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a. Partial agonists
- Other drugs attach at the receptor site.
- no new chemical reaction
- prevent activation of the receptor, stopping other reactions from occurring
comes from the Dutch, for centuries most drugs used for treating health problems came from dried plants
Are those drugs used in the prevention or treatment ofdisease
Deals with the study of drugs on living organisms. Itcomes from Greek
Reactions that are the opposite of what would beexpected
a. Allergic response
- the body develops hives, rashes, itching, or swelling of the skin
- a rash or shortness of breath is occasionally seen in patients allergic to aspirin
a. Anaphylactic response
Is a response that is severe form of an allergicreaction that is life threatening a patient develops shortness of breath maystop breathing or may have cardiac collapse
a. Additive effect
When two drugs are given together, the combined effect of the drug is equal to that of the single more active component of the mixer or of the sum of the effects of the individual drugs.
a. Antagonistic Effect
i. Antagonistic effect takes place when a drug interferes with the action of another drug.
Takes place when one drug replaces another at the drugreceptor site increases the effect of the first drug
a. Synergistic Effect
i. Place when the effect of two drugs are taken at the same time is greater than the sum of the effect of each drug given alone.
Ages 12 to 16
Shared values, beliefs, customs, and behaviors of themembers
Adults older than 65.
1 month to 12 to 24 months of age
a. Less than 1 month of age
When a patient does not follow the health care planfor taking medications
Infants through adolescents
a. Medication plan
that is most likely to cause malformations or damagein the embryo or fetus
ways that helps patient be compliant with taking meds and what helps with teaching the patient
- The goal of patient teaching for drug treatment plans is to work with patients to help them make informed decisions about taking their drugs. Many of the variables of age, culture, and belief affect a patient’s willingness to take medications that are ordered. It is important to be;
- a. Friendly
- b. Have a positive, confident approach
- c. Respond to patient complaints
- d. Encourage questions
- e. Have a supportive, nonjudgmental method of getting information and talking to a patient who admits noncompliance
- f. Encourage patients to become actively involved in their own healthcare, seeking active patient participation.
- g. Working together to decide the plan of care
- h. Identifying and resolving things that make the patient less cooperative with the plan
- i. Take time to motivate and encourage the patient
- j. Working to help with patient satisfaction.
how spiritual and religioncan play apart in compliance
a. In times of sickness people often think about religion or become more spiritual, and they try to find answers to why they have become sick or why they fail to get well. Many research studies have been done about the influence of religion on health. The results suggest that people who pray have better symptom relief. People who have a strong social support network through their religion also seem to do better than those without such support.
about the importance ofevaluating for noncompliance
- a. Reasons for noncompliance may be;
- · Cost of drug
- · Difficulty in getting medication from the pharmacy
- · Poor memory
- · Lack of desire to take the drug regularly
- · Depression
- · Overwhelmed by the responsibility of taking care of themselves
imporntance of evaluating for noncompliance 2
- a. Reasons for drug noncompliance can be classified as errors of omission (a prescribed medication is not taken), errors of commission (a medication that has not been prescribed is taken), dosage errors (the wrong dose is taken), and scheduling errors (the medication is taken on the wrong schedule, for example, once daily instead of twice daily)
- Studies have usually found that 1) patients are unfamiliar with their prescribed medications and how to take them, and 2) patients make errors in taking medications as much as 25% to 59% of the time. If the health care provider does not learn that the patient is not taking the medication asincorrect diagnosis.
two fractions that havedifferent denominators must be converted to a number that each denominator hasin common
a fraction that has a fraction as it's numerator, it's denominator, or both
- the bottom number of a fraction
fraction - one or more equal parts of a unit
- the numerator is the same as or larger than the denominator
a. - a whole number and a proper fraction
a. - parts per hundred
- the numerator is smaller than the denominator
- a way of expressing a relationship of equality between two ratios
a. - a way of expressing the relationship of one number to another number or expressing a part of a whole number
what os insulin?
a. Insulin is a parenteral medication that replaces the insulin not being produced in a patient’s body
whats the deal with insulin-- how its measured?
a. Insulin comes in a standardized measurement called a unit. Insulin is available in 10 –mL vials in two strengths: U-100 (100 units per 1 Ml of solution) and U – 500 (500 units per 1 mL of solution) --- so U – 500 are 5X stronger and then U – 100. ((U-500 is rarely used))
what type of syringes for insulin?
a. – Insulin should be drawn up in special syringes which are measured in units. IF an insulin syringe is unavailable, you can use a TB syringe that is calculated in minums.
when drawing up insulin, what special measures need to be taken?
a. 3 – ALWAYS! ALWAYS! ALWAYS! with insulin the order, the bottle, and the drawn up insulin should be rechecked by another nurse… small errors can cause BIG problems!!
when the insulin and the syringe are the same, how do you draw the insulin up?
a. When the insulin and the syringe are both the same (U-100) all you have to do is draw up the amount ordered!
what to do with twy different types of insulin?
a. When the order calls for two different types of insulin, both may be given at the same time, in the same syringe. One will be short acting insulin (regular) and the other will be a longer acting one.
what if you have an insulin order, and no insulin syringe?
(Insulin desired / insulin available) X 16 minums =
- a. IF an insulin syringe is unavailable you will have to use a TB syringe… GOSH DARN IT ALL!!!
- b. The formula for calculating insulin when a TB syringe is used is as follows:
a. Is an accepted method of calculating medications for children? b. It uses ratios to calculate children’s dosages taking into account average adult weight, and average dose to figure a child’s dosage ( according to the book, the average adult weighs 150lb.)
a. : Small, breakable glass containers that contain one dose of medication in each; used for intramuscular injections or intravenous infusions.
a. : Freedom from contaminated or infectious material; prevention of infection.
a. : Portion of a syringe that is the container for holding medication; it is marked by calibrations to indicate the volume of medication inside it.
a. Buccal administration: Applying medication directly against the buccal or mucous membranes of the cheek, where it is rapidly absorbed into the bloodstream, bypassing the liver.
a. : Gelatin containers that hold powder or liquid medicine.
a. Elixirs: Clear liquid made up of drugs dissolved in alcohol and water; may have coloring and flavoring agents added.
a. Solutions that have small droplets of water and medication dispersed in oil, or oil and medication dispersed in water.
Intramuscular (IM) Injections
a. Intramuscular (IM) Injections: Injections that deposit medication past the dermis and subcutaneous tissue, deep into the muscle mass where the rich blood supply allows for rapid and complete absorption.
Intravenous (IV) Route
a. Intravenous (IV) Route: Used to administer a drug directly into the bloodstream via a needle.
a. : Medicine mixed with a sugar base to produce small, hard preparations of various sizes or shapes. They are sucked to obtain that medication.
a. Mix-o-vial: A two-compartment vial that contains a sterile solution in one compartment and medication powder in the other, separated by a rubber stopper. Solution and powder are mixed together immediately before use.
Nasogastric (NG) tube
a. Nasogastric (NG) tube: An enteral route for medication; tube that goes through the nose and opens directly into the stomach.
a. Needle: Instrument used with a syringe to deliver medication; made up of the hub, which attaches to the syringe; the shaft, which is the hollow part through which the medication passes; and the beveled tip, which pierces the skin.
a. Parenteral route: Administration of drug by injection directly into dermal, subcutaneous, or intramuscular tissue, or epidurally into the cerebrospinal fluid, or through intravenous injection into the bloodstream.
a. Percutaneous administration: Administration of drug through topical (skin), sublingual (under the tongue), buccal (against the cheek), or inhalation (breathing) methods.
a. Piggyback infusion: A second intravenous infusion added to allow administration of medication while the original infusion is clamped off. Patient requires only one needle for both infusions.
a. Pill: Oral, solid medication; may be a tablet or a capsule.
a. Plunger: Inner portion of a syringe that fits into the barrel. When the plunger is pushed into the barrel, the medication is forced out through the needle.
a. Subcutaneous injection: Injections that place no more that 2 mL of fluid into the loose connective tissue between the dermis of the skin and the muscle layer.
a. Sublingual administration: Applying medication to mucous membranes under the tongue.
a. Suspensions: Liquids with solid, insoluble drug particles dispersed throughout. Must be shaken before putting pouring because the solids tend to settle out in layers.
a. Syringes: Calibrated containers used for injecting liquids into the body. May be plastic or glass and are available in 1, 3, 5, 10, 20, and 50 mL sizes.
a. Syrups: Liquids with a high sugar content designed to disguise the bitter taste of a drug; often used in pediatric patients.
a. Tablets: Dried, powdered drugs compressed into shaped small enough to be swallowed whole; may contain coating to increase solubility or absorption.
a. Tip: portion of a syringe that holds the needle. The needle either screws onto the top or firs tightly so it does not fall off.
a. Topical Medications: Drugs applied directly to the area of skin requiring treatment; most common forms are creams, lotions, and ointments.
Vials: Small single- or multiple –dose glass containers ofmedication
1. Know the procedure to draw up and administer parenteral medications
- a. Check accuracy of order and get clarification if needed
- b. Wash hands to be sure to not contaminate medication
- c. Assemble medication equipment
- d. Correctly prepare medication; if the patients have disorders of the esophagus, are in a coma, or cannot swallow, liquid medications may be ordered for them; some tablets may be crushed with 30 mL of water and given through and NG tube.
- e. Check the medication with order and bottle, and double check. Because many of the patients getting medications by NG tube are seriously ill or in a coma, it is especially important to be accurate in all phases of giving the medication. The patient may not be able to tell you if something is going on with the medication process.
- f. Deliver medication to the patient.
- g. Make sure that the NG tube is in the stomach and take out stomach contents with a syringe. Do not give medications if the NG tube is in the lungs (listen for breath sounds by holding tubing to ear).
- h. If nasogastric suction is attached to the tubing, disconnect it and clamp the suction tube shut. Clamp the NG tube and let the medicine run by gravity. Run water (Usually 50 mL) to flush and clean out the tubing after medicine has all passed through the tube. Reclamp the tube and wait 30 min to reattach suction tube.i. Clean up and document, document, document! Check the patient later and note any responses or adverse effects.
1. Know the suggested guide for selecting syringe and needles
- a. Check order on Kardex, for accuracy of order as written, and the time it needs to be given.
- b. Wash hands!!!
- c. Assemble equipment; order card, med tray, proper size needle and syringe, alcohol swabs, tubing and med cart. Make sure it is all STERILE.
- d. Get correct medication and compare med card with label on container.
- e. Attach needle to syringe and ready the medication for withdrawal.
- f. Check med card with label AGAIN
- g. Draw up medication from container and get out air bubbles, checking for a third time for accuracy against label.
- h. Change needle for new sterile needle.
- i. Go to patient and het then into the proper position for administering meds. PROPERLY IDENTIFY YOUR PATIENT!! Never give a medication without first confirming who your patient is.
- j. Explain procedure, answer any question, and inspect and prepare the sight for injection.
- k. Put on gloves, use an alcohol wipe to cleanse injection area.
- l. Insert needle firmly into the correct layer (dermal, subq, etc.) gently pull back on plunger to aspirate for blood. If you get blood or hit a vein and there is now blood in the syringe, get rid of that one and prepare a new one.
- m. Assist patient to a comfortable position.
- n. Clean up and document. Make sure to come back and watch and note any effects, normal or adverse.
1. Know about the different types of pills
- a. Capsules: gelatin containers that hold powder or liquid medicine. Timed-release or sustained-release capsules contain granules that dissolve at different rates, providing slow and constant release of medications. Capsules are available in a variety of sizes and shapes. They provide an easy way to administer medications that have an unpleasant taste or odor. Capsules must not be opened, crushed, or chewed because irritation and excessive or lessened drug activity may be produced.
- b. Elixirs: liquids made up of drugs dissolved in alcohol and water they may have coloring and flavoring agents added. The alcohol makes the drug more dissolvable than water alone
- c. Emulsions: solutions that have small droplets of water and medication dispersed in oil, or oil and medication dispersed in water. These preparations help disguise the bitter taste of a drug or increase its solubility
- d. Lozenges: medication mixed with a hard sugar base to produce small, hard preparation of various sizes or shapes. Medication is released slowly when the lozenge is sucked.
- e. Suspensions: liquids with solid, insoluble drug particles dispersed throughout. These solid particles tend to settle out in layers, so the medication must be shaken before pouring.
- f. Syrups: liquids with high sugar content designed to disguise the bitter taste of a drug. These are often used for pediatric patients.
- g. Tablets: dried, powdered drugs compressed into small shapes. These shapes are small enough so that they can be swallowed whole. Tablets usually contain trademarks, designs, or words for product identification and may have a line through the middle so the tablet may be divided. Tablets may also contain coating of various types to increase solubility or absorption.
1. Know about inhalers
- a. Metered-dose inhalers: used to deliver specific amounts of corticosteroids or bronchodilators to nasal or lung tissue.
- b. Pressurized with gas, which propels the medication out and breaks it up into small particles that can be carried deep down into the lungs as the patient takes a deep breath
- c. Medication is carried directly to the site of action with very little systemic effect.
- d. Onset is rapid
- e. Some medications are designed to be administered though the mouth, and others through the nose
- f. Important to read the directions completely
- g. Medication should be shaken before use
- h. If pt can stand, have them lean slightly forward so they can see their feet.
- i. If the pt must sit upright, have them hold the nebulizer in the hand 1-2 inches in front of the mouth or at the opening of the nose.
- j. If pt cannot cooperate, she may place her lips around the mouthpiece.
- k. Pt should exhale the squeeze the canister in its holder as the next inspiration begins.
- l. The pt should hold breath as long as possible before exhaling to allow the medication to settle before administering again.
- m. Important to time squeezing of the nebulizer to ensure that medication travels in with the next breath and is not just squirted on the back of the throat or nose.
- n. Nebulizer must be cleaned with water after each use.
- o. Important that the pt keeps an adequate supply of medication on hand
- p. By placing the canister in a glass of water you can tell approximately how much is in it. (see p 131)
- · They are applied directly to the area of skin requiring treatment. Most common forms include creams, lotions, and ointment, although there are many other. Each form has specific advantages and characteristics.
- Astringents: Creams: Disks or patches: Powders: Shampoos: Soaps: Solutions:
: alcohol-based medications used for cleaning oilyskin, and for cooling and soothing skin. They have a drying effect.
- Creams: semisolid emulsions (mixture of two liquids) that contain medication and water –soluble base. They are rubbed into the skin
Disks or patches
- Disks or patches: a semi permeable membrane pad containing medication that is attached to the skin by its adhesive edges. The placement of the pad and length of time it is left in place are ordered by the physician. Medications may be left in place for 24 hours, providing gradual release of medication into the skin. Some estrogen products may be left on for several days. Nitroglycerin patches are often removed during the night to reduce the amount of tolerance the patient develops to medication. The dosage the patient gets depends on the concentration of the medication and the area of skin covered.
- Lotions: aqueous (watery) preparations that contain suspended materials. They cleanse or soothe the skin. Or act as a drawing agent or astringen. Lotions should be shaken thoroughly and applied sparingly by patting on the skin, not rubbing.
- Ointments: semisolid preparations of medicines in an oily base, such as petrolatum or lanolin. Ointments provide good skin contact and are not easily removed. They are used sparingly, sometimes according to an application guide, and are often covered with dressings.
- Powders: finely ground medication particles in a talc base. They are used for their dying, cooling, or protective effects.
- Shampoos: medications in an aqueous or alcohol base that are poured onto the hair, allowed to stand, and then rubbed into the hair and scalp before being rinsed off. They are designed to treat problems of the hair and scalp.
- Soaps: may be used to cleanse the skin and to moisten dry skin. Some soaps also leave a residue that helps reduce bacteria and oil
a. Capsules: gelatin containers that hold powder or liquid medicine. Timed-release or sustained-release capsules contain granules that dissolve at different rates, providing slow and constant release of medications. Capsules are available in a variety of sizes and shapes. They provide an easy way to administer medications that have an unpleasant taste or odor. Capsules must not be opened, crushed, or chewed because irritation and excessive or lessened drug activity may be produced.
a. Elixirs: liquids made up of drugs dissolved in alcohol and water they may have coloring and flavoring agents added. The alcohol makes the drug more dissolvable than water alone
a. Emulsions: solutions that have small droplets of water and medication dispersed in oil, or oil and medication dispersed in water. These preparations help disguise the bitter taste of a drug or increase its solubility
a. Lozenges: medication mixed with a hard sugar base to produce small, hard preparation of various sizes or shapes. Medication is released slowly when the lozenge is sucked.
a. Suspensions: liquids with solid, insoluble drug particles dispersed throughout. These solid particles tend to settle out in layers, so the medication must be shaken before pouring.
a. Syrups: liquids with high sugar content designed to disguise the bitter taste of a drug. These are often used for pediatric patients.
a. Tablets: dried, powdered drugs compressed into small shapes. These shapes are small enough so that they can be swallowed whole. Tablets usually contain trademarks, designs, or words for product identification and may have a line through the middle so the tablet may be divided. Tablets may also contain coating of various types to increase solubility or absorption.