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68 Cards in this Set
- Front
- Back
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What should a nurse know about a drug?
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know the drug, generic and trade name, side effects, and adverse effects
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What should nurses know about their pt's meds?
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know all of them and know if there are any contraindicting one another
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What is a synthetic drug?
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a synthetic drug source is chemically pure
easier and cheaper to process and prepare excellent control on the quality of the drug |
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What is a natural drug?
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natural drug sources are dervied from roots, leaves or barks of plants, animal souces, microbiological sources and mineral sources
(morphone, insulin) |
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What is pharmacology?
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pharmacology is the study or science of drugs
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What is the definition of a drug?
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any substance or product that is used or intended to be used to modify or explore the physilogical system or the pathological state for the benefit of the pt.
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Medications elicit different responses depending upon what?
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client age, sex, body mass, health status, and genetics
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What is pharmacotherapy?
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the application of drugs for the purpose of disease prevention and treatment of suffering
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What is therapeutics?
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branch of medicine concerned w/ the prevention of disease and treatment of suffering
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Substances for therapeutic purposes fall into one of three general categories:
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drugs or medications
biologics (hormones) alternative therapies (yoga) |
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What is a biologic?
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an agent naturally produced in animal cells, by microorganisms, or by the body itself
hormones, vaccines, interferon |
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What is the difference between prescription drugs and OTC drugs? advantages of both
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prescription drugs require an order from a healthcare provider
healthcare provider has opportunity to examine the client for diagnosis healthcare provider can maximize therapy by ordering proper drug, dose and frequency of drug based on the client's condition have better education and monitoring OTC drugs do not require an order from the healthcare provider. easier to obtain no app. with healthcare provider required safe when instructions followed carefully save time and money |
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What are some disadvantages to OTC drugs?
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can be challenging to choose without healthcare provider
OTC drugs may react with foods, herbal products, prescription meds, or other OTC meds self treatment may be ineffective, with potential for harm |
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What is a formulary?
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the 1st standard commonly used by pharmacists
contains a list of drugs and drug recipes |
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What is the US pharmacopoeia?
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the 1st comprehensive publication of drug standards in the US
is a medical referencee summarizing standards of drug purity, strength and directions for synthesis is now merged w/ the national formulary and published every 5 yrs |
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What does the FDA do?
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exercises control over which prescription and OTC drugs can be used for therapy
keeps the drugs available safe regulates the use of biologics regulates herbal and dietary supplements |
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What is the first stage of approval for therapeutic and biological drugs?
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preclinical investigation
extensive lab research testing on animals and cultured cells can take several yrs |
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What is the second stage of approval for therapeutic and biological drugs?
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clinical investigation
perfrom tests on healthy volunteers to determine proper dosage and to determine adverse effects. then a large group of selected clients w/ the particular disease takes the medicine to determine effectiveness, interactions w/ other meds, worsens other medical conditions |
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What is the third stage of approval for therapeutic and biological drugs?
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review of the new drug application
clincal phase III trials may continue FDA permits 6 mos. to initially review an NDA; if rejected the process is suspended to review concerns; review time for new meds is usually 17-24 months |
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What is the fourth stage of approval for therapeutic and biological drugs?
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post-marketing surveillance
begins after clinical trials and the NDA have been completed used to survey for harmful drug effects in larger populations |
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What is the prescription drug user fee act?
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requires drug and biologic manufacturers to provide yearly product user fees to the FDA
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What is therapeutic classification?
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organizing drugs based on their therapeutic usefullness in treating particular diseases
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What is pharmacologic classification refer to?
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the way an agent works at the molecular, tissue and body system level
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What is a drugs mechanism of action?
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how a drug produces its effects in the body
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What is a prototype drug?
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is the well-understood drug model with which other drugs in a pharmacological class are compared
by knowing the prototype drug one may predict the actions and adverse effects of other drugs in the same class but not always the most widely used drug in the class |
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What are the three basic types of drug names?
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chemical, generic and trade
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What is the chemical name of a drug?
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is assigned using standard nomenclature established by the international union of pure and applied chemistry
each drug only has one chemcial name helpful in predicting a substance's physical and chemical properties can be hard to remember due to complexity |
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What is the generic name of a drug?
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is assigned by the US adopted name council
usually less complicated than the chemical name often the name used by governing agencies written in lowercase |
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What is the trade name of a durg?
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is assigned by the company marketing the drug
usually capitalized usually short and easy to remember also called the proprietary name or brand name the drug developer is given exclusive rights to name and market a drug for 17 yrs after a new drug application is submitted to the FDA, allowing the drug company to recoup the money spent in research and development of the drug after 17 yrs, competing companies can sell a generic equivalent drug, using a different name |
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What is a combination drug?
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contains more than one active ingredient
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Is there a difference between brand-name drugs and their generic equivalents?
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the drug dosages may be the same but the drug formulations may be different
depends on the bioavailability of the two preparations |
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What is bioavailability?
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physiological ability of the drug to reach its target cells and prodcue its effect
the length of time it takes to exert its effect |
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What are controlled substances and drug schedules used for?
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to restrict the use of drugs that have a high incidence of abuse, dependence or addiction
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What is physical dependence?
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an altered physical condition caused by the adaptation of the nervous system to repeated drug use
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When does withdrawl occur?
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when the drug is no longer available and the pt has physical signs of discomfort
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What is psychological dependence?
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exhibits few signs of physical discomfort with drug withdrawal but does feel an intense compelling desire to continue drug use
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How are scheduled drugs classified?
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according to their potential for abuse though not all drugs w/ an abuse potential are regulated
(alcohol, caffeine) |
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Before a nurse gives any drug he/she must know what?
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what drug is ordered
name and class intended use effects on the body contraindications side effects ordered administration dose ranges special considerations: weight, body fat distribution, etc why prescribed for this pt how med is supplied nursing process |
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What is an allergic reaction? What are signs?
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an acquired hyperresponse of body defenses to a foreign substance
skin rash, urticaria, edema, runny nose, red, teary eyes, problems w/ breathing, hypotension, even death |
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What does a nurse have to do if an allergic reaction occurs?
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communicate any allergy to the physician and nurses and document any allergy in the medical chart and medication administration record. must also place an allergy bracelet on the pt
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What is anaphylaxis?
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severe type of allergic reaction that involves the massice systemic release of histamine and other cxhemical mediators of inflammation that cna lead to shock
treated with antihistamines |
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What are the 5 rights of drug administration? and additional rights
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right client
right medication right does right route right time right to refuse meds right to reveice drug ed right preparation right documentation |
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What are the 3 checks of drug administration?
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checking the drug w/ the MAR or the medication info system when removing it from the med drawer, refrig, or controlled substance locker
checking the drug before administering it to the client checking the drug when preparing it, pouring it, taking it out of the unit-dose container, or connecting the IV tubing to the bag |
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What is compliance?
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taking a med in the manner prescribed by the practioner or in the case of OTC drugs, following the directions on the label
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What is an asap order?
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as soon as possible
the time between writing the order and administering the medication should be 30 mins |
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What is a single order?
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is for a drug that is to be given only once and at a specific time, like a preop med
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What is a routine order?
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orders not written as stat, PRN, ASAP, NOW
usually carried out within 2 hrs. of the time the order is written |
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What is a standing order?
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is written in advance of a situation and is to be carried out in certain situations.
usually PRN ex: an order for pain meds for the pt undergoing a hernia repair due to legal implications, standing orders are no longer allowed in certain hospitals |
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What is the automatic discontinuation of narcotics, and other scheduled drugs?
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narcotics and other scheduled drugs are often automatically discontinued after 72 hrs without a specific MD order
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In the metric system the volume of durg is expressed in terms of & ?
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liters L and mililiters mL
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The metric weight of a drug is stated in , , or ?
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kilograms kg, grams g, miligrams mg, or micrograms mcg
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What is the enteral system of administration?
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includes oral, nasogastric, or gastrostomy drugs.
oral is the most common, convenient, less costly and the safest route because skin barrier is not compromised and can induce vomiting with overdose oral preparations include tabs, caps and liquid forms meds administered by the enteral route have the advantage of the vast absorptive surfaces of the oral mucosa, stomach, and small intestine |
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Tabs and caps
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most common and most preferred
may require crushing if problems w/ swallowing- make sure the drug can be crushed per the manufacturer some have enteric coatings on them (can't crush) XL, SR, LA tabs or caps dissolve slowly, releasing the med over a longer period of time (can't crush) client must be conscious and able to swallow some drugs (proteins) are inactivated by digestive enzymes in the stomach and small intestine variations in motility can create differences in bioavailability |
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What is the sublingual and buccal system of administration?
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sublingual is placed under the tongue and allowed to dissolve (nitroglycerin)
buccal is placed between the gum and the cheek and allowed to dissolve extended or sustained release best with buccal route b/c the greater mucosal area teach not to manipulate the drug and not to eat or drink until the drug completely dissolved avoid first pass metabolism by the liver and then enzymatic processes of the stomach and small intestine |
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What is the nasogastic & gastrostomy drug administration?
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NG tube is a soft, flexible tube inserted via the nasopharnyx with the tip lying in the stomach
gastrostomy tubes are surgically placed into the client's stomach when long-term care is needed meds usually administered in liquid form crushed or dissolved drugs can cause clogging never crush extended release meds for NG or G tube administration |
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What is the topical drug administration?
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dermatologic preparations
instillations and irrigations inhalations often produce a local effect though slow release and slow absorption are a benefit for some systemic meds fewer side effects w/ local effect |
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What is the transdermal delivery system of administration?
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rate and delivery of drug may vary
change as ordered rotate sites- document sites on the MAR!!! verify previous patch has been removed before applying new patch avoid first pass metabolism and bypass digestive enzymes |
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What is the opthalmic administration?
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treats local conditions of the eye and surrounding structures
excessive dryness, infection, glaucoma |
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What is the otic administration?
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treats local conditions of the ear, including infections and soft blockages of the auditory canal
eardrops and irrigations |
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What is the nasal administration?
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local and systemic drug administration
nasal mucosa very absorptive avoids first pass and digestive enzymes can damange cilia within the nasal cavity with mucosal irritation nasal meds often have astringent effect, shrinking swollen mucous membranes or loosen secretions and facilitate drainage requires proper positioning |
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What is the vaginal administration?
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treats local infections and to relieve vaginal pain or itch
suppositories, creams, jellies, or foams privacy and dignity empty bladder before administration perineal pad |
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What is the rectal administration?
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use for local or systemic drug administrations
safe for comatose clients or clients experiencing nausea suppository form or enema slower absorption |
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What is the parenteral drug administration?
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routes other than oral or topical
delivers meds via a needle into the skin layers, subcutaneous tissue, muscles, or veins more advanced parenteral administration includes, intrathecal (into the spinal fluid), intracardiac, intraarterial (immediate) |
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What is the intradermal and subcutaneous administration?
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delivers drugs to the blood vessels that supply the layers of the skin
difference in intradermal and subcutaneous is depth of injection only small volumes can be delivered ID-adminnistered into dermis layer of skin; limited to .1-.2 mL; non hairy surfaces SQ- deepest layers of skin; insulin, heparin, vaccines; .5-1 mL volume; needle lenght is half the size of a pinched skinfold grasped between thumb and forefinger; rotate sites; no aspiration insulin syringes and TB syringes are not interchangeable!!! |
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What is the intramuscular administration?
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delivers meds into specific muscles
the rich blood supply of the muscle allows for more rapid absorption can receive larger volumes- a large muscle could hold 4 mL though 2-3 mL is recommended the deltoid tricep muscles should only receive 1 mL require selecting administration sites away from bone, large blood vessels, and nerves site and lenght are determined by body mass, size, type of drug, amount of adipose overlying the muscle, and client age |
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What are the intramuscular injection sites?
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ventrogluteal
deltoid dorsogluteal vastus lateralis |
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What is the intravenous administration?
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administered directly into the bloodstream and immediately available to the body through rapid onset of action
most dangerous route can introduce pathogens directly into bloodstream monitor closely |
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What are the three types of IV administrations?
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large volume infusion- fluid maintenance, replacement, or supplementation
intermittent infusion- small amounts arragned tandem w/ or piggybacked to the primary large volume infusion IV bolus- concentrated dose delivered directly into bloodstream |
