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
