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What is a drug?
Any chemical that affects the physiologic processes of a living organism.
What are the 4 types of drugs?
- 1.Prescription-dispensed upon an order of a license helathcare provider
- 2.Non-prescription-over the counter drug
- 3.Controlled substance-potentially addictive substances/medications
- 4.Recreational-illicit drugs. not approved for treatment or disease
What is the chemical name of a drug?
Describes the drugs chemical composition and molecular structure.
What is the generic name of a drug?
Name given by the united states adopted name council.
What is the trade name of a drug?
registered trademark name.
Ibuprofen, Mortion, 50 mg, PO, daily. Mortion is the what name?
What is Pharmaceutics?
Study of how various drug forms influence pharmacokinetic and pharmacodynamic activities.
The study of the body absorbs, distriubtes, metabolizes, and excretes a drug is what?
As the drug metabolizies and it passes the liver first and then into the circulation is called?
Which routes go throught the first pass effect?
- -Hepatic arterial
- -portal venous
What are the routes of administering a drug?
- -Eternal route- drug absorbed into the systemic circulation through the oral or gastric mucosa
- -Parenteral rote- only doctors right orders for. All by pass the first-pass effect
- -Topical-localized areas that will only be used in that area
What is the most common blood protein?
What carries the majority of protein bound drug molecules. If another drug binds, there will be a limited amount of the drug that is not bound.
What is unbound or a "free drug"?
Drug that the body can use
Metabolism/Biotransformation of a drug is what?
- - an inactive metabolite.
- - a more soluble compound
- - a more potent metabolite
What are the factors that decrease metabolism?
- -Cardiovascular dysfunction
- -Renal insufficiency
- -Obstructive jaundice
What is excretion of a drug?
- The elimination of drugs from the body.
What excretion of a drug by intestines, taken by liver, released into bile and then eliminated in feces?
How is a drug absorbed in an enterohepatic recirculation?
Drug in bile, reaborbed into bloodstream, return to liver, then again secreted into the bile.
What is the primary process involved in drug excretion and the approximate location where these processes take place in the kidneys?
Glomerular filtration rate
What is half time?
The time it takes for one original amount of a drug to be removed from the body.
How long does it take most drugs to be considered effectively removed?
about five half lives
The physiological state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose. Is what?
the steady state
What are drug actions?
The cellular processes involved in the drug and cell interaction.
What is the drug effect?
The physiological reaction of the body to the drug?
The time it takes for a drug to elicit a therapeutic response, is when?
Onset, also known as the absorption time.
The time a drug concentration is sufficient to elicit a therapeutic response, is when?
Duration, the whole process of absorption to elimination.
The time it takes for a drug to reach its maximum therapeutic response, is when?
Peak, right before distribution starts.
What is the peak level?
The highest blood level. Blood level too high then drug toxicity occurs.
What is the trough level?
The lowest blood level. Blood level too low at therapeutic levels.
How does a drugs produce therapeutic effects?
1. Increase/decrease the rate at which the cells or tissues function.
What are the 3 ways drugs can exert their actions?
- 1.receptor interactions
- 2.enzyme interactions
- 3.nonselective interactions
What is pharmacodynamics?
Concerned with the mechanisms of a drug and its action in living tissues.
The ratio of a drug's toxic level to the level that provides therapeutic benefits is referred to as?
Therapeutic index. A low index indicates that a drug may have a more chance of having an adverse reaction and causes more monitoring.
What is tolerance to a drug?
A decreasing response to repeated drug doses.
what is dependence to a drug?
- A physiological or psychological need to a drug.
- -Physical dependence=needs drug to avoid symptoms
- -Psychologic dependenc=addiction
What are the TJC National Patient Safety Goals for administering meds?
- 1. The nursing process is the foundation for medication administration.
- 2.Ensuring patient safety is the nurse's primary responsibility in administering medication.
How many identifiers are required to administer meds? And what are they?
- 2 idenitifers
- Name and DOB
What to look for on the patients id bracelet?
2 idenitifers and any known allergies
How many times should you check the medication before administering? How many signatures required for high alert drugs?
check 3 times before administering. 2 signatures required.
When charting medications on the MAR what are you charting?
- 1.Therapeutic responses
- 2.Adverse reactions
It is okay to leave the patient if they have not finished all their meds.
False, never leave medications on the bedside table or meal trays
Single dose/Unit dose are distruibuted and stored where?
Distributed by pharmacy and stored in the med cart
Stock meds are distributed by and stored where?
Distributed by nurse. Stored on unit.
What are the components of a Physician orders?
- 1.Client full name
- 2.Date & time
- 3.Drug name
- 4.Drug dose
What are the six rights?
What are the forms of medications?
- -solid (pill form)
- --Troche (lozenge)
- --Aerosol (inhalers)
- --sustained release (not crushable pills)
- -Topical (eye drop)
- -Parenteral (IV & injections0
Oral (PO) is the easiest and most common route for patients.
Which route of a drug prevents destruction of a drug in the GI. Allow rapid absorption into bloodstream. No fluids allowed. Can not swallow.
Sublingual and Buccal
After administering a topical route (eye drops) how long should you apply pressure to the patients nasolacrimal duct.
30 to 60 seconds
What is the difference between side effects and adverse effects?
- S/e=are predictable and unavoidable
- A/e=unintendeds, undesirable, and unpredictiable
What is a idiosyncratic reactions?
an abnormal and unexpected response to a medication, not an allergic reaction.
The effect of two medications that is greater than the effect of one medication given separately is known as a?
What are the steps in a collaborative process in regards to drug administration?
- 1.physician writes the order
- 2.pharmacist checks and fills/inputs medication orders
- 3.nurse checks and administers the meds & documents
What are the nurses responsibilites in drug administrations?
- Correct adminstration
- Assessment & interventions for therapuetic reactions and adverse effects of the medication
- Ready to respond to adverse/side effects
- First to respond to drug responses
Where should you be looking when assessing patient?
- medical records
- diagnostic studies
- interview with families/client
Never tell the patient what drug they are getting, why they are getting it, effectiveness and route of the drug.
False. Always tell patient.
What are tips for teaching about drugs?
- be positive
- include significant others
- emphasize to take drug as prescribed
- provide written instructions
- space instructions over serval sessions
What are the two ethical nursing practices?
- American Nurses Association (ANA)
- International Council of Nurses (ICN)
What is the nursing responsibilities under the ANA?
Respect the rights, dignity, and wishes of each client.
Clients have the right to refuse drugs, be informed about their drugs, drug actions, and any side effects.
In the US, who has to approve all prescription drugs?
What are the FDA approval process steps?
- 1.Preclinical testing
- 2.Clinical studies
- 3.Investigational drug studies
- 4.Expedited drug approval
What are the clinical phases of investigational studies?
- Phase I-small groups of healthy adults
- Phase II-volunteers w/ the disease
- Phase III-Large groups of pts. w/ medical researchers
- Phase IV-post market studies
List the ethical principles involvoing human subjects.
- Autonomy-respect for the person
- Beneficence-duty not to harm others
- Justice-be fair to all patients
- Veracity-tell the truth
- Confidentiality-respect privileged information
The RN is responsible for what in a drug study?
- Promotes individual autonomy
- Protects clients from harm
- Avoids fraud in health care
- Encourage professionals to be thorough and clear in communicating information
- Promotes educated decision making among clients
- Promotes of self-determiniation of the client
What is drug polymorphism?
The effect of a patient's age, gender, size, and body composition and other variables on the client's ability to metabolize specific drugs
What theraphy maintains the integrity of body functions while patient is recovering from illness or trauma?
What theraphy supplies the body with a substance needed to maintain normal function?
What theraphy involves more intensive drug treatments and is implemented in the acutely ill or even critically ill?
What theraphy goal it to make the patient as comfortable as possible. Typically used in the end stages of an illness when all else has failed.
What theraphy typically does not remove a problem the patient has but does prevent progression of a disease or condition?