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Pharmacology 1 > Medication Administration > Flashcards

Medication Administration Flashcards

1
Q

Medication Rights

What are the 8 rights of medication administration?

The right…

(“Do dogs train relentlessly for praise during regular running outings?”)

A
  1. Drug
  2. Dose
  3. Time
  4. Route & Form
  5. Patient
  6. Documentation
  7. Reason
  8. Reponse Occurs
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2
Q

Medication Rights

What are the other rights of medication administration besides the 8?

A
  • The right for the patient to refuse the medication
  • The right for the medication to be presented in the right professional manner
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3
Q

Do’s and Don’ts of charting medication errors!

  • Chart just the ___(1)_____
  • Don’t chart about ___(2)______ or ____(3)___ on the unit
  • Don’t mention that an ___(4)______ was filled out
  • Don’t use words like ____(5)_____, ____(6)___, or ____(7)______
  • Comment on patient’s resopnse….maybe chart a new set of _____(8)_____
A
  1. FACTS!
  2. staffing problems
  3. conflicts
  4. incident report
  5. “accident”
  6. “mistake”
  7. “miscalutation”
  8. vital signs
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4
Q

Names of Medications

Generic Name

A

Long chemical names

-Every drug has ONE generic name

(memorize generic name for NCLEX)

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5
Q

Names of Medications

Trade Name

A

The catchy drug company name

-Each drug has SEVERAL trade names

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6
Q

Which is the generic name and which is the trade from the example?

Acetylsalicylic Acid

Aspirin

A

Generic name: acetysalicylic acid

Trade name: aspirin

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7
Q

Class Overview

In this class, we will be learning about drugs by _____(1)______ (big groups) of medications which usually have a similar use or action.

Then we will learn “____(2)____” or “____(3)___” for each drug classification.

A
  1. Drug classifications
  2. Prototype
  3. Typical drugs
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8
Q

Pharmacology Terminology

Pharmacodynamics

A

How the medication works & affects the body on the chemical level

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9
Q

Pharmacology Terminology

Pharmacotherapeutics

A

Understanding of drug actions for the treatment and prevention of disease

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10
Q

Pharmacology Terminology

Pharmacokinetics

A

The drug’s actions

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11
Q

Pharmacology Terminology

Absorption

A

Getting the medication inside the body into the blood

From outside, to the blood

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12
Q

Types of Absorption Routes

“PIE IT”

A
  1. Parenteral: Injections
  2. Enteral
  3. Intravenous
  4. Topical
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13
Q

Routes

P.O.

A

Enteral

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14
Q

Routes

Enteral (P.O.)

A

By mouth (oral)

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15
Q

Routes

Enteral (P.O.) medicinations are subjected to what effect?

A

First-pass effect

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16
Q

Routes

First-Pass Effect

A

When the medication passes through the liver before getting into the blood

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17
Q

Routes

What is the primary organ involved in the first pass effect?

A

Liver

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18
Q

Routes

What happens to the medication’s effectiveness when it goes through the first pass effect?

A

The liver starts to break down medications

Limits bioavailability

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19
Q

Routes

Pros of P.O. (enteral) Medications

A
  • Easy, cheap
  • Takes 30 minutes to work
  • Comes in a variety of different forms:
    • Pills, tablets, capsules, and liquids
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20
Q

Routes

Cons of P.O. (enteral) medications?

A
  • Not all drugs can be given P.O. route
  • Many things can interfere with oral route:
    • Acid or food in stomach
    • Small intestine disease
    • Poor blood flow to the stomach/intestine
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21
Q

Routes

What are the other variations of enteral (P.O.) medications?

“Soups and Regular Salads are Eat Completely”

A
  1. Sublingual
  2. Rectal Suppositories
  3. Enteric Coated
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22
Q

Routes

Enteric Coated Medications

A
  • Enteral (PO) route
  • Drugs that are destroyed by acid can sometimes be coated until they reach the alkaline pH of the intestine
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23
Q

Routes

Sublingual

A
  • Enteral (PO) route
  • Placed under the tongue
  • Absorbed into the venous system to bypass the liver
  • Avoids the “first-pass” effect
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24
Q

Routes

What can you NOT do to enteric coated medications?

A

CANNOT CRUSH THESE PILLS OR CAPSULES

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25
Q

Routes

What can you NOT do to sublingual medications?

A

DO NOT CHEW or SWALLOW

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26
Q

Routes

What is the most common sublingual medication?

A

Nitroglycerin

(nitro-glyc-er-in)

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27
Q

Routes

Rectal Suppositories

A
  • Not all are used for constipation (local effect)
  • Often used when oral meds can’t be given
    • Ex. Children or vomitting patient
  • Absorbed uncertainly (stool interferes)
  • Avoids the “first-pass” effect (liver
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28
Q

Routes

What enteral (PO) medications bypass the liver (“first-pass” effect)?

A
  • Sublingual
  • Rectal suppositories
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29
Q

Routes

Parental medications are also called?

A

Injections

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30
Q

Routes

Parental (injections) abbreviations:

SQ/SC

IM

A

SQ/ SC: subcutaneous

IM: intramuscular

31
Q

Routes

Parenteral: Injections (SQ/SC & IM)

A
  • Aborbed by diffusion into capillaries
  • Blood flow is important
32
Q

Routes

Parenteral: Injections

SQ/SC

A
  • Subcutaneous
  • Goes into the fat
  • Takes 20-30 minutes to begin
33
Q

Routes

Parenteral: Injections

IM

A
  • Intramuscular
  • Goes into the muscle
  • Faster into the bloodstream
    • Takes 10-15 minutes to begin
34
Q

Routes

What do both SQ/SC & IM parenteral/injections

avoid?

A

Both avoid the “first-pass” effect by bypassing the liver

35
Q

Routes

Pros of parenteral: injections

A
  • Quick
  • Easy to learn to administer
36
Q

Routes

Cons of parenteral: injections

A
  • Can damage tissue
  • Cannot control precisely
  • Can be affected by temperature of the body
37
Q

Routes

Intravenous (IV)

A

Into the veins

38
Q

Routes

Pros of intravenous (IV)

A
  • Fastest method (immediate)
  • Complete absorption
    • No barriers
  • Can be used for very irritating medications
    • Ex. potassium
  • 100% bio-available
39
Q

Routes

Types of topical medication sites

LENSE

A
  • L​ungs
  • Eyes
  • Nose
  • Skin
  • Ears
40
Q

Routes

Type of topical medication used on lungs

A

Inhalers

  • Very quick response
  • Most for direst action on lungs
41
Q

Routes

Types of topical medications for skin

A
  • Creams
  • Lotions
  • Transdermal patches
    • Patches are slow
    • Patches are used for systemic use
42
Q

Routes

Types of topical medications used on eyes

A
  • Drops
  • Ointments
43
Q

Routes

Type of topical medication used on ears

A
  • Drops
44
Q

Routes

Types of topical medications for the nose

A
  • Drops
  • Sprays
45
Q

Routes

Pros of topical medications

A
  • Can have an excellent local affect
  • Bypasses the liver
    • No “first-pass” effect
46
Q

Routes

Cons of topical medications

A
  • Does not work quickly or predictably for a systematic effect
47
Q

Pediatric Variations in Pharmacokinetics

Absorption

  • ____(1)______ has less ____(2)___ until ____(3)___.
  • ___(4)__ is ___(5)___.
  • ___(6)____ is faster d/t ___(7)____.
  • ___(8)____ is faster and irregular.
A
  1. Stomach
  2. acid
  3. age 3
  4. Peristalsis
  5. irregular and slow
  6. Topical absorption
  7. thin skin
  8. IM absorption
48
Q

Geriatric Variations in Pharmacokinetics

Absorption

  • Less ___(1)___.
  • Slowed ___(2)_____.
  • Less ____(3)____.
  • ____(4)_____ = less ____(5)____.
A
  1. HCl acid in the stomach
  2. GI emptying
  3. blood flow to GI d/t decrease cardiac output
  4. Villi flattening
  5. absorptive area
49
Q

Pharmacokinetics

Distribution

A

Getting the medication from the blood into the cells where it can be used

  • Begins to be eliminated by the liver or kidney
50
Q

Pharmacokinetics

Factors r/t Distribution

  • ___(1)____ is key.
  • More drug goes to areas where there is more ___(2)___.
    • Such as ______(3)______.
  • Less drug goes to areas like _____(4)____.
A
  1. blood flow
  2. blood
  3. organs- heart, liver, brain, kidneys, etc.
  4. fat and bone
51
Q

Pharmacokinetics

Blood Brain Barrier

(BBB)

A

The BBB is a system of special capillaries with limited entry.

52
Q

Pharmacokinetics

Pros of the blood brain barrier (BBB)

A

BBB keeps harmful substances out

53
Q

Pharmacokinetics

Cons of blood brain barrier (BBB)

A

The BBB keeps helpful substances out

  • Drugs must be fat soluble or have their own transport system to get past the BBB
54
Q

Pharmacokinetics

Fat soluble drugs are…..

A

…better distributed b/c they don’t bind to proteins.

55
Q

Pharmacokinetics

Water soluble drugs are …

A

…less well distributed- proteins whisk them away out of the body.

56
Q

Pediatric Variations in Pharmacokinetics

Distribution

  • Greater ____(1)______.
  • Less _____(2)_____.
  • Decreased ____(3)_____ d/t _____(4)_____ to make proteins.
  • Immature _____(5)_____ (drugs easily cross it).
A
  1. total body water
  2. fat content
  3. protein binding
  4. immature liver
  5. blood brain barrier (BBB)
57
Q

Geriatric Variations in Pharmacokinetics

Distribution

  • ____(1)_____ and less ____(2)_____
    • Affects water soluble and fat soluble drugs.
  • Less ____(3)____ produced by the ____(4)____.
A
  1. more fat
  2. water
  3. proteins
  4. liver
58
Q

Pharmacokinetics

Metabolism

A

Transformation of the drug into something that can be excreted or made (AKA bio-transformation) inactive.

59
Q

Pharmacokinetics

What is the main organ of metabolism?

A

Liver

60
Q

Pharmacokinetics

Metabolism is affected by (3):

A
  1. Age: the very young have an immature live & the very old have a worn out liver.
  2. Malnutrition: the liver doesn’t have all the enzymes needed to metabolize medication.
  3. Route: medication’s contact with the liver
61
Q

Pediatric Variations in Pharmokinetics

Metabolism

  1. Immature ____(1)____ doesn’t make many of the enzymes needed to ____(2)____ drugs.
  2. Older children may actually need _____(3)____ because of their liver is working so well (age 8+).
A
  1. liver
  2. detoxify
  3. a higher dose
62
Q

Geriatric Variations

Metabolism

  1. Decreased __________(1)_________.
  2. Decreased __________(2)_________.
A
  1. enzyme production by liver
  2. liver blood flow.
63
Q

T/F

Pediatric and geriatric patients have less stomach acid in the stomach which can impact the distribution of medications.

A

F

Less stomach acid in the stomach affects absorption NOT distribution

64
Q

Pharmacokinetics

Excretion

A

Removal of the drug from the body

65
Q

Pharmacokinetics

Which is the main organ of excretion?

A

Kidneys

66
Q

Pharmacokinetics

Most drugs are excreted in the ______.

A

Urine

67
Q

Pharmacokinetics

Other routes that drugs are excreted from

SIBBS

A
  1. Saliva
  2. In expired air
  3. Bowels
  4. Breast milk
  5. Sweat
68
Q

Pediatric Variations in Pharmacokinetics

Elimination

  1. _____(1)______ are immature so ______(2)________.
  2. Less blood flow to the ______(3)______.
A
  1. kidneys
  2. filteration is slower
  3. kidneys
69
Q

Geriatric Considerations

S/E: If there is a _______(1)______ in ______(2)______ or _____(3)______, consider the patient’s medications.

A
  1. change
  2. behavior
  3. consciousness
70
Q

Pharmacokinetics

Geriatric Variations

Elimination

  1. Decreased ______(1)_________
  2. Less _______(2)________.
A
  1. number of functioning nephrons
  2. blood flow to kidneys
71
Q

Geriatric Considerations

Physiologic changes with advanced age:

  1. Cardiac:
  2. GI:
  3. Hepatic:
  4. Renal:
A
  1. Cardiac: decreased cardiac output (CO) = decreased blood flow
  2. GI: less acid in stomach & less peristalsis
  3. Hepatic: decrease in liver enzyme production
  4. Renal: decrease of blood flow to the kidneys
72
Q

Geriatric Considerations

Polypharmacy

A

Multiple drugs take at once for a variety of problems

73
Q

Geriatric Considerations

Polypharmacy

  1. Types of drugs used
  2. More drugs causes what?
  3. Polypharmacy is likely do to
A
  1. Both prescription and OTC
  2. More drugs = more interactions
  3. Multiple MDs prescribing
74
Q

Geriatric Considerations

What is the goal of eliminating polypharmacy?

A

This goal is to eliminate unneeded drugs, so less drug interactions occur

Pharmacology 1 (15 decks)

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