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73 Cards in this Set
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Pharmacology
NUR 135 Core Principles of drug Therapy Charlene Gagliardi, RN, MSN Assistant Professor Nursing Responsibilities Regarding Drug Therapy * ___________ * ___________ * _____________ * Providing patient teaching about drugs * Monitoring to prevent medication errors |
* Administering drugs
* Assessing drug effects * Intervening to make drug regimen more tolerable * Providing patient teaching about drugs * Monitoring to prevent medication errors |
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Nursing responsibilities regarding drug therapy
* Administering drugs * Assessing drug effects * Intervening to make drug regimen more tolerable * ________________ * _______________ |
* Administering drugs
* Assessing drug effects * Intervening to make drug regimen more tolerable * Providing patient teaching about drugs * Monitoring to prevent medication errors |
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Sources of Drug Information
* __________ * __________ * __________ * Internet * Pharmacists |
Sources of Drug Information
* Package inserts * Reference books * Journals * Internet * Pharmacists |
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Sources of Drug Information
* Package inserts * Reference books * Journals * _______ * _________ |
Sources of Drug Information
* Package inserts * Reference books * Journals * Internet * Pharmacists |
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Information Contained in a Drug Monograph
* ______________ * ______________ * _____________ * Action and effect of the drug on the body * Uses for the drug; conditions limiting use |
Information Contained in a Drug Monograph
* Generic and brand name and pronunciation * FDA pregnancy category * Therapeutic drug classes * Action and effect of the drug on the body * Uses for the drug; conditions limiting use |
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Information Contained in a Drug Monograph
* Generic and brand name and pronunciation * FDA pregnancy category * Therapeutic drug classes * ____________ * ___________ |
Information Contained in a Drug Monograph
* Generic and brand name and pronunciation * FDA pregnancy category * Therapeutic drug classes * Action and effect of the drug on the body * Uses for the drug; conditions limiting use |
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Information Contained in a Drug Monograph
--_________________ * ________________ * ________________ |
Information Contained in a Drug Monograph
--Forms and dosages available, recommended dose * Actions of body on drug * Nursing actions for administration * Anticipated interactions |
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Names of Approved Drugs
* Brand name - ____________ – Trade name given by the developer * Generic name -_____________ – Original designation of drug during approval process * __________- name – Name that reflects the chemical structure of a drug |
Names of Approved Drugs
* Brand name - Synthroid – Trade name given by the developer * Generic name -levothyroxine – Original designation of drug during approval process * Chemical name – Name that reflects the chemical structure of a drug |
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Types of Drugs
* ___________ (OTC) drugs – Available without a prescription -_____________________ – Not financially viable – Developed in exchange for tax incentives |
Types of Drugs
* Over-the-counter (OTC) drugs – Available without a prescription * Orphan drugs – Not financially viable – Developed in exchange for tax incentives |
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Sources of Drugs
* ________ * ________ * _________ * ________ |
Sources of Drugs
* Plants * Animal products * Inorganic compounds * Synthetic sources |
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Sources of Drugs Derived From Plants
Inorganic Elements and Possible Therapeutic Effects * _________ – Antacid to decrease gastric acidity * _________ – Prevention of dental cavities * _________ – Treatment of rheumatoid arthritis * __________ – Treatment of iron deficiency anemia |
Inorganic Elements and Possible Therapeutic Effects
* Aluminum – Antacid to decrease gastric acidity * Fluoride – Prevention of dental cavities * Gold – Treatment of rheumatoid arthritis * Iron – Treatment of iron deficiency anemia |
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Pharmacology vs. Pharmacotherapeutics
* Pharmacology – Study of the _________ effects of chemicals * Pharmacotherapeutics – Branch of __________ – Uses drugs ___________ – Addresses the effect ______________ |
Pharmacology vs. Pharmacotherapeutics
* Pharmacology – Study of the biological effects of chemicals * Pharmacotherapeutics – Branch of pharmacology – Uses drugs to treat, prevent, and diagnose disease – Addresses the effect of the drug and the body’s response |
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Federal Legislation Affecting the Clinical Use of Drugs
* 1906______________ Act * 1938: _____________ Act * 1951: ___________ Amendment |
Federal Legislation Affecting the Clinical Use of Drugs
* 1906: Pure Food and Drug Act * 1938: Federal Food, Drug, and Cosmetic Act * 1951: Durham–Humphrey Amendment |
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Continued…
* 1962 - __________ Act * 1970 - _________ Act * 1983 - ___________ act * 1991 – ______________ |
Continued…
* 1962 - Kefauver – Harris Act * 1970 - Controlled Substances Act * 1983 - Orphan drug act * 1991 – Accelerate Drug Approval DEA Schedules of Controlled Substances * Schedule I (C-I): _____________ * Schedule II (C-II): _____________ * Schedule III (C-III): ____________ |
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Continued….
* Schedule IV (C-IV): ___________ * Schedule V (C-V): ___________ |
Continued….
* Schedule IV (C-IV): some potential for abuse * Schedule V (C-V): limited abuse potential |
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Steps Involved in Developing a New Drug in the United States
* Preclinical trials – _______________ * Phase I studies – ______________ * Phase II studies – _____________ * Phase III studies - Drug used in vast clinical market * Phase IV – Post-marketing studies |
Steps Involved in Developing a New Drug in the United States
* Preclinical trials – Chemicals tested on laboratory animals * Phase I studies – Chemicals tested on human volunteers * Phase II studies – Drug tried on informed patients * Phase III studies - Drug used in vast clinical market * Phase IV – Post-marketing studies |
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Steps Involved in Developing a New Drug in the United States
* Preclinical trials – Chemicals tested on laboratory animals * Phase I studies – Chemicals tested on human volunteers * Phase II studies – Drug tried on informed patients * Phase III studies - ________________ * Phase IV |
Steps Involved in Developing a New Drug in the United States
* Preclinical trials – Chemicals tested on laboratory animals * Phase I studies – Chemicals tested on human volunteers * Phase II studies – Drug tried on informed patients * Phase III studies - Drug used in vast clinical market * Phase IV – Post-marketing studies |
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Clinical Trials
The Role of the Nurse in Drug Research * Basic ethical principles – _____________ * ____________ * ____________ * Promotion of ___________ as a general social value |
Clinical Trials
The Role of the Nurse in Drug Research * Basic ethical principles – respect for the person * Beneficence * Justice * Promotion of self-determination as a general social value |
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Continued…
* Informed consent: protection of individual _______, _________, avoidance of ______ and ______ in health care, encourage HCP to scrutinize their efforts in communicating information and promotion of rational decision-making among patients |
Continued…
* Informed consent: protection of individual autonomy, protection from harm, avoidance of fraud and duress in health care, encourage HCP to scrutinize their efforts in communicating information and promotion of rational decision-making among patients |
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Drugs and the Body
Drug Processes * _____________ – How the body acts on the drug * _____________ – How the drug affects the body |
Drugs and the Body
Drug Processes * Pharmacokinetics – How the body acts on the drug * Pharmacodynamics – How the drug affects the body |
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Pharmacokinetic Considerations in Clinical Practice
* Onset of drug action * Drug half-life * Timing of the peak effect * Duration of drug effects * Metabolism or biotransformation of the drug * Site of excretion |
Pharmacokinetic Considerations in Clinical Practice
* _____________ * ______________ * _____________ * Duration of drug effects * Metabolism or biotransformation of the drug * Site of excretion |
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Pharmacokinetic Considerations in Clinical Practice
* Onset of drug action * Drug half-life * Timing of the peak effect * _____________ * ____________ * _______ |
Pharmacokinetic Considerations in Clinical Practice
* Onset of drug action * Drug half-life * Timing of the peak effect * Duration of drug effects * Metabolism or biotransformation of the drug * Site of excretion |
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Pharmacokinetic Considerations in Clinical Practice... Continued….
* Onset – ________ * Peak – __________ * Duration – __________ |
Continued….
* Onset – time it takes a drug to elicit a response * Peak – time it takes to reach a maximum response * Duration – time that drug concentration is sufficient to elicit a therapeutic response |
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Medication Administration Routes
* ________ – Safest and most frequently used * ______ – More likely to cause toxic effects * _______ – Takes time for absorption * __________ – Timing of absorption varies with Sub-Q injection |
Medication Administration Routes
* Oral route – Safest and most frequently used * Intravenous injection – More likely to cause toxic effects * Intramuscular injection – Takes time for absorption * Subcutaneous injection – Timing of absorption varies with Sub-Q injection |
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Mechanisms of Pharmacokinetics
* _____________ (AKA steady state) – The amount of a drug that is needed to cause a therapeutic effect * _____________ – A higher dose than that usually used for treatment * ______________ – The actual concentration that a drug reaches in the body |
Mechanisms of Pharmacokinetics
* Critical concentration (AKA steady state) – The amount of a drug that is needed to cause a therapeutic effect * Loading dose – A higher dose than that usually used for treatment * Dynamic equilibrium – The actual concentration that a drug reaches in the body |
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Phases of Pharmacokinetics
* Absorption – W____________ – Involves ________ and _________ |
Phases of Pharmacokinetics
* Absorption – What happens to a drug from the time it is introduced to the body until it reaches the circulating fluids and tissues – Involves passive diffusion and active transport |
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Mechanisms of Pharmacokinetics
Absorption (continued) * ____________ – orally administered drugs must pass intestinal wall then liver before reaching systemic site. Large percentage of oral doses are destroyed by liver enzymes * __________ – determines how much of a drug gets into the body * Parameter is designated as ____ * IV bioavailability is _____% (__=___%) |
Mechanisms of Pharmacokinetics
Absorption (continued) * First pass effect – orally administered drugs must pass intestinal wall then liver before reaching systemic site. Large percentage of oral doses are destroyed by liver enzymes * Bioavailability – determines how much of a drug gets into the body * Parameter is designated as F * IV bioavailability is 100% (F=100%) |
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Distribution of Drugs – the transportation of drug molecules within the body
Factors Affecting the Distribution of Drugs * ______ * ____ * _______ * _________ |
Distribution of Drugs – the transportation of drug molecules within the body
Factors Affecting the Distribution of Drugs * Protein binding * Perfusion of the reactive tissue * Lipid solubility of the drug * Blood brain barrier |
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Metabolism/biotransformation
* ________ * _________ |
Metabolism/biotransformation
* Hepatic system * Lipid soluble to water soluble |
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Excretion
* _____________ – kidney is main organ of excretion * Drugs also excreted via ___, _____, ___, ____ and feces |
Excretion
* Removal of drug from the body – kidney is main organ of excretion * Drugs also excreted via skin, saliva, lungs, bile and feces |
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Half-Life (t ½)
* Indication of the time it takes for a __________ * __________ must elapse before a drug reaches a ____________ (critical concentration) |
Half-Life (t ½)
* Indication of the time it takes for a dosing regime to achieve a steady-state concentration of drug in the blood * 4 -5 half-lives must elapse before a drug reaches a steady state (critical concentration) |
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Influence of Biologic Half-Life
Pharmacodynamics (how the drug affects the body) - Four Mechanisms * ___________ * __________ * ___________ * __________ |
Pharmacodynamics (how the drug affects the body) - Four Mechanisms
* Replace or act as substitutes for missing chemicals * Increase or stimulate certain cellular activities * Depress or slow cellular activities * Interfere with the functioning of foreign cells |
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Receptor Theory
* Can be ___________ * ___________ - drugs that produce similar effects to those produced by the body; they enhance cell function, accelerate or slow normal cell processes * _________ – drugs with opposing action that inhibit cell function. Occupy cell receptor sites or bump out molecule already in cell receptor site |
Receptor Theory
* Can be enzymes, proteins, nucleic acids * Agonists - drugs that produce similar effects to those produced by the body; they enhance cell function, accelerate or slow normal cell processes * Antagonists – drugs with opposing action that inhibit cell function. Occupy cell receptor sites or bump out molecule already in cell receptor site |
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Factors Influencing Drug Effects
* _________ * ____________ factors * ___________ factors * ____________ factors – drug allergy * Psychological factors – attitudes, placebo * Environmental factors * Tolerance and cross tolerance * Cumulation |
Factors Influencing Drug Effects
* Weight, age, gender * Physiological and pathological factors * Genetic factors * Immunological factors – drug allergy * Psychological factors – attitudes, placebo * Environmental factors * Tolerance and cross tolerance * Cumulation |
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Factors Influencing Drug Effects
* Weight, age, gender * Physiological and pathological factors * Genetic factors * Immunological factors – drug allergy * _________ factors – attitudes, placebo * __________ factors * ____________ * ____________ |
Factors Influencing Drug Effects
* Weight, age, gender * Physiological and pathological factors * Genetic factors * Immunological factors – drug allergy * Psychological factors – attitudes, placebo * Environmental factors * Tolerance and cross tolerance * Cumulation |
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Factors (cont) - Drug Interactions
* Drug–drug interactions: ____, _______, _________, ________, ________ * Drug–alternative therapy interactions * Drug – food interactions * Drug – laboratory test interactions |
Factors (cont) - Drug Interactions
* Drug–drug interactions: synergism, additive, interference, displacement, incompatibility * Drug–alternative therapy interactions * Drug – food interactions * Drug – laboratory test interactions |
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Factors (cont) - Drug Interactions
* Drug–drug interactions: synergism, additive, interference, displacement, incompatibility * Drug–____________ * Drug – ______interactions * Drug – ________ interactions |
Factors (cont) - Drug Interactions
* Drug–drug interactions: synergism, additive, interference, displacement, incompatibility * Drug–alternative therapy interactions * Drug – food interactions * Drug – laboratory test interactions |
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Therapeutic Index/Monitoring
* Therapeutic Index (TI) = _____ * Lethal dose in ____% of test population to effective dose in ____% of test population. * Closer ratio is to ____, the greater the toxicity * _______ has narrower safety margin |
Therapeutic Index/Monitoring
* Therapeutic Index (TI) = LD50/ED50 * Lethal dose in 50% of test population to effective dose in 50% of test population. * Closer ratio is to 1, the greater the toxicity * Low TI has narrower safety margin |
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Therapeutic Index/Monitoring
* TI = _____ (TI ____) VS TI _____ (TI = ____ which is not close to 1) * TI = ___(low) vs TI= _____ (high margin of safety) Therapeutic range – MEC/MTC which is the difference between the minimum effective concentration and the minimum toxic concentration * To determine this, blood levels are measured |
Therapeutic Index/Monitoring
* TI = 99/100 (TI = 0.99) VS TI 25/1000 (TI = 0.025 which is not close to 1) * TI = 2 (low) vs TI= 100 (high margin of safety) Therapeutic range – MEC/MTC which is the difference between the minimum effective concentration and the minimum toxic concentration To determine this, blood levels are measured |
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Therapeutic Index/Monitoring
* TI = 99/100 (TI = 0.99) VS TI 25/1000 (TI = 0.025 which is not close to 1) * TI = 2 (low) vs TI= 100 (high margin of safety) ______________ – MEC/MTC which is the difference between the minimum effective concentration and the minimum toxic concentration To determine this, blood levels are measured |
Therapeutic Index/Monitoring
* TI = 99/100 (TI = 0.99) VS TI 25/1000 (TI = 0.025 which is not close to 1) * TI = 2 (low) vs TI= 100 (high margin of safety) Therapeutic range – MEC/MTC which is the difference between the minimum effective concentration and the minimum toxic concentration To determine this, blood levels are measured |
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LD 50 / ED 50
* _________ * ______ – highest concentration of drug in blood that is drawn when absorption is complete – depends on route * ______ – lowest concentration of drug in blood, usually drawn 30 minutes and up to the next dose |
LD 50 / ED 50
* Therapeutic Indices * Peak – highest concentration of drug in blood that is drawn when absorption is complete – depends on route * Trough – lowest concentration of drug in blood, usually drawn 30 minutes and up to the next dose |
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Time response Curve
Toxic Effects of Drugs Reasons Adverse Effects of Drugs Occur * _______ * ________ * _______ * _________ |
Toxic Effects of Drugs
Reasons Adverse Effects of Drugs Occur * Other effects of drug on the body besides therapeutic effect * Sensitivity to the drug * Other responses to the drug that are undesirable or unpleasant * Patient takes too much or too little of the drug |
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Types of Drug Effects
* Primary actions – ____________ * Secondary actions – ______________ * Hypersensitivity reactions – __________ |
Types of Drug Effects
* Primary actions – Overdosage; extension of the desired effect * Secondary actions – Undesired effects produced in addition to the pharmacologic effect * Hypersensitivity reactions – Excessive response to primary or secondary effect of drug |
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Classification of Drug Allergies
* ______ reactions * _______ reactions * _______ sickness * _______ reactions |
Classification of Drug Allergies
* Anaphylactic reactions * Cytotoxic reactions * Serum sickness * Delayed reactions |
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Drug-Induced Tissue and Organ Damage
* _______ reactions – Rashes/hives * _________ – Inflammation of mucous membranes * _________ – Destruction of the body’s normal flora * __________ – Bone marrow suppression |
Drug-Induced Tissue and Organ Damage
* Dermatological reactions – Rashes/hives * Stomatitis – Inflammation of mucous membranes * Superinfections – Destruction of the body’s normal flora * Blood dyscrasia – Bone marrow suppression |
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Organ Toxicity
* _______ – Most drugs are metabolized in the ____; toxic metabolites affect ______ integrity * _______ – Some drug molecules get plugged into the capillary network causing severe ______ problems * ______ – Overdose of a drug damages multiple body systems |
Organ Toxicity
* Liver – Most drugs are metabolized in the liver; toxic metabolites affect liver integrity * Renal – Some drug molecules get plugged into the capillary network causing severe renal problems * Poisoning – Overdose of a drug damages multiple body systems |
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Alterations in Glucose Metabolism and Appropriate Interventions
* Hypoglycemia – Low ____________ – Restore ___________ * Hyperglycemia – High _________ – Administer _________ |
Alterations in Glucose Metabolism and Appropriate Interventions
* Hypoglycemia – Low serum blood glucose concentration – Restore glucose; provide supportive measures * Hyperglycemia – High serum glucose levels – Administer insulin therapy to decrease blood glucose; provide support to patient for symptoms |
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Electrolyte Imbalances and Interventions
* __________: Low serum potassium levels (<____ mEq/L) – Replace serum potassium – Monitor serum levels and patient response – Provide supportive measures * ________: Increase in serum potassium levels (>___ mEq/L) – Decrease the serum potassium concentration – Offer supportive measures – Monitor cardiac effects |
Electrolyte Imbalances and Interventions
* Hypokalemia: Low serum potassium levels (<3.5 mEq/L) – Replace serum potassium – Monitor serum levels and patient response – Provide supportive measures * Hyperkalemia: Increase in serum potassium levels (>5 mEq/L) – Decrease the serum potassium concentration – Offer supportive measures – Monitor cardiac effects |
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Sensory Effects of Drug Toxicity
* _________ – Some drugs are deposited into tiny arteries in the eyes, causing inflammation and tissue damage * __________ – Certain drugs can easily irritate and damage tiny vessels and nerves in the eighth cranial nerve |
Sensory Effects of Drug Toxicity
* Ocular toxicity – Some drugs are deposited into tiny arteries in the eyes, causing inflammation and tissue damage * Auditory damage – Certain drugs can easily irritate and damage tiny vessels and nerves in the eighth cranial nerve |
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Neurological Effects of Drug Toxicity
* ____________ – Affects CNS directly or by altering electrolyte or glucose levels * __________ (anticholinergic) effects – Blocks the effects of the parasympathetic nervous system by blocking cholinergic receptors (dry mouth, constipation, HA, PI, bloating, confusion) |
Neurological Effects of Drug Toxicity
* General central nervous system (CNS) effects – Affects CNS directly or by altering electrolyte or glucose levels * Atropine-like (anticholinergic) effects – Blocks the effects of the parasympathetic nervous system by blocking cholinergic receptors (dry mouth, constipation, HA, PI, bloating, confusion) |
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Neurological Effects of Drug Toxicity (cont.)
* ___________ syndrome – Drugs that affect dopamine levels in the brain causing a syndrome that resembles Parkinson’s disease * ____________ syndrome – Caused by general anesthetics and other drugs that have direct central nervous system effect (cause dangerous rise in body temperature) |
Neurological Effects of Drug Toxicity (cont.)
* Parkinson-like syndrome – Drugs that affect dopamine levels in the brain causing a syndrome that resembles Parkinson’s disease * Neuroleptic malignant syndrome – Caused by general anesthetics and other drugs that have direct central nervous system effect (cause dangerous rise in body temperature) |
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Risks of Teratogenicity (i.e. skeletal/limb abnormalities, heart defects)
* Advise ______________ * Weigh __________ * Advise __________ |
Risks of Teratogenicity (i.e. skeletal/limb abnormalities, heart defects)
* Advise the pregnant woman of the possible effects on the baby before administering a drug * Weigh the actual benefits against the potential risks * Advise pregnant women not to self-medicate during pregnancy |
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Drug-Induced Tissue & Organ Damage
General Guidelines * ___________ * ______ – ________ (increases compliance) * _____________ – recommended doses are only guidelines |
Drug-Induced Tissue & Organ Damage
General Guidelines * Maximize beneficial and minimize adverse effects (try non-drug therapies also) * Least drug – least doses (increases compliance) * Individualize doses – recommended doses are only guidelines |
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Drug-Induced Tissue & Organ Damage...Continued….
* Consider _________ – generic vs. trade for costs, effectiveness, solubility; effect of drug * Consider _____ - * Children - ________ when possible, meds out of reach, safe ranges less well defined |
Continued….
* Consider quality of life – generic vs. trade for costs, effectiveness, solubility; effect of drug * Consider age - * Children - oral route when possible, meds out of reach, safe ranges less well defined |
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Drug-Induced Tissue & Organ Damage...Continued….
* Older adults – ____________ * Use _________ * __________ |
Continued….
* Older adults – over age 65 may be for care than for cure to control symptoms and be able to continue ADL’s * Use least number of drugs, least amount for greatest effect * Start low – go slow |
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Nursing Management – Nursing Process and Patient Teaching
Key Elements of the Nursing Process * ________ – Gathering information * __________ – Analyzing the information to arrive at conclusions * _________ – Performing actions to meet patient needs/accomplish the goals * _______ – Determining the effects of interventions |
Nursing Management – Nursing Process and Patient Teaching
Key Elements of the Nursing Process * Assessment – Gathering information * Nursing diagnosis/goal setting – Analyzing the information to arrive at conclusions * Intervention – Performing actions to meet patient needs/accomplish the goals * Evaluation – Determining the effects of interventions |
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Role of the Nurse in the Nursing Process
* ____________ * ____________ * ____________ |
Role of the Nurse in the Nursing Process
* Assessing the whole person * Considering the person’s response to the treatment plan * Acting as the key HCP |
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Role of the Nurse in the Nursing Process
* _________ * _________ * __________ |
* Administering therapy as well as medications
* Teaching the patient how best to cope with the therapy * Evaluating effectiveness of therapy |
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Factors Assessed to Collect Patient Data
* ________ * ________ * _________ * _________ * _________ |
Factors Assessed to Collect Patient Data
* Physical * Intellectual * Emotional * Social * Environmental |
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Patient History Influencing a Drug’s Effect
* ________ * _______ * ________ * __________ * Level of understanding of disease and therapy * Social and financial supports * Patterns of health care |
Patient History Influencing a Drug’s Effect
* Chronic conditions * Drug use * Allergies * Level of education * Level of understanding of disease and therapy * Social and financial supports Patterns of health care |
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Patient History Influencing a Drug’s Effect
* Chronic conditions * Drug use * Allergies * Level of education * _________ * _______ __________________ |
Patient History Influencing a Drug’s Effect
* Chronic conditions * Drug use * Allergies * Level of education * Level of understanding of disease and therapy * Social and financial supports Patterns of health care |
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Physical Assessments Prior to Drug Therapy
* _______ – Determines whether recommended dose is appropriate * _______ – Extremes often require dosage adjustments * __________ – Provides a baseline level for future assessments |
Physical Assessments Prior to Drug Therapy
* Weight – Determines whether recommended dose is appropriate * Age – Extremes often require dosage adjustments * Physical parameters related to disease or drug effects – Provides a baseline level for future assessments |
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Nursing Diagnosis
* Definition – ____________ * Forming Diagnoses ________________ |
Nursing Diagnosis
* Definition – A statement of the patient’s status from a nursing perspective * Forming Diagnoses – Use the data gathered during the assessment to determine actual or potential problems that require specific nursing interventions |
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Types of Interventions Involved in Drug Therapy
* __________ * ___________ * __________ |
Types of Interventions Involved in Drug Therapy
* Drug administration * Provision of comfort measures * Patient/family education |
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Considerations for Drug Administration
* ______ * ______ * ______ * _______ * Preparation * Timing * Recording |
Considerations for Drug Administration
* Drug * Storage * Route * Dosage * Preparation * Timing * Recording |
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Considerations for Drug Administration
* Drug * Storage * Route * Dosage * _______ * ______ * ________ |
Considerations for Drug Administration
* Drug * Storage * Route * Dosage * Preparation * Timing * Recording |
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Factors to Consider When Timing Drug Therapy
* ________ * ______ * _______ |
Factors to Consider When Timing Drug Therapy
* Frequency * Other drugs * Meals |
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Comfort Measures for the Patient on Drug Therapy
* _________ – Anticipation that a drug will be helpful * _________ – Environmental control, safety, comfort measures * ________ – Changing lifestyle to cope with drug effects |
Comfort Measures for the Patient on Drug Therapy
* Placebo effect – Anticipation that a drug will be helpful * Managing adverse effects – Environmental control, safety, comfort measures * Lifestyle adjustment – Changing lifestyle to cope with drug effects |
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Key Elements of a Drug Education Program
* _________ * __________ * _________ * Specific OTC drugs or alternative therapies to avoid * Special comfort or safety measures * Specific points about drug toxicity * Specific warnings stopping drug |
Key Elements of a Drug Education Program
* Name, dose, and action of drug * Timing of administration * Special storage and preparation instructions * Specific OTC drugs or alternative therapies to avoid * Special comfort or safety measures * Specific points about drug toxicity * Specific warnings stopping drug |
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Key Elements of a Drug Education Program
* Name, dose, and action of drug * Timing of administration * Special storage and preparation instructions * Specific ________ * Special _________ * Specific ___________ * Specific __________ |
Key Elements of a Drug Education Program
* Name, dose, and action of drug * Timing of administration * Special storage and preparation instructions * Specific OTC drugs or alternative therapies to avoid * Special comfort or safety measures * Specific points about drug toxicity * Specific warnings stopping drug |
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Example of Patient Instruction Sheet
Patient Evaluations for Drug Therapy * __________ * ________ * ________ |
Example of Patient Instruction Sheet
Patient Evaluations for Drug Therapy * Therapeutic response * Occurrence of adverse drug effects * Occurrence of drug–drug, drug–food or drug–laboratory test interactions |
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The Continual Dynamic Nature of the Nursing Process
Discussion * 1. A 54-year-old man with high cholesterol is participating in a Phase II clinical drug trial for a cholesterol-lowering agent. He is anxious to know when the drug will be widely available. * a. What are differences in phase I, II, and III clinical trials* * b. Four weeks into the study, the drug is removed from further investigation. As the research nurse, explain to him factors related to the drug’s removal from research. Discussion * . A 35-year-old man has recently lost his full-time job. He is taking an over-the-counter multivitamin four times per day, four times over the recommended dose, because he feels his energy level is decreased. Since it is over-the-counter, he states it must be safe. What points should be included in this patient’s teaching plan* |
Discussion
* Your clinical instructor has assigned you to give medications during clinical next week. The instructor expects you to be able to explain the following concepts during post-clinical conference. a. Explain how each of the following factors influences drug effectiveness: * Weight * Age * Gender * Genetic differences * b. Explain the concepts of tolerance and cumulation and what this means for patients. Discussion |
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* Mr. Rzepka is a 50-year–old male who has just been started on a new medication for an infection and is very confused about this medication. During morning rounds, he heard the care team mention terms including loading dose, half-life, first-pass effect, and
excretion. Mr. Rzepka wants to know what these terms mean and what they have to do with his new medication. * a. Develop a teaching plan that explains the following terms: * Half-life * First-pass effect * Excretion (including the primary organ involved) * * b. Explain the importance of a loading dose. Why do some drugs require loading dosing and others do not. |
Discussion
* The nurse has received morning report, which includes information that patient A is currently receiving an IV dose of antibiotics and has called out with the complaint of difficulty breathing with a red, itching rash. Patient B has discharge orders but is complaining of feeling sleepy after receiving an antihistamine and plans to drive home alone. * * a. What type of allergic reaction is patient A experiencing* Describe each common type of allergic drug reaction and nursing interventions for each. * b. What type of adverse effect is Patient B experiencing* List the most common types of adverse drug effects. Discussion * A patient is admitted to your institution directly from her attending physician’s office. The patient has been admitted to your institution before; however, the previous medical records are not available. * a. What questions should be asked about medications during your admission assessment* * b. What objective information is important to d |
