The right to deny medications, after you tell them side effects or adverse effects
What are clincal concerns? (4)
1. nurses monitor for drug actions/reactions
2. nurses provide teaching to patient/caregiver
3. nurses administer drugs in all forms
4. nurses adminter drugs via all routes
Whta is pharmacology?
Study of chemical properties of a drug and how they effect living systems.
What are drug names (generic)?
Related to a drug that any company is free to produce.
What are drug names (brand)? (2)
1.Relate to a specific, registered patent per drug company 2.has a superscript above the name.
What are OTC Drugs?
OTC Drugs are drugs that can be purchased without a prescription
What is a prescription drug?
drug which requires a signed prescription by authorized health care provider
What is a controled substance?
drugs which have been identifed by the government as having the ability to cause physical and or psychologcal dependance.
What is a product insert?
a detailed description as mandated by the FDA and must be included in the drug packaging.
What is an Allergic reaction?(3)
1.Body triggers a exaggerated immune responce to the drug
2.Usually after the second exposure to the drug
3. may be fatal
What is anaphylaxis?
a life threatening allergic reaction.
What are the signs and sypmtoms of Anaphylaxis? (7)
1. urticaria [hives]
2. Profuse vasodialation
3. decrease BP
4. increase Pulse
5.Respiratory tract edema [ may lead to Bronchioconstriction]
6. hypoexmia ( decrease oxygen in blood, may lead to syncope- fanting)
How do you treat anaphylaxis?(3)
What are the 4 forms of drugs?
1. oral solids
What is oral solids? (4)
3. time released
What are the 3 solutions?
What are 2 parenteral drugs?
1. IV soultions
Entric- coated tablets should not be administered with what and why? (2)
1.should not be administered with milk, antiacids, or other alkaline substances.
2. This is because entric-coated agents require the acid envirnment of the stomach to be affective.
Why should entric-coated tablets not be crused before administered?
with crushing it will alter absorption
What are never administer intravenously?
What must be shaken throughly before admistration? (2)
Before admisitering anything intravenously, or parientaly what must be the first precausion?
Everything must be sterilized before administered to the patient
What is important to prevent contanimation and evaporation of solutions?
What should be assessed before applying topical medications?
skin intregrety for rashes or open areas as this can alter the absorption time
Why should a nurse be careful about when giving a transdermal med?
to prevent self medication
What should a nurse always read before giving a med?
What are the rights of medication administration? (8)
1. the right drug
2. in the right dose
3. to the right client
4. at the right time
5. by the right route
6. right documentation
7. clients right to refuse
8. always check for allergies
For certain drugs, what should be checked before administration?
What is pharmacokinetics?
the study of how drugs are liberated, absorbed, distributed, metabolized, and excreted
What is liberation mean?
Liberation of a drug may be via? (2)
1. stomach acid
A drug may be altered by certain? (2)
2. other drugs taken
What is absorption and distribution?
process by which drug gets to site is meant to act on.
What is the sequence of slowest to fastest absorption? (which type of injection?) (3)
1.Many drugs are bound to what? 2.Because of this they need to get what to work?
1. plasma proteins (albumin)
What is biotransformation?
how fast a drug is metabolized
(biotransformation) drugs usually need to become water-soluble in order to exit via the?
(biotransformation) what is usually the site that changes the molecular structure of most drugs so they may be excreted in urine or stool?
What is elimination?
process of removing drug or its metabolites from the body
What are the exceretion routes? (5)
1. breast milk
5. urine (USUALLY)
Clients with liver or kidney damage may have problems with elimination, therefore drugs may? (2)
1. become toxic to them.
2. may need lower dose or alternate treatment
What are 4 important things to know about drug interactions?
1. certain drugs "potentiate" other drugs
2. certain drugs "anatagonize" other drugs
3. cerrtain drugs may be toxic when given together
4. A. OTC drugs
may interact with other drugs
When it comes to drugs, if a patient cannot swallow, never?
mix with food, give in liquid form
aa. (a line above both a's)
freely, as desired
twice a day
c (with a line above it)
at bedtime or hour of sleep
IV or I.V.
keep vein open
ml, mL (cc)
in the right eye
on call to operating room
in the left eye
everyday or once a day
p (with line above it)
as the occasion arises, as needed or requested
every # hours
a sufficient quantity
four times a day
s (with line above it)
S.C., s.c., or sub q
ss (with a line above both s's)
3 times a day
total parenteral nutrition
What abbreviations are on the "DO NOT USE LIST"? (14)
1. U (unit)
2. IU (international unit)
3. Q.D., q.d., qd (daily)
4. Q.O.D., QOD, q.o.d., qod (every other day)
5. Trailing zero (X.0 mg)
6. lack of leading zero (.X mg)
7. MS (morphine sulfate or magnesium sulfate)
8. > (greater than)
9. < (less than)
10. abbreviations for drug names
11. apothecary units
13. cc (ml)
14. symbol for micrograms
1 kilogram= ? grams
30 mL= ? oz
1 teaspoon= ? mL
1 tablespoon= ? mL = ? oz
60 minims= ? fluid dram= ? mL
1 fluid dram
1 g= ? mg
250 mL= ? oz
8 + fluid oz
1 mg= ? mcg
500 mL= ? pints
1 mcg= ? nanograms
1000 mL= ? quarts
1 fluid oz= ? mL
1 mL= ? minims
4 mL= ? fluid drams
1 L= ? mL
1 kg= ? lbs?
4 g= ? gr
1 g= ? gr
.3 g=? gr
60 mg= ? gr
30 mg= ? gr
1 mL- ? cc
1 L= ? qt
What is the pain pathway? (5 paths with 4 things released)
Stimulus->nociceptors in afferent endings and or tissue injury releases 1. histamine 2. serotonin 3. bradykinin 4. prostaglandins->afferent nerve action potential->perception of pain in creberal cortex->triggers many autonomic and learned responses
What is analgesic?
Drugs that relieve pain without loss of consciousness
What is an opiod anagelsic? (3)
1. tend to induce euphoria
2. may cause drug dependence
3. combine with opiod receptors in CNS to block transmission of pain impulses
What are opiod anagelsics available in? (3)
2. cough syrups
What are the side effects of opiod analgesic? (7)
3. lower respirations
4. impaired mentation
5. decreased BP
Does drug addiction occur frequently when opiods are used therapautically?
What do you do to avoid constipation for clients taking opiods?
increase dietary fiber and fluid intake unless it opposes it from the patients treatment plan.
Withdrawal symptoms of opiods can be prevented or treated by? (2)
1. withdrawing the opiod slowly
2. use methadone
Do not adminster opiods to a person with less than?
12 respirations per minute
Respiratory depression may be treated with?
What is equi-analgesic doses?
Different drugs may have the same pain killing effect but doses that are needed are different.
What is an agonist?
A drug which assists and enhances the actions of another
What is an example of an agonist?
Tylenol #3, which has acetaminophen helping codeine
What is an antagonist?
A drug which opposes the action of another drug, or reverses it
What are some examples of non-opiod analgesics? (3)
What are the main side effects of ASA?
1. GI bleeding
2. decreased clotting
Why is ASA no longer used to control flu-like symptoms, chickenpox symptoms, or viral illnesses in adolscents or children?
Because of the risk of reye's syndrome (brain inflammation)
What is the main toxicity of acetaminophen if overdosed?
The side effects of ibuprofen are similar to that of?
What is a anti-pyretic?
drugs which reduce fever
What in general should not be given to children?
What are the 5 rules of opioid drugs and the law?
1. all are kept under double locks
2. Use of all these must be recorded on a special record and the clients record
3. Lost or contaminated doses should be signed for by 2 nurses
4. Opioid are counted by 2 nurses, one from the oncoming shift and one from the departing shift. Both nurses sign the record
5. Must be aware of the hospitals policy for stop time of opioids
What is DMARD stand for?
Disease-modifying antirheumatic drugs
What does DMARDs do?
inhibit inflammation caused by RA
Many DMARDs cause? (3)
2. GI irritation
What is the route for ASA?
What is the usual anti-inflammatory dosage for ASA?
3.2-6 g daily
What are the side effects of ASA? (2)
1. GI distress
What are the nursing implications for ASA?
1. monitor for GI irritation
2. Contraindicated in ASA hypersensitivity, gastric ulcers, GI bleeding
3. observe client for ringing in the ears (tinnitus) when large doses are used
4. avoid use one week prior to surgery to prevent post operative bleeding
5.so not igve 2 clients on a anticoagulant because the action of the anticoagulants will be increased
6. monitor bleeding times
what is the route for Ibuprofen
what is the usual anti inflammitory dosage for ibuprofen?
it is 300mg 4x a day or 400-800mg 3 or 4 times daily
what are the sideeffects for ibuprofen? (5)
1. GI distress
what are the nursing implications for ibuprofen?
1. monitor client fir visual changes
2. available in non prescription form as advil, haltran, nuprin.
3. monitor for GI irritation
What are the precautions what taking ASA or ibuprofen? (6)
1. give with food or milk
2. monitor for GI bleeding/ stomach upset/ulcers
3. stop 1-2 weeks
4. stop 1-2 weeks prior to surgery as ordered by doctor
5. do not take with anticoagulants
6. watch labs for bleeding times/ for signs of bruising
What are corticosteroids?
synthetic or natural steroid drugs for reducing inflammation
Systematic use of corticosteroids may be associated with?(4)
1. gastric ulceration
2. suppression of the hypothalamic-pituitary-adrenal system
4. changes in location of body fat deposits
Cleints recieving corticosteriods should be monitored for? (2)
1. gastrointestinal bleeding
2. weight gain
Both diabetics and nondiabetics should be monitored for what while using corticosteroids?
blood glucose evelations
Clients recieving intra-articular injections of corticosteriods must be cautioned not to?
overly stress the joints
Teach clients on long term therapy of corticosteriods to? (4)
1. carry ID and info on their treatment
2. continue therapy
3. not to share meds
4. contact health care professional whenever they are under unusual stress
Impending adrenal crisis (going cold turkey when using corticosteroids) is indicated by? (9)
8. vomiting and/or 9. diarrhea
What are the dietary modifications for people on corticosteroids? (3)
1. sodium restriction
2. encouraging intake of Ca (because of risk to osteoporosis)
3. K supplements
When is the right time to administer corticosteroids and why?
early in the day to avoid insomnia
What are the S&S of corticosteroid use? (6) longterm? (1)
1. decreased immune function
2. increased blood glucose
3. weight gain
4. water retention (edema)
5. depression/mood swings
6. moon face
How do you take a person off corticosteroids?
wean off gradual because of bodies reliance to them.
What are the reasons to prescribe corticosteroids? (4)
2. auto-immune diseases
3. certain cancers
4. skin eruptions (non-bacterial)
What physiologically causes gout?
increases uric acid levels in blood (hyperuricemia)
What do the increases uric acid levels of gout lead to? (2)
1. gouty arthritis
2. tophi crystal deposits in joints
1. uric acid is a byproduct of? 2. It is usually excreted via the?
1. protein metabolism
What are the meds used for gout? what do these meds help with?