applied pharmacology & applied nursing

what are pharmacokinetic factors that increase drug interactions?

Absorption(bind or chelate, alter gastric pH or motility, distribution, metabolism(alteration of enzymes, inhibition, alcohol intake, cigarette smoking, caffeine intake, excretion(urine pH)

Define Drug Dependence

Drug dependence is the term preferred over the previous terminology of "habituation" and "addiction" can be physical or psychological

Define Idiosyncrasy

Idiosyncrasy is any abnormal of peculiar response to a drug which may manifest by itself by 1) overresponse or abnormal susceptibility to a drug 2) underresponse, which demonstrates abnormal tolerance 3) a qualitatively different effect from the one expected, such as excitation after the administration of a sedative 4) unpredictable and unexplainable symptoms. often from genetic enzymatic deficiencies.

Define summation

Summation (addition or additive effect) occurs when the combined effect of two drugs produces a result that equals the sum of the individual effects of each agent.

which medications are less effective in post-myocardial infarction therapy in african american?

adrenergic B-blockers are not as efficacious as monotherapy

what are adverse effects of medications?

adverse effects are unintended, undesirable, and often unpredictable drug effects that range from mild to fatal.

list perceived causes of poor health in hispanic americans.....

an imbalance in the body, embarrassment, envy, anger, fear, fright, excessive worry, turmoil in the family, improper behavior, or violations of moral or ethical codes. Environmental or natural conditions such as bad air, germs, dust, excess heat or cold, bad food, or poverty. supernatural causes such as malevolent spirits, bad luck, or the witchcraft of living enemies ( who are believed to cause harm out of vengeance or envy)

What anithypertensive agents have less blood pressure lowering effects on african americans?

angiotensin-converting enzyme inhibitors

what is the influence of aging on drug therapy?

blood-brain barrier more permeable to fat soluble drugs. reduced baroreceptor response. decline in liver function. increased abdominal fatty tissue. altered peripheral venous tone. decreased renal blood flow and filtration. slower gastric emptying.

what are possible reasons for genetic variations in drug response?

changes in receptor configuration, receptor quantity, or intracellular porteins that interact with the receptors. unique variations in drug absorption an distribution. unique variations in drug metabolism by cytochrome P450 isoenzymes.

What are positive drug interactions?

combination drugs-decrease amount of pills, can target many different disease processes in one pill. Concurrent drugs-working together to treat a disease process, individually targeting a specific dysfunction of a disease process.

List examples of nursing care of patients requiring drug therapy in the assessment process?

complete drug history. list of all medications taken by patient. list of all prescribers for patient. review of prescription bottles for possible use of multiple pharmacies for prescriptions. review of all medication expiration dates. assessment of self-medication practices. assessment of limitations to self-medication.

what are influences on drug therapy regarding beliefs and practices?

culture, environment, economics, genetics, previous and current health status, psychosocial factors.

define cumulative effect

cumulative effect occurs when the body cannot metabolize one dose of a drug before another dose is administered.

Potential pharmacokinetic changes in older adults regarding excretion.

decrease in renal function (often 10% of renal function per decade after age 50 years)

Potential pharmacokinetic changes in older adults regarding distribution.

decreased lean body mass and total body water. increased adipose stores. decreased serum albumin, blood flow, cardiac output.

Potential pharmacokinetic changes in older adults regarding metabolism.

decreased phase I metabolic reactions, cytochrome P-450 enzyme system activity, hepatic blood flow, drug metabolism.

Define drug antagonism

drug antagonism occurs when the combination effect of two drugs is less than the sum of the drugs acting separately.

Define Drug interaction

drug interaction occurs when the effects of one drug are modified by the prior or concurrent administration of another drug, thereby increasing or decreasing the pharmacologic action of each.

list preventions of adverse drug reactions in the older adult..

ensure dose has been adjusted for the older adult. decrease the incidence of polypharmacy. educate patient on how to take medications and what medications are for.

what are common food-drug interactions?

grapefruit juice & food with high vitamin K levels

list examples of nursing care of patients requiring drug therapy in the implementation process?

health promotion-educating the patient and family. acute care-receiving med orders, correct transcription and communication of orders, accurate dosage calc. and measurement, correct administration, correct documentation.

list common types of adverse reactions..

hepatotoxicity, nephrotoxicity, blood dyscrasias, hypotension, electrolyte disturbances, neurologic effects.

Potential pharmacokinetic changes in older adults regarding absorption.

increased gastric pH, altered gastric emptying and intestinal blood flow, decreased first pass metabolism in the liver.

what is the process for administration of drugs to the older adults?

offer water to reduce dry mucous membranes and enhance swallowing. position upright to reduce aspiration. check mouth for residual pill if needed. administer drugs slowly at patient's pace. select IM injection sites carefully because of reduced muscle mass.

What is the native american perspective regarding health?

perceive illness as being out of balance because of ill spirit, not following traditional beliefs, or a disruption in nature. do not ascribe to the germ theory and need to trace back cause of illness to an action or lack of action by patient, which may be kwon or unknown. recovery is based on diagnosing problem and reestablishing harmony or balance with nature. each tribe(more than 200) has specific ideas and practices related to health and illness.

Define potentiation

potentiation refers to the concurrent administration of two drugs in which one drug increases the effect of the other drug.

what are attributes of asian/pacific islanders regarding health?

represent a very diverse group, enriched by tenets of chinese medicine, yin and yang (imbalance leads to illness), traditional methods of chinese healing: holistic, medicine, acupuncture, moxibustion, meditation, and herbal remedies.

list examples of nursing care of patients requiring drug therapy in the diagnosis process?

risk for poisoning:drug toxicity. deficient knowledge related to initiation of or change in medication regimen. noncompliance. ineffective therapeutic regimen management related to (specify)

list examples of nursing care of patients requiring drug therapy in the planning process?

setting priorities. continuity of care-incorporating family/caregiver, ensuring the patient knows how to access meds. etc within the community. setting goals and outcomes-the patient will verbalize understanding of desired effects and adverse effects of medication, the patients will establish a daily routine that will coordinate timing of medication with mealtimes.

what are side effects of medications?

side effects are usually predictable secondary effects such as anorexia, nausea, vomiting, dizziness, dry mouth, abdominal gas or distress, constipation, and diarrhea.

Define synergism

synergism describes a drug interaction in which the combined effect of drugs is greater than the sum of each individual agent acting independently.

define tachyphylaxis

tachyphylaxis refers to a quickly developing tolerance that occurs after repeated administration of a drug.

list examples of nursing care of patients requiring drug therapy in the evaluation process?

therapeutic response to drug. non-therapeutic responses to drug, such as adverse effects related to administration drug itself, patient's health status, or concurrent to drug therapy. level of patient's knowledge related to medication regimen. patient's ability to manage therapeutic regimen(self-medicate).

what anithypertensive agents have greater blood pressure lowering effects on african american?

thiazide diuretics and long action calcium channel blockers.

define tolerance

tolerance refers to a decreased physiologic response that occurs after repeated administration of a drug or a chemically related substance.