official or nonproprietary name, not protected by trademark, usually not capitalized, easier to pronounce than chemical name, may be cheaper than trade name products, one of 3 names a drug may have
name that shows the actually chemical make-up of a drug, one of 3 names a drug may have
brand name, developed and marketed by a pharmaceutical company under a registered trademark, drugs have only one generic name, only one chemical name but may have many trade/brand names; usually start with a capital letter, usually protected for 17 years
commonly observed side effects on a tissue or organ system other than the one being sought by administration of the drug
the action of one drug decreases the intensity or shortens the duration of action of another drug
one drug increases the intensity or prolongs the action of another drug. This can have a positive or negative effect
a form of synergism in which the action of one drug is increased by the presence of another drug. In this case, the 2 drugs have different actions, but one increases the effect of another
signature of a prescription
On prescription: directions for the patient, usually preceded by "sig:" this is where the physician indicates what instructions are to be put on the label to tell the patient how, when and in what quantities to take the medication.
On prescription: patient's name and address, date, Rx symbol
On prescription: directions for pharmacist, size of each dose, amount to be dispensed, form of the drug like tablet or capsule
On prescription: may be regulated by federal law if the drug is a controlled substance; must write number of times refill allowed
On prescription: must include a manual signature of the physician and the DEA number
On prescription: name of drug, dosage form and strength, Main part of prescription
Federal Trade Commission. Regulates advertising of OTC drugs. Protects consumers from misleading and fraudulent advertising. Reviews advertising claims. Can order a company to change their ad.
Food and Drug Administration
Drug Enforcement Administration. Purpose to enforce drug laws. The federal law enforcement agency responsible for the control of narcotics and drug abuse, investigates illegal sale of dangerous substances, educates public for drug abuse prevention. Regulates the manufacture, dispensing, storage, and shipment of controlled substances including medications with human abuse potential.
What schedule of drugs is illegal to possess has a high potential for abuse and is not accepted for medical use in the U.S.?
What schedule of drugs has a high potential for abuse and may lead to severe physical or severe psychological dependence, but also has a currently accepted medical use in the United States?
Which schedule drug's potential of abuse is less than those in Schedules I and II and there is a currently accepted medical use in the U.S., but abuse may lead to moderate or low physical dependence or high psychological dependence and includes combination drugs that contain limited amounts of narcotics or stimulants?
Which drug schedule has a lower potential for abuse relative to Schedule III drugs and there is a current accepted medical use in the U.S., but abuse may lead to limited physical or psychological dependence relative to Schedule III drugs and includes minor tranquilizers and hypnotics?
Which drug has a low potential for abuse and there is a current accepted medical use in the U.S., but abuse may lead to limited physical dependence or psychological dependence relative to Schedule IV drugs, and they include drug mixtures containing limited amounts of narcotics?
Factors that affect drug action
time of day
level is measured from the end of the black part of the plunger closest to the needle. Insulin syringes are calibrated to 50 or 100 units, tuberculin syringes hold only 1 mL and are marked in tenths of a mL, and 3 mL syringes are calibrated with cc's and minims. mL and cc are the same.
4 main sources of drugs
synthetic drugs developed in laboratories
Decreased sensitivity to the effects of a drug over repeated exposures. Effect lessens or will not occur at all. Drugs may need to be increased or entirely changed.
Quicker than other routes; body absorbs oral meds more slowly because they have to be digested before entering the bloodstream; parenteral injections are more immediate
may be treated w/ epinephrine or EpiPen. EpiPen can be injected thru clothing, firmly press to outer thigh, hold for 10 seconds, remove and massage to promote absorption, notify physician or go to ER, periodically check unit for exp. date, store where readily available
reading a drug order
Make sure it is complete and clarify any information that is unclear
patient population and drug dose
usually geriatric and pediatrics are considered to respond differently than an average adult patient
documentation of medication administration
medical office may use a preprinted form to record the medications (Rx and OTC)(also vitamin supplements and herbals) a Pt is taking; it includes detailed info about each med so physician can tell at a glance what the Pt. is on; includes: Pt name, date of birth, any drug allergies, date prescribed or when Pt started taking OTC, name and dose of medication, route of administration, whether it is Rx or OTC, also called patient medical record, always document administration of meds carefully in chart, if it wasn't charted, it wasn't done
to detect TB infection
2 methods: Mantoux test (we did) or Tine test
Test reactions based on the amount/size of induration present and are interpreted according to the manufacturer's instructions that accompany the test.
Recommended for individuals w/ close day-to-day contact with active TB Pt, individuals w/ symptoms of TB, individuals w/ lowered immunity such as HIV Pts.
patient population and drug dose-geriatric
Patients 65 and older
body processes slow down
changes in body effect a change in the pharmacokinetics of a drug, including its absorption, distribution, metabolism and excretion
denotes any medication route other than the alimentary canal/gastrointestinal tract/oral
Standards for both brand and generic drug manufacturers
The generic drug's label must contain the same information for patient education. The FDA has found no difference in the rates of reported side effects between brand-name and generic drugs. The generic manufacturing process must have comparable quality and production standards. Brand name firms produce approximately 50% of the generic drugs on the market, making generic versions of their own products or other brand-name products. Generic versions must act in the same period of time as the brand-name version, delivering the same amount of active ingredient into the bloodstream in the same amount of time. The generic version must have the same active ingredients, labeled strength, route of administration & dosage form (tablet, patches, etc). Generics do not have to replicate the human clinical trials of the brand-name drugs but applicants must prove that the product performs exactly as the brand-name version.
Specific geriatric problems possible with drug dosage
Fat-soluble medications pass through blood-brain barrier more easily: May affect central nervous system; increases risk of vertigo and confusion
Fewer protein-binding sites available in bloodstream: Decreases drug passage through cell membranes; increases drug blood level; may lead to toxicity
Increased percent of adipose/fat tissue in the body: Increases likelihood of drug storage in fat; may lead to drug toxicity
Stomach takes longer to empty, level of gastric acidity
decreased: Geriatric patient physiologic changes may result in: increased risk of stomach irritation and ulceration
patient population and drug dose-pediatric
includes neonates, infants and children up to about age 18
requires special considerations because dosages are based on body weight and body mass
a pediatric patient's body weight and body mass are lower than average for regular drug doses so the medical assistant must properly weigh and measure and record vital signs with pediatric patients
hypersensitivity known as anaphylaxis, a severe and rapid multisystem allergic reaction, can be fatal, type of shock which causes massive blood vessel dilation and capillary leak, decreased cardiac contractions, dysrhythmias and edema of bronchial tissues
an immune response to a drug that results in inflammation and organ dysfunction; immediate or days later, itching, sneezing, rash to life threatening symptoms
abnormal unexplained unusual drug response in a patient with a peculiar effect in body chemistry; unlike an allergy the chemical defect is not part of a hypersensitivity reaction
effect of a drug administered to the mother that results in abnormalities in the fetus
caused by tubercle bacillus, Mycobacterium tuberculosis, rod-shaped bacteria; infectious disease usually attacks lungs but can occur almost anywhere particularly brain and kidneys; may be present and cause positive test result without active symptoms
rarely used TB test, 2 mm tines on disk inpregnated with tuberculin, pressed into skin 1 to 2 mm, amount of tuberculin not precisely controlled so not clear results
most commonly used TB test, uses short (3/8" to 1/2") small gauge (25G to 27G) intradermal needle and 1 mL capacity syringe, standard dose 0.10 mL of PPD solution containing 5 TU (tuberculin units); Brand names Tubersol, Aplisol
Mantoux Test process
1. use anterior of forearm approx 4" below elbow bend (volar surface) avoid hairy areas, visible veins, scar tissue, red swollen areas, bruised areas, dermatitis or other skin conditions.
2. cleanse skin thoroughly w/ antiseptic wipe, allow to dry completely.
3. Inject tuberculin into superficial layer of skin. If blood appears, it is not significant and will not interfere with test.
4. When test has been administered, must be read 48 to 72 hours, best at 48.
purified protein deriverative extracted from a culture of tubercle bacilli (the causative agent of TB) makes up tuberculin which is injected to test for sensitivity to the microrganism; when introduced into the skin of an individual with an active or latent case of TB, tuberculin causes a localized thickening of the skin, resulting in induration
raised area on a positive TB test; an abnormally hard spot caused by accumulation of small sensitized lymphocytes that occurs in an area in which the tuberculin was injected into the skin
Controlled substances (like Schedule II or CII) must be kept in a locked cabinet separate from other drugs including OTCs and inventoried separately. Inventories are kept of all drugs. Damaged or spilled drugs must be witnessed and documented by 2 people. Prescription pads must also be secure.