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41 Cards in this Set

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Pharmaceutics
Pharmacokinetics
Pharmacodynamics
Pharmacotherapeutics
4 components of pharmacology
in clinical pharmacology, this term combines everything - drugs or chemicals used for treatment, prevention and diagnosis of disease
Pharmacotherapeutics
Interactions between drugs and chemical components of living tissues or systems (the basic science of the drug – how and why). It determines the nature and intensity of the response.
Pharmacodynamics
study of movement of drugs in body - absorption, distribution, metabolism, excretion
Pharmacokinetics
1.sources
2.constituents
3.dosage forms
4.routes of administration
5.stability
6.storage (follow directions of how to handle)
Pharmaceutics
ANY CHEMICAL that is put into the human body with the intent to affect function.
food extracts, herbs, supplements, Rx, illegal (natural is not safe)

FDA definition: a chemical INTENDED to diagnose, cure, mitigate, treat, or prevent disease.
Drug
It reviews the implementation of the Food, Drug and Cosmetic Act of 1938 – to regulate drug safety, all new drugs must undergo testing for toxicity. It oversees and approves/denies new drugs for marketing, including both Rxs and OTCs

(BEFORE marketing, the MANUFACTURER determines with clinical trials:
safety, effectiveness, possible interaction with other substances, appropriate dosages)
Federal Drug Administration (FDA)
1.Marketing
2.Not required to report OTC adverse reactions
3.Can substitute a GRASE* ingredient without changing name of OTC drug
4.Can substitute a GRASE ingredient without warning (label) to public
*(GRASE generally regarded as safe equivalent)
What is not regulated by the FDA of Over the Counter Drugs (OTCs)
The FDA does not authorize or monitor premarket testing of these.
No quality control.
As long as the manufacturer does not use the terms "cure" or "treat" a specific disease, they can legally get away with selling a lot of unproven things.
NATURAL does not equal SAFE
FDA does not regulate supplements - a supplement is not a drug
1.Chemical classification - like structure
2.Pharmacological classification - mechanism of action
3.Therapeutic classification - indications or uses
4.Prototypes - Individual drugs that represent a group (classification) of drugs. Other drugs in that category will have similar features.
Drug Classification
This is therapeutically equivalent to original trade name.
Must prove BIOEQUIVALENCE without repeating all of the R&D (occasional differences in absorption - increase could lead to toxicity while decrease could lead to lessened therapeutic effect)
FDA approved
Generic Drug
The generic name is consistent (universal) for all. For older drugs, there may be many trade names. Not everyone prescribes the same trade name.
Why is the generic name used in drug reference books?
-Not everyone knows/uses the same trade
-Single chemical can have multiple trade names
-Different chemicals can have same trade name
-leads to miscommunication and medication errors
What are the disadvantages of using trade names?
Unapproved use of an FDA approved drug.
Practitioner prescribes drug for a different Dx that has not undergone research for that use.
Not illegal (malpractice if outcome is bad).
Off label Drug (unlabeled)
research only, no legal use
peyote, LSD, heroin
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule I
Therapeutic use, high abuse potential
no refills on Rx; rewrite only
amphetamine
morphine
cocaine
opium
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule II
lower abuse potential
5 refills before rewrite
refills must be made w/i 6 mos
stimulants
amobarbital
pentobarbital
paregoric
anabolic steroids
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule III
lower abuse potential with possible psychological dependence
phenobarbital
petazocine
diazepam
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule IV
low abuse potential
states vary
Terpin hydrate w/ codeine
triamine w/cod
Lomotil
Robitussin A-C
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule V
TO ADMINISTER DRUGS
(per order of MD/DO, APN with *CTP)
*CTP=certificate to prescribe
What is the nursing legal responsibility regarding drugs?
right drug
right dose
right client
right time
right route of administration
Documentation sometimes considered the "sixth right"
5 Rights
T/F: an RN Cannot DISPENSE DRUGS IN OHIO.
T: an RN Cannot DISPENSE DRUGS IN OHIO.
T/F: MD/DO, APN with CTP can prescribe drugs in Ohio.
T: MD/DO, APN with CTP can prescribe drugs in Ohio.
MD/DO, APN with CTP
WHO CAN DISPENSE DRUGS or SAMPLES IN OH?
When discussing the use of any chemical with a patient, the professional and ethical responsibility is the same no matter what the chemical.
What are the chemicals?
Prescriptive
Over the counter FDA approved drug
Herbal or supplement not approved by FDA
A customized medication prepared by a pharmacist according to a doctor's specifications to meet an individual patient need. Pharmacists make medications from scratch using raw chemicals, powders and devices to meet the unique needs of prescribers and patients.
Who:Pharmacists
Where:Local pharmacy or corporate
Regulated:FDA, Federal govt., State govt.
Compound Pharmacy
Ask your pharmacist for recipe
Ask your pharmacist for reference on pharmacokinetics e.g. at MCO: Micromedic data base
How you find out about the drugs compounded
drug used for Dx, Tx, or prevent disease or condition affecting <200,000 people USA.
Not considered good financial investment for R&D and marketing.
orphan drug
1. preadministration assessment
2. dosage and administration
3. evaluating and promoting therapeutic effects
4. minimizing adverse effects
5. minimizing adverse interactions
6. making PRN decisions
7. managing toxicity
Seven aspects of drug therapy
5 rights – drug, patient, dose, time, route (documentation), in addition,
1.certain drugs have more than one indication
2.Many drugs can be administered by more than one route and dosage
3.certain intravenous agents can cause severe local injury if the line through which they are infused becomes extravsated.
*do not administer if you don’t understand
"dosage and administration" basic guidelines to help the nurse provide correct drug administration
pro re nata – as needed. Need to know the reason for the drug
PRN decision
1.drug name and therapeutic category
2.dosage size
3.dosing schedule
4.route and technique of administration
5.expected therapeutic response and when
6.nondrug measures to enhance
7.duration of tx
8.method of drug storage
9.symptoms of side-effects
10.drug-drug and drug-food interactions
11.whom to contact in event of therapeutic failure, severe adverse rxns, or interactions
10 items the nurse must provide during patient education
a.collect baseline data needed to evaluate therapeutic responses
b.collect baseline data needed to evaluate adverse effects
c.ID high-risk pts
d.asses the pts. capacity for self-care
DRUG HISTORY: included Rx, OTCs, supplementals and herbals, and nonmedicals, allergies, and idiosyncratic to pt.
Nursing Process For Drugs:
1. Preadministration Assessment
a.judge the appropriateness of the prescribed regimen
b.id potential problems the drug may cause
c.determine the pts capacity for self-care
Nursing Process For Drugs:
2.Analysis: 3 objectives
•the drug has no actions that are known to benefit individuals with the pts medical diagnosis
•the pt failed to respond to the drug in the past
•the pt had a serious adverse rxn to the drug in the past
•pt has a condition or is using a drug that contraindicates the prescribed drug
When to question a drug's appropriateness
goal: to produce maximum benefit with minimum harm.
Allows you to anticipate adverse effects, rather than react after the fact.
a. define goals
b. set priorities
c. id interventions
-drug administration, interventions to enhance therapeutic effects
-interventions to minimize adverse effects and interactions
-pt education
d. establish criteria for interventions
Nursing Process For Drugs:
3. Planning
a.drug administration
b.pt education
c.interventions to promote therapeutic effects
d.interventions to minimize adverse effects
Nursing Process For Drugs:
Implementation
a.therapeutic responses
b.adverse drug rxns and interactions
c.compliance
d.satisfaction with Tx
Nursing Process For Drugs:
5.Evaluation
To reinforce the relationship between pharmacologic knowledge and nursing practice.
What is the reason nursing implications are integrated into each chapter?
1.Preadministration Assessment
Therpaeutic Goals
Baseline Data
ID High-Risk Pts
2.Implementation: Administration-Routes, Administration
Implementation: Measures to Enhance Therapeutic Effects
3.Ongoing Evaluation and Interventions
Summary of Monitoring
Evaluating Therapeutic Effects
Minimizing Adverse Effects
Minimizing Adverse Interactions
Managing Toxicity
Modified Nursing Process Format
deficient knowledge related to the drug regimen
A good all-purpose nursing diagnoses when it comes to drugs.