Exam #1 Flashcards
(86 cards)
0
Q
Pharmacotherapeutic
A
Clinical pharmacology: drugs used to treat, prevent and diagnose disease
1
Q
What is pharmacology?
A
Study of the biological effects of chemicals
2
Q
Adverse effects
A
Undesirable, unpleasant or even dangerous drug effects
3
Q
Brand name
A
Name given by drug company aka trade name
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Q
Chemical name
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Name reflecting chemical structure
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Q
Generic name
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The original name given when the drug company that developed it applies for approval
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Q
Orphan drug
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Drugs that are not profitable and are used to treat rare diseases; are not financially viable
7
Q
Teratogenic
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Having adverse effects on the fetus
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Q
Drug therapy: nursing responsibilities
A
Administer Assess effects Make regimen more tolerable Provide pt teaching Monitor pt care plan
9
Q
Sources of drugs
A
Plants
Animal products
Inorganic compounds
Synthetic sources
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Q
Drug
A
Chemicals introduced into the body and affect the body’s chemical processes
11
Q
FDA controls …
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Scientific testing for therapeutic, toxic effects of drugs, and drug approval
12
Q
FDA stages of approval
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Preclinical trial Phase 1 Phase 2 Phase 3 Phase 4
13
Q
Preclinical trials
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Animal testing
14
Q
Phase 1
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Testing on young healthy adult men
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Q
Phase 2
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Testing on small numbers of ppl with the disease
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Q
Phase 3
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Testing in vast clinical markets
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Q
Phase 4
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Drug approval and continual evaluation
18
Q
Drugs will be removed from clinical trials if:
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Less effective than anticipated Too toxic Unacceptable adverse effects Low benefit to risk ratio No more effective than other drugs
19
Q
1938 federal food drug and cosmetic act
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Mandates testing for drug toxicity and provided means of recall; established procedures for introducing new drugs
20
Q
1970 controlled substance act
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Defines drugs by their abuse potential; strict control over distribution, storage, and use
21
Q
1983 orphan drug act
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Provides incentives for development of orphan drugs for treatment of rare diseases
22
Q
Pregnancy categories are:
A
A, B, C, D, and X
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Q
Pregnancy category A
A
Demonstrated no risk to fetus
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Pregnancy category B
Animal studies show no risk
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Pregnancy category C
Animal studies show adverse effects but still acceptable for use
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Pregnancy Category D
Evidence of human fetal risk
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Pregnancy category X
Fetal abnormalities
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Who regulates controlled substances
DEA
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Schedule 1 drugs
No medical use
| I.e. Heroin
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Schedule 2 drugs
High abuse potential with severe dependence
| I.e. Dilaudid, demorol
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Schedule 3 drugs
Less abuse potential than C2 and moderate dependence
| I.e. Prozac, sedatives
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Schedule 4 drugs
Less abuse potential than C3 and less abuse potential
| I.e. PO pain meds
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Schedule 5 drugs
Limited abuse potential, small amounts of narcotics
| I.e. Cough syrup with codeine, anti tissues and antidiarrheals
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OTC
Over the counter meds; available without a prescription for self treatment
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Problems related to OTC
Mask S/Sx of underlying disease
Drug interactions
Could result in serious side effects
Many don't report use of
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Generic drugs
Are no longer protected by a patent and can be produced by other companies, are often less expensive
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Why are women not used for clinical trials?
Females are more apt to suffer problems with ova, which are formed only before birth
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Absorption
What happens to the drug from the time it enters the body until it enters circulation
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Chemotherapeutic agents
Synthetic chemicals used to interfere with the functioning of foreign cell populations; usually neoplasms
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Critical concentration
The concentration a drug must reach in the tissue to cause a desired therapeutic effect
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Distribution
Movement of drugs to body tissues
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Excretion
Removal of drug from body primarily in the kidneys
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Bio transformation
Aka metabolism; primarily in the liver
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First pass effect
A decrease in amount of effective medication when broken down by liver enzymes
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Pharmacodynamics
The way a drug affects the body
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Pharmacokinetics
The way the body deals with the drug; involves ADME
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Half life
The amount of time it takes for the drug in the body to decease to one half of its peak level
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Loading dose
Use of a higher dose than what is usually used to reach the critical concentration
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Selective toxicity
The ideal that drugs only affect systems found in foreign cells without damaging healthy cells
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Drugs are taken to:
Replace or substitutes missing chemicals , increase or stimulate, depress or slow, and interfere with functioning of foreign cells
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Receptor sites
Specific areas on the cell membrane;
| Lock n key
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Agonists
Have the same affect as the body
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Antagonists
Act to prevent the breakdown of natural chemicals
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Dynamic equilibrium
Absorption
Distribution
Biotransformation
Excretion
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Stomach acidity is ________ when food is present and the stomach empties more _________.
Higher and slowly
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First pass effect
A large precent of drugs taken orally are broken down and never reach the tissue.
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Wastes are readily excretes from the kidneys by __________ ___________.
glomerular filtration
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Considerations for determining the half life
Absorption rate
Distribution to the tissues
Speed of Biotransformation
How fast it is excreted
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Factors influencing drug effects
Weight, age, gender, physiologic/ pathologic/immunologic/ psychologic/ environmental/ genetic factors, drug tolerance, cumulation effects, and interactions
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Fried's rule
Infant dose (>1yr)= inft age(mons).
______________
150 lbs
X average adult
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Young'a rule
Child dose (1-12yr)= age (in years)
______________
Age + 12
X average adult dose
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Clark's rule
Child dose= wt of child ( lbs )
________________
150
X average adult dose
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Surface Area Rule
Child dose= surface area (m2)
________________
1.73
X average adult dose
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Interactions
Two or more drugs or substances Re taken together, there is a possibility that unanticipated interactions can occur
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Drug excreted in the urine, what points should the nurse include in her assessment?
Renal function tests
Fluid intake
Other drugs that affect kidney function
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Drug allergy
Formation of antibodies to a drug or drug protein, causing and immune response
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Hypersensitivity
Excessive responsiveness to primary or secondary effects of s drug
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Superinfection
Infection caused by the destruction of normal flora bacteria by certain drugs
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Primary action
Most common occurrence is the development of adverse effects from a simple overdose
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Secondary action
A wide variety of effects in addition to the desired effects
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Anaphylactic reaction
Immediate reaction; can lead to respiratory distress or arrest.
Hives, rash, dyspnea, increased BP, dilated pupils, diaphoresis, panic feeling, increased HR, resp arrest
ADMIN epinephrine
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Cytotoxic reaction
Antibodies in circulation attacking antigens, causing cell death.
CBC showing damage- decreased H&H, WBC, platelets. Elevated liver enzymes and decreased renal function. Notify physician and discontinue drug
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Serum sickness reaction
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Antibodies circulation in blood, can be see 1 week after exposure.
Itchy rash, high fever, swollen lymph nodes and painful joints, edema to face and limbs.
Comfort measures ( cool environment, skin care, positioning, ice joints, admin anti-inflammatories)
```
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Delayed allergic reaction
Several hours after exposure.
Rash, hives, swollen joints.
Notify physician, discontinue drug, comfort measures- antihistamines or topical corticosteroids
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Dermatological reaction
Reaction involving the skin
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Stomatitis
Inflammation of mucous membranes
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Superinfection assessment
Fever, diarrhea, black or hairy tongue, inflamed or swollen tongue, mucous membrane lesions, vaginal discharge
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Blood dyscrasia
Bone marrow suppression caused by drug effects
| Fever, chills, sore throat, weakness, back pain, dark urine, decreased hematocrit
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Liver toxicity
Malaise, nausea, vomiting, jaundice, change in urine and stool, abdominal pain, elevated liver enzymes
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Renal injury
Most frequently caused by gentamicin; elevated BUN and creatinine, decreased hematocrit, electrolyte imbalance, fatigue, edema, skin rash
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Poisoning
Occurs when an overdose of a drug damages multiple body systems leading to the potential for fatal reactions
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Nursing process
Assessment, nursing diagnosis, planning, implement, evaluation
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8 rights of medication administration
Patient, drug, storage, route, dose, preparation, time, recording
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Medication errors #1 cause:
Distractions
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Challenges to effective drug therapy
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Consumer expects more
Alternative therapy
Early discharge
Government regulation
Biological weapons
Illicit drugs
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