Understanding Pharmacology Quiz 1 chps 1,2,6,7,30

What are the advantages/disadvantages of parenteral administration?

Advantages: Speed, 100 percent bioavailibility, decreased first pass loss. Disadvantages: Speed, invasive administration, increased cost, discomfort.

What are the advantages/disadvantages of rectal administration?

Advantages: Usually painless. Disadvantages: Embarassing.

True or false, always ask a patient if they are taking an OTC drug daily.

True

True or false, each state has the ability to determine who writes drug orders.

True.

True or false, rectal delivery may be enteral or percutaneous.

True; Drugs placed within the lowest 1.5 inches of the rectum can be considered percutaneous, whereas drugs placed higher can be considered enteral.

True or false, some cells can act as both agonist and antagonists.

True; epinephrine is an example. It acts as an agonist when biding to the heart muscle cells, and acts like an antagonists when attaching to muscle cells in the airways.

Transdermal

Type of percutaneous drug delivery in which the drug is applied to the skin, passes through the skin and enters the bloodstream.

-Wear gloves to avoid getting medication on hand/skin -Apply in a smooth, thin layer, and cover the area -remove old patches/doses of drug -never shave skin before application -write date, time and initials on new patch

What are the responsibilities related to giving drugs through the skin?

-Always wear gloves to avoid exposure to blood and other body fluids -Use needles and syringes safely -Do not recap needles -Always dispose needles and syringes into a sharps container -Always clean the insertion site with an alcohol prep pad in a circular motion

What responsibilities are related to giving parenteral drugs?

Because medications are faster acting

Why are patients sometimes given medications through IVs?

histamine

chemical made by the body that binds to receptor sites and causes inflammatory responses; short acting; main inflammation mediator and capillary leak

corticosteroids

drugs similar to natural cortisol that prevent or limit inflammation by slowing or stopping inflammatory mediator production

unit-dose drugs

drugs that are dispensed to fill each patient's drug orders for a 24-hour time period.

disease-modifying antirheumatic drugs (DMARDs)

drugs that reduce the progression and tissue destruction of the inflammatory disease process by inhibiting tumor necrosis factor

Stinging nettle can cause what when taken with digoxin?

Makes a normal dose of digoxin toxic. Stinging nettle can cause dehydration, lowering cardiac output and BP.

What is a consequence of a cell having more than one receptor?

Means a drug can affect a cell in multiple ways.

Absorption

Movement of a drug from the outside of the body into the blood stream.

Percutaneous Route

Movement of a drug from the outside of the body to the inside through the skin or mucous membranes.

Generic Name

National and international public drug name created by the United States Adopted NamesCouncil to indicate the usual use or chemical composition of a drug.

What is the target for morphine?

Neurons that receive pain impulses.

What drugs can be given transdermally?

Nitroglycerin in the form of a transdermal patch, pain medications, and continuous hormone treatments.

Sequestration

The trapping of drugs within certain body tissues, delaying their elimination and extending their duration of action.

What are the advantages/disadvantages of buccal administration?

Advantages: Less invasive/obtrusive. Disadvantages: Effect is reduced when patient eats or drinks.

True or false, herbal medicines are always safe.

False, herbal products can interfere with prescribed medications and produce adverse effects.

Prefix that indicates a beta-blocker.

-olol

Prefix that indicates lipid lowering effect in generic drugs.

-statin

What factors does drug therapy involve?

1. Identifying the specific health problem. 2. Determining what drug or drugs would be the best treatment for the problem. 3. Deciding the best delivery method and schedule. 4. Ensuring that the proper amount of the drug is given. 5. Helping the patient become an active participant in his or her drug therapy.

Which paraenteral structures can drugs be administered in?

1. Intra-arterial injection. (artery) 2. intravenous (IV, vein) 3. intradermal (skin) 4. subcutaneous (adipose/connective) 5. Intramuscular (IM) 6. Intracavity (Body cavity) 7. intra-articular (joint) 8. intra-osseous (bone) 9. Directly into specific organs.

What are symptoms of Adverse Drug Reactions?

1. Muscle breakdown with cholesterol lowering drugs (statin). 2. Lung Fibrosis with the use f amiodarone (drug to correct heart rate) 3. Pseudomembranous colitis with antibacterial drugs. 4. Seizures and heart rhytm problems with the use of a bronchodilator (theophylline)

The largest drug compartment that includes the blood volume, the watery spaces between cells, and the space inside the cells.

Intracellular space

What are common allergic responses?

1. Tightness in chest. 2. Difficulty breathing. 3. Low blood pressure. 4. Hives on skin. 5. Swelling of face, mouth, and throat. 6. Weak and thready pulse. 7. A sense that something bad is happening.

Cytoxic

A drug action that is intended to kill a cell or organism.

High Alert Drug

A drug that has an increased risk of causing patient harm if it is used in error.

Black Box Warning

A notice that a drug may produce serious or even life threatening effects in some people in addition to its beneficial effects.

What are the advantages/disadvantages of sublinguals?

Advantages: Less invasive. Rapid absorption. Disadvantages: Effect is reduced when a patient eats or drinks.

What are the advantages/disadvantages of transdermal administration?

Advantages: Bypasses gastrointestinal tract. Offers large selection of body areas. Disadvantages: Absorption is less predictable. Can lead to skin breakdown.

What are the advantages/Disadvantages of enteral administration?

Advantages: Convenient, high patient acceptance, least expensive route, large surface area for absorption. Disadvantages: Can cause gastrointestinal disturbance, first pass loss, can bind to other substances in the tract and not get absorbed, absorption dependent on motility; has great individual variation.

What are the advantages/disadvantages of percutaneous administration?

Advantages: Convenient. Disadvantages: Absorption dependent on circulation.

Agonist

An extrinsic drug that activates the receptor site of a cell and mimics the actions of naturally occurring drugs.

Antagonist

An extrinsic drug that blocks the receptor site of a cell, preventing the naturally occurring substance from binding to the receptor.

Give some examples of OTC drugs.

Aspirin, antacids, vitamins, and antihistamines.

Which drugs have been reclassified as OTC?

Benadryl, Zantac, and Prilosec

Vaporized

Changing of a drug from a liquid form to a gas that can be absorbed into the body by inhalation.

What conditions reduce drug distribution?

Dehydration and hypotension.

A plan to improve or prevent a health problem that includes the use of drugs.

Drug therapy.

Extrinsic Drugs

Drugs that are man made or derived from another species; not made by the human body.

anti-inflammatory drugs

Drugs that prevent or limit inflammatory responses to injury or invasion

Antihistamines

Drugs that reduce inflammation by preventing the inflammatory mediator histamine from binding to its receptor site; same as histamine blockers or histamine antagonists.

The most commonly used route of administration.

Enteral

Mechanism of Action

Exactly how, at the cellular level, a drug changes the activity of a cell.

Which name of a drug is commonly used by physicians, pharmacists, nurses, and other healthcare professionals?

Generic

Pharmacokinetics

How the body changes drugs; drug metabolism.

Smaller drugs that are water seeking.

Hydrophilic

If a person who is taking warfarin (Coumadin) also ingests white willow or gingko biloba, what will happen?

Increases risk for brain hemorrhage.

A desired effect of a drug.

Intended action or therapeutic response.

The watery body spaces between all body cells.

Interstitial space.

Drugs given via the enteral route have ____ bioavailablity.

Less.

Only what kind of drugs can be absorbed percutaneously?

Lipid soluble drugs.

-Know the drug that you are administering and their uses, actions, common adverse reactions, special precautions, and delivery methods. - Know the patient's: -allergies -previous adverse reactions - pertinent lab values - any important changes in condition prior to administering drug

List important principles related to preparing and giving drugs.

-Ensuring patient can swallow - Tell what drugs you are administering -Stay at pt bedside until they are swallowed (never leave drugs at bedside or ask someone else to administer) -document that the drugs were taken and that you witnessed the occurence -check on patient shortly after and monitor for side effects

List the responsibilities related to giving enteral drugs.

-The 5 step process of medication administration -Current list of medications -Current list of medications being prescribed -Compare the 2 lists -Communicate the new list to appropriate caregivers and the patient -Always follow the 8 rights of safe drug administration -Always check 2 unique identifiers

List ways to prevent drug errors.

What is the smallest drug?

Lithium

Half Life

Time san needed for one half of a drug dose to be eliminated.

Another name for idiosyncratic response.

Personal response.

Receptors

Physical place on or in a cell where a drug can bind and interact.

What are examples of state approved prescribers?

Physicians, dentists, podiatrists, advanced practice nurses, and physician's assistants.

Steady State

Point at which drug elimination is balance with drug entry, resulting in a constant effective blood level of the drug.

What does PINCH stand for?

Potassium Insulin Narcotics Chemotherapy Heparin

First pass loss

Rapid inactivation or elimination of oral drugs as a result of liver metabolism.

Other names for adverse effect.

Toxic effect; toxicity.

Drugs given via parenteral route must be ___ while drugs given via enteral route must be _____.

Sterile; Clean

An agency of the U.S government responsible for enforcing the standards of the USP.

The FDA

Works together with the U.S congress and Supreme Court to ensure public protection and drug safety.

The FDA and USP

Responsible for developing standards for drug manufacturing, including purity, strength, packaging, and labeling.

The United States Pharmacopoeia (USP)

National Institute for Occupational Safety and Health (NIOSH)

The __________________________________________________________ oversees workplace safety, including safety issues related to IV therapy.

Target Tissue

The actual cells or tissues affected by the mechanism of action or intended actions of a specific drug.

Physiologic Effects

The change in body function as an income of the mechanism of action off a drug.

Distribution

The extent that a drug absorbed into the bloodstream spreads into the three body water components.

Loading Dose

The first dose of a drug that is larger than all subsequent doses of the same drug; used when it takes more drug to reach steady state that it does to maintain it.

Most drugs are sent to where?

The interstitial spaces.

What does the paraenteral route bypass?

The intestinal organs as well as the liver.

Duration of Action

The length of time a drug is present in the blood at or above the level needed to produce an effect or response.

onset of action

The length of time it takes for a drug to start work.

Bioavailability

The percentage of a drug dose that actually reaches the blood.

Where do hydrophilic drugs distribute to?

The plasma volume and the watery spaces.

Each state's nurse practice act

The practice of IV therapy is governed by?

medication reconciliation

The process of identifying the most accurate list of all medications that the patient is taking, including name, dosage frequency and route, by comparing the medical record to an external list obtained from a patient, hospital, or other provider.

Minimum Effective Concentration

The smallest amount of drug necessary in the blood or target tissue to result in a measurable intended action.

What is the nurse's role in drug therapy?

To administer drugs.

What is the pharmacists role in drug therapy?

To mix and dispense prescribed drugs.

What is your responsibility in regards to herbal medication?

To obtain the correct information and to educate the patient about potential health problems of specific herbal therapies.

What is the prescriber's role in drug therapy?

To select and order specific drugs.

Who creates the generic names for all drugs?

United States Adopted Names (USAN)

Pharmacodynamics

Ways in which drugs work to change body function.

1. right patient 2. right drug 3. right dose 4. right route 5. right time 6.right documentation 7. right diagnosis 8. right response

What are the 8 rights of Safe Drug Administration?

-Before drugs know Nurse Practice Acts for your state -Always use the 8 rights of administration -Always check 2 unique identifiers -Use medication reconciliation process -Document immediately after administration -Always evaluate and monitor for adverse effects

What are the responsibilities before and after administering drugs?

-With eardrops remember for children 3 and younger pull ear lobe down and back -With children over 3 and adults pull ear up and out -Don't let dropper touch inside of ear -Have patient stay laying on their side for 5 min. after administration

What are the responsibilities related to giving drugs through the ears and eyes?

-Check orders to determine which eye or both eyes to administer drugs in -Use aseptic technique for eye drops -Have patient remove contact lenses -Wait 10 minutes in between different eye drops

What are the responsibilities related to giving drugs through the eyes?

-Be sure to use a clean/sterile technique -teach patient to avoid chewing or swallowing buccal or sublingual drugs, and not to eat or drink until the medication is completely dissolved

What are the responsibilities related to giving drugs through the mucous membranes?

inflammation

syndrome of tissue and blood vessel responses to injury or invasion