Fundamentals chapter 35

OTC medications

(1) clearly understanding the desired effect and potential side and adverse effects of all ingredients in the medication. (2) possible reactions. (3) potential interactions with other medications and herbs. (4) warnings (5) directions and dosage, and (6) features (such as safety caps)

toxic effect

Results from a medication overdose or the buildup of medication in the blood due to impaired metabolism and excretion. Toxic levels of a drug can lead to serious physiologic effects that may be lethal

prescription

a piece of paper written by a doctor that lets you get medicine at the pharmacy

side effects

are predictable but unwanted and sometimes unavoidable reactions to medications. may be minor and harmless or they may cause patient injury. Patients may refuse to continue a medication because of this

adverse effects

are severe, unintended, unwanted, and often unpredictable drug reactions. May occur after one dose, such as a severe allergic response, or it may develop over time, such as a the development of anemia associated with a medication.

controlled substances

are types of medication that have government-regulated manufacturing, prescribing, and dispensing requirements. a written record is required to track all records of the medication. an accurate record must be documented and inventory must be kept.

allergic reactions

are unpredictable immune responses to medications. Is first exposed to a foreign substance (antigen), the body produces antibodies. The medication, a chemical preservative, or one of the metabolites can initiate the immune response. The patient exhibits an allergic reaction to the antigen that ranges from minor to severe. Reactions include: rash, itching of the skin, inflammation of the nasal passages causing swelling and a clear discharge, and raised skin eruptions (hives)

Safe Nursing Practices

includes knowledge about medication actions; side effects; interactions with food herbs, and other medications; associated assessment and evaluations; ethical considerations; and legal aspects of medication therapy. Educating patients about medications, administering medications according to accepted protocols, and evaluating the patient's response to medications.

peak plasma level

indicates the highest serum (blood) concentration. After the peak is reached, serum levels decrease until another dose is administered.

medication

is a drug specifically administered for its therapeutic effect on physiologic function

trade name (brand name)

is a registered name assigned by the drug manufacturer

idiosyncratic reaction

is an unpredictable patient response to medication. This response can be an overresponse, underresponse, or abnormal reaction to the medication

drug

is any substance that positively or negatively alters physiologic function.

half-life

is the expected time it takes for the blood concentration to measure one-half of the original drug dose due to drug metabolism and excretion

trough

is the lowest serum level of the medication. Levels of medication are measured with serum laboratory results. Adjust dose amount and monitor for toxicity

absorption

is the passage of a drug from the administration site into the bloodstream.

metabolism

is the process by which a drug is altered to a less active form to prepare for excretion. Also called metabolites. Takes place in the liver, which may be slowed in elderly individuals or anyone with impaired liver function

pharmacokinetics

is the study of how a medication enters the body, moves through the body, and ultimately leaves the body

onset of action

is the time the body takes to respond to a drug after administration. affected by the administration route, drug information, and pharmacokinetic factors

nonprescription medications

many medications, vitamins, herbs, and supplements can be obtained without a prescription from a heath care provider. Over-the-counter (OTC) medications.

alternative therapies

many people take herbal supplements to support and maintain their health. Herbal therapy has roots that date back to ancient times. Fish oil, glucosamine or chondroitin, probiotics, melatonin, coenzyme Q-10, echinacea, cranberry, garlic, ginseng, and ginkgo biloba. Found in many foods, dried and processed, capsule or pill

drug incompatibility

mixing medications in a solution that causes precipitation or combining a drug with another drug that causes an adverse chemical reaction. compatibility must be verified before mixing or administering medications with a syringe or through IV tubing. If medications that are not compatible are prescribed, they must be administered separately with appropriate safety measures, such as flushing the IV tubing between medications.

Vitamins

needed by the body are usually acquired from foods that are part of a well-balanced diet. The body uses vitamins for the biologic processes of growth, digestion, and nerve function.

medication interactions

occur when the drug action is modified by the presence of a certain food or herb or another medication. the interaction can alter the way the medication is absorbed, metabolized, or eliminated

synergistic effect

occurs when the combined effect is greater than the effect of either substance if taken alone. Alcohol, for example, is a central nervous system depressant that has an increased effect when taken with antihistamines, antidepressants, or barbiturates. Hypertension may receive a diuretic and a vasodilator to achieve a greater antihypertensive response than would be achieved by either drug alone.

antagonism

occurs when the drug effect is decreased by taking the drug with another substance, including herbs. For example, antibiotics can lessen the effect of birth control medications, and grapefruit juice alters the absorption of statins, a class of lipid- lowering drugs

therapeutic effect

or intended effect, is the desired result or action of a medication. the medication must be taken into the body, be absorbed and distributed in cells and tissues, and alter physiologic functioning. medication dose, route of administration, frequency of administration, function of metabolizing organs (such as the liver or kidneys) and age of the patient

excertion

process removes the less active drug or its metabolites. Metabolites exit the body through the kidneys, but some may be excreted in feces, breath, saliva, sweat, and breast milk. The drug may accumulate to unwanted levels in elderly individuals and people with impaired kidney function, necessitating prescription of smaller doses or longer durations between doses

several factors that affect absorption

route of administration, ability of the drug to dissolve or become soluble, blood flow to the administration site, body surface area, and patient age. Intravenously or directly into a blood vessel, is the quickest rate of action. Distribution is affected by the chemical properties of the drug., the effectiveness of the cardiac system, the ability to pass through tissue and organ membranes.

If a controlled drug needs to be wasted,

two licensed clinical staff members must witness the disposal of the substance and document the wasting of the drug in the appropriate manner

anaphylactic reaction

which is a medical emergency. Can occur immediately after administration of medication and can be fetal. Immediate discontinuation of the drug and administration of epinephrine (an antagonist) intravenous (IV) fluids, steroids, and antihistamines while providing respiratory support.

generic name

which is simpler than the chemical name. It is not capitalized and often contains a prefix or suffix that helps identify the drug class. Ex: beta blockers are drugs that are prescribed for cardiac conditions; it ends in olol: propranolol, metoprolol, labetalol