Pharmacology Chapter 2 and 3

Question 1

What is the Drug Cycle

Answer 1

Absorption, Distribution, Metabolism and Excretion

Question 2

What is Absorption

Answer 2

AKA Pharmacokinetics: Medication moves from administration site to bloodstream; speed of absorption depends on a variety of different things

Question 3

What affects the rate of absorption?

Answer 3

Route of administration: topical or systemic; solubility, pH, and concentration of medication; Length of contact; age; food; depth of breathing

Question 4

Topical Medications

Answer 4

Condition of skin (scars, tattoos, eczema, etc)

Question 5

Systemic medication

Answer 5

Oral, intravenous (IV), injection, patches

Question 6

Distribution

Answer 6

Delivery of a drug to the site in need after it has been absorbed into the blood stream; barriers to distribution may be blood-brain barrier, blood-testicular barrier, and blood-placental barrier

Question 7

Blood-brain barrier

Answer 7

This barrier protects the brain from any harmful substances. Psychotropic drugs may cross this barrier

Question 8

Blood-placental barrier

Answer 8

This barrier protects the fetus from any harmful substances. However, alcohol, cocaine and some OTC medications may cross barrier and inflict harm onto the fetus

Question 9

Blood-testicular barrier

Answer 9

This barrier protects the sperm from any harmful substances

Question 10

Metabolism

Answer 10

also known as biotransformation; medication is transformed to a less active or inactive form (metabolite). This phase takes place in the liver, kidneys and intestines

Question 11

Excretion

Answer 11

the process where waste products are removed from the body. Kidneys are the main organ of this phase; Lungs, bile, sweat glands and breast also participate in this phase

Question 12

Accumulation of medication

Answer 12

The buildup of medication in the body leading to illness and adverse reactions.

Question 13

Therapeutic level

Answer 13

the point which the drug is at its maximum desired effect.

Question 14

Ototoxic

Answer 14

toxic to ears

Question 15

Nephrotoxic

Answer 15

toxic to kidneys

Question 16

Agonist

Answer 16

when two drugs work together for one drug to be more effective

Question 17

Antagonist

Answer 17

when a drug makes another less effective

Question 18

Side Effects

Answer 18

Mostly mild, some changes to diet and exercise may help relieve side effects

Question 19

Central Nervous system side effects

Answer 19

agitation, delirium, hallucinations, confusion, disorientation, depression, sedation/drowsiness, decreased respirations, decreased circulation, dizziness and coma

Question 20

Urinary System side effects

Answer 20

Fluid and electrolyte imbalance, abnormally high potassium levels, increased blood urea nitrogen levels

Question 21

Hematology side effects

Answer 21

decreased white blood cells, decreased red blood cells, decreased platelets

Question 22

Liver side effects

Answer 22

high liver enzyme levels in blood, jaundice

Question 23

GI system

Answer 23

anorexia, nausea, vomiting, constipation, diarrhea, ulcers and colitis

Question 24

Drug resource information for healthcare providers

Answer 24

There are comprehensive resources, cover medications in depth and only available as printed materials

Question 25

Drug resources for patients

Answer 25

Clinically based resources include information on medication that patient will understand: how to administer, appropriate dose, identify indications and contraindications, patient education information; CD-ROM or digital downloads for smart phone. Package inserts that accompany drugs from manufacturer

Question 26

Patients right to safety

Answer 26

Right patient, right drug (check three times), right dose, right time, right route (and technique), right documentation

Question 27

How do you document medication the correct way

Answer 27

Medication name, dose, route/site, and for vaccines lot number and manufacturer

Question 28

Medication names and abbreviations

Answer 28

safety is key; consolidation of all patient medication: patient needs, appropriate, accounting for other factors and schedule is appropriate; look alike/sound alike; abbreviations, when in doubt ask

Question 29

Factors affecting medication administration

Answer 29

nutrition and physical activity: poor diet may reduce therapeutic level, check drug resource for food interactions, exercise can influence metabolism and increase speed of absorption; drug doses are based on the average body weight of 150 pounds.

Question 30

Geriatric affects on medication administration

Answer 30

decreased absorption due to diminished GI function and congestion of abdominal vessels; slowed distribution because of low plasma protein levels lead to larger amount of unbound drug action; altered liver and kidney function can lead to accumulation; polypharmacy- multiple medications increase risk of drug interaction and side effects; sedative hypnotics, anticoagulants, NSAIDs, antihypertensive, and thrombolytics cause adverse drug events; patients with dementia may become agitated when given tranquilizers

Question 31

Pediatric affects on drug administration

Answer 31

higher metabolism: rate of absorption is faster; lower body weight; injection site of choice for infants and small children is the thigh muscle; may become overhydrated; medication doses most commonly calculated with weight; neonate/premature: metabolism and excretion is impaired, central nervous system is more susceptible, medication miscalculation may become devastating due to size, use ototoxic/nephrotoxic drugs with caution, due to weight changes in pre mature/ neonates adjustment to dosing is as necessary.

Question 32

Gender affects on administration

Answer 32

men have more muscle than fat so they absorb medication and distribute faster; men tend to have faster metabolism than women; antidepressants affect men and women differently due to hormones

Question 33

Pregnancy affect on drug administration

Answer 33

blood-placental barrier protects fetus from certain medications; fat soluble medications more likely to cross barrier leading to possible death or malformation to fetus; medications that may cause malformation or death: teratogenic medication; fetuses are most vulnerable during first trimester due to vital organs forming; fetus is also vulnerable during third trimester due to accumulation of medication

Question 34

Culture affects on medication administration

Answer 34

cultures whose beliefs are in science are more likely to depend on primary healthcare providers to choose drugs; more holistic cultures believe imbalances cause disease, less likely to use convention drugs, more likely to use herbs; others believe illness comes from evil spirits and may be alternative healers.

Question 35

FDA guidelines for pregnancy

Answer 35

A- Safety established by human studies; B- Presumed safe established by animal studies C- Uncertain safety: animal studies show risk, weigh benefits of use D- Unsafe: human studies show risk, weigh benefits of use X- Highly unsafe: positive evidence of harm

Question 36

Liver dysfunction

Answer 36

Metabolism of medication is affected

Question 37

Kidney dysfunction

Answer 37

Excretion of medication is affected

Question 38

Heart dysfunction

Answer 38

distribution throughout circulatory system of medication is affected

Question 39

Ethical and safety considerations

Answer 39

patient information: education and participate in care; patient consent: the right to refusal; patient privacy; patient emergencies