X Foundations - Chpt 23 - Med Amin Flashcards
1
Q
Who can prescribe Rx
A
Nurse Practitioner, PA’s
2
Q
purpose of USP
A
US Pharmacopeia
program for standardization
3
Q
purpose of NF
A
National Formulary
4
Q
FDA tests all new drugs. 10 yrs min testing
A
.
5
Q
How many years is proprietary for formulas
A
5yrs
6
Q
Schedule 1
A
Highest potential for abuse. NO MEDICAL USE ACCEPTED
7
Q
Schedule 2
A
Controlled Substance
8
Q
Schedule 3
A
High potential for abuse
9
Q
Schedule 4
A
Less potential for abuse
10
Q
Types of Names for drugs
A
Brand Name
Generic Name
Checmical Name
11
Q
Drug Action
A
Drugs ability to combine w cellular receptor. Local or systemic effect.
12
Q
Pharmacology
A
study of drug’s effect on living organisms
13
Q
Half Life
A
time taken to eliminate half the blood concentration of original drug dose. How well does the liver break down drug.
Heparin HL - 2hrs
14
Q
Doctors create drug Rx based on
A
HL
15
Q
Routes of entry - Speed
A
IV, SL, IM, PO, topical
16
Q
Onset of Action
A
time for body to respond to drug
17
Q
Peak plasma level
A
highest concentration of single drug dose before elimination rate equals rate of absorbtion
18
Q
Plateau
A
when blood concentration level is maintained
19
Q
Loading dose
A
extra high dose given at start of medication therapy.
20
Q
drugs classiffied by
A
- Body system with which they interact
- Drugs approved therapeutic use
21
Q
Routes
A
- Oral (SL, Buccal)
- Parenteral - other than GUT (injection, subQ, IM, IV)
- Topical
- Respiratory/Inhalation
22
Q
Pharmacokinetics
A
How drugs move through body
- ABSORBTION (intest, rectal, SL)
- DISTRIBUTION (from blood to tissue, fluid) *
- METABOLISM (processed by body, Liver/kidney)
- EXCRETION (meds w be in glomerular filtrate, kidneys)
(*worry about distro if person protein starved and drug needs to bind to protein molecules or if patient has low cardiac rate)
23
Q
If patient has problems with liver or kidney, they will have problems with what Pharmokinetic function?
A
Metabolism and Excretion
24
Q
Polypharmacy
A
taking multiple pills
25
Drug Interaction
effect one drug has on another.
26
Pharmacodynamics
why are we getting the drug?kill bacteria, softening stool, lower bp?
27
Side effect
non therapeutic effect of drug, mild and predicatble (i.e. Benadryl causes sleepiness)
28
Adverse reaction
bad reaction
29
Drug Tolerance
body accustomed to drug and require larger dose for efficacy
30
Toxic Effect
body cannot metabolize drug, accumulates in body
31
Idiosyncratic reaction
very unpredictable reaction. unexpected response
- Over response (reacty violently to normal dose)
- under response (1g morphine, still fee pain)
- atypical response (opposite effect, awake for days when taking sleeping pill)
32
Factors affecting drug action
- genetics
- age
- height (no Rx without height/weight)
- weight
- physical condition (muscle/fate)
- mental condition
33
Pharmacokinteics
Absorption
Distribution
Metabolism
Excretion
34
DAW
dispense as written. (don't substitute with generic)
35
MAR
Medication Admin Record
36
7 Rights
```
right client
right drug
right dose
right route
right time
right documentation
right to deny or refuse
```
37
Right TIME rules
have 1 hour on either side of scheduled medication time.
38
non compliant
when clients don't take meds consitently
39
NEVER administer meds prepared by another nurse
never
40
NEVER leave meds by clients bedside to administer on their own
never
41
Pharmacology
study of drugs and their action on the living body
42
Pharmaceutical Phase
until given to patient - The making of the drug until absorption of the durg takes place in patient's body
43
Pharmacokinetic Phase
movement of drugs's active ingredient from body fluids into entire system to site where intended action of drug takes place.
44
Pharmacodynamic Phase
interaction of drug's active ingredient with intended body tissue.
45
Drug Dosage based on
Half Life
46
Agonist
Drugs that bring on an effect.
47
Antagonist
Drug that prevents the action of a another drug
48
Drug Interaction types
Local vs Systemic
49
Drug Interaction
One drug alters another
50
Potentiation
one drug increases action or effect of another drug
51
Incompatibility
drugs that do not combine chemically with other drugs
52
Idiosyncratic response
a unique response to a drug
53
Tolerance
reduced response to a drug
54
Contraindications
conditions under which NOT to give a drug
55
Factors affecting patient's response to a drug
age, weight, height, health, phsycological, environ temp, gender, food in stomach, dosage forms
56
Waste Narcotics
must have another certified witness to discard narcotics
57
Standing Orders
already written by doctor for all patients in certain area/unit etc.
58
Verbal Orders
given orally, and signed for by doc when present
59
6 Rights
Right
- medication
- dose
- time
- route
- patient
- documentation
- right to refuse
60
Enteral
into GUT, via GI tract
| Powders, pills, tabs, liq, suspensions, supp
61
Percutaneous
through skin
| Topical, instillation (eyes/nose drops), inhalation
62
Parenteral
other than GUT
| Usually means needle, ampules, vials, IM, subQ, ID, IV
63
What routes of admin SKIP Pharmacokinetics
IV, SL and IM - they go directly into bloodstream
64
Eyedrops administered here
Conjunctival Sac
65
If you don't eye drops to circulate , close which duct?
Lacrimal duct so won't be absorbed into punctum
65
Instillation
Nose or eye drops
66
Inhalation
Through lungs
67
What temp to use ear drops?
Room temp
68
When using transdermal patches NEVER
- use in same spot twice
- use heating pads in same area as patch (w cause vasodilation and increase amt of drug being absorbed)
- too close to umbilicus
69
Angles for shots
IM - 90
SubQ - 45
ID - 10-15
70
IM injection sites
- Gluteal (dorsal/ventral or Maximus/medius)
- Vastus lateralis
- Rectus femoris
- deltoid muscle
71
3 checks before administration
1) take it out
2) pouring
3) b4 you put the bottle away
Administer medicine
72
Needle Shaft
Length of needle
Nurses choice depending on type of shot
0.5 - 2.5"
73
Filter needles used when?
Drawing from Glass ampules
74
Smaller the lumen #
Larger the lumen diameter
18-27guage
18 for donating blood, large so doesn't burst cells
75
Max amount you can inject IM?
3 ml
76
Never recap needle after use. Only scoop and recap...
After obtaining fluid in syringe and before injecting patient
77
Purpose of syringe barrel
To hold med
78
2 most common SQ injection mess
```
Insulin (rotates since taken for life)
and Heparin (in abdomen)
```
79
Insulin measured in
UNITS never in mg
80
When injecting in abdomen, stay xxx from umbilicus
2 finger widths away
81
Lipodystrophy
scar tissue making insulin no longer able to be asorbed
81
?Lipoatrophy
Scar tissue, from repeated injection in same site. Insulin no longer absorbed through this site.
82
Lipoatrophy
localized loss of fat tissue. breakdown of subq fat.
83
Lipohypertrophy
buildup of subq fat.
84
Cloudy Insulin
Long acting, added Zinc to absorb more slowly
| gently rotate btwn hands, don't shake. don't want to break up insulin proteins
85
can you mix clear and cloudy insulin in same syringe?
Yes, for a sort time. don't leave long or they will combine though.
86
never rub site after what shot?
Heparin (anti coagulant)
| causes bruising and moving blood around
87
aspirate air then administer Heparin shot to allow air bubble after shot to prevent
bleeding at injection site
88
Dorsogluteal Site
upper outer quadrant to avoid sciatic nerve
89
in IM injections, do you aspirate air?
Yes, to ensure you are not injecting into blood vessels, pull up needle to stay in muscle.
90
Ventrogluteal Site
Gluteus Medius and minimus musles in hip
91
Vastus lateralis site
vastus lateralis muscle, outer thigh
92
Rectus Femoris site
anterior thigh
93
Deltoid site
shoulder arm
94
Ztrack technique
stretch skin slightly, inject, then release to prevent bleeding back through injection site
95
Gerentological preferred Injection sites
Deltoid, Ventrogluteal. AVOID Dorsal Gluteal due to risk of sciatic nerve injury in diminished muscles
96
Infant preferred injetion sites
leg only. Vastus lateralis, rectus femoris
97
Teratogenicity (Teratogenic)
causes birth defects if taken during pregnancy
98
Synegist
drug that when given with an agonist, action of both is greater than if each were given alone
99
Biotransoformation
metabolism
100
inability to excrete creates what condition?
toxicity
101
AngioEdema
Swelling
102
Urticaria
Rash
103
NKA, NKDA
No known allergies, No know drug allergies
104
IV bolus
dose given all at once, not broken down into intervals
105
anaphalactic shock
drastic drop in bp
106
Metabolism
drug broken down into metabolites
107
Distribution
protein binding. worry in patients with low protein
108
Onset of Action
time it takes for drug to take action
109
Duration of Action
how long it works for.
110
Ceiling effect
when a higher does won't make a difference in effect on body. you just urinate out excess. (i.e. vitamins, tylenol
111
Ototoxicity
affects crannial nerve VIII. (ringing in ears)
112
Sub Q, Aspirate?
NO
