COMPREHENSIVE MEDICAL ASSISTING Chapter 23 & 24
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What does AHFA ?
- American Hospital Formulary Service
- concise inforamtion arranged by drug classification
- distributed to physicians
What does USPDI stand for and what is it?
- United States Pharmacopeia Dispensing Information
- provides drug inforamtion for health cre provider
Anyone who manufactures, prescribes, administers, or dispenses controlled substances must register with the?
U.S. attorney general
anyone that can write a prescribing muste renew ever?
- Study of how drug act within body factor that influence
- existing pathology
Intradermal injection is
- dermal layer of skin
- 10 to 15 angle
- needle tip & lumen visible under skin
- for skin test/allergy test/MANTOUX
- anterior forearm
subcutaneous (SQ or SC) injection
- fatty layer
- 45 angle
- 25-gauge, 5/8-inch needle
- for drug that should not be absorbed rapidly
- upper arm
- massage the site with an antiseptic wipe after the injection to distribute the medication
intramusclar injection (IM)
- 1-1 1/2 needle
- 90 angle
- absorption fairly rapid
- Common sites
- and vastus lateralis muscles
- Z method used when irritate or damage to tissue may occur
What is an antagonistic
- active opposition
- hostility toward something.
What is a drug?
a chemical substance that affects body function/s
A medical assistant who has a valid suspicion that controlled substances are being diverted by another member of the health care team has an ethical responsibility
report the matter authority
A patient is to be NPO for 12 hours before the study, Explain this in lay terms
nothing by mouth for 12 hours before the study
two drugs working together increase each other to higest level ?
How do antianginal agents work?
What is a medication called that is administered by any method other than the gastrointestinal system?
What is an old system of measurement that uses grains, minims, and drams?
apothecary system of measurement
What is the synergistic action of two substances in which the total effects are greater than the sum of the individual effect of the two substance
Drugs that relieve pain are called
What are the seven rights of administration medication?
- right patient
Which type of medication mimics the activity of the sympathetic nervous system?
adrenergic=a similar substance
Antiemetic agents are used to
- nausea and vomiting
What was the purpose of the Kefauver-Harris Amendment of 1962?
- It required testing of medications for effectiveness before their release for
Pharmacies may fill schedule II drugs only when they have an original prescription signed
by a doctor. Name some of the schedule II drugs?
What is an ampule?
- a glass container
- that must be
- broken at the neck to
- aspirate the solution
- can not be use twice
Why are thrombolytics prescribed?
They prevent the formation of blood clots or dissolve blood clots
At what level of scheduled drugs are opium, marijuana, lysergic acid diethylamide
(LSD), peyote, and mescaline placed?
Where must control substance be located?
must be kept in a locked box in a locked cabinet
Is it legal for a doctor to ask you to complete a prescription form (including the medication, quantity, and directions) for him or her to sign?
Yes. The doctor will review the information and sign his signature.
A drug in ointment or lotion form usually produces
a localized effect
What is the buccal route of administration?
inside the oral cavity between the cheek and gum
After 1 hour, a patient's intravenous catheter has infiltrated. What should you do?
Stop the flow of fluids, remove the intravenous catheter, and notify the doctor
Why would medications not be broken down and absorbed properly by the body?
The kidneys may be compromised by disease
Reactions to medications that are predictable (e.g., nausea) are called
You are going to give a hip injection of testosterone, an oil-based medication.
What size needle will you need to use?
- 21-gauge because it oil based
- 1 to 1 1/2 -inch needle depend on size of patient
With a pediatric doses of medication what do you need?
- age in months
- weight in pounds
- height in inches
The appropriate needle for administering an intramuscular injection to an obese
patient would be:
- 1 1/2 inch needle
What is used to neutralize or reduce the acidity of the stomach?
- HINT: feel like ant crawling in stomach
The doctor orders Vistaril 25 mg IM for a patient, but you misread the label,
giving the patient 50 mg IM. What should you do?
- Chart it as ordered and as given. Tell the doctor and then chart "doctor
>>Who do a physician needs to register with every 3 years?
U.S. attorney general
>>When a drug is contraindicated it?
should not be used
>>Emetics are used to?
>>A symptom of an allergic reaction is?
- anaphylaxis = life threatening
>>Two drugs when taken together that can create synergism are:
sedatives & barbiturates
>>Drugs with a potential for abuse and currently accepted medicinal use are:
schedule I and IV
>>A drug is given a brand name when it:
is approved by the FDA
>>When administering an unfamiliar drug, you should look up information on:
route of administration
>>What is the three checks for safe administration of medication?
- check the label when taking from shelf
- when prepare it
- and when replacing it on the shelf/disposoing
>>When preparing medications you should:
- work in a quiet
- well-lighted area
>>Patient safety is protected by ensuring:
you are administering the right drug
>>Which method is the most accurate means of calculating pedicatric dosages?
- BSA method
- body surface area
- (BSA x Adult dose) ./. 1.7 = child's dose
Medicine administered under the tongue follows the?
Where is the vastus lateralis?
You are told to administer a medicine be otic route. This medicine should be given by?
directly on the skin
- study of drugs and their
- study of drugs and their origin, nature, properties and effects upon living organisms action
- and side effects
- identifies the chemical components of the drugs
- first name given
- assigned during research
- and development
//Trade Name / Brand Name?
- for commercial use and distribution
- registered with US patent Office
- has official trademark symbol
Food and Drug Administration
Drug Enforcement Agency (DEA)?
- controlled substances Act
- branch of the department of justice
- concerned only with controlled substance
- revising list of drugs in the schedule of contolled substances
Is oxygen consider medication?
What does V.O stand for?
Factors that can influence a drug's action? (pharmacodynamics)
- exiting pathology
- administer only under the direct order of a doctor
Study of the action of drugs within the body are based of? (pharmacokinetics)
- administration route
- absorption rate
- duration of action
Physician's Desk Reference (PDR) ?
- identifies drug name
- characteristices of drugs
- contains photos or tablest, capsules, etc
How can Medications can be given?
- Administered - given in office
- dispensed - given for later use
- prescribed - written order to be filled by a pharmacist
What information must be on a prescriptions/RS form?
- patients name
- patients address
- physician's signature
- name of medication
- desired form
- and strength
What does DAW mean?
dispense as written
amount to dispense
What is Pharmacokinetics based on?
- study of the action of drugs with the body from administration to excrection
- route or administration
- rate of absorption
- duration of action
- elimination from body
What will you need to be familiar with when dealing with medications ordered ?
Safety Guidelines needed when dealing with medication
- 1.Know office policies
- 2.Give only medications physician has given a written order.
- 3.any doubt check with the doctor
- 4.Pay attention when preparing & administering.
- 5.Work in a quiet, well-lit area.
- Check the label when taking from shelf, preparing it, and replacing it on the shelf or disposing of the empty container
- 7.Place order & medication side by side 8.Check the strength and route
- 9.Read the labels carefully.
- 10. Check patient’s record for allergies. 11. Check the expiration date
- 12. Be aware changes in the medication.
- 13.Measure exactly.
- 14. Keep sharps containers close to the area.
- 15. For all procedures, wear gloves.
- 16. Stay with the patient while taking oral medication.
- 17. Never return medication to the container after it has been removed.
- 18. Never recap, bend, or break unused needles.
- 19.Never give a medication poured or drawn by someone else.
- 20. Always lock the medication cabinet.
- 21. Limit access to medication cabinet keys.
- 22. Never document medication given by someone else.
Metric system most commonly used?
based on multiples of 10 and decimals are
- Length – meter (m)
- Weight – gram (g or gm)
- Volume – liter (L or l)
Rules for converting Kilograms to pounds?
multiply the kilograms by 2.2
Rules for converting Pounds to kilograms?
divide the pounds by 2.2
Method for Calculating Adult Dosages
(Desired ÷ On hand) × Quantity = Dose
Rules for Calculating pediatric dosages for children 12 months to 12 years old?
- Young’s rule
- [Child’s age ÷ (Child’s age + 2) × Adult dose = Child’s dose
- Clark’s rule
- (Child’s weight ÷ 150) × Adult dose = Child’s dose
What rules are used to calculate pedicatric dosages for infants younger than age 2?
- Fried’s rule (Child’s age in months ÷ 150) × Adult dose = Child’s dose
Routes of Medication vary by medication because of what factors?
- Speed by when the drug is absorbed
- ?Some drugs have multiple routes of administration
What method of administring drug is prefered by the patient
- Easiest to administer
- Usually slower to take effect
- Cannot be used
- ?Nauseous or
- Ordered to take noting by mouth
What is sublingual route?
- placed under tongue
- absorbed directly into bloodstream through the oral mucosa
- covering the sublingual vessals
Things about the buccal route?
- placed in the pouch between the cheek and gum
- absorbed through the vascular oral mucosa
When is Transdermal Administration used:
- Produces a systematic effect
- Absorbed through the skin
- Slow absorption to maintain a steady, stable level of medication
Why is inhalation used to administre medication?
- throught the lungs
- Administration of medication, water vapor, or gas
- Absorbed quickly through the alveolar walls
Principles of Intravenous (IV) therapy?
- Sterile solution
- injected through a catheter or needle inserted into a vein by venipuncture
- Quickest action
- Enters the bloodstream immediately
- Fluids (chosen by the physician)
- IV catheter (angiocatheter)
- Tubing and valve
Determining the amount of fluid to be administered
(Volume in milliliters ÷ Time in minutes) × Drop factor (gtt/min) = Drops per minute
- ?Can occur when the intravenous catheter has caused inflammation of the vein or when an infection is present
What information should be recorded in the patient's medical record after administering any medication?
- name of medication
- site (if injected)
What are the three systems used to measure medications?
- household system
An example of an antagonist effect is?
an adrenergic and blocking agent ordered together
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