Medication

Front 1

SECTION 1

Front 2

List what is required for a drug chart to be legal. (7):

Back 2

·Px identification details (UR number, DOB, Full name)

· Date and time

·Drug name

· Dose

· Doctors signature

· Frequency

· Allergy

Front 3

What needs to be written in a DD book? (7):

Back 3

· Clients name and UR number

·Prescription drug and dosage

·Date and time of administration

·Balance of medication (when you take a drug out you have to record what’s left in the package)

·Signature of 2 nurses

·Any errors should be ruled out in ink so it can still be read

·Remaining drugs should be disposed of (In sharps bin)

Front 4

What is polypharmacy:

Back 4

· Excessive or unnecessary use of drugs

· May cause:

> Adverse drug reactions

> Drug interaction

> Financial difficulty

> Death

Front 5

What is OTC?:

Back 5

Over The Counter drugs. Such as paracetamol. Noscript needed.

Front 6

Who can legally complete a drug chart?:

Back 6

Doctors

Front 7

Paracetamol 500mg 4/24 PRN PO

Back 7

500mg of paracetamol every 4 hours as required

Front 8

Insulin 24 units mane

Back 8

24 units of insulin in the morning

Front 9

Antibiotics QID AC

Back 9

Antibiotics 4 times daily before meals

Front 10

Vitamin B12 1000units 3/12

Back 10

1000 units of Vitamin B12 every 3 months

Front 11

Normal saline 1000ml 12/24 IV

Back 11

1000ml of normal saline every 12 hours intravenously

Front 12

Morphone 10mg IM Stat

Back 12

10mg of morphine intramuscularly immediately

Front 13

Salbutamol 500mg Neb 2-4/24 PRN

Back 13

500mg of Salbutamol through a nebuliser every2-4 hours as required

Front 14

Temazapam 10mg Nocte PRN

Back 14

10mg of temazapam at night as required

Front 15

6/24

Back 15

6hourly

Front 16

6/12

Back 16

6monthly

Front 17

6/7

Back 17

Every 6 days

Front 18

6/52

Back 18

Every 6 weeks

Front 19

Stat

Back 19

Immediately

Front 20

BD

Back 20

Twice Daily

Front 21

QID

Back 21

4 times daily

Front 22

SECTION 2

Front 23

Define the term pharmaceutics:

Back 23

The brand of pharmacy that deals with the formulation of pharmalogical agents

Front 24

Explain why oily solutions should not be used for nasal drops:

Back 24

Should not be used as the oil hinders the ciliary action of the nasal mucosa

Front 25

Under what conditions do you not give drugs orally to a client?:

Back 25

>If they have aphagia

>Nil orally

>Are feeling nausea

Front 26

What reaction can occur if ear drops are not instilled at room temperature?:

Back 26

Pain, vertigo or nausea

Front 27

When referring to tablet formulation:

What does EC stand for?

Back 27

Enteric-coated preparations

Front 28

When referring to tablet formulation:

What conditions are required for it to be broken down?

Back 28

They break down in the intestines, rather than the stomach ( only in alkaline conditions)

Front 29

What are the 6 rights of drug administration?:

Back 29

o Right drug

o Right dose

o Right client

o Right route

o Right time

o Right documentation

Front 30

SECTION 3

Front 31

List 4 factors that influence gastric absorption and explain how this occurs

Back 31

·pH of the gastrointestinal tract. This determines where the drug is absorbed.

·The presence of other drugs. Some drugs may increase or decrease the absorption rate in the stomach

·Some drugs cannot be absorbed in the gastrointestinal tract and need to be administered via another route.

·Enteric coated medications are able to with stand the acid in the stomach and are safely provided to the intestine for absorption.

Front 32

Why can’t most drugs cross the blood-brain barrier and how does meningitis affect?

Back 32

Only lipophilic drugs can cross the blood-brain.

Meningitis makes it more permeable so that medications that would normally not be able to cross the barrier can.

Front 33

Explain what the therapeutic window of drug administration is:

Back 33

An index or estimation of drug dosage which can treat disease effectively while staying within the safety range

Front 34

Whatis a drug half life?:

Back 34

The time interval needed for half of the amount of the drug to be eliminated to be reduced from the body.

Front 35

What is first pass clearance?

What impact does it have on medication when it has been ingested?:

Back 35

·The extent to which a drug is removed from the portal circulation by the liver.

·When a drug is administered orally it moves into the bloodstream.

·The flow of the blood goes past the liver

Front 36

SECTION4

Front 37

List 4 adverse drug reactions that you and/or the patient might notice:

Back 37

· Bleeding

· Diarrhoea

· Skin rash

· Severe nausea and vomiting

Front 38

Define the term anaphylaxis

Name five common severe symptoms:

Back 38

· Anaphylaxis is a “systemic reaction”.Meaning various parts of the body are affected that are distance from the allergen’s initial entry site (e.g., a sting site for insects or the stomach for foods).

· hives

· swelling

· itch

· throat tightness

Front 39

Outline the treatment for anaphylactic shock:

Back 39

·Identify the cause and if possible discontinue therapy

·If response occurs during blood administration,Div 1 nurse will discontinue the transfusion and replace with normal saline.

·In cases where the cause cannot be removed,

Doctorwill administer:
Ø Adrenaline

Ø Or other another drug

· Maintain patient airway

· Ensure adequate breathing by encouraging coughing and deep breathing

·Assess temperature, pulse, respirations and BP ·Assess for chest pain

·Check for manifestations of respiratory distress: wheezing, crackles, flaring nostrils

·Assess periphery for colour, warm1. Nameand describe the three broad categories that drug interactions fall into:th pulses, andoedema

·Assess renal function

Front 40

Name and describe the three broad categories that drug interactions fall into:

Back 40

·Drug – Drug- occurs when 2 or more drugs react with each other

·Drug – Food- interactions result from drugs reacting with foods or beverages.

·Drug – Condition interactions- may occur when an existing medical condition makes certain drugs potentially harmful.

Front 41

List any 2 possible reactions that can occur with consuming alcohol whilst taking prescribed medication:

Back 41

·Medication takes longer to react

·Nausea or vomiting

Front 42

What is the storage condition for Amoxycillin?:

Back 42

· Amoxycillin in powdered form – below 25 *C

· Amoxycillin in reconstituted form – refrigeratedat 2*C – 8*C

Front 43

What is the shelf life after opening of Glyceryl trinitrate tablet?:

Back 43

90 days

Front 44

Where should drugs that are light sensitive be stored?:

Back 44

·Dark protective containers. Which should be stored in a cupboard or a trolley that is away from direct sunlight.

Front 45

SECTION 5

Front 46

Name the 4 most common sites used for IM injections:

Back 46

· Deltoid site

· Dorsogluteal site (gluteus Maximus)

· Vastus lateralis (outer quadriceps)

· Ventrogluteal (Gluteus medias and minimus)

Front 47

Name the 3 most commonsites used for SC injections:

Back 47

· Upper outer arm

· Abdomen

· Buttocks

· Upper outer thighs

Front 48

What is the preferred site for IM injections in infants under 12 months of age?:

Back 48

Vastus lateralis

Front 49

What are the implications of exercising following an IM injection?:

Back 49

· When a person exercises, the blood flow to their muscles increases. This leads to improved absorption of any medication that has been injected into a muscle

· The drug is moved quickly into the blood stream leading to a higher concentration of drug available. This means that the patients risks overdose, toxicity or severe adverse drug reactions

· The drug is eliminated quicker from the body.This may lead to the patient not having adequate coverage by the medication given.

Front 50

What immediate steps must you take if you sustain a needle stick injury?:

Back 50

· Wash the wound with soap and water

· If soap and water aren’t available, usealcohol-based hand rubs or solutions

· Notify your supervisor or occupational andhealth and safety officer/ you will need to fill out an incident report form

· Go consult the doctor

Front 51

What must you NEVER do with a used needle?:

Back 51

· Re-Cap it

Front 52

What injection method would you use to give an iron preparation?

Why?

How would you achieve this?:

Back 52

· Z-track injection method: this method seals the medication deeply within the muscle and allows no exit path back into the subcutaneous tissue and skin.

· You would use this method because the medicationmay stain the subcutaneous tissue or skin

Front 53

What size needle is usually used for an IM injection?

Back 53

·23 gauge

Front 54

After inserting an IM injection, what is the first thing that you should do before you inject the medication?

Why should you do this?

Back 54

· Aspirate

· If blood appears in the syringe it is an indication that a blood vessel may be punctured.

Front 55

Name 4 complications that can occur following IM injections:

Back 55

· Bleeding (blood vessels are injured)

· Nerve injury (nerve is injured)

· Abscess formation (inoculation of the site with bacteria from the needle, syringe or medication)· Pain (irritation or chemical neuritis of a nerve)

Front 56

SECTION 6

Back 56

.

Front 57

Define isotonic solution:

Back 57

· Osmotic pressure has no change in osmolality as the extracellular fluid volume is increased without a net movement of water.E.g 0.9% sodium chloride (normal saline)

Front 58

Define hypertonic solutions:

Back 58

· Hypertonic solution result in a water shift out of cells into the intravascular compartment to re-establish equilibrium.E.g mannitol

Front 59

State the 3 aims of IV fluid therapy.

Give 2 examples of each:

Back 59

· Electrolyte imbalance ( Diarrhoea &vomiting)

· To provide blood products to patients

(Platelets bleeding as a result of severe thrombocytopenia)

· Hypovolaemia ( Burns & excessive diarrhoea)

Front 60

Define crystalloid solution, and give 2 examples:

Back 60

· A solution with small molecules that flow easily from the bloodstream into cells and tissues. May be isotonic, hypotonic or hypertonic.

· 0.9%sodium chloride (isotonic)

· 0.45% sodium chloride (hypotonic)

Front 61

Define blood products administered intravenously, and give 2 examples:

Back 61

· Fresh frozen plasma

· Platelets

Front 62

How frequently should an IV cannula be changed?:

Back 62

72 hours

Front 63

What nursing considerations need to be taken into account when caring for a patient receiving IV therapy?:

Back 63

· Check info on flask

· Comfort

· Correct flow rate

· Regular checking of flow rate

· Check level of solution

· Check insertion site for abnormalities

· Splint area if cannula is over joint

· Minimise exposure to moisture

· IV bag should be kept elevated

· Check tubing for kinking

· Check vital signs for abnormalities

Front 64

State the risk and complications associated with IV therapy:

Back 64

· Thrombus formation

· Haematoma

· Air embolus

· Infection

Front 65

What signs and symptoms would indicate intravenous infiltration of tissues?:

Back 65

·Pain

·Oedema

Front 66

SECTION7

Front 67

Whatis a neurotransmitter?:

Back 67

· Neurotransmitters are chemical substances that transmit nerve impulses from one nerve cell to another across the synapse

Front 68

Name the major groups of neurotransmitters, their function and the mental illness that is related.

Front 69

Acetylcholine

Back 69

Sleep,arousal, pain

Increased depression Parkinson’s disease

Front 70

Monoamines (Dopamine)(Histamine)

Back 70

Mood, cognition, locomotion

Anxiety, Schizophrenia

Front 71

Amino Acids

Back 71

Slow down of body activity Recurrent inhibition of motor neurons

Decreased spastic motor movements

Front 72

Neuro-peptides

Back 72

Perception of pain, taste, smell

Increased drug addiction, anorexia, autism

Front 73

*

Antipsychoticsare divided into typical and atypical, give two examples of each type:

Back 73

o Typical-Relive symptoms by blocking dopamine receptors. E.g major tranquilizer & neuroleptics

o Atypical- Clozapine,Olanzepine

Front 74

Discuss the reason why atypical antipsychotics are more favoured than typical antipsychotics:

Back 74

· Because they are less likely to cause EPSE,which is a movement disorder, which some can be irreversible

Front 75

*

What are the major side effects of clozapine and why is it closely monitored?:

Back 75

· It can cause life threatening illnesses such as myocarditis and arrhythmias

· Because it is life threatening

Front 76

Define Agranulocytosis:

Back 76

· Severe reduction in the number of leucocytes

Front 77

*

Define EPSE:

Back 77

· Extrapyramidal side – effects are – (dopamineside effects)

· Drug – induced movement disorders that includeacute and tardive symptoms

Front 78

Define Neuroleptic Malignant Syndrome (NMS):

Back 78

· Caused by an adverse reaction to neuroleptic orantipsychotic drugs – skin rash

Front 79

Name the drug that is used to counteract side effects:

Back 79

Bengtropin

Front 80

Name two groups of drugs used to treat anxiety disorders and give one example of each:

Back 80

Benzodiazepines - Temazepam

Non - Benzodiazepines - Zopiclone

Front 81

Describe advantages and disadvantages of non-benzodiazepines in treating anxiety:

Back 81

· Advantages: It is a non-sedative medication, has no abuse potential and does not intensify the effects of CNS depressants.

· Disadvantages: Very slow to produce effect.Takes a week to appear and several weeks for a good effect.

Front 82

DopamineSide Effects:

Back 82

Muscular spasm

Nausea

Dystonia

Constipation

Front 83

Non- Dopamine Side Effects:

Back 83

Weight gain

Thirst

Skin rash

Suicide

Seizures

Front 84

Nervous System Tree:

Back 84

Nervous System > Central Nervous System

Nervous System > Peripheral Nervous System > Somatic Nervous System

Nervous System > Peripheral Nervous System > Autonomic Nervous System > Parasympathetic Nervous System > Sympathetic Nervous System

Front 85

SECTION 8

Front 86

Which signs and symptoms indicate that the level of Lithium is too high?:

Back 86

Hand Tremors

Front 87

Discuss the reason why the SSRI’s are preferred over TCA’a for the treatment of depression:

Back 87

· They do not effect the histamine and acetylcholine, therefore they do not have anticholinergic effects. They are the least toxic drugs in overdose.

·Less side effects

·Less toxic overdose

Front 88

To what category of drugs do these drugs belong and what diseases are they used to treat?:

Back 88

.

Front 89

*

o Lipitor

Back 89

Category: Statins / anticholesterol

Treat: High cholesterol and to lower the risk of stroke, heart attack

Front 90

o Aricept

Back 90

Category: Anti-dementia drug

Treat: Dementia caused by Alzheimer's Disease

Front 91

o Comtan

Back 91

Category: COMT inhibitors

Treat: Parkinson's Disease

Front 92

*

oEpilim

Back 92

Category: Anticonvulsants

Treat: Epilepsy / Mood stabilisers

Front 93

o Coumadin (Warfarin)

Back 93

Category: Anticoagulant

Treat: Treat or prevent blood clots in veins or arteries

Front 94

*

List 5 common side effects of Lithium toxicity:

Back 94

· Fine hand tremor

· Muscle weakness

· Headache

· Weight gain

· Nausea and vomiting

Front 95

*

Name the main groups of antidepressants:

Back 95

· Tricyclic (TCA's)

· Selective serotonin reuptake inhibitors (SSRI's)

· Monoamine oxidase inhibitors (MAOI's)

Front 96

Define Status epilepticus

Back 96

· Clinical emergency

· A state of recurrent seizures for more than 30 minuets without a period of consciousness.

Front 97

Dementiais described as an incurable disease but certain drugs can alleviate some of the symptoms.

Name 4 drugs that can alleviate dementia symptoms:

Back 97

· Donepezil

· Galantamine

· Memantine

· Rivastigmine

Front 98

Name 2 neurotransmitters that are out of balance in patients with Parkinson’s Disease:

Back 98

Dopamine

Acetylcholine

Front 99

Differentiate between Ischaemic stroke and Haemorrhagic stroke:

Back 99

Ischemic stroke is when there is a block in an artery where as Haemorragic stroke is when there is a blood in the brain

Front 100

*

How many days after commencing Lithium are levels to be measured?:

Back 100

5-7 days

Front 101

*

What are Antiemetic's used for?:

Back 101

To prevent or overcome nausea or vomiting

Front 102

*

Name 2 types of Epilepsy:

Back 102

Partial seizures

Generalized seizures

Front 103

*

What class of medications are used to induce sleep?:

Back 103

Hypnotics

Front 104

Name a commonly prescribed anxiolytic:

Back 104

Diazepam - Valium

Front 105

*

Fluoxetine (prozac) is an example of what class of drug?:

Back 105

Anti-depressant

Front 106

*

What is the generic name for Maxalon?:

Back 106

Metoclopramide

Front 107

*

Name two symptoms or Parkinsonism

Back 107

-Shuffling gait

-Impaired speach

Front 108

Name a drug that can counteract EPSE's

Back 108

Benztropine

Front 109

*

What is Madopar used for?:

Back 109

Parkinson's Disease

Front 110

*

Common side effects of aspirin:

Back 110

- Rash

- Nausea

- Headache

- Fluid retention

Front 111

*

Define Akathisia

Back 111

Pronounced restlessness - mostly legs, patients cannot sit still

Front 112

*

Name the generic name for Normison

Back 112

Temazapam

Front 113

*

What class of drug does Normison belong to?:

Back 113

Hypnotic

Front 114

*

Name 3 types of strokes:

Back 114

- Haemorrhagic

- Thrombotic

- Embolic

Front 115

*

Why is Levadopa given instead of Dopamine to treat Parkinson's Disease?:

Back 115

Dopamine can't cross the Blood Brain Barrier, so Levadopa is given as it does cross the BBB. It is then Converted into Dopamine once it has crossed the BBB.