/creans
-transdermal patches
-eye and ear
-nasal
-vaginal
-rectal
Respiratory inhaler
Nebulization-mist from liquid drug. Absorbed by airway and alveoli.
Absorption via alveoli and blood supply
-atomizer:makes large droplets
-aerosols:suspends droplets in gas
-metered dose inhaler:type of nebulizer that gives measured dosage
Parenteral
Intradermal
Subcut
Intramuscular
Intravenous
IV
Med action takes place in seconds.
Ivs very useful in emergency.
No way to stop IV adverse reaction, unless there is antidote.
What metabolizes drug
Liver
What happens once drug reaches liver
It is in bloodstream
Do liquid or solid drugs metabolize faster
Liquid
Difference between brand name and generic drugs
Ph ionization
What organ regenrates
Liver
Who usually gets palliative meds
Terminally ill
Do drug side effects require intervention
Yes
Opioid side effects
Constipation
Respiratory distress
Do we need for check for contraindication
Yes
Drug metabolism
The reduction of drugs potency/therapeutic effect before being excreted from body
Primary source of drug excretion
Kidneys
