Basic Pharmacology Ch. 1-4; Test 1 Review

document side effects

Should a client experience an adverse reaction that the nurse doesn't recognize and deal appropriately with, a med error has been committed, just as if the wrong med has been given. What would you do?

all ages

genetics, smoking, diet, other meds, liver disorders affect metabolism in people of _______ _________

Antidiabetic

helps control the blood sugar level; example: metformin (Glucophage)

a nursing dx evaluates a pt's response to actual or potential health problems; medical dx is the actual dx

how does a nursing dx differ from a medical dx?

drug actions

how drugs produce changes w/in the body

duration of action

how long the drug has a pharmacologic effect

some meds __________________ another med's actions, contributing to toxicity

increase

Diuretic

increases urine secretion; example: furosemide; loop of Henle on the kidneys

Hypnotic

induces sleep or dulls the senses; example: pentobarbital (Nembutal)

tertiary sources

literature to provide background information, diagnostic tests, diet

older adults

liver and blood flow decreases and affects metabolism in ____________ _____________

herbs and homeopathic remedies

may have potential drug interactions w/ a prescribed med; the supplement may decrease or increase the desired effect of the med or treatment; combining herbs and prescribed meds may have life threatening adverse effects

antagonist

med that has an opposing effect, or acts against another med

agonist

med that produces a desired response

scopolamine

med used for motion sickness

nursing interventions

meeting the physical needs of the pt, providing for pt safety, monitoring for potential complications, assessing and evaluating to identify changes in the pt's needs

liver

metabolism primarily occurs in the ___________

transdermal

method of applying a pre-measured amount of medicine to unbroken skin through an adhesive- backed disk; good method for administering meds slowly into bloodstream over a pd of time; example: Nitroglycerin Paste

Polypharmacy

multidrug therapy

potentiation

occurs when 2 drugs administered together produce a more powerful response than the sum of their individual effects

Therapeutic effect

one client receives acetaminophen (Tylenol) to lower fever, whereas another client receives it to relieve pain; this is an example of what?

adverse reaction

one in which the body reacts to a drug in an unexpected way that may endanger a pts health and safety

Antihistamine

opposes action of histamine, released in allergic reactions; example: cetirizine (Zyrtec)

Anesthetic

partially or completely numbs or eliminates sensitivity w/ or w/out loss of consciousness; example: lidocaine (Xylocaine)

Risk/High Risk

particular problem

cumulation

peak and trough; occurs when a drug is not completely excreted from the body before another dose is given; when repeated doses are given the drug starts to accumulate in the body tissue and toxic effects may occur

vaginal

percutaneous; easiest method for treating the specific area

inhalation

percutaneous; med is sprayed or inhaled into nose, throat, and lungs; good absorption due to large surface contact area and provides rapid treatment; sometimes difficult to regulate dose; used in emergencies

buccal

percutaneous; placed in mouth next to cheek (tablet form); faster absorption than oral; higher concentration of med reached bloodstream; example: suckers

sublingual

percutaneous; placed under the tongue and dissolves in saliva; faster absorption than oral; higher concentration of med reaches bloodstream; example: Nitroglycerin (vasodilator)

dependent actions

performed by a nurse based or health care provider's orders

physical

person develops withdrawal symptoms if drug withdrawn

Anticoagulant

prevents clot continuation and formation; example: warfarin sodium (Coumadin)

Laxative

prevents constipation; example: docusate calcium (Surfak)

Antineoplastic

prevents development, growth, or reproduction of cancerous cells; example: fluorouracil (Adrucil)

Antihypertensive

prevents or controls high BP; example: nadolol (Corgard)

Anticonvulsant

prevents or relieves convuslsions (seizures); example: clonazepam (Klonopin)

Antiemetic

prevents or relieves nausea and vomitting; examples: meclizine. hydrochloride (Bonine, Dramamine 11, Antivert)

primary source

produced by the pt

independent actions

provided by nurse by virtue of education and license

Half-Life

refers to the period of time needed for the medication to be reduced by 50% in the body; liver and kidney function can have an effect

nursing dx

refers to the pt's ability to function in activity of daily living; it identifies the pt's response to the illness; ex: pt broke leg, so gave dilaudid

secondary sources

relatives, significant others, medical records, lab reports

Antitussive

relieves cough due to various causes; example: hydrobromide

Skeletal Muscle Relaxant

relieves muscle tension; example: carisoprodol (Soma)

Analgesic

relieves pain; examples: acetylsalicylic acid, aspirin, Bayer Children's Aspirin

Pyxis

requires an identifier

tolerance

resistance to effect of a drug; a characteristic of drug addiction

local effect

response to a medication that's confined to a specific part of the body

Syndrome

signs and symptoms

decrease

some meds _________________ another med's actions, decreasing effectiveness

subjective

statement from pt

females

stomach empties more slowly, gastric pH greater, and alcohol absorbed faster in males or females?

Pharmacodynamics

study of how drugs interact in the human body

Immunosuppressant

suppresses the body's natural immune response to an antigen, as in treatment for transplant pts; example: cyclosporine (Sandimmune)

Antidiuretic

suppresses the formation of urine; example: vasopressin (Pitressin)

Possible

suspected

3 reasons for obtaining a drug hx

to evaluate need for med to obtain current & past use of otc med to identify problems related to drug therapy

infants

topical absorption increased

females

total body fat is higher in _______________, affecting distribution

Brand name

trademark; is capitalized

Wellness

transition

Antiulcer

treats and prevents peptic ulcer and gastric hypersecretion; example: ranitidine (Zantac), cimetidene

Lipid-Lowering Agent

treats high choleterol; hypolipidemic; examples: atorvastatin, lovastatin

Beta Blocker

treats hypertension, angina, and various abnormal heart rhythms; example: metoprolol, Atenolol

Calcium Channel Blockers

treats hypertension, angina, and various abnormal heart rhythms; examples: amlodipine, diltiazem, nifedipine, verapamil

Antiviral Agent

treats various viral conditions such as serious herpes virus infections, chickenpox, and influenza, shingles, cold sore; example: acyclovir (Zovirax), famciclovir

Adverse effects

undesired, inadvertent, and unexpected dangerous effects of a med; example: the antibiotic gentamicin can cause hearing impairment

Parallel-tracking

used for pts w/ life-threatening illnesses who cannot participate in controlled trials and there's no other alternative

Fast-tracking

used to expedite drug development and approval for life-threatening illnesses

food water

what are 2 things that effect absorption?

water

what follows salt, sugar, and protein (albumin)?

nursing process

what is the foundation for the clinical practice of nursing?

A. verifies the correct route of med administration

which is an independent nursing action? A. verifies the correct route of med administration B. orders meds based on the pt's medical dx C. orders lab tests depending on the meds ordered D. chooses an alternative route for meds if indicated

infant

which pt has the greatest % of body water?

water-soluble

which type of topical drug is more readily absorbed by infants?

nonpharmacologic

without using pharmacy drugs

systemic effect

generalized or widespread response to a drug by the body bc it's absorbed into the bloodstream

Antifungal

Destroys or inhibits the growth of fungi; example: fluconazole (Diflucan)

8-15

How many yrs on average does it take for a drug to be brought to market from the time of its conception?

neonates

IM absorption erratic, reduced gastric acidity

Antidiarrheal

examples: loperamide hydrochloride (Imodium)

Enternal

Via the GI tract by the oral, rectal, or nasogastric routes

protein binding lipid (fat) soluble

What are 2 factors that influence drug distribution?

Percutaneous Enteral Parental

What are the 3 routes of drug administration from slowest to fastest?

*ADME* Absorption Distribution Metabolism Excretion

What is the correct order of the drug stages after administration?

3.13 mg

When the nurse administers a 50 mg dose of a drug with a half-life of 6 hrs, how many mg will remain in the body at 24 hrs?

Side effects

________ __________ are usually identified according to body systems; example: morphine given for pain relief usually results in constipation

Serum Creatinine

_____________ ___________________ levels give estimate of renal function

peak

a drug reaches the highest concentration

medical dx

a dx of a disease or disorder that impairs normal physiologic function

psychological

a person is emotionally attached to a drug

nocebo effect

a pts negative expectation can result in a less-optimal outcome

placebo effect

a pts positive expectation can positively affect the outcome

nursing dx

a systemic method of working w/ pts is used to identify4 types of _____________ _________ risk/high risk health promotion and wellness syndrome

interdependent actions

able to do but needs help; cooperation of a team

Percutaneous

absorbed through the skin and mucous membranes; includes inhalation, sublingual, or topical

Pharmacokinetics

actions of drugs

side effect

additional effect on the body by the drug that was not part of the goal for that med

half-life

age, activity, effectiveness of drug, and metabolism all effect what?

synergist

aka potentiating effect; med that enhances the effects of another med

idiosyncracy

an unusual, inappropriate response to a drug or to the usual effective dose of a drug; anaphylactic shock is a more severe type

therapeutic use/clinical indications

antacids, antibiotics

physiologic/chemical action

anticholinergics, calcium channel blockers

contraindication

any special symptom or circumstance that indicates that the use of a particular drug or procedure is dangerous, not advised, or has not been proven safe for administration; not always drug interactions- culture, drug interaction, polypharma, toxicity

topical

applied directly to the skin or mucous membrane for a local effect; slow absorption

Therapeutic methods

approaches to treating illnesses; include diet therapy, drug therapy, physiotherapy, and psychotherapy; often used in combination

therapeutic outcomes

are developed to evaluate the effectiveness of the care given

Vitamin

ascorbic acid (vitamin C)

Sedative

exerts a soothing or tranquilizing effect on the body; example: phenobarbital (Nembutal)

distribution

factors affecting _________________________ depends on pH, body water concentrations, fat tissues, protein binding, cardiac output, and blood flow

chemical name

based on this, a chemist can understand the exact chemical constitution of the drug and the exact placement of its atoms or molecular groupings

generic name

before a drug becomes official; common name; not capitalized; official name of drug

Parental

bypasses the GI tract by using subcutaneous, intramuscular (IM), and intravenous injection; fastest route because it goes directly into the bloostream

objective

facts, results

Therapeutic Drug Monitoring

fox glove plant; Digoxin, digitalis, and lonoxin are given M, W, & F and are monitored because they're toxic. What is this called?

body system classification

cardiovascular, GI, respiratory, integumentary

drug effect

changes that take place in the body as a result of drug action

onset of action

concentration of a drug is sufficient to start a pharmacologic response

US Pharmacopeia/National Formulary (USP/NF)

contains formulas and information that provide standards for preparation and dispensation of drugs; needed so we know what drugs are coming in the US

Antiarrhythmic

corrects cardiac arrhythmias; examples: digoxin (Lanoxin)

Anti-Inflammatory

counteracts inflammation in body; example: naproxen sodium (Anaprox, Aleve)

Actual

defining

Excretion

depends on GI tract and kidneys; kidneys are the major organ; elimination of drug metabolites and some of the active drug from the body

Distribution

depends on circulation to be transported throughout the body; drugs are transported throughout the body by body fluids to the sites of action; some drugs cannot pass through the blood barrier or the placental barrier

Metabolism

depends on enzyme systems; primary organ is the liver; process whereby the body inactivates drugs

Absorption

depends on route of administration; subcutaneous and IM injection absorption is affected by circulation

drug level

determines the amount of drug present

decreased

distribution is affected in the elderly because their total body water content has ____________

liberation

drug released from the dosage form and is dissolved in body fluid; process of converting oral drug can be influenced by food and water in the stomach

trough

drug's lowest level

proteins

drugs are bound to _____________ in the blood during transportation

teratogens

drugs that cause abnormal development of fetal tissues

the dosage should be increased

due to the decreased protein-binding capacity in preterm infants, what adjustment in dosage of protein-binding drugs would need to made?

desired effect

effect of drug in the body that was intended

oral

enternal method; easiest, safest, and most economical method; slow absorption and can be destroyed by gastric juices

rectal

enternal method; one method of choice when pt is nauseated or cannot take meds orally; absorption is slow and irregular

infants

enzymes take several weeks to a yr to develop in ___________ affecting metabolism