Pharm Module 2

Front 1

Nursing Process 5 steps:

Back 1

Assessment
Nursing Diagnosis
Planning
Implementing
Evaluating

Front 2

Assessment includes:

Back 2

Physical exam
Health history
Diagnostic tests/Lab values
Medication history

Front 3

Nursing diagnosis includes:

Back 3

North American Nursing Diagnosis Association

Front 4

Planning includes:

Back 4

Identification of significant interactions between core drug knowledge and patient variables.

Front 5

Implementation includes (aka: Intervention):

Back 5

Maximizing theraputic effects
Minimizing adverse effects
Patient and Family Education

Front 6

Evaluation includes:

Back 6

Evaluate the outcome, change implementations as needed.

Front 7

6 RIGHTS:

Back 7

Right Drug
Right Dose
Right Time
Right Route
Right Patient
Right Documentation

Front 8

Pharmacokinetics:

Back 8

How the body effects the drug.

Front 9

4 phases of Pharmacokinetics:

Back 9

1. Absorption
2. Distribution
3. Metabolism
4. Excretion

Front 10

Absorption:

Back 10

The movement of the drug from the site of administration to the bloodstream.

Front 11

Aborbtion sites slowest to quickest:

Back 11

Oral
SQ
IM
IV

Front 12

3 Influential factors of Distribution:

Back 12

Blood flow to the tissues
Drug's ability to leave the blood
Drug's ability to enter the cell (must be lipophilic)

Front 13

Drug ditribution works off of:

Back 13

Protein binding

Front 14

If a drug binds easily to protein the patient will receive?

Back 14

Less of the drug/Increased dosage is needed.

Front 15

To cross the BBB drugs must be?

Back 15

Lipophilic or have a transport system.

Front 16

Metabolism primarily occurs where?

Back 16

The Liver (Can also occur in GI tract, lungs, kidney, skin

Front 17

Metabolism of a drug is?

Back 17

Conversion of the drug into another substance. Lipophilic to hydrophilic.

Front 18

First Pass Effect:

Back 18

% of drug that is metabolized by the liver with each pass through the portal vein.

Front 19

What percent of cardiac output is sent to the liver?

Back 19

25%

Front 20

Excretion;

Back 20

Removal of the drug or metabolites from the body.

Front 21

Excretion usually occurs through:

Back 21

Urine (also bile, exhaled air, breast milk, sweat, saliva)

Front 22

What is a drug?

Back 22

Any chemical that can affect living processes.

Front 23

Three factors of Renal Excretion:

Back 23

1. Glomerular filtration
2. Passive tubular reabsorption
3. Active tubular reabsorption

Front 24

Glomerular Filtration:

Back 24

Drugs enter capillaries surrounding Bowmans capsule. Most drugs filter easily through capillary walls and into proximal tubule (urine). Proteins do not pass

Front 25

Passive Tubular Reabsorption:

Back 25

Drug tries to move down concentration gradient.

Front 26

Precautions of Active Tubular secretion:

Back 26

If several drugs need active transport one drug will have to wait to be excreted.

Front 27

Pharmacodynamics:

Back 27

How the drug affects the body.

Front 28

Drugs cannot create new responses in the body, they?

Back 28

Turn on/off, promote or block responses.

Front 29

Pharmacotherapeutics:

Back 29

Desired therapeutic goal/effect/outcome
Why we are giving the drug.

Front 30

Effective Dose=

Back 30

dose required to produce a therapeutic response in 50% of population. Becomes standard dose.

Front 31

Lethal Dose=

Back 31

Dose would be fatal in 50% of population.

Front 32

Therapeutic Index:

Back 32

relationship between Effective and Lethal doses. If margin is narrow, patient must be monitored closely.

Front 33

Drugs come from:

Back 33

animals
plants-Alkaloids (end in -ine, nicotine), glycosides (end in -in, digoxin), gums
synthetic

Front 34

Pure Food and Drug Act 1906

Back 34

Designated Uonited States Pharmacopeia and National Formulary as the official standards and empowered Fed Gov to enforce standards.

Front 35

Federal Food, Drug, and Cosmetics Act 1938:

Back 35

Established the FDA (Drugs must be labeled)

Front 36

Durham-Humphrey Amendment:

Back 36

Defined 2 categories for drugs; Prescription and OTC

Front 37

Clinical trials have how many phases?

Back 37

4

Front 38

Clinical trial phase 1:

Back 38

20-80 healthy volunteers to est. a drug's safety. About 1 year.

Front 39

Clinical trial phase 2:

Back 39

100-300 patient volunteers to assess the drug's effectiveness. (about 2 years)

Front 40

Clinical trial phase 3:

Back 40

1000-3000 patients in clinics and hospitals who are monitored carefully to determine effectiveness and identify adverse reactions. (about 3 years)

Front 41

Clinical trial Phase 4

Back 41

After final approval, drug available for physicians to prescribe. Drug co. will continue to report cases of adverse reactions and other data to FDA.

Front 42

Additional safeguards for drugs:

Back 42

MedWatch
Practitioners Reporting Network
Medication Error Index

Front 43

Process of new drug developement takes?

Back 43

Aprox 12 years and $350 Billion

Front 44

Controlled Substances
Category C-I:

Back 44

High abuse pot.
Severe Dep liability
Heroin, hashish, LSD, GHB
No medical use/research only

Front 45

Controlled Substances
Category C-2:

Back 45

High abuse pot.
Severe Dep liability
Amphetamines, some opioid narcotics, dronabinol.
Requires specific type of prescription
No phone orders
Refills require new prescription

Front 46

Controlled Substances
Category C-3:

Back 46

Moderate abuse pot.
Moderate Dependence
Some opioid narcotics (codeine, hydrocodone), some CNS stim and anabolic steroids.
Written or phone order accep.
May be refilled 5 x's in 6 mos.from date of issue.

Front 47

Controlled Substances
Category C-4:

Back 47

Low abuse pot.
Limited dep liability
Benzodiazepine anxiolytics, anticonvulsants, muscle relaxants, Some opioid narcotics such as propoxyphene or pentazocine.
Written or phone order accep.
May be refilled 5 x's in 6 mos.from date of issue. (same as C-3)

Front 48

Controlled Substances
Category C-5:

Back 48

Limited abuse pot.
Lowest dep liability
Antidiarrheal, small amounts of narcotics such as codeine used as antitussives.
Many of these may be obtained w/o prescription.