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NURS 212 > Ch 8 > Flashcards

Ch 8 Flashcards

1
Q

Pharmacokinetics

A

how the drug is absorbed,
distributed, metabolized and excreted

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2
Q

Pharacodynamics

A

how the body is affected by the drug at the
cellular level and in relation to the target organ).

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3
Q

Absorbtion

A

refers to the passage of a medication from its site of introduction,
usually the gastrointestinal tract, into the general circulation.

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4
Q

Absorption of oral meds can be affected by

A

can be affected by
diminished gastric acid, increased gastric pH, delayed gastric
emptying and the presence of other substances (e.g., food,
nutrients, medication additives).

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5
Q

Elimination/serum half-life

A

is the time required to decrease the drug concentration by one half
of its original value.

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6
Q

It takes ______ half times to reach steadystate
concentrations after a drug is initiated or to completely
eliminate a drug from the body after a drug is discontinued.

A

5

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7
Q

The clearance rate

A

measures the volume of blood from
which the drug is eliminated per unit of time

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8
Q

Can herbs be taken along with medications without worry of any potential intereaction

A

No

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9
Q

How could oldr adult bod ycomposition affect the effects of medications?

A

decreased
body water and lean tissue and increased body fat)
can affect substances according to their degree of fat or water
solubility. Consequently, medications that are distributed
primarily in body water or lean body mass may reach higher
serum concentrations in older adults and their effects may be
more intense. Similarly, the serum concentration of highly
fat-soluble substances can increase, so the immediate therapeutic
effects are diminished, but the overall effects are prolonged
or erratic.

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10
Q

Polypharamacy

A

typically
refers to the use of more medications than are clinically indicated.

(Many drugs)

Not about the number, about the appropriateness & combination of meds

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11
Q

Medication nonadherence

A

refers to medication-taking patterns
that differ from the prescribed pattern, including missed
doses, failure to fill prescriptions, or medications taken too
frequently or at inappropriate times.

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12
Q

prescribing cascade

A

an adverse drug reaction
is misinterpreted as a new medical condition, a drug is
prescribed for this condition, another adverse drug effect occurs,
the patient is again treated for the perceived additional
medical condition, and the sequence perpetuates new adverse
events.

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13
Q

Ac

A

before meal

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14
Q

Pc

A

After meal

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15
Q

Hs

A

At bedtime

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16
Q

Qd

A

Every day

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17
Q

PO

A

Per oral

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18
Q

Absorption medication affect by

A

Reduced gastric acid, increased gastric pH, delayed gastric emptying, and the presence of other substances

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19
Q

Age-related physiological changes that affect the action of medications in older adults

A

Decline in renal function (eGFR) - older adults have slower GFR
Hepatic blood flow declines
Decreases muscle mass and water content
Low serum albumin (protein)
Altered receptor sensitivity

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20
Q

What affects medication-taking behaviour

A

Motivation
Knowledge abt med
Cultural and psychosocial influences
Physical ability to remove the substance from the container and administer it
Ability to swallow oral preparations
Additional skills related to administering nasally, transdermally, SC and other routes

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21
Q

Considerations of polypharmacy

A

All meds have side-effects

Older adults are more likely to experience stronger side-effects

Always consider wether the benefit outweighs the risk

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22
Q

Side-effects and medication

A

Every med has side-effects, they are just not necessarily common

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23
Q

Narcotics do what

A

Slow respiratory rate

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24
Q

Functional consequences associated with medications in older adults

A

Disease or polypharmacy may alter the
therapeutic effects of a medication

Adverse effects

Anticholinergic Adverse Effects

Altered mental status

Antipsychotics in people with dementia

Tardive Dyskinesia and Drug-Induced
Parkinsonism

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25
Factors that increase older adults risk for adverse events
Higher number of medications * Malnourishment or dehydration * Multiple comorbidities * An illness that interferes with cardiac, renal or hepatic function * Cognitive impairment * History of medication allergies or adverse effects * Fever that can alter the action of certain medications * Recent change in health * Certain medications: anticoagulants/ antiplatelets, antidiabetics, NSAIDs, CNS drugs
26
Antipsychotics should not be given to
Dementia
27
Anticholinergics
Drugs blocking action of AcH, inhibiting the parasympathetic NS Higher specificity to older adults (Often not reccomended if better option available)
28
Morbidity
Illness
29
cardiac, renal or hepatic function in
Main metabolizing organs
30
Exzmples of anticholinergics
OTC cough, cold flu and sleep problems Treatment for older adults (antihistamines, antidepressants antipsychotics CV agents, antiparkinsonians) Safer alternatives usually exist and should be advocated for
31
Anti-psychotics
Increasingly used in LTC facilites US restricted by FDA to prescribe ONLY for psychotic symptoms
32
Tardive dyskenisia
* Rhythmic involuntary movements of the trunk, extremities, jaw, lips, mouth or tongue. Can begin 3-6 months after initiation of antipsychotic use and persist after medication is discontinued
33
Drug induced parkinsonism
Parkinson-like symptoms such as shaking, involuntary or poorly controlled movement. * Condition can be easily misdiagnosed as Parkinsonism and patients are started on new medications
34
BEERS
A list of medications known to increase the risk of delirium and other adverse reactions in older adult should not be prescribed for older adults unless there is a greater benefit -risk ratio for a particular situation, and then should only be used for the shortest possible duration.
35
When are meds safest and most therapeutic
Prescribed and regularly reviewed
36
Goals of assment
Determine effectiveness of existing regimen Identify any factors that interfere with the current regimen Notice risk for adverse effects Detect adverse medication effects Identify teaching needs regarding medications
37
Scope of Medication Assessment
Prescription and OTC medications (all routes) taken regularly Medications taken “as needed” or PRN Vitamins, minerals, and dietary supplements Herb and Folk remedies and complementary/ alternative modalities Alcohol, substances Smoking/inhaling
38
Medication reconciliation
Identifying medications at any transition in care View all the medications Address ability to get prescriptions filled Address issues that affect adherence Allow the client to ask questions
39
Nursing intervention
Recommend all odler adulrs have a list of what the are currently taking Snesure clients and caregivers understand the appropriate use of "as needed" (PRNP meds) Encourage use of decices and systems to improve medication adherances
40
What info should we know when gathering med history from patient
Current medications (including herbal, OTCs, and PRNS) Dose/freq Why? Working? Side effects/concerns
41
Qs pertinent to med administration
Age, weight, BMI All medical diagnoses Prevailing symptoms and reason for hospitalization/care, ongoing lab draws Known drug allergies? (describe) Previous drug reactions? (describe) Any difficulty swallowing pills? Other concerns? Smoker? Provider managing medications _
42
What must be know ABOUT the medication before adminsitering
What drug is ordered? Drug name (generic and trade) and classification Intended or proposed use Effects on the body Contraindications Special considerations Side effects Why the medication has been prescribed How the med is to be administered including dosage ranges
43
10 Rights
Drug Client Dose Route Time of delivery and frequency Documentation History and assessment Drug approach and right to refuse Drug- drug interaction and evaluation Right education and information
44
3 checks of drug admin occur
When preparing it When removing the drug Immediately before administering
45
What is the first check of the med
Comparing the physians order to the MAR
46
ac
Before meal
47
pc
After meal
48
gtt
Drop
49
Hs
At bedtime
50
Standing order
To be completed on a regular basis
51
Nursing actions when preparing to administer drug
Wash hands, assemble supplies Calculate dose (safe range?) Brief patient assessment - Administer drug accurately 10 rights, 3 checks aseptic or sterile techniques talk to patient
52
Enteric coating
Coating diesinged to hold the tablet together when it is in the stomach and break down in none acidic conditions in the intestines
53
SR vs IR
Sustained/timed release vs immediate release SR means a drug can be taken less frequently and is administered slower and steadier
54
Why would a drug be enteric coated
Protect stomach from drug Protect drug from the stomach Relase drug after the stomach
55
First pass effect
a phenomenon in which a drug gets metabolized at a specific location in the body that results in a reduced concentration of the active drug upon reaching its site of action or the systemic circulation.
56
Disadvtages of oral route
First pass effect Slower release Pt must be able to swallow
57
Reccomendations ofr adinstering meds by NG
Use liquids where possible Tablets to be crushed or dissolved
58
Topical drugs include
Drugs applied to the skin Drugs applied into body cavities Inhaled drugs
59
Topical meds side affects?
Low side effects because amounts reaching general circulation are minimal
60
Parental route
Needle into the skin layers sc tissue, muscles or veins SC IM IV `
61
Preventing med errors
Neveruse trailing 0s (2.0) Always use leading )s (0.25)
62
What should patients know about medication usage
What it’s for If it interacts with anything else How to monitor oneself
63
How are drugs categorized
Based on their target body tissue use and/or their action
64
Significant info to know about a drug
Indication ( What it's for) Most COMMON side effect + any lethal side effect Mot important nursing implications (administration or monitoring need-to-do) Most needed patient education
65
If an older adult is having any unusual sign of confusion or diorientation, where should our first culprit be
Adverse drug affect
66
Important fact about older adults recieveing medications
Older adults face an increased risk of adverse medication effects.
67
What age related change relates to slower drug clearance
Reducae heaptic blood flow
68
Does diet affect an older adults ability to receive medication
Not usually
69
What are medication on the BEERS criterea for?
catalogues medications that cause side effects in older adults due to the physiologic changes of agin
70

NURS 212 (21 decks)

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