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Taylor: Chapter 29 - Medications

Terms in this set (54)

pharmacology
the study that deals with chemicals that affect the body's functioning
generic name
Assigned by the manufacturer that first develops the drug. Identifies the drug's active ingredients.
official name
the name by which the drug is identified in the official publications USP and NF
trade name
The brand name or proprietary name is a trademarked name selected by the drug company to market the product.
pharmacolkinetics
the effect of the body on the drug
absorption
the process by which a drug is transferred from its site of entry into the body to the bloodstream.
pharmacotherapeutics
the dose of a drug that achieves the desired therapeutic effect without causing other undesireable effects
What factors determine distribution?
- blood flow to the tissues
- the drug's ability to leave the bloodstream
- the drugs ability to enter the cells
metabolism
Biotransformation or change of a drug from its original form to a new form. Liver is the primary site for drug metabolism.
excretion
the process of removing a drug, or its metabolites from the body
pharmacodynamics
the process by which drugs alter cell physiology and affect the body
adverse drug effects
undesirable effects other than the intended therapeutic effect of a drug
allergic effect
An immune system response that occurs when the body interprets the administered drug as a foreign substance and forms antibodies against the drug.
anaphylactic reaction (anaphylaxis)
A life threatening allergic reaction that results in respiratory distress, sudden severe bronchospasm, and cardiovascular collapse. It is treated with vasosupressors, bronchodilators, corticosteriods, oxygen therapy, intravenous fluids, and antihistamines.
drug tolerance
Occurs when the body becomes accustomed to the effects of a particular drug over a period of time. Larger doses are required to produce the desired effect.
toxic effects
Specific groups of symptoms related to drug therapy that carry risk for permanent damage or death. The organ or system effected by the toxicity is used to name the toxicity.
cumulative effect
Occurs when the body cannot metabolize one dose of a drug before another dose is administered
idiosyncratic effect
Any unusual or peculiar response to a drug that may manifest itself by over response, under response, or even the opposite of the expected response.
antagonist effect
When two drugs have a combined effect that is less than that of each drug alone.
synergistic effect
When two drugs have a combined effect that is greater than that of each drug alone.
teratogenic
Known to have the potential to cause developmental defects in the embryo or fetus and are definitely contraindicated.
placebo
pharmacologically inactive substance
What are the factors that affect drug action?
- developmental considerations
- weight
- gender
- cultural and genetic factors
- psychological factors
- pathology
- environment
- timing of administration
therapeutic range
The concentration of drug in the blood serum that produces the desired effect without causing toxicity.
peak level
Highest plasma concentration of a drug. Measured when absorption is complete.
trough level
The point when the drug is at its lowest concentration. Test is usually drawn in the 30 minute interval before the next dose.
half-life
The amount of time it takes for 50% of the blood concentration of a drug to be eliminated from the body.
medical orders
A licensed practitioner must issue orders for a medication to be administered to a patient.
p.r.n. order
"as needed"
What makes up a medication order?
1. patient's name
2. date and time the order is written
3. name of the drug to be administered
4. dosage of the drug
5. route by with the drug is to be administered
6. frequency of administration of the drug
7. signature of person writing the order
MAR
medication administration record
CMAR
computerized medication administration record
What should you ask yourself before administering a drug?
1. Do the patient's condition, symptoms, and health status warrant receiving this medication?
2. Does it make sense for the patient to have this medication?
3. Is the correct dose and preparation ordered?
What are the three checks of medication administration?
1. When the nurse reaches for the container or unit dose package
2. After retrieval from the drawer and compared with the CMAR, or compared with the CMAR immediately before pouring from a multidose container
3. When replacing the container to the drawer or shelf or before giving the unit dose medications to the patient
What are the "rights" of medication administration?
1. right medication
2. right patient
3. right dosage
4. right route
5. right time
5. right reason
6. right documentation
parenteral
outside the intestines or alimentary canal
ampule
a glass flask that contains a single dose of medication for parenteral administration
vial
a glass bottle with a self-sealing stopper through which the medication is removed
prefilled cartridge
cartridge with a single does of medication with a reusable holder or injection device
prefilled syringe
syringe already filled with a medication and usually have their own needle attached
intradermal injections
- administered into the dermis
- longest absorption time
- sensitivity tests and local anesthesia
- inner surface of forearm, upper back under the scapula
- tuberculin syringe calibrated in tenths and hundredths of a milliliter with a 1/4 to 1/2"" 26 or 27 gauge needle.
- dosages are usually < 0.5 ml
- deliver at a 5 to 15 degree angle
subcutaneous injections
- administered into adipose tissue
- slow, sustained rate of absorption
- insulin and heparin
- outer aspect of upper arm, abdomen, anterior aspects of the thigh, upper back, upper ventral or dorsogluteal area
- absorption rate varies based on site
- use syringe with volume appropriate for dose with 3/8 to 1"" 25 to 30 guage needle
- dosages must be less than 1mL to minimize discomfort
- deliver at a 45 to 90 degree angle
intramuscular injections
- delivered into certain muscles
- faster onset of action than subq injections.
- antibiotics, hormones, and vaccines
- hip, the mid thigh and upper arm
- needle length based on patient's adipose tissue using a 18 to 25 gauge needle depending on the medication
- dosage is generally 1 to 4 mL for all but the deltoid site which should be no more than 1mL
- deliver using the z-track technique at a 72 to 90 degree angle
z-track technique
Recommended for all IM injections to ensure medication does not leak back along the needle track and into the subcutaneous tissue.
intravenous route
Most dangerous route because the drug is placed directly into the bloodstream, can't be recalled, and actions cannot be slowed.
What methods are used to administer IV medications?
- IV solution - medications are added to infusion solution
- intravenous bolus or push - single injection of a concentrated solution directly into an IV line.
- intermittent intravenous infusion - using a IV infusion pump
piggyback delivery system
Requires the intermittent of additive solution to be placed higher than the primary solution container so the primary solution will not back up into the additive bag once it is complete.
volume-control administration set
Medication is diluted with a small amount of solution and administered through the pt IV line.
mini-infusion pump
A syringe pump used for intermittent infusion that is battery operated and allows medication mixed in a syringe to be connected to the primary line and delivered by mechanical pressure applied to the syringe plunger.
topical application
usually intended for direct action at a particular site although they can also have systemic effects
What areas of the body are topical medications applied?
- skin
- mucous membranes
- eyes
- ears
- nose
- rectum
- vagina
What are the most common types of skin applications?
- ointments
- creams
- lotions
- transdermal delivery systems
What types of drugs are delivered via the transdermal route?
- hormones
- narcotic analgesics
- cardiac medications
- nicotine
inhalation route
Aerosolized drugs delivered in small particles and breathed in by the patient
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