Intro To pharmacology Flashcards
(153 cards)
1
Q
Controlled substances, schedules, or classifications
A
Determined by the drug enforcement agency (DEA) ,justice department, and then scheduled according to the controlled substance act.
2
Q
How is a drug classified or scheduled?
A
Based on potential for abuse and physical, psychological dependence on the drug
3
Q
Controlled substances required information
A
Name of patient receiving narcotic
Amount of narcotic used
The date and time the narcotic was given
The name of the physician prescribing the narcotic
Name of the nurse administering narcotic
A narcotic prepared and not used must be witnessed by another nurse, that it was destroyed
Documentation is done by both nurses in the narcotic record 
4
Q
Requirements for narcotics in facilities
A
Kept in a locked cabinet or cart. Usually double locked.
Facility check on opioids at the beginning and ending of every shift and count whenever dispensing them by two nurses
Checked after administration of the opioid
Narcotics may be ordered routinely or PRN
5
Q
What is pharmacology?
A
Exploration of substances that are used to heal and comfort the sick, and then other ways help us to live longer and healthier lives
6
Q
Pharmacodynamics
A
Refers to the effects of drugs on the body or more scientifically the negative and positive bio chemical, or physiological changes that a drug creates
There are six categories of desired effects
7
Q
Categories of medication
A
Curative
Prophylactic
Diagnostic
Palliative
Replacement
Destructive
8
Q
Curative
A
treats, a problem
Examples are antibiotics or a diuretic
9
Q
Prophylactic
A
Prevents a problem
10
Q
Diagnostic
A
Helps diagnose a disease or condition
Examples are contrast dyes or barium enema
11
Q
Palliative
A
Treat symptoms to make the patient more comfortable
Examples are pain, meds or inhalers
12
Q
Destructive
A
Destroys, tumors, and or microbes
13
Q
Drug class classifications
A
Classified by body systems by how the medication react to certain body systems, or relieves symptoms
Examples are anticoagulant
14
Q
True, or false drugs can be part of more than one classification
A
True
15
Q
What do the last syllables of generic medication indicate?
A
The last syllables indicate the class
Examples are OLOL, PRIL, TIDINE, PRAZOLE
16
Q
Generic drug names
A
Assigned by the manufacturer that first developed the drug, name is lowercase, name can be used by anyone
This is the manufacturers name
Examples are acetaminophen
17
Q
I drug brand or trade name
A
Copyrighted by the company that sells the drug
Uppercase
Example Tylenol
18
Q
Pharmacokinetics
A
A drug cycle, or the process of how medication gets to the target site and what happens to the medication during the journey
19
Q
Where is most absorption done in the body?
A
Muscles or G.I. track
20
Q
What is absorption?
A
The process by which a substance moves into the bloodstream from the site where it is administered
21
Q
True or false sub Q is less absorbing than intramuscular
A
True 
22
Q
What factors very absorption rate
A
Route of administration: topical is the slowest
Ability to dissolve
Blood flow of the area
Body surface
Solubility of the med
23
Q
Distribution
A
The delivery of a drug to the appropriate site after the drug has been absorbed into the bloodstream
24
Q
Factors that affect drug distribution
A
Circulation
Membrane permeability
Plasma, protein binding
25
Circulation
The greater the blood supply, the greater the distribution-easier to move drug to the site
26
Membrane permeability
Drug must be able to cross the cell membrane in order to be distributed
27
Brain barrier vs. Placental barrier.
Fat soluble can cross this barrier
28
Plasma, protein binding
once the protein is in the circulation it attaches to plasma proteins, like albumin and decreases the amount of free drug available
Can create toxicity because it’s not getting binded
Liver problem or malnutrition
29
Metabolism
Is medication reaches the specific site bio transformation occurs under the influence of enzymes, that detoxify, degrade, and then biologically act of chemicals are removed.
The liver is the primary site for drug metabolism
30
What factors affect drug metabolism?
Age
Genetic
Disease state
Nutritional state
31
Excretion
The drug is excreted from the body after it is metabolized it exits the body through the kidneys, liver bowel, lungs, or exocrine glands, and respiratory
Kidneys are the main organ for excretion of drugs
32
Factors that affect the drug action
Developmental considerations-elderly, kids, does calculation by weight
Weight
Genetics and cultural factors differences in metabolizing medication’s, and or tolerance of medication
Psychological factors -state of mind placebo
Pathology -disease, kidney or liver
Environment-noise nutritional state
Timing of administration -empty stomach, food, diuretics
33
Drug affects are classified as
Local or systemic
34
Therapeutic effect
The concentration of a drug in the blood serum that produces the desired effect without side effects or toxicity
Intended or desired, physiological response of medication
35
Therapeutic range
Range between the minimum effect, concentration MEC and toxicity concentration
36
Side effects
Most drugs have additional effects be on the therapeutic effect on the body. These are generally mild.
Examples are nausea or constipation
37
Adverse drug affects
Severe side effects that lead to harm or death these are unpredictable
38
Toxic affects
Occurs when there is a prolonged intake of a medication, or when the medicine accumulates in the body
Example respiratory depression with narcotics opioids
39
Idiosyncratic effect
Abnormal or peculiar response to a drug that may manifest itself by over response, under response, or different from the expected outcome
Such as an allergic reaction
40
Symptoms of drug allergy
Uticaria— hives
Eczema
Pruritus— itching
Rhinitis
Wheezing
Anaphylactic shock
41
Anaphylactic reaction
Respiratory distress
Severe bronchial spasm
Airways close
Cardiovascular shock or collapse
42
Treatment for anaphylactic shock, or drug allergy
Antihistamine or epinephrine
43
Drug interactions
Agonist
Synergist
Antagonist 
44
Agonist
When a drug is taken with another drug, so the two can work together
45
Synergist
A greater effect than that of each drug alone
Example, ginseng, and Coumadin
46
Antagonist
When two drugs are taken together, the effect of each is lessened
Example is antibiotics and birth control
47
Half-life
The time it takes the body to eliminate half the blood concentration level of the drug
The time interval required to reduce the amount of the drug in the body by 50%
48
Loading dose
A larger than normal, initial dose of a drug to achieve therapeutic affect as quickly as possible
49
Serum drug level
Serum level can be monitored by drawing a serum blood level after the drug has been administered and has had time to absorb in the body
50
Onset
Medication effect first begins
51
Peak
Medication is at its highest concentration or at its peak affect
52
Duration
How long medication effects last
53
trough
The lowest serum concentration of a medication before the next medication dose is administer
54
Teratogenetic drug
Pass placenta barrier
Drug known to cause birth defects
Examples are Accutane for acne and alcohol
55
Three checks
Always check the medication label with the mar during the three checks
1.When the nurse reaches for the medication
2. Before pouring or opening the medication.
3. When replacing the medication, punch, card or medication, bottle back or before opening the unit at bedside
56
10 rights
Right client
Right medication
Right dose
Right time,frequency
Right route
Right documentation
Right client education
Right to refuse
Right assessment
Write evaluation
First five rights are always done with the three checks
57
Right client
Most important nursing intervention* used every time medication is given*
Check ID band
Patient states name and birthdate
Photo ID
NEVER USE ROOM NUMBER
58
Right medication
Read the medication label and compare it to the MAR three times:
—— before removing the container
—— just before opening and pouring medication
—— immediately prior to administration
59
Right dose
Compared to average dosages
Metric dosages, containing decimal are of particular concern
Split or crush medication given with pudding or applesauce
60
Right time
Administer medication‘s in long-term care one hour before or one hour after designated time
Administer medication in acute care. 30 minutes before or 30 minutes after the designated time.
61
Military time
000 one for one minute after midnight
2359 for one minute before midnight
No duplication in numbers
62
Right route
Oral
Parenteral or intramuscular
Topical
Rectal
63
Right documentation
When medication administered, must be documented immediately
Never record before administration
MAR‘s or immediate reference for medication administration
MAR’s must be maintained up to the minute
64
Right client education
Inform client about the medication, the purpose, and what to expect how to take it and what to report
65
Individualized education
What does the client already know?
What do they need to know?
What do they want to know?
66
Right to refuse
Respect the right to refuse
Explain the consequences, inform the provider and document the refusal
67
Write evaluation
Follow up with the client to verify therapeutic effect as well as adverse effect
68
Maintaining a safe environment
Wash your hands before beginning medication administration
Good lighting
Don’t leave meds, unattended
Nurse who prepares the med gives the med
69
Administering medication’s
Check for allergies
Check compatibility of medication
Prepare one med at a time
Identify patient
Remain with patient to ensure the med is taken
If one is refused or dropped, positive identification can be made, and the drug recorded or replaced
Never leave medication at bedside
Record the medication was given right after administering
70
Medication distribution system
Stock supply
Individual supply
Unit dose
Automated medication, dispensing system
71
Stock supply
For all residence
72
Individual supply
Per client
73
Unit dose
One dose
74
Are automated medication dispensing system
Computerized medication system
Barcoded medication cart
75
Medication orders include:
Patients full name
Date and time order is written
Name of drug to be administered -generic
Dose of drug
Route by which drug is to be administered
Time in frequency
Signature of provider
76
Types of medication orders
Standing order
PRN order
Single one time order
Stat order
Now order
Routine order
77
Standing order
Protocol nurse has permission to do certain things with medication
78
PRN order
As needed
79
Single order
Given only once
80
Stat order
Given immediately
81
Now order
To be given with a 90 minutes
82
Routine order
scheduled on a daily basis
83
Actions for medication errors
Report as soon as discovered
Institute necessary remedial measures immediately
Determine reason for error
Institute corrective policy procedure to prevent reoccurrence
84
Preventing medication errors
The two biggest factors in medication errors are distraction and fatigue
Use extreme caution when administering medication
Always use 10 rights
Routine should not be routine
85
Medication errors are one of the most common allegations in nursing liability
86
Patient education
Start teaching as soon as the patient is admitted
Education is key to success at home
Teach to the patience level of understanding
Verbal instruction is complemented by written instruction
Teach back to us, demonstrates their understanding of our teachings
87
Placement of zero
Prevents overlooking, decimal point 
88
 How do you round medication orders?
To the nearest 10th
89
Metric system
Logically organized
Safest to use
Widely used
90
Household measurements
Least accurate system
Commonly known
often used for teaching
91
Advantages of oral medication
Safe
Inexpensive
Easy and convenient
92
Disadvantages of oral medication
Oral medication’s have high variable absorption
Inactivation can occur in the G.I. track or buy first pass effect
Clients must be cooperative and conscious
93
Solid forms of oral medication
Tablets
Capsule
Powders
Lozenges
94
Liquid form of oral medication’s
Elixirs
Syrups
Suspensions or shakes
95
How do you pour a liquid med?
Palm. The label.
Read at bottom of meniscus
Eye level
Wipe lip of bottle
96
Sublingual
Under the tongue
97
Buccal
Between the cheek and the gum
98
Translingual
Top of tongue
99
What does sublingual buccal and translingual bypass
The stomach and liver
100
Oral medication procedure general guidelines
Check for patient allergies
Check expiration dates on package
Prepare meds for only one patient
Do not open wrapper until at bedside
Hold medication‘s that need assessment
Offer fluids
If medicine falls anywhere, but the patient bedside is contaminated
Remain with patient until swallowed
Do not leave med at bedside
Document in the MAR
Follow up 30 to 60 minutes after doses given 
101
Rectal suppository administration
Suppositories can be for local or systemic affect
Wear gloves
Position patient in left Sims
Suppositories in place for as long as it can be tolerated at least five minutes
102
Administering medication through a internal feeding tube
Gastrostomy
Jejunostomy
103
Gastrostomy
Into the stomach
104
Jejunostomy
G.I. track
Small intestine
105
NG tube nasal gastric
Inserted in the nose
106
Administering meds via external feeding tube
Check for placement of tube by aspiration method
Aspirate 20 to 30 mLs of stomach Content or intestinal Contant
Check pH content
Flush tube with 15 to 30 mils of water
Medication should be liquid or may need to be crushed or added to water
Flush tube with 30 to 60 ML’s of water
Extended release should not be given via G-tube
Keep track of how liquid is instilled on the I/O
** if continuous feeding discontinue feeding prior to medication administration by 30 minutes**
107
Stomach contents
Greenish brown
pH of, 1 to 5
108
Intestinal continents
Yellowish green
PH of 6+
109
Criteria for choosing equipment for injection
Route of administration
Viscosity of a solution
Quantity to be administered
Body size
Type of medication
110
Needleless systems
Prevents needlestick injuries
Sheathed and plastic guard
Retractable needle
Blunt cannulas
111
Prefilled cartridges
Provide a single dose of medication
Cartridges fit in a reusable holder, called a Tubex or carpuject
112
Five types of insulin
Rapid acting insulin
Short acting insulin
Intermediate insulin
Long acting insulin
Insulin mixture
113
How are insulins administered?
Always subcutaneous
114
Regular insulin
It is clear, fast acting, and is the only one that can be given IV
115
NPH
It’s cloudy, and you need to roll it
116
Lantus
Long acting, and it cannot be mixed
117
Insulin mixtures
They are premixed and contain to insulins
118
Sliding scale for insulin
Doctors order insulin ranges based on blood sugar readings
This dose is given in addition to the routine insulin orders
119
What is insulin?
It is a hormonal, meant to take up sugars and raise levels
120
Reconstitution of medication
Salute
Solvent or diluent
Solution
121
Solute
A powder or liquid concentrates to be diluted or dissolved
122
Solvent or diluent
Liquid added to a solution
123
Solution
Is the liquid that results when the solvent dissolves in the solute
124
What is reconstitution?
The technique of adding a diluent to a powder drug 
125
Intradermal=ID
Gauge— 25 to 27
Links — 1/2 to 5/8 inch
Angle— 5 to 15°
Sites — upper chest, upper back inner forearm
126
Subcutaneous=SQ
Gauge— 25 to 27
Length— 3/8 to 5/8 inch
Angle— 45 to 90° angle
Sites— outer upper arm, middle of back love, handles, and lower stomach 
127
Intramuscular=IM
Gauge— 18 to 25
Length— 5/8 to 1 1/2 inch
Angle— 90° angle
Sites— ventrogluteal, vastus lateralis, deltoid
128
Intradermal injections
TB testing
Allergy testing
Longest absorption time
Inner surface of forearm
129
Subcutaneous injection
Injecting medication into the adipose fat tissue
Pinch of the skin and insert the needle at a 90° angle
If the person is thin, insert at 45°
130
Heparin and Lovenox
No sub Q
Do not massage
Rotate site
Adminis. 2 inches from umbilicus(heprin)
—-administer anterior lateral posterior lateral abdomen Lovenox love handles
131
Antidote for heparin and Lovenox
Protamine sulfate
132
When choosing an IM site
4 mils can be given to adults in larger muscles
1 to 2 mills in a single site for children and elderly
133
Primary sites for intramuscular injections
Ventral gluteal
Vastus lateralis
Deltoid 
134
Vastus lateralis
One hand breath above the patella
One handbreadth below the greater trochanter
Locate the midline of the thighs lateral middle third
135
Deltoid
Locate the acromion process
Count 2 to 3 finger widths below the acromion process 
Locate the axillary fold
Imagine an upside down triangle and inject into the center
136
Z track method
Prevents seepage of the medication
———-vitamin B and iron
Reduces pain and discomfort of certain I am injections
Ventral, gluteal site preferred
Paul skin approximately one to one and a half inches laterally
Holds skin tight
Inject with darting motion
Release skin
137
What does inject slowly mean?
One mL for every 10 seconds
138
Documenting on the MAR after administering a med
Date
Time
Medication
Dose
Route
Site
Patient name
Nurses signature
139
1 L =
1000 mL
140
1 g =
1000 mg
141
1 kg =
1000 g
2.2 pounds.
142
1 mg=
1000 mcg
143
30 cc
1 ounce
2 tablespoons
144
1 teaspoon
5 mL
145
1 cup
8 ounces
240 mL
146
2 cups
1 pint
147
2 pints
1 quart
148
4 quarts
1 gallon
149
1 pound
16 ounces
150
1 foot
12 inches
151
1 inch
2.54 cm.
152
Need Fahrenheit
Take Celsius X 1.8+32.
153
Need Celsius
Take Fahrenheit -32÷1.8
