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Pharmacology Exam 3

Terms in this set (70)

pharmacology
the study of drugs, their sources, their nature, and their properties - and the study of the body's reaction to drugs
1. chemical name
2. generic name
3. trade name (brand name)
all drugs have a chemical, generic, and trade name. identify which is which
1. 7-chloro-1,3-dihydro-1methyl
2. diazepam
3. Valium
which body system it affects
the therapeutic use
chemical class (beta blocker/ace inhibitor, etc.)
pharmacological class (how it works, its action)
(OTC or Rx
Illicit )
name 4 ways you can classify a drug
generic name is NOT capitalized
trade name is always capitalized
ex: diazepam / Valium
how can you tell the difference between a drug's generic name and trade name when they are both written?
always, but especially when you suspect it
When should you ask about illicit drug and alcohol use?
the pharmacist
what is one of the best resources for drug quality and safety questions?
pharmacist
nursing drug handbook
pharmacology texts
medication package inserts
physicians desk reference (PDR)
if you have a question about a drug's safety and quality, what are some resources you could refer to?
sets official drug standards
defines prescription drugs
regulates controlled substances
improves safety
requires proof of efficacy
list 5 things the US Drug Legislation does
schedule 1 drugs - things like heroin, LSD (illegal drugs)
schedule 5 drugs - things like cough syrup
the higher the schedule indicates the more dangerous the drug, more addictive with more adverse side effects
with schedule drugs (controlled substances), describe the difference between schedule 1, schedule 5, and in between
pharmokinetics
the study of drugs within the body, absorption , distribution, metabolism, excretion; what the body does to the drug
pharmodynamics
the study of what a drug does to the body
absorption
the movement of a drug into the bloodstream
(how will it get in?)
route of administration
drug solubility
pH / ionization
BLOOD FLOW
vascularity of the target area
list some factors that affect absorption
NEVER
should you ever let a controlled substance out of your sight, sign off on someone else without seeing them waste it, or administer it to a pt without being the one to draw up the medication?
IV = fastest (BUT ALSO WEARS OFF THE FASTEST)
coated = slowest
what route of medication administration yields the fastest absorption rate?
what route yields the slowest absorption rate?
enteral route
which route of administration is the most common, most cost efficient, and safest?
enteral route
which route of drug administration has the advantage of having a vast amount of absorptive surface area?
client must be able to swallow
client must be conscious
subject to "first pass metabolism"
variations exist in the ability of the GI tract to absorb (subject to the environment of the stomach
list some considerations to keep in mind when using the oral / enteral route
topical route
which route of drug administration is effective at producing a local effect with minimal amounts of medication reaching the systemic circulation
kidneys, stool, skin, lungs
list 4 ways that excretion of a drug can happen
liver
what is the main organ involved in drug metabolism?
distribution
drug transport to tissues and organs
(where will it go?)
local blood flow to the target area
membrane permeability
protein-binding capacity
list 3 factors that affect distribution
inflamed areas are very permeable due to vasodilation

the blood-brain barrier is not very permeable, which is helpful in not letting just anything through to affect the brain
give an example of a highly permeable membrane where distribution would be more active, vs a less permeable membrane that does not allow for much distribution
proteins can transport drug particles in the body, so the more proteins in the blood, the better the distribution. BUT they have to be able to let them go
how does protein-binding capacity affect distribution of a drug?
metabolism
the biotransformation or chemical conversion of a drug in the body (usually done by the liver)
(how is it broken down?)
there are enzymes in the liver that can deactivate certain chemicals of a drug
how does biotransformation occur in the liver?
liver function
health/disease status
first-pass effect
list 3 factors that can affect metabolism of a drug
drugs that are absorbed via the GI tract are circulated to the liver first via the hepatic portal vein

liver then acts as a filter, filtering out a percentage of the drug to be excreted without use

only part of the drug is circulated systemically

the combination of processes is termed "first pass effect"
describe the process of the first-pass effect
excretion
elimination of a drug from the body
(how does it leave?)
functioning of the organs (especially kidneys, liver, and lungs)
exocrine glands
list 2 factors that affect the excretion of a drug from the body
therapeutic index/range
some drugs have a narrow therapeutic index so we have to draw blood to check active levels
the ratio between a drug's therapeutic benefits and toxic effects
half-life
the length of time it takes for your body to eliminate 50% of a drug
an individual's ability to metabolize and excrete a drug
KIDNEY FUNCTION PLAYS A HUGE ROLE
kidney failure = longer half life
what determines the half-life of a drug?
pharmacodynamics
the study of the interactions between drugs and their receptors and the events that result
receptors
think "lock and key"
only form if receptor and drug have similar shape
the better the fit, the better the response
some drugs don't need a receptor
drugs form chemical bonds with specific sites called:
temperature
pH
(must be correct environment for drugs to work)
what can affect the shape of a receptor so that drugs cannot bind to them?
palliative effects
(used often in end-of-life care)
some drugs are given to provide comfort to a pt, not a cure. what is this type of effect called?
palliative effects
supportive effects
substitutive effects
chemotherapeutic effects
restorative effects
what are some types of primary effects that medications can have?
side effects
adverse reactions
toxic reactions
allergic reactions
idiosyncratic reactions
cumulative effect
what are secondary effects that medications can have?
idiosyncratic reaction
an unexpected reaction to a drug that is unusual and unexplainable, but not necessarily harmful
anaphylactic reaction
what type of allergic reaction is characterized by:
rapid onset
sweating
feeling of apprehension
tightness in throat
bronchospasms
tingling in mouth, throat, or face
itching
weakness
loss of consciousness
tingling
leads to bronchospasms wherein airways can close off and you lose that airway -> massive vasodilation which leads to drastic drop in BP - no airway, no BP = possible death
what is a red flag when it comes to anaphylactic allergic reactions?
synergistic drugs
what are 2 drugs called when the effects of giving both drugs are more than the effect of individual drugs taken separately (can work together)
antagonistic drugs
drugs that block or change the effects of an addictive drug
tolerance
a decreasing response to repeated doses of a medication
drug dependence
a person's reliance on or need for a drug
drug misuse
the nonspecific, indiscriminate, or improper use of drugs including alcohol, OTC, and prescription drugs
drug abuse
the inappropriate intake of a substance by amount, type, or situation, continuously or periodically
illicit drugs
drugs that are sold illegally
a drug that has no risk to the fetus
what is a category A drug in regards to pregnancy?
a drug that has no risk for animal fetuses but the affects on human fetuses is unknown and unavailable
what is a category B drug in regards to pregnancy?
a drug that is known to cause adverse effects in animal fetuses but the effects are unknown in humans
what is a category C drug in regards to pregnancy?
a drug with possible risk reported for human fetuses; mother and physician must do a risk-benefit analysis to decide whether or not to use this type of drug
what is a category D drug in regards to pregnancy?
a drug that should never be used during pregnancy because it is known to cause adverse effects in the fetus
what is a category x drug in regards to pregnancy?
order is carried out until otherwise cancelled by physician
ex: 500 mg Ampicillin PO q6h
what is a routine drug order? give an example
STAT order
an order for a drug to be given one time only and NOW
single order
when a drug is ordered to be given one time only
PRN order
an order written to administer a drug to a pt as needed; nurse has to determine the need
read back to confirm and sign that you have done so
what should you always do when taking a verbal or telephone medication order from a physician?
medical hx
routine meds taken at home
allergies
vital signs
whether pt's general condition is appropriate for the medication
evaluate your knowledge of the medication
identify biological factors that affect drug metabolism
mental status
coordination
ability to self-administer the drug
swallowing
what are some things the nurse should always assess for or have knowledge of before giving a medication?
effectiveness of the drug
side effects
signs of toxicity or adverse reactions
what should the nurse always asses for after a medication is given?
realistic and individualized
what should goals set for your pt always be?
never
when should you assume that a pt has taken their medication if it is not documented?
dirty
never recap a _________ needle
immediately assess pt vital signs and physical status

notify physician of mistake and vital signs

notify charge nurse and other nurses in the area

check with your agency for incident reporting
what steps should be taken if you commit a medication error?
true
when taking a medication history, do not assume the pt is taking his/her prescribed meds correctly, or at all. true/false?
is the pt accepting of their dx for which the medication is being given?

does the pt understand why meds are being taken and the intended effect?

what is the pt's normal schedule for an average day?

how many meds is the pt taking?

are meds given more than once a day?

are there financial concerns?

is there a healthcare provider-client conflict?

does the pt see more than one physician?

is the pt forgetful?

does the pt have sensory deficits?
what types of questions might you ask (yourself and the pt) if a pt is noncompliant to taking their prescribed medications?
better if you have a relationship with the child
be truthful
give only information the child can handle
give child a role to play
be positive - expect cooperation
disguise bad taste in applesauce, pudding, etc.
use smaller doses
mild restraints may be needed
what are some considerations to keep in mind when administering medication in pediatrics?
they often have altered memory
less acute vision
decrease in renal function
less complete and slower absorption from the GI tract
decreased liver function
decreased organ sensitivity
altered quality of organ responses
what are some considerations to keep in mind when giving medications to elderly adults?
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