Objectives for Pharmacology Exam #1
USP (united states pharmacopeia)
Mission Statement: to improve global health through public standards and related programs that help ensure the quality, safety, and benefit of medicines and foods
Schedule I-V categories
Opioids (highest to lowest potential for abuse) 1: Heroin 2: morphine, opium 3: hydrocodone 4: butorphanol 5: Codeine (cough syrup
Phase I-IV Clinical trials
Phase 1: small number, normal subjects, initial evaluation Phase 2: limited number of subjects with target disease, determines effectiveness & side effects Phase 3: large number of subjects, multiple centers, determine effectiveness, safety, dosage range Phase 4: post marketing sureveillance
5 authoritative sources for looking up Drugs
USPDI PDR Computerized databases Nurse's Drug Handbook Manufactured drug cards Pharmacists Package Inserts Textbook web links
PRN orders
- "as needed" medications - administered when the patient requires it - Provider sets limit in between doses
Evaluation
- Asking... Were outcome criteria met? - Did the medication help or hurt or have no effect - Nurse's input is required by law
Implementation
- Interventions based on rationale - Monitoring of effects - Preparing and administering drugs (withholding a dose & obtaining to change an order) - Client education is a legal requirement
NANDA
- North American Nursing Diagnosis Association
Military time and advantages
- Prevents confusion
Biotransformation
- Process of decreasing (along with excretion) amount of active drug in body - Chemical inactivation of a drug by converting it into a more water-soluble compound or metabolite that can be excreted from the body - Major site is liver (also seen in lung, kidney, and small intestine) - Most reactions done by cytochromes P450 which are isoenzymes (grapefruit inhibits this enzyme; Can increase levels of some drugs—What should patients be taught?) - Remember: Only free/unbound drugs can be metabolized
Planning
- Setting goals (outcome criteria) & plans for intervention - Oriented to client, environment, and future - Prioritized Example: Client will not be injured from drug side effect of dizziness
Distribution
- Transport of a drug in body fluids from the bloodstream to tissues & site of action - produces a variety of effects quickly compared to absorption - Local blood flow, drug reservoirs, competition for binding sites, hypoalbuminemia, tissue binding, blood brain barrier, and placental barrier are distribution variables
Antagonists
- affinity without efficacy - likes the receptor but has no effect - Example is naloxone
Assessment
- age, BMI, inherited factors (pharmacogenics), experience with meds, preexisting conditions, concurrent medications, baseline observations, allergies, attitudes, behavior, culture, and ethnicity - infants, children and older than 61
Holistic Nursing
- healing the whole person as a goal (mind, body, soul)
One time or Single orders
- medication delivered at once at a specific time
Standing Order
- prewritten medication order and specific instructions from the licensed independent practitioner to administer a medication to a person in clearly defined circumstances - medication administered as scheduled until cancelled
Absorption
- process by which a drug moves from site of administration into fluids to site of action - Drug solubility, drug ionization, drug stability, local blood flow, GI motility, food in stomach are variables that affect absorption
Nurse practice act
- professionally, morally, legally, and personally responsible for every dose of medication they administer - liable for actions & omissions & for duties delegated - entrusted with potent & habit forming drugs - obligated to report offenders - to practice safely
7-8 components of a valid medication order
1) Client's name 2) Date order written 3) Medication Name 4) Dosage 5) Route 6) Frequency 7) Prescriber signature 8) PRN orders require and indication
Identify components of a goal
- seen at "Planning" - oriented to client, environment, and the future - prioritized
STAT orders
- urgent/rush order
State at least 8 principles for health teaching related to drug therapy plans
1) Comprehensive drug use and health history 2) Reason for medication therapy 3) Expected results 4) Side effects and adverse reactions 5) When to notify health care provider or pharmacist 6) Drug-drug, drug-food, drug-laboratory, and drug-environment interactions 7) Required changes in activities of daily living (ADLs) 8) Demonstration of learning; may take several forms, such as listening, discussing, or return demonstration of psychomotor skills (insulin administration)
3 times a drug order must be checked before administration
1) removing drug from storage area check it against MAR 2) as you prepare the drug 3) at the bedside before administration
Nursing process
Assessment>Diagnosis>Planning>Implementation>Evaluation - Systematic method for identifying actual or potential health care problems or impediments to the activities of daily living
Nursing diagnosis
Don't worry about this... State BON will not ask you a nursing diagnosis question.
5 plus 5 patient rights
Right: - Time - Route - Amount - Medication - Patient - Evaluation - Documentation - Education - Assessment - Refusal
Patients rights to drug administration
Right: - Time - Route - Amount - Medication - Patient - Evaluation - Documentation - Education - Assessment - Refusal
TPAPN
Texas Peer Assistance for Nurses Does not go to the BON A way to report a fellow nurse for chemical dependency or mental illness Client is the most important participant
PDR (Physicians reference desk)
an available resource to when looking up drug
