week 1 PHARM Ch 1, 2, 10, 12, & 13

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week 1 PHARM Ch 1, 2, 10, 12, & 13
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2010-10-27 20:13:44
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pharmacology
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some pharmacology questions
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  1. What are practical concerns?
    Nurses seen as resource persons
  2. What are legal concerns?
    Nurses are liable for any meds they administer
  3. What are ethical concerns? (2)
    • 1.Do not harm patients
    • 2. they have a right to informed consent
  4. What is informed consent?
    The right to deny medications, after you tell them side effects or adverse effects
  5. 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
  6. Whta is pharmacology?
    Study of chemical properties of a drug and how they effect living systems.
  7. What are drug names (generic)?
    Related to a drug that any company is free to produce.
  8. What are drug names (brand)? (2)
    1.Relate to a specific, registered patent per drug company 2.has a superscript above the name.
  9. What are OTC Drugs?
    OTC Drugs are drugs that can be purchased without a prescription
  10. What is a prescription drug?
    drug which requires a signed prescription by authorized health care provider
  11. What is a controled substance?
    drugs which have been identifed by the government as having the ability to cause physical and or psychologcal dependance.
  12. What is a product insert?
    a detailed description as mandated by the FDA and must be included in the drug packaging.
  13. 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
  14. What is anaphylaxis?
    a life threatening allergic reaction.
  15. 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)
    • 7. anxiety
  16. How do you treat anaphylaxis?(3)
    • 1. epinephrine
    • 2. oxygen
    • 3. anti-histamines
  17. What are the 4 forms of drugs?
    • 1. oral solids
    • 2. solutions
    • 3. transdermal
    • 4. parenteral
  18. What is oral solids? (4)
    • 1. tablets
    • 2. capsules
    • 3. time released
    • 4. gelatin
  19. What are the 3 solutions?
    • 1. syrups
    • 2. enemas
    • 3. tinctures
  20. What are 2 parenteral drugs?
    • 1. IV soultions
    • 2. injections
  21. 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.
  22. Why should entric-coated tablets not be crused before administered?
    with crushing it will alter absorption
  23. What are never administer intravenously?
    suspensions
  24. What must be shaken throughly before admistration? (2)
    • 1. suspensions
    • 2. emulsions
  25. Before admisitering anything intravenously, or parientaly what must be the first precausion?
    Everything must be sterilized before administered to the patient
  26. What is important to prevent contanimation and evaporation of solutions?
    proper storage
  27. What should be assessed before applying topical medications?
    skin intregrety for rashes or open areas as this can alter the absorption time
  28. Why should a nurse be careful about when giving a transdermal med?
    to prevent self medication
  29. What should a nurse always read before giving a med?
    product insert
  30. 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
  31. For certain drugs, what should be checked before administration?
    • 1. BP
    • 2. Pulse
    • 3. respiration
  32. What is pharmacokinetics?
    the study of how drugs are liberated, absorbed, distributed, metabolized, and excreted
  33. What is liberation mean?
    release
  34. Liberation of a drug may be via? (2)
    • 1. stomach acid
    • 2. blood
  35. A drug may be altered by certain? (2)
    • 1. pH
    • 2. other drugs taken
  36. What is absorption and distribution?
    process by which drug gets to site is meant to act on.
  37. What is the sequence of slowest to fastest absorption? (which type of injection?) (3)
    SQ->IM->IV
  38. 1.Many drugs are bound to what? 2.Because of this they need to get what to work?
    • 1. plasma proteins (albumin)
    • 2. "unbound"
  39. What is biotransformation?
    how fast a drug is metabolized
  40. (biotransformation) drugs usually need to become water-soluble in order to exit via the?
    kidney
  41. (biotransformation) what is usually the site that changes the molecular structure of most drugs so they may be excreted in urine or stool?
    liver
  42. What is elimination?
    process of removing drug or its metabolites from the body
  43. What are the exceretion routes? (5)
    • 1. breast milk
    • 2. salivia
    • 3. feces
    • 4. sweat
    • 5. urine (USUALLY)
  44. 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
  45. 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
    • B. vitamins
    • C. alcohol
    • may interact with other drugs
  46. When it comes to drugs, if a patient cannot swallow, never?
    mix with food, give in liquid form
  47. aa. (a line above both a's)
    of each
  48. ad lib
    freely, as desired
  49. a.c.
    before meals
  50. b.i.d., B.I.D.
    twice a day
  51. c (with a line above it)
    with
  52. caps.
    capsules
  53. dl, dL
    deciliter
  54. elix.
    elixir
  55. ext.
    extract
  56. g
    gram
  57. gr
    grain
  58. gtt
    drop (s)
  59. h
    hour
  60. H.S., h.s.
    at bedtime or hour of sleep
  61. ID
    intradermal
  62. IM
    intramuscularly
  63. inj.
    by injection
  64. IV or I.V.
    intravenously
  65. IVPB
    intravenous piggyback
  66. kg
    kilogram
  67. kvo
    keep vein open
  68. L
    liter
  69. mcg
    micrograms
  70. mEq
    milliequivalents
  71. mg
    milligram
  72. ml, mL (cc)
    milliliter
  73. NGT
    nasogastric tube
  74. O.D.
    in the right eye
  75. OCTOR
    on call to operating room
  76. O.S.
    in the left eye
  77. Q.D.
    everyday or once a day
  78. o.u., O.U.
    both eyes
  79. p (with line above it)
    after
  80. p.c.
    after meals
  81. p.o.
    by mouth
  82. p.r.n., PRN
    as the occasion arises, as needed or requested
  83. q
    every
  84. q.h.
    every hour
  85. q#h
    every # hours
  86. q.s.
    a sufficient quantity
  87. q.i.d., Q.I.D.
    four times a day
  88. s (with line above it)
    without
  89. S.C., s.c., or sub q
    subcutaneously
  90. S.L.
    sublingually
  91. sol.
    solution
  92. ss (with a line above both s's)
    one-half
  93. stat
    immediately
  94. susp.
    suspension
  95. tab.
    tablet
  96. t.i.d., T.I.D.
    3 times a day
  97. TPN
    total parenteral nutrition
  98. tr.
    tincture
  99. tsp.
    teaspoon
  100. 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
    • 12. @
    • 13. cc (ml)
    • 14. symbol for micrograms
  101. 1 kilogram= ? grams
    1,000
  102. 30 mL= ? oz
    1
  103. 1 teaspoon= ? mL
    5
  104. 1 tablespoon= ? mL = ? oz
    • 15 mL
    • 1/2 oz
  105. 60 minims= ? fluid dram= ? mL
    • 1 fluid dram
    • 4 mL
  106. 1 g= ? mg
    1,000
  107. 250 mL= ? oz
    8 + fluid oz
  108. 1 mg= ? mcg
    1,000
  109. 500 mL= ? pints
    1+ pints
  110. 1 mcg= ? nanograms
    1,000
  111. 1000 mL= ? quarts
    1+quarts
  112. 1 fluid oz= ? mL
    30
  113. 1 mL= ? minims
    16
  114. 4 mL= ? fluid drams
    1
  115. 1 L= ? mL
    1000
  116. 1 kg= ? lbs?
    2.2
  117. 4 g= ? gr
    60
  118. 1 g= ? gr
    15
  119. .3 g=? gr
    5
  120. 60 mg= ? gr
    1
  121. 30 mg= ? gr
    1/2
  122. 1 mL- ? cc
    1
  123. 1 L= ? qt
    1
  124. 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
  125. What is analgesic?
    Drugs that relieve pain without loss of consciousness
  126. 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
  127. What are opiod anagelsics available in? (3)
    • 1. pills
    • 2. cough syrups
    • 3. injections
  128. What are the side effects of opiod analgesic? (7)
    • 1. euphoria
    • 2. dependence
    • 3. lower respirations
    • 4. impaired mentation
    • 5. decreased BP
    • 6. constipation
    • 7. dizziness
  129. Does drug addiction occur frequently when opiods are used therapautically?
    no
  130. 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.
  131. Withdrawal symptoms of opiods can be prevented or treated by? (2)
    • 1. withdrawing the opiod slowly
    • 2. use methadone
  132. Do not adminster opiods to a person with less than?
    12 respirations per minute
  133. Respiratory depression may be treated with?
    intravenous naloxone
  134. What is equi-analgesic doses?
    Different drugs may have the same pain killing effect but doses that are needed are different.
  135. What is an agonist?
    A drug which assists and enhances the actions of another
  136. What is an example of an agonist?
    Tylenol #3, which has acetaminophen helping codeine
  137. What is an antagonist?
    A drug which opposes the action of another drug, or reverses it
  138. What are some examples of non-opiod analgesics? (3)
    • 1. aspirin
    • 2. acetaminophen
    • 3. ibuprofen
  139. What are the main side effects of ASA?
    • 1. GI bleeding
    • 2. decreased clotting
    • 3. tinnitus
  140. 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)
  141. What is the main toxicity of acetaminophen if overdosed?
    liver
  142. The side effects of ibuprofen are similar to that of?
    ASA
  143. What is a anti-pyretic?
    drugs which reduce fever
  144. What in general should not be given to children?
    ASA
  145. 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
  146. What is DMARD stand for?
    Disease-modifying antirheumatic drugs
  147. What does DMARDs do?
    inhibit inflammation caused by RA
  148. Many DMARDs cause? (3)
    • 1. hepatoxicity
    • 2. GI irritation
    • 3. stomatitis
  149. What is the route for ASA?
    oral
  150. What is the usual anti-inflammatory dosage for ASA?
    3.2-6 g daily
  151. What are the side effects of ASA? (2)
    • 1. GI distress
    • 2. tinnitus
  152. 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
  153. what is the route for Ibuprofen
    oral
  154. what is the usual anti inflammitory dosage for ibuprofen?
    it is 300mg 4x a day or 400-800mg 3 or 4 times daily
  155. what are the sideeffects for ibuprofen? (5)
    • 1. GI distress
    • 2. diziness
    • 3. headache
    • 4. drowsiness
    • 5. tinnitus
  156. 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
  157. 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
  158. What are corticosteroids?
    synthetic or natural steroid drugs for reducing inflammation
  159. Systematic use of corticosteroids may be associated with?(4)
    • 1. gastric ulceration
    • 2. suppression of the hypothalamic-pituitary-adrenal system
    • 3. hypertension
    • 4. changes in location of body fat deposits
  160. Cleints recieving corticosteriods should be monitored for? (2)
    • 1. gastrointestinal bleeding
    • 2. weight gain
  161. Both diabetics and nondiabetics should be monitored for what while using corticosteroids?
    blood glucose evelations
  162. Clients recieving intra-articular injections of corticosteriods must be cautioned not to?
    overly stress the joints
  163. 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
  164. Impending adrenal crisis (going cold turkey when using corticosteroids) is indicated by? (9)
    • 1. hypotension
    • 2. restlessness
    • 3. weakness
    • 4. lethargy
    • 5. headache
    • 6. dehydration
    • 7. nausea
    • 8. vomiting and/or 9. diarrhea
  165. 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
  166. When is the right time to administer corticosteroids and why?
    early in the day to avoid insomnia
  167. 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
    • 1. hypokalemia
  168. How do you take a person off corticosteroids?
    wean off gradual because of bodies reliance to them.
  169. What are the reasons to prescribe corticosteroids? (4)
    • 1. allergies
    • 2. auto-immune diseases
    • 3. certain cancers
    • 4. skin eruptions (non-bacterial)
  170. What physiologically causes gout?
    increases uric acid levels in blood (hyperuricemia)
  171. What do the increases uric acid levels of gout lead to? (2)
    • 1. gouty arthritis
    • 2. tophi crystal deposits in joints
  172. 1. uric acid is a byproduct of? 2. It is usually excreted via the?
    • 1. protein metabolism
    • 2. kidneys
  173. What are the meds used for gout? what do these meds help with?
    • 1. NSAIDs (reduce inflammation)
    • 2. Prednisone:corticosteroid (reduces inflammation)
    • 3. Colchicine (to alter body's response to deposits of uric acid crystals)
    • 4. Allopurinol (to reduce body production of uric acid once the acute attack has passed)
  174. What are the food high in purines that people with gout SHOULD NOT eat? (18)
    • 1. anchovies
    • 2. bacon
    • 3. beer
    • 4. codfish
    • 5. goose
    • 6. haddock
    • 7. herring
    • 8. mackerel
    • 9. mussels
    • 10. organ meats (liver, kidneys)
    • 11. salmon
    • 12. sardines
    • 13. scallops
    • 14. smelts
    • 15. trout
    • 16. turkey
    • 17. veal
    • 18. venison
  175. What is approx. width of a baby finger?
    1cm
  176. What is approx. the weight of a thumbtack or paperclip?
    1g
  177. What is approx. 1 yard?
    1m
  178. What is approx. 2.2 lbs?
    1kg
  179. what is approx 30 ml?
    30 cc or 1 oz
  180. What is approx 1 tsp?
    5 ml
  181. 15 ml is approx how many tsp and tbsp?
    3 tsp and 1 tbsp
  182. AM
    before noon
  183. aq
    aqueous (water)
  184. A.S.A.
    aspirin (acetylsalicylic acid)
  185. buc
    inside the cheek
  186. cm?
    centimeter
  187. comp
    compound
  188. d?
    day
  189. D/C or dc?
    discontinue
  190. dil?
    dilute
  191. D5W?
    5% dextrose in water
  192. DS?
    double strength
  193. EC?
    enteric coated
  194. fl or fld
    fluid
  195. L (with a circle around it)
    left
  196. LA?
    long acting
  197. mixt?
    mixture
  198. NPO?
    nothing by mouth
  199. N.R.
    do not refill
  200. NS or N/S
    normal saline (.9% sodium chloride)
  201. OS
    mouth
  202. OTC
    over-the-counter
  203. oz
    ounce
  204. per
    by, through
  205. PM
    after noon
  206. q a.m. or QM
    every morning
  207. ung?
    ointment
  208. USP?
    United States pharmacopeia
  209. QNS?
    quantity not sufficient
  210. qt?
    quart
  211. R (with a circle around it)
    right
  212. R or PR?
    by rectum
  213. Rx?
    treatment, prescription
  214. subl?
    sublingually
  215. SR?
    sustained release
  216. syr?
    syrup
  217. supp?
    suppository
  218. vag?
    vaginal
  219. x?
    multiply, times
  220. x (with line above it)
    except
  221. T or Tbs or tbsp
    tablespoon
  222. t?
    teaspoon
  223. tab?
    tablet
  224. tinct?
    tincture
  225. u.d. or ut dict?
    as directed

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