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118 Cards in this Set

  • Front
  • Back
The word "pharmacology" is derived from what two Greek words?
pharmakon ("medicine")
and
logos ("study")
How many drugs are currently available (including brand-name, generic, and combination drugs)?
More than 10,000
Individual patient factors to take into account in the administration of drugs include
Age
Sex
Body mass
Health Status
Genetics
What is the difference between therapeutics and pharmacotherapy?
Therapeutics is concerned with the prevention of disease and Tx of suffering

Pharmacotherapy (pharmacotherapeutics) is the application of drugs for the purpose of disease prevention and the Tx of suffering.
What is the difference between a drug and a medication?
A drug is a chemical agent capable of producing biologic responses within the body (therapeutic or adverse)

A medication is what a drug is referred to AFTER it is administered.
Explain complementary and alternative therapies
They involve natural plant extracts, herbs, viatmins, minerals, dietary supplements, and techniques considered by some to be unconventional (acupuncture, hypnosis, biofeedback, massage)
Why do patients often prefer OTC drugs? How can OTC drug Tx be ineffectual?
They are obtained more easily the Rx drugs (no appt necessary--saving time and money)

Without guidance from a physician, patients may not know some of the side effects, interactions or reactions with herbal products, foods, Rx meds and other OTC drugs, and the potential for harm may increase if the disease is allowed to progress.
When was the US Pharmacopoeia (USP) established?
1852
1890
1850
1820
When was the American Pharmaceutical Association (APhA) founded?
1875
1975
1852
1900
What is the USP-NF and when did it come to be?
It is the combined publication (US Pharmacopoeia and the National Formulary) that became the US Pharmacopoeia-National Formulary, the single publication containing 2,400 pages of 3,777 drug monographs (164 chapters) that was first published in 1975. It is printed every 5 years.
What is found on a USP label?
Purity
Exact amounts of ingredients
In what year was the Biologics Control Act passed?
1862
1902
1912
1944
What is the Sherley Amendment?
It made medicines safer by prohibiting the sale of drugs labeled with false therapeutic claims.
In 1944, congress passed the Public Health Service Act. What did this cover?
Many health issues including biological products and the control of communicable diseases.
What are the four phases of approval for therapeutic drugs and biologics?
1. Preclinical investigation
2. Clinical investigation
3. Review of the New Drug Application (NDA)
4. Postmarketing Surveillance
What does Preclinical investigation involve?
Extensive laboratory research (tests on human and microbial cells cultured in labs to examin drug effectiveness at different doses and to look for adverse effects)
What is the longest part of the drug approval process? Explain why.
Clinical investigation. Because of the length of time required to test volunteers to determine proper dosage and assess for adverse effects. Clinical investigation takes place in 3 stages (clinical phase trials) and New Drug Application (NDA must be submitted before the drug is allowed to proceed to the next stage of the approval process.
What happens during the NDA review stage of the approval process?
The drug's brand name is finalized. Phase III and animal testing may continue depending on results from preclinical testing. If NDA is approved, it is moved to the final stage.
What is the final stage of drug approval? What is its purpose?
Postmarketing surveillance. The purpose is to survey for harmful drug effects in a larger population.
How many steps are in the Canadian drug standars approval process?
6 steps
What are the major priorities in the approval process in both Canada and the US?
Drug testing
and
Risk assessment
In Canada, who is responsible for ensuring that health products and foods approved for sale are safe and of high quality?
The Health Products and Food Branch (HPFB)
In nursing, what step has the most frequent opportunity for participation in the drug approval process (give number for both US and Canada)
Phase IV for US
Step 6 for Canada

Essentially, nurses are responsible for monitoring for therapeutic effects and adverse reactions from the drugs they give to their patients. They are reponsible for reporting reactions to the prescriber and appropriate health care agency personnel.
Therapeutic agents may be classified three ways. List how?
Traditional drugs
Biologics
Alternative therapies
How many years of research and development does it take before a drug is submitted to the FDA for review?
11 years
Describe Phase I in regard to length of time and volunteers needed. Phase II? Phase III?
Phase I-- 1 year and 20-80 healthy volunteers
Phase II-- 2 years and 100-300 volunteer patients with disease
Phase III-- 3 years and 1,000-3,000 patients in hospitals and clinic agencies
For every 5,000 chemicals that enter preclinical testing how many make it to human testing? How many are finally approved?
20; 4
16; 4
10; 2
5; 1
Describe therapeutic classification and give an example.
Organizing drugs based on their therapeutic usefullness in treating particular diseases.
ie: Anticoagulants (influence blood clotting)
Describe pharmacologic classification and give an example.
Refers to the way an agent works at the molecular, tissue, and body system level.
ie: Adrenergic antagonist (blocks physiologic reactions to stress)
What is a mechanism of action?
How a drug produces its effect in the body
Explain what a prototype drug is and how it differs from other drugs in its representative class.
It is the well-understood drug model with which other drugs in its representative class are compared. By learning the characteristics of the prototype, (ie: penicillin V), students can predict actions and adverse effects of other drugs in the same class (other penicillins)
How is a chemical name assigned?
Using the IUPAC nomenclature (chemistry)
Who is responsible for assigning generic names of drugs?
The US Adopted Name Council
Who assigns the drug's trade name?
The company marketing the drug
Describe a combination drug
A combination drug contains more than one active generic ingredient (ie: diphenhydramine)
Are there differences between brand-name drugs and their generic equivalent?
Maybe. While dosages may be identical, drug formulations are not always exactly the same. (ie: ingredients in tablet form may be more tightly compressed in one preparation than in another)
Explain bioavailability
Bioavailability is the physiologic ability of the drug to reach its target cells and produce its effect. It may be affected by inert ingredients and tablet compression, absorption, distribution, etc.
What is included on a negative formulary list?
A list of trade-name drgus that may not be dispensed as generic drugs.
Define dependence and explain the two types
A need for a substance, either physiologic or psychologic.

Physical dependence refers to an altered physical condition caused by the adaptation of the nervous system to repeated drug use (leading to withdrawal)

Psychological dependence refers to an intense compelling desire to continue drug use without the physical discomfort when the drug is withdrawn.
Why are drugs placed into schedules?
These five categories have a significant potential for abuse and are classified according to that potential. (I-V)
Describe each schedule (I-V) of the controlled substances
I -- highest abuse potential, high potential for physical and psychologic dependency

II -- high abuse potential, high potential for both phycial and psychologic dependency

III -- moderate abuse potential, moderate potential for physical dependency, high potential for psychologic dependency

IV -- lower abuse potential, lower potential for both physical and psychologic dependency

V -- lowest abuse potential, lowest potential for physical and psychologic dependency
Which schedules have therapeutic use?
Schedules II thru V have therapeutic use, with schedule V being the only one used therapeutically without a prescription
Give examples of drugs with abuse potential that are not regulated or placed into schedules.
Tobacco
Alcohol
Caffeine
When was the Controlled Substances Act passed?
1970
What does the Controlled Substances Act do?
Restricts drugs with abuse potential and potential for physical or psychologic dependency by requiring hospitals, pharmacies, physicians, NPs, and others with Rx authority to register with the DEA and receive and assigned number before prescribing controlled substances.
It is the responsibility of the nurse to the know and understand what about the drug ordered?
Name (generic/trade)
Classification
Intended/proposed use
Effects on the body
Contraindications
Special considerations
Side effects
Aside from the info about the drug specifically, what about the task fo administering meds must the nurse be responsible for?
~Knowing why the med has been prescribed for this patient
~How the med is supplied by the pharmacy
~How the med is to be administered (including dosage ranges)
~What nursing process considerations related to the med apply to this patient
List the 5 rights of drug administration
1. Right patient
2. Right medication
3. Right dose
4. Right route of administration
5. Right time of delivery
What are the three checks of drug administration used in conjunction with the five rights to ensure patient safety and drug effectiveness?
1. Check the drug witht he MAR or the med info system when removing it from med drawar, fridge, or controlled substance locker
2. Check the drug when preparing it, pouring it, taking it out of the unit-dose container, or connecting the IV tubing to the bag
3. Check the drug before admininstering it to the patient.
What is compliance?
Compliance is taking a medication in the manner prescribed by the health care provider, or in the case of OTC, following the instructions on the label.
ac
before meals
ad lib
as desired / as directed
AM
morning
bid
twice per day
cap
capsule
gtt
drop
h or hr
hour
IM
intramuscular
IV
intravenous
no
number
pc
after meals
PO
by mouth
PM
afternoon
PRN
when needed / necessary
qid
four time per day
q2h
every 2 hours (even or when first given)
q4h
every 4 hours (even)
q6h
every 6 hours (even)
q8h
every 8 hours (even)
q12h
every 12 hours
Rx
take
STAT
immediately; at once
tab
tablet
tid
three times per day
Why is grapefruit not recommended for people taking certain medications?
Chemicals (flavanoids) lower the activity of a specific enzymes in the intestinal tract that would normally break down meds, resulting in increased drug activity. It should be consumed at least 2 hours before or 5 hours after taking a med that may interact with it.
What drugs may be affected by grapefruit juice?
midazolam (Versed)
cyclosporine (Sandimmune, Neoral)
antihyperlipidemics (Mevacor)
simavastatin (Zocor)
erythromycin
itraconazole (Sporanox)
ketoconazole (Nizoral)
mibefradil (Posicor)
1 mL
15-16 minims
15-16 drops
4-5 mL
1 fl dram
1 teaspoon/60 drops
15-16 mL
4 fl drams
1 tablesoon/3-4 teaspoons
30-32 mL
8 fl drams or 1fl oz.
2 tablespoons
240-250 mL
8 fl oz. (1/2 pint)
1 glass or cup
500 mL
1 pint
2 glasses or cups
1 L
32 fl oz or 1 quart
4 glasses/cups or 1 quart
1 mg
1/60 grain
60-64 mg
1 grain
300-325 mg
5 grains
1 g
15-16 grains
(no household)
1kg
(no apothecary)
2.2 pounds (household)
Convert grains to grams
Divide grains by 15 or 16
Convert grams to grains
Multiply grams by 15 or 16
Convert minims to milliliters
Divide minims by 15 or 16
STAT or PRN orders are usually carried out within what time frame of the order?
2 hours
What is a standing order?
An order written in advance of a situation that is to be carried out under specific circumstances.
(ie: postoperative PRN Rx written for all patients undergoing a specific surgical procedure: common standing order for tonsillectomy is "Tylenol elixir 325 mg PO every 6 hours PRN sore throat")
Once meds are administered, what is the next step?
Nurse must correctly document that they have been given to the patient and that is documented only AFTER the meds have been given, not when they are prepared.
Prescription for narcotics and other scheduled drugs are often automatically discontinued after how long?
72 hours, unless specifically reordered by a physician
What is included in drug adminstration documentation?
Drug name
Dosage
Time administered
Any assessments
Nurse's signature
A patient is instructed to drink 2,400 mL of fluid per day upon being discharged. What is the nurse to tell the patient?
Drink 10 8-oz glasses of fluid per day
When explaining drug administration to a parent of a sick child, 5mL is the same as what?
1 teaspoon
What does enteral drug administration include?
Drugs given orally and administered through an NG or G tube
List 4 types of enteral drugs
1. Tablet/capsule/liquid
2. Sublingual
3. Buccal
4. NG and G tubes
What is the difference between an NG tube and a G tube?
NG (nasogastric)--inserted through the nasopharynx into the stomach (short term)
G (gastrostomy)--surgically placed directly into patient's stomach (longer term care)
What is topical drug administration?
Applied directly to the skin or membranous linings of the eye, ear, nose, and repiratory tract urinary tract, vagina, and rectum.
What do topical drug applications include?
1. Dermatologic preps (skin)
2. Instillations/Irrigations (eyes, ears, nose, urinary, rectum/vagina
3. Inhalations (respiratory tract)
There are 6 drug forms of topical administrations. What are they?
1. transdermal
2. ophthalmic
3. otic
4. nasal drops
5. vaginal
6. rectal suppositories
What is parenteral drug administration?
Any dispensing of medicaiton by routes other than oral or topical (usually needles)
What are the 4 types of parenteral drug administration?
1. intradermal
2. subcutaneous
3. intramuscular
4. intravenous
In regard to intradermal administration, what is the proper angle of insertion for the needle?
10-15 degrees, bevel facing upward
What is the angle of insertion for an injection using the subcutaneous route?
45-90 degrees depending on body size (90 if obese, 45 if average)
What is the proper angle of insertion for injection using the intramuscular route?
90 degrees, dartlike movement
What are the 4 sites for IM injections?
Ventrogluteal
Dltoid
Dorsogluteal
Vastus lateralis
What is the preferred site for IM injections?
Ventrogluteal
In regard to IV administration, what are the 3 types?
1. Large-volume infusion
2. Intermittent infusion
3. IV bolus (push) admin
In regard to enteral drug administration, what is the very first step the nurse is responsible for?
Assessing the patient is alert and has the ability to swallow or hold the medication in their mouth.
In regard to NG and G tubes, which of the following cannot be administered via this route?
(select all that apply)
1. liquids
2. enteric-coated tablets
3. sustained-release tablets
4. finely crushed tablets
5. IV meds
What is the primary role of a nurse in medication administration?
To ensure meds are administered and delivered in a safe manner.
For heparin, the recommended needle size is
3/8 inch and 25-26 gauge
For all other subcutaneous route injections, what is the recommended syringe and needle size?
1-3mL syringe
23-24-gauge
1/2-5/8-inch needle
What is the proper needle size range for intramuscular injections?
20-23 gauge, 1-1.5-inch needle