Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
176 Cards in this Set
- Front
- Back
|
what are the three types of names that all drugs have
|
generic, trade, and chemical name.
|
|
|
what is ibuprofen's trade name?
|
Motrin
|
|
|
how can you tell the difference between a trade name, and a generic name?
|
generic: lower case
TRADE: Starts with UPPER CASE |
|
|
What are some sources of drugs?
|
Plants – alkaloids, glycosides, gums, resins, oils
Animals and humans Minerals Chemical substances |
|
|
What drug treats GOUT?
|
Colchicine
|
|
|
where was the first medical school?
|
Salerno
|
|
|
What did the Greeks do?
|
they looked at the drug sources, not just the disease.
|
|
|
What was done for diseases in the pre-christian age?
|
magic, superstitious beliefs.
|
|
|
when was ipecac discovered?
|
17th century
|
|
|
when was the smallpox vaccination discovered?
|
18th century.
|
|
|
when were morphine and chlorophorm discovered?
|
19th century
|
|
|
when were insulin and antihistamines discovered?
|
20th century
|
|
|
when were antihistamines and insulin discovered?
|
20th century
|
|
|
when was the polio vaccine discovered?
|
20th century
|
|
|
what is Senna?
|
a harsh laxative
|
|
|
when was tincture of opium discovered?
|
17th century
|
|
|
what year was the Harrison Narcotic act?
|
1914
|
|
|
what did the controlled substance act of 1970 do?
|
regulated the distribution of narcotics and other drugs with potential for abuse....organized by schedule.
|
|
|
What did the food, drug, and cosmetic act of 1906 recognize?
|
that substances were being used for specific purposes.
|
|
|
What did the food, drug, and cosmetic act of 1938 help do?
|
helped protect the public by distribution, labeling, and advertising of drugs.
|
|
|
What did the Harrison Narcotic act of 1914 do?
|
delineated (to trace the outline of) drugs that altered states of consciousness
|
|
|
What is the def of a Schedule 2 drug?..and an example..
|
high potential for abuse, addiction; verbal order only in emergency, countersigned by 48 hrs ie narcotics: morphine, Dilaudid, amphetamines, barbs
...an example would be a street named drug "angel dust." |
|
|
What is the def of a Sch 3 drug?
|
less abuse potential ie Tylenol w/ codeine
|
|
|
what is the def of a schedule 4 drug?
|
drug dependency ie Darvon, Valium
|
|
|
Schedule 5 drug?
|
low abuse potential...no Rx (prescription) in many states
|
|
|
what is an example of a schedule one drug...
|
heroin/LSD (acid)...no medical use
|
|
|
What kind of subject does the FDA test their drugs on first...and what are they looking for?
|
They test animals first, and they are examining the toxicity, therapeutic index, and modes of absorption, distribution, metabolism, and excretion
|
|
|
in human studies of drugs, who is tested, and what kinds of studies are done?
|
only small studies, and only done on healthy VOLUNTEERS.
|
|
|
Phase 2 is called the limited controlled evaluation. What kind of a study is this, and who is tested?
|
Only a select group of volunteers is tested, and they are observed for dosages, and observed for toxicity
|
|
|
What is phase 3 called?
|
extended clinical evaluation
|
|
|
what does phase 3 testing do? (in testing new drugs?)
|
large numbers of pts are treated, adverse effects are noted, double-blind
|
|
|
out of the 5 categories of drugs used for pregnant women, which ones are harmful for the fetus?
|
C,D,X
|
|
|
which category of drugs should NEVER be used on a pregnant woman?
|
category X
|
|
|
which category of drugs has no potential risks for a pregnant woman in the first trimester?
|
category A
|
|
|
who is able to administer meds?
|
NOT a PA, MD, Psychiatrist, NP...
|
|
|
what are the three extra "rights?"
|
The right for the patient to refuse,
the right to correct documentation, and the right to patient education. |
|
|
can a drug bring a new fxn on an organ/tissue in the body?
|
No..it can only modify existing functions...
|
|
|
Pharmaceutical
|
dissolution of a drug, available for absorption
|
|
|
Pharmokinetic
|
drug available for ACTION
|
|
|
Pharmacodynamic
|
effect in body
|
|
|
what are the four pharmacokinetic activities?
|
absorption, distribution, metabolism, and excretion.
|
|
|
absorption
|
passage of drug from administrative site into bloodstream
|
|
|
Distribution
|
transport of drug to target tissue
|
|
|
metabolism/biotransformation
|
degredation of drug, preparation for excretion
|
|
|
excretion
|
elimination of drug from teh body
|
|
|
In the drug-protein complex, is the bound drug active, or inactive?
|
it is inactive because it is bound.
|
|
|
What is an important question to ask about the absorpability of a drug?
|
is it more soluble in a base medium, or an acidic medium?W
|
|
|
what are some factors affecting the absorption of a drug?
|
-concentration
-dosage form: tab, cap, enteric coated (released in Sm. intestine) -route: IV, IM -rate of blood flow -pH |
|
|
which kind of molecule can pass through a cell membrane?
|
non-ionized
|
|
|
what happens to acidic drugs in an acid medium?
|
they become non-ionized...can pass through cell membranes easily. (become lipophilic...love phospholipid membrane)
|
|
|
What happens to a basic drug put into a basic medium?
|
it becomes more non-ionized...can pass through cell membrane more easily.
|
|
|
what is the dosing interval?
|
the time it takes when the drug reaches the minimum dosage, another dosage is given, and for the drug to reach the NEXT minimum dosage.
|
|
|
Why is the amount of plasma protein binding that occurs with the drugs dependent on the Albumin level?
|
Because there is a competition for binding sites, and if tehre is low albumin, there is a lack of binding sites.
|
|
|
What are two natural barriers that drugs have to cross?
|
BBB...keeps drugs from entering the CNS, and placenta (in pregnant women)...protects the fetus
|
|
|
What are the two types of tissue binding drugs?
|
fat-soluble, and water soluble.
|
|
|
where is the primary site for drug metabolism?
|
hepatic system: LIVER
|
|
|
Where is anesthesia metabolized?
|
in the lungs
|
|
|
Where else can drugs be metabolized besides the lungs, and liver?
|
intestinal mucosa, plasma, and kidneys.
|
|
|
What happens with patients who have liver, cardiovascular, or renal disease? (relating to the metabolism of drugs)
|
prolonged, decreased metabolism, drug accumulates…ELDERLY and premature babies are at risk for liver/cardiovascular disease
|
|
|
what kind of drug is propanalol?
|
BP drug
beta-blocker |
|
|
what does phenabarbitol do to your metabolism?
|
increases its rate.
|
|
|
when are the BUN levels elevated?
|
with the breakdown of tissue
|
|
|
what are the primary organs of elimination?
|
KIDS
|
|
|
what happens in the GI tract in relation to drug excretion
|
metabolite is excreted and turned into bile, enterohepatic cycle – drug is reabsorbed from intestinal tract
|
|
|
what is the def of a drug's half-life?
|
amount of time needed for serum concentration of a drug to decrease by 50%
|
|
|
What does teh rate of half-life depend on?
|
rate of drug excretion, and the frequency of administration
|
|
|
What does high levels of Creatinine mean?
|
shows renal dysfunction
|
|
|
what is the trough of a drug dosage?
|
the amount of drug in the bloodstream right before the next dose.
|
|
|
what is the PEAK of a drug dosage?
|
the amount of drug in teh bloodstream after 1 hour of IV administered drug.
|
|
|
What does the Therapeutic index represent?
|
the ratio between the lethal dose, and the effective dose.
|
|
|
What are SE's?
|
are usually predictable secondary effects, such as anorexia, nausea, vomiting, dizziness, drowsiness, dry mouth, abdominal gas or distress, constipation, and diarrhea.
|
|
|
What are adverse effects?
|
unintended, undesirable, and and often unpredictable drug effects that range from mild to fatal.
|
|
|
what are toxic effects?
|
are intolerable, cause major injury or damage to tissues & organs, need to stop drug
|
|
|
what is an example of a type 1 drug rxn?
|
anaphylactic shock...collapse of cardio/pulmonary systems…high risk of death
|
|
|
what is an example of a type 2 rxn?
|
Cytotoxic reaction:little more delayed than anaphylactic.
|
|
|
What is a type 3 drug rxn?
|
Arthus rxn
|
|
|
What is a type 4 rxn?
|
cell-mediated rxn
|
|
|
what is Tachyphylaxis ?
|
a rapidly decreasing response to a drug following administration of the initial doses
|
|
|
Drug antagonism
|
when two drugs taken simultaneously are in opposition.
|
|
|
what is the cumulative effect of drugs? (also known as Synergism)
|
when two drugs are given at the same time that create a bigger response than if taken separately.
|
|
|
Idiosyncrasy
|
a peculiarity of the physical or the mental constitution, esp. susceptibility toward drugs,
|
|
|
Potentiation
|
to cause to make potent/powerful
|
|
|
what does it mean when a nurse is acting in a dependent domain:
|
dependent on MD
|
|
|
what does it mean when a nurse is acting in a collaborative domain?
|
wants to collaborate with pt. and other staff members
|
|
|
what does it mean when a nurse is acting in a independent domain?
|
nursing diagnoses, and decisions independent from MD
|
|
|
nursing diagnosis related to drugs:
|
Client issues related to the client’s preexisting health status
Client issues related to concurrent drug therapy Client issues relate to the ineffectiveness of the drug Client issues related to the drug side effects/adverse reactions Risk for poisoning: drug toxicity Client issues related to the client’s preexisting health status Client issues related to concurrent drug therapy Client issues relate to the ineffectiveness of the drug Client issues related to the drug side effects/adverse reactions Risk for poisoning: drug toxicity Knowledge deficit related to initiation of or change in the medication regimen Noncompliance Ineffective management of the therapeutic regimen related to (specify) |
|
|
what is important to check before adminstering drugs through an NG tube?
|
any food-drug interactions
|
|
|
what do you always do with any kind of medication given in NG/IV tube?
|
flush..before, AND after
|
|
|
what do you have the pt. do after administering meds?
|
sit upright
|
|
|
what's the name of the vein on the pinky side?
|
Basilic vein
|
|
|
what's the name of teh vein in the middle?
|
Dorsal vein
|
|
|
What's the name of the vein on the thumb side?
|
Cephalic vein
|
|
|
what's the name of the vein in the pinky finger?
|
dorsal metacarpal vein
|
|
|
what kind of medications are harmful to Native Americans?
|
cannot receive medications that have alcohol in them because they do not have enzymes to metabolize alcohol.
|
|
|
what is the biggest population of people used in drug trials?
|
black males (majority that is incarcerated)
|
|
|
What are some factors to consider before giving drug therapy to a pregnant woman?
|
The dose that reaches the fetus depends on the maternal dosage, distribution, and clearance rate
Fetal gestational age at the time of exposure Duration of therapy Fetal and maternal genotypes Other drugs administered concurrently |
|
|
Why is it that drug excretion into breast milk happens very readily?
|
because of the low molecular weight.
|
|
|
what percent of iron is absorbed into breast milk?
|
20-50% is absorbed
|
|
|
what percent of iron is absorbed into cow's milk?
|
4-7%
|
|
|
what is clark's rule for calculating safe medication doses in children?
|
average adult dose x child's weight in pounds / 150
|
|
|
which way do you pull the ear when giving a child ear drops?
|
down and back
|
|
|
which way do you pull the ear when giving an adult ear drops?
|
up and back
|
|
|
what is representative of over 50% of deaths/hospitalizations of adults over 60 years?
|
Adverse Drug Reactions (from polypharmacy)
|
|
|
how many more times likely is it for an older adult to be admitted to the hospital for an ADR?
|
3x
|
|
|
what is the common denominator between 50% of all convicted felons?
|
they all were under the influence. bad...
|
|
|
what are some Common Nursing Diagnoses Related to Clients and Self-Administration of Medications
|
Knowledge deficit
Noncompliance Ineffective management of therapeutic regimen |
|
|
what kind of feeding is recognized as given orally, or through a tube?
|
Enteral
|
|
|
what kind of feeding is given by bolus doses or as continuous flow?
|
enteral
|
|
|
what kind of feeding supplies enough calories and nutrients for body function?
|
enteral
|
|
|
what kind of feeding is given through a peripheral, or central IV line?
|
parenteral
|
|
|
what kind of feeding provides nutrients needed in a ratio of a regular diet?
|
parenteral
|
|
|
the term cancer actually refers to what?
|
a group of about 300 diseases
|
|
|
which kind of cancer has increased the most percent in both males and females?
|
Lung cancer.
In Females: 147% increase In Males: 49% increase |
|
|
When considering combining chemotherapy treatments, what should each drug be able to accomplish on its own?
|
it should be effective against the specific cancer when used alone.
|
|
|
what does specificity mean, in relation to chemotherapy treatment?
|
each drug should have a different site of action and act at a different point of the cell-cycle
|
|
|
What is important to look for, regarding timing in combining chemotherapy treatments?
|
each drug should have a different organ toxicity, or if the toxicity effect is simillar, it should occur at DIFFERENT times for each drug.
|
|
|
what happens after the first round of chemotherapy?
|
the tumor size is reduced
|
|
|
what usually happens after the second round of chemotherapy?
|
the remaining cancer cells are destroyed by the body's immune system
|
|
|
what size of tumors is chemo more effective against?
|
SMALL
|
|
|
what is adjuvant chemotherapy used to help eradicate against?
|
micrometastasis after surgery or radiation
|
|
|
what is the action of anti-neoplastic agents?
|
ALL anti-neoplastic agents interfere with cell growth or division of cancer cells either directly, or indirectly.
|
|
|
what are anti-neoplastic agents used for?
|
all are used to treat neoplastic diseases, and they are rarely used to treat other diseases because of the severe side effects.
|
|
|
what size of a dose do you give of antineoplastic agents when treating an autoimmune disease?
|
they are prescribed in much lower doses than usual
|
|
|
what is the action of anti-metabolites?
|
they all interfere with DNA metabolism, and are cell-specific in the S phase of cell division
|
|
|
What is the prototype for antimetabolites?
|
MXT: methotrexate...because it can be given po, IV, IM
|
|
|
What type of drug is a folic acid antagonist?
|
Antimetabolites
|
|
|
What is the "rescue drug" for a high dose of an antimetabolite?
|
Leucovorin (folinic acid)
|
|
|
What are the side effects of antimetabolites?
|
N/V/D/Stomatitis, bone marrow depression, GI bleeding, hyperuricemia, and photosensitivity.
|
|
|
What's another prototype (example) of an antimetabolite?
|
5 FU...flourouracil
|
|
|
What is the action of Alkylating agents?
|
they are cell-cycle non-specific agents that cross-links DNA & RNA strands causing cell imbalance and death
|
|
|
What is the prototype for the Alkylating agents?
|
cyclophosphamide (Cytoxin)
|
|
|
What is especially important to remember when giving Cytoxin?
|
hydrate WELL, before and AFTER
|
|
|
what is a risk factor for giving a high dose of an alkylating agent?
|
they can be cardiotoxic
|
|
|
What are some SE's from alkylating agents??
|
A/N/V/S bone marrow depression, hemmorhagic cystitis
|
|
|
What type of drug is Nitrosureas, and what can it do?
|
It can cross the BBB, and it is an alkylating agent
|
|
|
What type of drug is cisplatin (Platinol), and what is it?
|
it is a heavy metal, and it's family is the alkylating agents
|
|
|
What type of drug is Mustargen, and what is one of it's high risks?
|
It is an alkylating agent, and it causes a risk for infection/bruising/bleeding
|
|
|
What is the action of (AAA) Antibiotic, Antitumor Agents?
|
They are natural cytotoxic products that directly bind DNA & interfere with the DNA dependent synthesis of RNA
|
|
|
What is the prototype for the AAA's?
|
doxorubicin (Adriamycin)
|
|
|
What is unique about doxorubicin (Adriamycin)?
|
once a patient has this dose, they can't have it again
|
|
|
What is a side effect about doxorubicin?
|
it turns the urine RED
|
|
|
what is red urine termed?
|
Rubin
|
|
|
How you get rid of red urine?
|
hydrate the pt. well
|
|
|
AAA SE's?
|
N/V/D/S alopecia, bonemarrowsuppression. BMS.
|
|
|
what are two examples, (besides doxorubicin) of AAA's? (antibiotic anti-tumor agents)
|
daunorubicin, and bleomycin
|
|
|
What is the action of Miotic-inhibitors (plant alkaloids)
|
Vinca alkaloids (periwinkle) cell-cycle specific agents taht arrest cell mitosis in the M-phase, to block cell division.
|
|
|
What is the prototype for miotic-inhibitors?
|
vincristine (Oncovin) given ONLY IV
|
|
|
what does vesicant mean?
|
a chemical agent causing blisters/burns, or causes the destruction of tissue both internally, and externally.
|
|
|
what are SE's of miotic-inhibitors?
|
peripheral neuropathy, (no feeling in extremities) parasthesias (tingling) cramps, muscle weakness, N/V/S/Constipation (most chemo's cause diahrrea, but this one causes constipation.) and paralytic ileus.
|
|
|
What does paralytic ileus mean?
|
Nonmechanical obstruction of the bowel from paralysis of the bowel wall, usually as a result of localized or generalized peritonitis or shock
|
|
|
what is another example of a miotic-inhibitor besides vincristine (Oncovin)?
|
Vinblastine.
|
|
|
what kind of anti-neo agents are used with lymph cancers?
|
corticosteroids...to help slow down lymphatic proliferation.
|
|
|
what is an example of a lymphatic cancer?
|
Hodgkin's disease
|
|
|
what drug is used to decrease cerebral edema d/t brain tumor or radiation?
|
Decadron
|
|
|
What type of hormones treat male-based tumors?
|
estrogens
|
|
|
for woman-based tumors, what hormones would you give?
|
anti-estrogens
|
|
|
what are some examples of anti-estrogens?
|
Armidex, (very aggressive) Evista, Novaldex
|
|
|
What is given to help pt's gain weight that is lost?
|
Megesterole (Megace)
|
|
|
What are some examples of radioactive isotopes?
|
Gold, iodine, phosphate
|
|
|
What is used against blood-forming cancers?
|
Hydroxurea (Hydrea)
treats sickle-cell anemia, and fetal Hgb |
|
|
Where is the Yew plant grown?
|
Seattle, Wa
|
|
|
What two drugs come from the yew plant?
|
Taxol, and Taxotere
|
|
|
what is the antidote for leucovorin?
|
methotrexate
|
|
|
what is the antidote for mesna?
|
ifosfamide (IFEX)
|
|
|
what is the antidote for filgrastim
|
neupogen
|
|
|
what is the antidote for sargramostim
|
Leukine, Prokine (G-CSF...granulocyte colony stimulating factor)
|
|
|
What is important to monitor when adminstering alkylating agents?
|
CBC values, electolytes, and uric acid values.
|
|
|
what are the two main problems caused from elevated uric acid levels:
|
gout, and kidney stones
|
|
|
what is ototoxicity?
|
having a harmful effect on the organs or nerves concerned with hearing and balance.
|
|
|
what is important to watch for with AAA's?
|
uric acid levels, CBC signs and symptoms of infection, and CARDIOTOXICITY
|
|
|
with AAA's, what should you administer to them?
|
allopurinol, and lots of FLUIDS!!!
|
|
|
what should you watch for signs of with AAA's, and Miotic inhibitor pt's?
|
Extravating (when blood is pushed out of vessels into surrounding tissues.)
|
|
|
What should you expect with anti-metabolite pt's?
|
black, tarry stools.
|
|
|
pt's taking anti-metabolite's should avoid what?
|
aspirin, vitamins, and alcohol products. ...all are irritating to stomach.
|
|
|
What are examples of some immunomodulator agents?
|
Interferons: Alpha 2a, Alpha 2b, and interferon Alpha n3.
CSF...colony stimulating factor Interleukin: Interleukin-2 |
|
|
what are 2 CSF drugs?
|
Epogen, and NEupogen
|
