VN 106 Study Guide Chapters 1 and 2

Schedule II drugs

- Drugs have high potential for abuse - currently accepted medical uses - refills not allowed --> must write multiple prescriptions at once

ADME

- absorption - depends on route of administration - distribution - depends on circulation to be transported throughout body - metabolism -depneds on enzyme systems - excretion- depends on GI tract and kidneys

Schedule III drugs

- has potential for abuse, but to a lesser degree than schedules I + II - drug has an accepted medical treatment - may not be refilled more than 5 times - may be prescribed orally or over phone

Schedule IV drugs

- low potential for abuse compared with drugs in schedule III - currently accepted for medical use in United States abuse potential that may lead to limited physical or psychological dependence compared with drugs in schedule III - prescription outdates in 6months; no more than five refills in that 6months

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

8 to 15 years

Peak action

A drug reaches the highest concentration

Teaching for a client, who develops urticaria, and puritis about the drug

PT should receive information about drug name, instruct all healthcare practitioners of such reactions they received on the drug and should not receive it again. When admitted to the hospital... PT should wear a medical alert bracelet or necklace that explains the allergy.

idiosyncratic

Peculiar to one person; highly individualized

How to help prevent med errors, eight rights of med pass?

Right Patient, Right Drug, Right Time, Right Amount, Right Reason, Right Response, Right Documentation, Right Route.

Which drug schedule indicates drugs with the highest risk for abuse?

Schedule I

carcinogen

causing cancer

Can nurse's have controlled substances in their possesion?

Nurse's may NOT have controlled substances in their posession.

trough

lowest drug level before next dose is due (20 to 30mins before)

What are enteric-coated tabs?

material that permits absorption through the stomach and small intestine before the medication is released.

What is a suppository?

medication given p.r. to melt and dissolve slowly.

Antagonist

no activation of the receptor

What type of a reaction are urticaria (hives)?

raised, irregularly shaped patches on the skin, causes severe itching.

How to calculate the half- life of a drug?

the amount of time required for 50% of the drug to be eliminated from the body. Example: 100 mg of a drug that has a half-life of 12 hours, after the 1st half-life 50 mg is left

Interference

the first drug inhibits the metabolism or excretion of the second drug, thereby causing increased activity of the second drug.

Side effects

the potential to affect more than one body system simultaneously, thereby producing responses.

incompatibility

when the first drug is incompatible with the second drug, thereby causing deterioration when the drugs are mixed in the same syringe or solution or are administered together at the same site.

types of orders

- standing orders - verbal or telephone orders

Absorption

-depends on route of administration -i.e., oral drugs won't take effect as quickly as IVs

What should the nurse do for a client with urticsria?

-its a medical emergency -must be treated immediately -don't take medication again -tell healthcare practitioner about such reaction -pt should wear a medical alert bracelet or necklace.

Schedule V drugs

-low abuse potential; prescription not needed (e.g., Robitussin)

Schedule I drugs

-very high potential for abuse -not currently accepted for medical use

What is the nurse's responsibility regarding controlled substances in hospital?

All individuals with controlled substances have responsibilities to ensure patient safety as well as the inventory and dispersion control records of scheduled drugs.

What is the primary characteristic of the OTC medications?

Are sold without a prescription in a pharmacy or in the health section of department or grocery stores.

Which name(s) of a drug should the nurse use when teaching a patient with a new prescription? a) Trade b) Generic and trade c) Generic and chemical d) Official

Answer: b Rationale: Drug prescriptions may be filled with a trade-name drug or a generic equivalent. If the nurse teaches only one name, it may lead to confusion for the patient when he or she receives a drug with a different name.

A patient reports postoperative pain, and the nurse administers morphine (a narcotic analgesic) intravenously to ease the pain. Fifteen minutes later, the nurse notes that the patient is very drowsy, respirations are slow and shallow, and oxygen saturation is low. The nurse administers another drug that decreases the action of the morphine. What is this effect called?

Antagonistic

What act defined five classifications or schedules of controlled substances?

Controlled Substances Act (1970)

Which source of information is best for the nurse to obtain drug information? a) Physicians' Desk Reference (PDR) b) Nursing journals c) United States Pharmacopeia (USP) and National Formulary (NF) d) Electronic databases

D Rationale: All can be sources of drug information, but keeping information current is extremely important. Reliable electronic databases can provide the most up-to-date information to health care providers, unlike printed resources that are published only periodically.

Describe the factors to consider when choosing routes of medication administration.

Desired rate of absorption, inactivity of drugs (ie. drugs broke down the GI tract before absorption occurs), and patient status.

unbound drugs

Drugs are bound to proteins in the blood during transportation -The more a drug is "bound" to a protein, the less available it is to the circulation

desired effects

Effects that produce therapeutic response

What are the different medication routes and know the rate they work from fastest to slowest?

Enteral Route is administered directly into the GI tract by oral, rectal, or nasogastric route. Parenteral Route bypasses the GI tract with the use of subcutaneous, intramuscular, and intravenous injection. Percutaneous drugs being absorbed through the skin and mucous membranes (inhalation, sublingual, and topical). IV is the most rapidly absorbed, second is IM. Slowest absorption rate would be subcutaneous.

A patient is being started on a new drug that has been used safely by many people for years. The patient has no known allergies, and the nurse administers the drug correctly. Suddenly the patient experiences cardiac arrest. What is this type of reaction called?

Idiosyncratic

Which is the legislation to determine drug safety?

The Federal Food, Drug, and Cosmetic Act of 1938

Ototoxicity

Toxicity to the ears, often drug induced and manifesting as varying degrees of hearing loss that is likely to be permanent.

which entity is response for monitoring drug safety in the United States?

U.S Food and Drug Administration (DEA)

What is The United States Pharmacopeia (USP)/National Formulary (NF)?

USP/NF sets standards of purity for drugs and lab tests used to determine purity.

all drugs are processed in the body through pharmacokinetics. what is the correct order thatbdrugs pass through the body?

absorption, distribution, metabolism, excretion

Adverse reaction

any noxious, unintended, and undesired effect of a drug, which occurs at dosages used in humans for prophylaxis (preventative medication), diagnosis, or therapy.

Drug Interactions

are caused by an alteration in metabolism, by inhibiting or stimulating the enzymes that metabolize a drug

Nephrotoxicity

damage to the kidneys by a toxic substance

Distribution

depends on circulation to be transported throughout body

What affects medication absorption?

depends on the route of administration, the blood flow through the tissue where the drug is administered, and the solubility of the drug.

Displacement

displacement of the first drug from protein-binding sites by a second drug increases the activity of the first drug because more unbound drug is available.

liberation

drug released from dosage form and is dissolved in body fluid

Agonist

drugs that interact with a receptor to stimulate a response

Compatibility

drugs that work together at the same time and can make the effect stronger or weaker

teratogen

fetal toxicity, effects the fetus

black box warning

indicates a very serious life-threatening problem