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72 Cards in this Set
- Front
- Back
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Drugs that absorb faster than the water-soluble and ionized drugs?
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lipid-soluble and non-ionized drugs
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Passive absorption of drugs occurs mostly by
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Diffusion (movement from high to low concentration/no energy require)
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Active absorption of drugs requires a carrier such as
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Enzyme or protein(energy require)
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cells carry a drug across their membrane by engulfing drugs
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Pinocytosis
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Drugs passes to the liver first is called
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First-pass effect or hepatic first pass
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In Pharmaceutic phase or dissolution (1st phase of drug action): drug in solid form (tablet or capsule ) must disintegrate into small particles why?
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Dissolve into liquid. Liquid drugs are already in solution
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Why does an infant can absorb more penicillin than adult?
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Infants gastric secretions have a higher pH (alkaline) than adult
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Which drugs that can absorb easily in the GI? Solid or liquid?
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Liquid
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What pH in acidic form that drugs are both disintegrated and absorbed faster?
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1 and 2 rather than alkaline fluids
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Both young and elderly have slower absorption of the drugs in the stomach why?
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Less gastric acidity
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Where do enteric-coated drugs disintegrate?
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in small intestine which alkaline environment/won’t disintegrate in acidic stomach
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What happen when you crushed the enteric-coated tablets or capsules and sustained-release(beaded) capsules?
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could alter the place and time of absorption of the drug
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Food in the GI tract may interfere with the dissolution and absorption of certain drugs. However food can also enhance _____?
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Absorption/some drugs should be taken with food. Food or fluid can help dilute drug concentration to prevent irritation of the gastric mucosa.
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time it takes for one half of the drug concentration to be eliminated
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Half life
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What happen to the half-life of the drug if the liver or kidney does not function?
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Will be prolonged and less drug is metabolized and eliminated and if drug continually taken then accumulation may occur or cause toxicity
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What part in our body that drugs metabolized? And which part is the most?
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GI and liver/ the Liver is the most
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A large percentage of drugs are lipid soluble, for what reason that liver metabolizes the lipid-soluble drug substance to water soluble substance?
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For renal excretion
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Most acute test to determine renal function is?
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Creatinine clearance(CLcr)
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. A metabolic byproduct of muscle that is excreted by the kidneys
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Creatinine
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Does clearance varies with age and gender?
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Yes
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is the age and gender that creatinine clearance is lower in values, why?
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Elderly and female clients. Decrease in muscle mass and decrease in functioning nephrons
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What happen when renal GFR is decrease then creatinine is also? Decrease or increase
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increase serum creatinine level and a decrease in urine creatinine clearance
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When there is a renal dysfunction or disorder in the elderly, drug dosage should be decrease. Creatinine clearance needs to be determined to establish dosage. When creatinine is decrease then dosage should be? Increase or decrease?
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decrease
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What happen when there is a continuous drug dosing according to a prescribed dosing regimen without evaluating creatinine clearance?
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result in drug toxicity
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How many hours creatinine clearance test?
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12-or 24 hrs urine collection and blood sample
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What is the normal value of creatinine clearance?
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85 to 135 ml/min
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What is the value of creatinine of an elderly client?
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60ml/min
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Therapeutic index (TI) estimates the ________ through the use of a ratio that measures the effective (therapeutic or concentration) dose (ED=50 % of persons or animals/lethal dose(LD) in 50% of animal. Closer to ratio is 1(greater danger)
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margin of safety of a drug
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Low therapeutic index=narrow _______Drug dosage should be _____ and plasma (serum) drug levels should be _____? Why?
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margin of safety/Adjusted/monitored=small safety range between ED and LD
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Correctly written goals identification
-Effective goal setting qualities:(6ans) |
1. Client-centered; clearly states the expected change
2. Acceptable to both client and nurse (dependent on client’s decision-making ability) 3. Realistic and measurable 4. Shared with other health care providers 5. Realistic deadlines 6. Identifies components for evaluation |
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liquid medications usually administered as a drops, ointment, or sprays
(example: eye drops and eye ointment) |
Instillations
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How you position a client when giving eye drops?
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Lie or sit down and to look up toward ceiling
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How you remove any discharge when giving eye drop?
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gently wipe from inner canthus and use separate cloth for each eye
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Where do administer the eye drop?
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Center of conjunctiva sac
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What happen when you place the medication directly on the cornea?
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Can cause discomfort or damage
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While you are administering the medication what else you wouldn’t touch?
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don’t touch the eyelids or eyelashes with dropper
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While self-administer of drops what are you going to use?
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Use drop-eze(cup-like device that holds the eyelids open
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Why you have to gently press on the lacrimal duct with sterile cotton ball or tissue for 1-2 min after instillation?
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To prevent systemic absorption through lacrimal canal
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How many minutes the client will keep his eyes close after the instillation or application of the drops?
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1-2 minutes
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Where you store the ear drops medication?
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At room temperature
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How would you position client when giving ear drops?
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up with head tilted slightly toward the unaffected side
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How you position the ear for child and adults when administering medication drops?
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Child: pull down and back/after 3 yrs same as adult: pull up and back on auricle
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How many minutes the client will wait after eardrops administration?
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2-3 min
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IM Site that most preferable for adults and infants older than 7 months(IM injection for 8 month old)
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ventrogluteal
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Medication is stored in a patch placed on the skin and absorbed through skin (systemic reaction).
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transdermal
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What are the patches drugs that they develop?
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Cardiovascular drugs, neoplastic drugs, hormones, treat allergic reactions, and insulin
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What does the transdermal different with oral and injection?
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Provide more consistent blood levels; avoid GI absorption problems associated with oral products
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How should you apply transdermal?
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Rotate to different sites and not reapplied over the exact same area when changed.
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Why you have to clean the area before application of a new transdermal?
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Prevent error in overdosing the client
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Do you allow to cut or giving patient a lower dose?
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Depends upon client situation and type of patch. If the drug is embedded in a matrix patc and diffuses into the skin, the drug is spread over the entire surface of the patch and probably maybe cut. Clients must be alert for under dosing or overdosing. Drug is pooled in a reservoir patch and is released via a semipermeable membrane (Druagesic, estraderm, traanderm scop)-shouldn’t be cut because too much drug may be released.
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You have to peel back the protective layer?
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Halfway
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You have to advise clients to secure patch with____?
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Tape
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What happen when you apply patch too tightly?
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could alter drug delivery
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For legal and financial reasons manufacturers do not recommend patches to be
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Cut
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In order to avoid skin burns remember to?
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Remove temporarily with any metallic component before magnetic resonance imaging MRI is performed. Many patches have a foil backing to prevent leakage
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Administration of intradermal
-What is the effect? |
Local effect
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Why does small amount should be injected in intradermal?
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Volume cannot interfere with wheal (blister or bleb) formation or cause a systemic reaction
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What is the use of intradermal and example?
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Observation For inflammatory (allergic) reaction to foreign protein
Example: tuberculin testing, test for drug and other allergic sensitivities, and immunotherapy for cancer |
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What are the sites used of intradermal?
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Lightly pigmented, thinly keratinized, and hairless (ventral midforearm, clavicular area of the chest, scapular area of the back)
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What is the gauge and needle length in intradermal?
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25-27 gauge and 3/8 to 5/8 inches
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What type of syringe and volume of Intradermal?
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1 ml calibrated in 0.01 ml (usually 0.01 to 0.1 ml injected)
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How you cleanse the area of ID?
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Circular motion and sterile technique
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How you insert needle of ID?
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Bevel up, degree of 10-15 angles, needle should be visible
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How you remove needle? Are you allowed to recap of ID?
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slowly/do not recap
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Are you allowed to massage the area and wash after ID administration?
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No massage/ do not wash the circle are until read by a health care provider
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How long the allergic reactions occur of intradermal?
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24 to 72 hrs
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How do you measure the site where Intradermal is given?
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The diameter of local reaction/for tuberculin, measure indurate area (don’t include redness for measurement)
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How to apply topical medication in a skin?
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With glove, tongue blade, or cotton-tipped applicator
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What nurses need to know when applying topical medication to the patient?
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Never apply a topical medication without first protecting own skin
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use appropriate technique to remove the topical medication from the container and apply it to clean and ______(dry, moist)?
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dry
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In order to avoid contaminating the topical medication in a container, you have to use?
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Gloves or applicator
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After the applicator with topical meds come in contact with the client, you should or shouldn’t “double dip” it to the container. What else you can do?
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should not/use fresh sterile applicator
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