Ch 61 Intro To Pharmacology

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Medication

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Medicinal agent that modifies body functions.

Medicine or drug is any substance used to prevent disease or pregnancy, aid in diagnosis & treatment, restore/ maintain bodily functions

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Pharmacology

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Science that deals with orgin, nature, chemistry, effects, and use of medication.

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RPH registered pharmacist

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Health care professional who is licensed to prepare and dispense med.

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Medication orders

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Legally written by doctor of medicine, doctor of osteopathy, dentist, veterinarian. Many states a PA is also allowed.

Some state allow nurses to write ptesciption NP, a certified registered nurse anesthetist (CRNA), certified nurse midwife.

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Nclex alert

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Important to teach client about medication, and side effects

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FDA

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Food and drug administration, ensure that medication and therapeutic agents are safe and effective for public use before they are released to public.

Sometimes not advise to use drugs from other country since they might not have Same safety precautions

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USP & NF

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United States pharmacopeia and national formulary define the standards of mediation approval.

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Route of administration

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Medications outside USA

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Some case, dangerous since not all countries have same FDA

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Schedule of controlled drugs

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S1- high potential for abuse, no accepted medical use

S2- high potential for abuse, severe dependence liability

S3- lower abuse, moderate dependence liability.

S4- lower abuse, limited dependence liability

S5- limited abuse, primarily small amounts of narcotics

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Controlled substances

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Must be managed carefully, and accurate inventory & dispensing record must be kept.

Must be kept in double locked area

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Controlled drug count

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To ensure drugs are properly controlled, all counts must correspond with documentation.

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Client rights

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Right to know name, action, & side effects of mess being given.

Right to refuse them.

Right to request generic form.

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Drug reference

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Tools use for learning classification, use, abuse, desired, actions, recommended dosage, for meds

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Physicians desk reference (PDR)

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Updated yearly is a source of extensive info concerning therapeutic dosages and effects

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Pharmacokinetics

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Actions of a drug

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Client admitted

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Assessment must include detailed history, allergies, reactions,

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Allergic reaction

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Some are not considered true allergies, and usually a reaction doesn't accure upon first exposure, so always be alert

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Med administration

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Oral- mouth

Topical - skin or mucous membrane

Inhalable- inhaled

Injectable- via needle

Trasdermal- absorbed by skin

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Chemical name

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Describes med's chemical composition

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Generic name

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Often similar to chemical name.

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Official name

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Name identified by USP, NF

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Trade name

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Copy right name assigned by company manufacturer

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Agonist

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Med that produces a desired response

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Anatagonist

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Med that has opposing effect or acts against another med

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Synergistic or potentiating

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Med that enhances the effects of another med

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Dietary supplement

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Always ask patient if they take dietary supplement, herb, or homeopathic remedies

These are potential drugs

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Liquid med

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Given orally, topically.

Syrup- liquid that has sweetener

Tincture- liquid that has alcohol

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Oral troche

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Med tablet that dissolves in mouth.

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Topical administration

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Liquids given in instillations (ear or eyes) or as an irregation to flush out wounds

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Solid med

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Given by mouth, either tablet, capsule, caplets, liquid gel, or chewing gum.

Either sublingual or translingual

Under or on the tongue

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Transmucosal

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Tablet placed between cheek and gum, and absorbed through oral mucosa.

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Capsule

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Med in powder form, enclosed in soluble, gelatin like material. Capsule may be used to delay med absorption over time.

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Caplet

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Tablet in shape of capsule. Easier for client to swallow.

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Release rate

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SR - slow release

DR - delayed release

ER/ XR- extended release

IR- immediate release

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Orally disintegrating tablet ODT

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Tablet in solid form that dissolves quickly when exposed to saliva in clients mouth.

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Powered

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Another type of solid, often mixed with liquid or soft foods for oral administration.

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Nursing alert

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Many pills can be crushed.. you shouldn't crush capsules, time release med, ODT.

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Semisolid med

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Are usually given by rectal, vaginal, or urethral routes. Design to melt at body temp, and absorbed through mocosa or skin.

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Inhaled med & nasal sprays

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Deliver med topically to area desired.

They are either an aerosol (metered dose inhaler) or a non aerosol powder inhaler (turbuhaler, diskus)

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Transdermal med (TD)

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Designed to be absorbed through skin. Can be either patch or paste. Usually need less of the med to reach same affects as an oral med.

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Injectable med

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Given by needle into tissue or blood vessel. Given into intradermal, subcutaneous, or intramuscular, or intravenous, intra-arterial

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Dosage

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Contains dose & schedule time

(Dose, is a single amount of med)

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Therapeutic dose

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Amount of med required to obtain desired effect

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Loading dose

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Is usually larger dose than the following, and given as first dose or new med.

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Maximum dose

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Maximum of med given without causing adverse effects or toxic effect

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Toxic dose

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Amount of med that causes poisoning or toxicity

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Lethal dose

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Amount of med that causes death.

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Affecting factors for med prescription

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Children or older adults may not be able to tolerate same amount of med as an average adult.

May experience paradoxical response- opposite desired response

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Gender

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Women usually more body fat, and male more bodily fluids.

Women require less than male dosage.

Pregnant or lactating women should talk to a doctor of what Meds to take

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Wieght

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Meds often prescribed to patients wieght. Especially for children. Heavier require larger dosage. Usually use kilo for this

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Environmental factors

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Temp may influence a med speed of absorption.

Some med are damaged by exposure to light.

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Time administration

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With food, drug is slower to absorbe than on empty stomach.

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Prescription

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Medication order, written or verbal formula for preparing and giving a med

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Legend drug

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Medicine that under law can't be dispensed without a prescription

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Over the counter drugs

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Don't need a prescription

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Part of a prescription

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Clients name

Date and time

Name of drug

Dosages/ amount

Time/ frequency

Method/ route

Providers signature

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VORB verbal order

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Verbal order, must be verified and documented

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TORB telephone order, read back

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Make sure order is cosigned by prescribing person asap, 12-24 hours