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Pharmacology exam 1

Terms in this set (178)

The "official drug name" that can be used by any country or manufacturer.
Generic name
T/F the first letter of a generic name is capitalized
false
Give an example of a generic name
acetominophen
A drug can have one or more of this type name. Name is given and restricted by the manufacturer.
Brand name
T/F the brand name is capitalized
true
Give an example of a brand name
tylenol
a _____________ _____________ includes multiple drugs placed in a group based on commonalities
drug classes
the ______________________________ class is based on what the drug is treating
therapeutic class
the _______________________________ class is based on how the drug works in the body
diuretics
a __________________________ is a single drug selected from multiple drugs in a drug class
prototype
the prototype is selected based on similarities of drug _________________________ and ____________________________ of drug class
components, characteristics
Identify ________________________ _____________________ to medications prior to administration of ANY medication
patient allergies
question unclear/inappropriate prescriptions with who?
the provider
(question multiple pills or vials for a single dose)
prepare medication for one ____________________ at a time
patient
T/F you can administer medications prepared by a fellow nurse
FALSE! Only administer medications that YOU prepare
double check high-alert medications with who?
another RN
Complete an ______________________ ____________________ for medications errors but do not reference or include in ______________________ _________________________
incident report, patient's chart
Give all the examples for a U.S. Schedule I drug
heroin, marijuana, LSD, ecstasy
Give all the examples for a U.S. Schedule II drug
oxycodone, cocaine, methadone, and adderall
Give all the examples for a schedule V drug
Lyrica, couh meds < 200mg/100ml (codeine)
Mechanism of action: _______________________ 'mimics'; produces action/response. Activates a receptor in the body. (Ex. Morphine)
Agonist
Mechanism of action: _________________________ 'blocks'; inhibits a response or effect of an agonist. Medication that blocks a receptor in the body (EX. naloxone).
Antagonist
List the eight components of a prescription
1. Patient's name
2. Date and time written
3. Name of med
4. Strength, Dose
5. Route of administration
6. Time and frequency
7. Quantity to dispense, number of refills
8. Provider signature
Telephone orders may require what two additional confirmative actions?
another RN listening and repeating the prescription back
Telephone orders: provider must sign prescription with ____________ hrs. of order
24
Types of prescriptions:
1. give on regular basis (30 min. before or after scheduled time)
routine
types of prescriptions
2. give once at specified time
one-time
types of prescriptions
3. Now
give once within 60-90 min
types of prescriptions
4. STAT
Give once immediately (within 5 minutes)
types of prescriptions
5. PRN
Administer as needed. Prescription includes dose, frequency, and under what conditions it can be administered
types of prescriptions
6. Standing
prescriptions that can be given for specific circumstances on specific units
When in doubt, assume all medications are not safe when?
during pregnancy
On the pregnancy risk classifications, A is (safest/most dangerous) and X is (safest/most dangerous)
safest, most dangerous
Process of compiling a complete and updated list of medications that the patient has been taking at home and compare it with the provider's orders.
medication reconciliation
Medication reconciliation includes what give groups?
prescribed, OTC, herbal supplements, not prescribed, illegal
An __ is an unwanted effect that is seen commonly with med
Side effect (SE)
An __ is more severe than the other and can place a person at first for harm
Adverse Effect (AE)
List the common AEs of medications
extrapyramidal, anticholinergic, orthostatic hypotension, and bleeding
List the six types of foods that affect medications
grapefruit juice
foods high in vitamin K
and protein
tyramine-rich foods
foods high in Potassium
Dairy products
This type of food that affects medications raises drug levels in the bdoy
grapefruit juice
This type of food that affects medications lowers effectiveness of WARFARIN
Foods high in vitamin K
This type of food that affects medications interferes with absorption
foods high in protein
This type of food that affects medications by elevating the risk of hypertensive crisis
tyramine-rich foods
This type of food that affects medications elevates the risk of hyperkalemia
foods high in potassium
This type of food that affects medications interacts with tetracyclines
dairy products.
what a drug does to the body
pharmacodynamics
pharmacodynamics focuses on what?
point of action
pharmacodynamics: conc. of drug needed to induce a _____________________ ____________________
therapeutic response
pharmacodynamics: interaction of drug with ___________________ ___________
target site
amount of drug required to produce a therapeutic effect
MEC (minimum effective concentration)
Amount of drug that will result in a serious AE
MTC (minimum toxic concentration)
describe the therapeutic index
the drug's safety margin, ratio of MEC to MTC
What do you need to do if the drug has a narrow therapeutic index?
monitor serum drug levels
Describe a half-life
the amount of time it takes for drug levels in the body to be reduced by 50%
Which kind of drug has a higher r/o toxicity? A long half-life or a short half-life. Why?
Long. It takes the drug a while to be metabolized, so too much takes too long to get out
What two levels need to be monitored for drugs with a narrow TI?
The peak and the trough
When do you draw to test for the trough?
Right before the next dose
1 mg = ________ mcg
1000
1 g = ___________ mg
1000
1 kg = ___________g
1000
1 oz = ______ mL
30
1 tsp = ____ mL
5
1 TBSP= _____ mL
15
1 TBSP = ______ tsp
3
1 kg = ________ lb
2.2
1 gr = ______ mL
60
Movement of drug through the body
pharmacokinetics
give the acronym for pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
Give the four questions behind ADME
How will it get in?
Where will it go?
How is it broken down?
How does it leave?
Define absorption
how the medication gets from site of administration to blood stream
Absorption is affected by the _________________ of _______________________
route of administration
Absorption normally depends on what four factors?
solubility of medication
presence of food in stomach
gastrointestinal pH
form of medication
How does pH affect absorption
higher pH = slower absorption
Who normally has a higher pH
older adults
define distribution
how a medication gets from the bloodstream to the site of action
give the three factors that usually affect distribution
protein binding, circulation, and permeability
medication need protein (albumin) to do what?
travel to the site of action (the drug binds to the proteins to travel, so diabetics who are peeing a lot of protein out of their body may have a hard time with medication effectiveness)
the concern with circulation affecting distribution is primarily seen in issues with ___________________________
perfusion
What does "breaking down" a drug mean?
INactivated
What breaks down drugs?
Enzymes
Which organ is the primary organ for metabolism of drugs?
liver
List three other organs that also participate in drug metabolism
lungs, bowel, and kidneys
Give four factors that may affect drug metabolism
age
first pass effect
nutrition
other medications
What two age groups have lower metabolisms?
infants and older adults
What problem are we concerned about with lower metabolisms?
drug toxicity
Describe the first-pass effect
Some medications are inactivated on their first pass through the liver (reducing drug effectiveness)
How do we get around the first-pass effect?
parenteral drug administration routes.
How can poor nutrition affect metabolism?
lowers
Excretion is primarily done through the ___________________
kidneys
though excretion is primarily done through the kidneys, name four other ways/paths
saliva, sweat, tears, and feces
Kidney dysfunction can impair excretion which can lead to possible ____________________
toxicity
Oral absorption depends on what two factors
food/gastric contents
and
form (liquid v. solid)
Oral: place patient in what position
High fowlers
Do not mix medications with large amounts of ________________
food
do not crush which two types of medications?
enteric coated or extended release
for liquid medication, the _____________ of the _______________ which is the ________________ point should be at the level of the ordered dose
base, meniscus, lowest
Oral: list the charted contraindications of oral medications
decreased LOC, lack of gag reflex, dysphagia, vomiting, and NG suctioning
Administer a sublingual (before/after) oral medication
after
True or false, you can give the patient water to help the SL drug dissolve
False. do not eat or drink until the drug is completely dissolved
Between oral and sublingual, which type of drug absorbs faster, why?
sublingual. Oral mucosa is highly vascular
T/F you do not need to use gloves when applying a transdermal patch
false. Any medicine that gets on you ends up in your system
Do/do not cut transdermal patches
do NOT
What must you make sure of before placing a new dermal patch (three steps)
washed skin
gloves
all old patches are removed
How do you dispose of an old TD patch?
fold it in half and use the approved disposal unit
_____________ sites to prevent irritation fromt ransdermal patches
rotate
the area you decide to place a transdermal patch must be _________, ___________, and _____________
clean, dry, and hairless
label the transdermal patch with what three items?
date, time, and initials
optic medication administration is a(n) ______________________________ technique
aseptic
never _______________ the tip of the dropper to a pt's eye
touch
Describe the process of administering eyedrops
rest dominant hand on pt's forehead
use the nondominant hand to pull the lower lid down gently to expose the conjunctival sac. Drop medication in the sac WITHOUT TOUCH THE EYE WITH THE DROPPER. Apply gentle pressure to the nasolacrimal duct (inner tea duct next to the nose) for one minute. Wait five minutes b/t different types of eyedrops
Ensure that eardrops are at __________________ _________________ at administration
room temperature
When preparing to administer eardrops, lay the patient on the ________________________ side
unaffected
Describe how you position the ear for an adult, a child.
adult: pinna/auricle up and back
children YOUNGER than 3: down and back
Hold dropper ______ above the ear canal
1 cm
After instilling drops, apply gentle pressure on ___________________
tragus
Leave the patient on their side for __-__ minutes
1-2
with inhalation, the drug travels directly to the ______________________
alveoli
Describe using an MDI (Meter-dose inhaler)
shake the device 5-6xs
attach spacer if applicable
take deep breath and exhale
place inhaler between lips
press inhaler
take a slow/deep breath (3-5 seconds)
hold breath for ten seconds
take inhaler out of mouth and slowly exhale
If using an inhaled __________________________ rinse mouth afterwards to prevent_________________ infection
glucocorticoid, fungal infection
describe using a DPI (Dry powder inhaler)
do not shake device
Spacer not used
Place inhaler b/t lips
engage inhaler
breathe in rapidly and deeply for 1-2 seconds
for an intradermal injection, you use a _______________ syringe, a __-__ gauge needle, ___-___ inch in length, volume ____-____
tuberculin, 26-29, 3/8-1/2 inch, volume 0.01-0.1
describe the process of an intradermal injection
spread skin taut with thumb and index finger of non-dominant hand
insert bevel up at 10-15 degree angle
advance needle until bevel is under skin
DO NOT aspirate.
inject medication to form a small wheal or bubble
remove needle quickly
DO NOT massage
for a subcutaneous injection, you use a __-__ gauge needle, ___-___ in lenght, volume ____-____
25-27, 3/8-5/8, 0.5-2
for a subcutaneous injection of insulin, use a(n) ___________________ syringe
insulin
inject into _____________ areas (give examples) at a ___-___ angle (with _____ for obese patients)
fatty, 45-90, 90
examples: abdomen, upper arms
For intramuscular injections, use a ____-____ gauge needle, ___-____ in length at a _____ angle
20-23, 1-1.5, 90 degree
intramuscular injection volume: for children under 2 yo, max volume is less than or equal to _____ ML
For adults, max is _______ mL in the deltoid muscle and ______ or less for vastus lateralis and ventrogluteal sites
1, 1, 3
intramuscular injection sites: what is the best for infants?
vastus lateralis
1: name three other muscles than vastus lateralis used for IM injections
2: Which one is rarely used?
3: Why?
1: ventrogluteal, deltoid, and dorsogluteal
2: dorsogluteal
3: risk for damage to sciatic nerve
IV: Give the gauge ranges for a trauma patient, a surgical patient, and a medical patient
16, 18, 20-24
Do not place an IV on the same side as a _________________________ or ___ ____________________
mastectomy or AV fistula (dialysis)
Use a _____________ needle for each insertion attempt
sterile
maintenance of IV: Flush with normal saline after _________-_________ hr. when continuous IV not in use.
8-12
Change IV site after ______-________ hours
72-96
Change IV tubing after ________-_____ hours
24-48
Wipe the port with an antiseptic alcohol wipe for fifteen seconds before __________________ a _________ or ___________
connecting a line or syringe
Flush with saline before and after ________________ of a __________
administration of a medicine
FIND COMPLICATIONS OF IV SYMPTOMS AND TREATMENT
:)
If the drug has a ___________ ______ warning, the FDA deems that this drug poses a particular significant risk to the patient
Black Box
KNOW 2-TRACK METHOD
:)
Where is an epidural injection given?
between the 4th and 5th vertebrae
NG tube: flush tubing before and after each med with ____-______ mL of ________________
15-30 saline
The ATI book lists additional rights to medication administration. Ten in all. What are they?
Right:
client
medication
dose
time
route
documentation
client education
refuse
assessment
evaluation
Which of these is not an acceptable form of identification for a patient before giving medication?
name
assigned identification number
telephone number
room number
birth date
photo ID
room number
What three ways can we check for allergies?
asking the client
looking for an allergy bracelet or medal
reviewing the MAR
Use _________________ ______________ to identify clients
barcode scanners
Read medication labels and compare them with the MAR ____________ times
three
Describe the three times you compare the medication labels with the MAR
before removing the container, when removing the amount of medication from the container, and in the presence of the client before administering the education
leave __________-________________ medication in its package until administration
unit-dose
True or false: when using an automated medication dispensing systems, you only perform one check since the computer essentially performs the others
false. Always check three times
Use a _______-___________ system to decrease errors. If not available, ____________________________ the correct medication dose
unit-dose, calculate
check a ____________ _______________ to ensure the dose is within the usual range
drug reference
when performing medication calculations or conversions, double-check yourself by both the drug reference and what additional step?
Having another qualified nurse check the calculated dose
what crucial principle of medication administration helps to maintain a consistent therapeutic blood level?
administering the medication on time
administer time-critical medications ______ min. before or after the prescribed time. Facilities define which medications are time-critical, usually this includes medications that require a consistent blood level (antibiotics)
30
administer non-time-critical medications prescribed once daily, weekly, or monthly within ______ hr(s) of the prescribed time
2
administer non-time critical medications prescribed more than once daily (but not more than every 4 hrs) within ____ hr(s) of the prescribed tiem
1
always use different syringes for _________________ and _______________ med admin
enteral and parenteral
immediately ____________________ the medication, dose, route, time, and any pertinent information, including the client's response. _______________________ (same word) the medication AFTER administration, NEVER before
document
For some medications, in particular those to alleviate pain, evaluate the client's response and document it later, perhaps after _________________ min.
30
ATI says to inform the clients about at least four aspects of their medication. What are they?
its purpose, what to expect, how to take it, and what to report
to individualize the teaching, determine what three questions pertaining to the client's knowledge?
what they already know, what they need to know, and what they want to know
T/F if the client refuses a medication, the patient is then deemed mentally unfit and security restrains them in order to administer the medication
.....................
it's false.
I really hope you said false.
If not I'm scared of you
Haha just kidding
But yeah if they say no it's gucci. Just explain the consequence, inform the provider, and document the refusal
follow up with clients to verify ________________ effects as well as ___________________ effects
therapeutic and adverse
Eating food with tyramine is contraindicated for those taking __________________
MAOIs
deficiency of ________________ ___ can decrease the therapeutic effects of warfarin and place clients at risk for developing blood clots
vitamin K
________________________________ can interact with a chelating agent (milk) and form an insoluable, unabsorbable compound.
...
__________________________ can interact with a chelating agent (milk) and form an insoluble, unabsorbable compound. Instruct clients not to take __________________________ within two hours of consuming dairy
tetracycline
______________________________ ________________ seems to act by inhibiting medication medtabolism in the small bowel, thus increasing the amount of medication available for absorption of certain oral medications. This increases either the therapeutic effects or the adverse reactions. Instruct clients to not drink _____________________________ ______________________ if they are taking such a medication
grapefruit juice
Food often ________________________________ the rate of absorption
decreases
Name the Pregnancy risk category with A being the least risk and X being the most risk:


Adverse effects have been demonstrated on animal fetuses. There are no adequate and well-controlled studies in pregnant clients, but use of the medication during pregnancy can be warranted based on the potential benefits

Adverse effects have been demonstrated on human fetuses based on data from investigational or marketing experience, but use of the medication during pregnancy can be warranted based on the potential benefits

There is no evidence of risk to fetus during pregnancy based on adequate and well-controlled studies

There is no evidence of risk to animal fetuses based on studies, but there are no adequate and well-controlled studies in pregnant clients

Adverse effects have been demonstrated on animal and human fetuses based on studies and data from investigational or marketing experience. The use of the medication is contraindicated during pregnancy because the risks outweigh the potential benefits
C
D
A
B
X
Describe the barriers to absorption for the sublingual and buccal route
swallowing before dissolution allows gastric pH to inactivate the medication
List the barriers to absorption for the rectal/vaginal route
presence of stool in the rectum or infectious material in the vagina
list the barriers to absorption for the inhalation route (via mouth/nose)
inspiratory effort
describe the absorption pattern of the intradermal route
slow and gradual
__________________ _______________________ act as agonists and antagonists, with limited affinity to receptor sites. For example, nalbuphine acts as an antagonist at mu receptors and an agonist at kappa receptors, causing analgesia with minimal respiratory depression at low doses
partial agonists
For doses less than 1.0 mg, round to the nearest _______________________
hundredth place
for dosages greater than 1.0 mg, round to the nearest ______________________
tenth place
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