Introduction to Pharmacology- Chapter 61

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_______is a substance other than food used to prevent disease or pregnancy, aid in diagnosis and treatment of disease, restore or maintain functions in the body

Medication -Drug

_______is the study of chemicals (drugs, medications) and their effects

Pharmacology

________is the healthcare proffessional who is licensed to prepare and dispense medications on the order of a licensed practitioner of medicine

Registered Pharmacist RPh

What is an important part of nursing practice ?

Teaching the client about the effects and possile side effects of medications prescribed for them.

Documentation of teachings and the clients response to instruction verifies that teaching did what?

take place and that the client understands his or her medication regimen

What does the FDA (food and drug administration) operate under?

US Department of Health and Human Services

What does the FDA do?

Makes sure medications and therapeutic agents are safe and effective for public use and sets the standards of strength and purity

What are two national publications that state the standards for medication approval?

USP- US Pharmacopia
NF- National Formulary

When was the Comprehensive Drug Abuse and Control Act established?

May 1970

What is another name for Comprehensive Drug Abuse and Control Act?

Controlled Substance Act

Who enforces the Controlled Substance Act?

DEA- Drug Enforcement Agency

What does the Controlled Substance Act do?

regulates manufacture, prescription, and distribution of psychoactive medications.

What are examples of psychoactive medications that the Controlled Substance Act regulates?

1. Narcotics
2. Depressents
3. Stimulants
4. Hallucinogens

Controlled Substance Act uses what to classify drugs?

Schedule 1-5

Schedule 1

High abuse- no medical use
example: Marijuana

Schedule 2

High abuse- severe dependency
example: Morphine

Schedule 3

Lower abuse- moderate dependency
example: Anabolic steroids

Schedule 4

Lower abuse- limited dependence
example: Xanax

Schedule 5

Limited abuse- Robitussin

How do you protect controlled substances in a healthcare facility?

1. keep in double locked drawers and cabinets
2. keys must be in a licensed nurses possession at all times
3. specialized forms or computer documentation for the use of controlled substance

What is done between shift for controlled substance drug verfication?

Two nurses one coming in and one leaving does a drug count to verfy

What does the client have a right to?

Know the name, action, and possible side effects of medications administered to them and to refuse the medications

What does drug references provide?

1. classification
2. use
3. abuse
4. desired actions
5. recommended dosage
6. adverse actions of medications
7. facts and comparisons
8. pharmakinetics

What are drug references used today?

1. PDR- Physicians Desk Reference
2. PDR Nurse's Drug Handbook
3. USD- US Despensatory
4. NF- National Formulary
5. Nursing Drug Reference
6. Handbook of Drugs for Nursing Practice
7. Nurse's Drug Looseleaf

What does admission to healthcare facility include?

Detailed medication history with assessment

When does the client usually experience an adverse or allergic reaction?

usually not on the first exposure to medication usually second or third usually worse with each dose therafter

You should stay alert for what when giving medication?

adverse reactions even if the client has received the medication previously

Nurses are obligated to know the what of any medication administered?

- generic and common trade name
- classification
- use
- recommended dosage
- desired effects
- possible adverse or untoward effects
- route

If a client experiences an adverse reaction and the nurse does not recognize and doesnt institute appropriate action what has happened?

The nurse has committed a medication error which is the same as if the wrong medication had been given

What are the routes of admistration of medication?

1. Enteral- Oral or Rectal
2. Parenteral- Injectable, Transdermal, Inhalant

________Uses GI tract

Enteral

_______does not use GI tract

Parenteral

_______administered by mouth

Oral

_______applied to the skin or mucous membranes

Topical

_______Inhaled or breathed in

Inhalant

______given via a needle

Injectable

_______applied to and absorbed through the skin

Transdermal

_______is medictions chemical composition

Chemical name

_______often similar to the chemical name and is assigned by the medications first manufacturer

Generic name

_______is the name identified in the USP or NF

Official name

_______,_____or_______is the copyrighted name assigned by the company making the medication and is followed by the trademark R symbol

Trade, Proprietary or Brand

________Medication that produces a desired response

Agonist

_______medication that has an oppsing effect or acts against another medication

Antagonist

_______or ______medication that enhances the effects of another medication

synergistic or potentiating

What are side effects?

Secondary effects that are produced which are not the desired therapeutic effect, some can be considered adverse reactions

What are two adverse responses to medications?

Side effects and interactions

The primary care provider may not be aware that the client takes what?

supplements of herbs or homeopathic remedies

Herbs and homeopathic remedies may have potential drug interactions with a prescribed medication. (T/F)

true

Combinations of herbal supplements or of supplements and prescribed medications may also produce____________

life-threatening adverse effects

What are some medicatin forms?

1. liquids
2. solids
3. semisolids
4. inhalers- metered-dose inhaler MDI
5. transdermal- through the skin
6. Tablet
7. Capsule
8. Caplet
---Slow release SR
---Extended releas ER
9. Orally disintigrating tablet ODT
10. Powder
11. Chewing gum

_______is a tablet that coating does not dissolve until it reaches the intestine because the medication can irritate the stomach mucosa

Enteric-Coated

_______is medication in powdered or pellet form enclosed in soluble cylindrical gelatin like material

Capsule

______is a tablet in the shape of a capsule

Caplet

_________form of solid medication that is placed on the clients tongue and dissolves instantly thus ensuring medication compliance

ODT- orally disintegrating tablet

Many tablets and pills can be ______for easier swallowing or to make sure the client takes them.

crushed

What medications should not be crushed?

Capsules, Time-released medications, orally disintegrating tablets and enteric coated tablets

Many facilities require a Physicains order to crush any medications.(T/F)

true

What are forms of injectable medications?

1. intradermal
2. subcutaneous
3. intramuscular
4. intravenous IV or intraarterial IA
5. Intrathecal

______with in the layers of skin

Intradermal

______under the skin into the subcutaneous tissue layer

Subcutaneous

______into the muscle tissue

Intramuscular

________into the blood vessels

intravenous IV or intraarterial IA

_______into the area surrounding the spinal cord

intrathecal

_______ single amount of a medication administered to achieve a therapeutic effect

Dose

_______contains the dose and scheduled times

Dosage

_____amount of medication required to obtain a desired effect in the majority of clients

Therapeutic dose

______smalles amount of drug necessary to achieve a therapeutic effect

Minimal dose

_____larger than the usual continuing dose, may be given as the first dose of a newly perscribed medication to establish a minimum blood level

Loading dose

_______is the largest amount that can be given safely without causing an adverse reaction or toxic effect

Maximal Dose

_______is amount of medication that causes symptoms of poisoning or toxicity

Toxic Dose

______is amount of medication that will cause death

Lethal dose

What are the factors affecting medication prescription?

1. age
2. paradoxical response
3. Gender
4. Weight
5. Client's Condition
6. Disposition and psychological state
7. method of administration
8. distribution
9. time of administration
10. elimination

_________is responses to medications offosite of the desired response

Paradoxical

_________is a medication order, written formula for preparing and giving a medication

Prescription

_______is medications that can be purchased without and Rx

Over the Counter OTC

Nursing students should not take_______or______orders at any time

verbal or telphone

All medication and other orders must be clear, understandable and open to only one interpretation befor the nurse can do what?

take any action

What must you do if you can not read the providers handwritting?

Clarify it

What is one of the nurses most important responsibilities?

The safe administration of medications

Whose responsibility is it to question the order if it doesnt seem valid?

the nurses

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