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108 Cards in this Set
- Front
- Back
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What is pharmokinetics? |
How the body processes a drug after it is administered. Also known as the study of drug movement throughout the body. |
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What is diffusion? |
Passive transport not requiring ATP where solutes move from an area of high concentration to an area of lower concentration. In this case it is smaller drugs that can use this process. |
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What is active transport? |
Transport requiring ATP. In this case larger drugs use carrier proteins to cross the plasma membrane. |
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Oral medications are digested where? |
These medications are first exposed to digestive enzymes and stomach acids. The drugs are then exposed to liver enzymes in the liver. |
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What can happen if drugs are exposed to the kidneys or large intestine? |
They may be eliminated before they have an effect on the body. |
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What is A.D.M.E.? |
Absorption, Distribution, Metabolism, and Excretion. |
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What is absorption? |
How a drug gets to the bloodstream after it is administered. |
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What is distribution? |
The process by which drugs are transported through the body. |
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What is metabolism? |
Also called biotransformation, it is the process by which the body chemically alters a drug to a form that is more easily removed from the body. |
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What is excretion? |
The process by which the body eliminates the drug from the body. |
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What is the minimum effective concentration? |
The time it takes for an accumulated concentration of the drug to become minimally effective or produce a therapeutic effect. |
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What is therapeutic range? |
Also known as the duration of action, it is the concentration of the drug needed to produce a therapeutic response; it describes when the therapeutic response begins, peaks, and remains therapeutic. Between minimum and toxic effects! |
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What is plasma half-life? |
How long it takes for the plasma concentration of the drug to decrease by half. |
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What is a toxic concentration? |
The level at which the drug concentration exceeds the therapeutic range and results in serious adverse effects for the client. |
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What is a loading dose? |
A high dosage of medication administered to a client in order to achieve a quick therapeutic response. Often given once or twice to "prime" the patient's blood stream with a sufficient level of the drug. |
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What is a maintenance dose? |
A dosage administered to keep a preferred plasma drug concentration in the body. |
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What are pharmacodynamics? |
How drugs change the body, or how the body responds to drugs. |
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What is the therapeutic index? |
The ratio that indicates how safe the drug dose is. It is based on a calculation that divides the median lethal dose by the median effective dose. The greater the difference between the tow doses, the greater the therapeutic index. |
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What is the dose response relationship? |
How the drug works, depending on its concentration. The goal is to find the lowest dose that will provide the therapeutic range with minimal adverse effects. |
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What is potency? |
The more potent the drug, the less is needed to reach a therapeutic effect. |
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What is efficacy? |
The maximum response one can get from a drug. It addresses what the greatest response is that an individual can get from a drug. The greatest effect the drug can produce. |
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What is the receptor theory? |
Drugs have to bind to receptor sites to be effective. Those that do bind easily have a high intrinsic activity and in essence have a high efficacy. |
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What is an agonist? |
They mimic or increase the response of an endogenous substance. |
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What is an antagonist? |
They block or reverse the response of an endogenous substance. May be used to reverse the effects of a drug overdose. |
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What is pharmacogenetics? |
Not all drugs elicit the same response in all people. Many people experience adverse effects from certain drugs. Studies, including the Human Genome Project, are being conducted to see if drugs can be customized to treat clients who are genetically similar. It is thought that through DNA testing, many adverse reactions can be avoided. |
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What is teratogenicity? |
A drug side effect that has the potential for causing birth defects. |
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What substances can affect how a drug works? |
Other drugs, dietary supplements, herbal products, and even food. |
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What are the most common factors associated with medication errors? |
* Not following the five rights of medication administration (the sixth right refers to proper documentation) |
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Why should you be careful when administering oral medications that come as SR, LA, XL, or XR? |
These types of medications should never be crushed or chewed. |
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When educating clients on proper medication usage, what should you focus on? |
* Instructing clients about the drugs they are prescribed (dosage, frequency, and time) |
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What can affect the drug therapy response? |
* Age |
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What is a therapeutic classification? |
Based on why the drug is being prescribed and how effective it is in treating a particular disease or condition. Examples:
* Antihypertensive medications—work to lower blood pressure |
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What is a pharmacologic classification? |
Based on how the drug works in the body (mechanism of action). Examples:
* Calcium channel blockers—block calcium channels of the heart |
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What is a prototype drug? |
They are one of the first drugs used in that classification. Examples include levodopa, diazepam (valium), morphine sulfate, lidocaine, verapamil hydrochloride, and ampicillin. |
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What is the chemical name of a drug? |
* These names are based on a drug’s physical and chemical properties. |
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What is the generic name of a drug? |
* Each drug has one. |
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What is the trade name of a drug? |
* Pharmaceutical companies market drugs under brand names. |
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What three things are included in a drug order? |
Heading, body, and closing. |
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What is in the heading of a drug order? |
* Name, address, and telephone number of the health care provider who is writing the prescription |
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What is in the body of a drug order? |
* Name of the drug prescribed
* Dosage of the drug prescribed * Amount of drug to be dispensed * Instructions for clients regarding how to take the drug (how many times per day) |
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What is in the closing of a drug order? |
* Prescriber’s signature
* Number of refills (at the bottom of the script) * Name of generic drug if a substitution for a brand-name drug is allowed * Drug Enforcement Administration (DEA) number if the drug is a controlled substance |
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What should be included in the MAR? |
* Drug name |
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What are enteral drugs? |
Drugs administered orally, including sublingual and buccal administration, or by way of a nasogastric or gastrostomy tube. |
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What are topical drugs? |
Medications are applied directly on the skin surface or mucous membranes. Delivery systems include:
* Transdermal |
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What are parenteral drugs? |
Medications are administered via a needle. Examples are:
* Intradermal and subcutaneous |
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What is pharmacology? |
The study of medicine (used to relieve suffering). |
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What is pharmacotherapy? |
The application of drugs for the purpose of disease prevention and treatment of the suffering. |
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What are the three categories of therapeutic agents? |
Drugs or medications, biologics, or CAM (complimentary and alternative medicine). |
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What is therapeutics? |
The branch of medicine concerned with the prevention of disease and treatment of suffering. |
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What is a drug? |
A chemical agent capable of producing a biologic response within the body. |
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What is the difference between a drug and medication? |
After the drug is administered it is called medication. |
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What are biologics? |
Agents naturally produced in animal cells by microorganisms or by the body itself. They include hormones, monoclonal antibodies, interferons, blood products, and vaccines. |
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What are CAMs? |
Complimentary and alternative medicine therapies that include natural plant extracts, herbs, vitamins, miners, dietary supplements, and many techniques considered by some to be unconventional. Also includes massage, acupuncture, hypnosis, etc. |
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What is the role of the FDA when it comes to drugs? |
Control whether prescription drugs or OTC drugs can be used for therapy. They facilitate the availability of safe, effective drugs by keeping unsafe or ineffective drugs off the market. They provide clear, easily understandable drug information for consumers. They require approval before a new drug is introduced. They created black box warnings. They also regulate biologics in the same manner. |
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What is a therapeutic response? |
A desirable response. |
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What is an adverse response? |
An undesirable response. |
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What is the difference between a prescription drug and an OTC drug? |
Prescription drugs require that the recipient obtain a written order from a person with the legal authority to write such a prescription. |
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What is the nurse's job in regards to the drug approval process? |
-Nurses participate in Phase IV or the post marketing surveillance period.
-All nurses administering medications monitor for its therapeutic effects or adverse reactions.
-Nurses are responsible for reporting adverse reactions. |
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What is bioavailability? |
The physiological ability of the drug to reach its target cells and produce its effects. |
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What is a negative formulary list? |
A list of drugs that must be dispensed as trade-name vs. generic brand. |
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What are scheduled drugs? |
Drugs that have a potential for abuse. |
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What are schedule I drugs? |
Drugs that have the highest potential for abuse. They are restricted for use in situations of medical necessity, if at all allowed. They have little or no therapeutic value or are intended for research purposes only. Examples include: -Heroin -LSD -Peyote -Marijuana -Extasy |
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What are schedule II drugs? |
Drugs that have a high potential for abuse. They include: -Methadone -PCP -Oxycodone -Fentanyl -Amphetamine -Methamphetamine -Cocaine -Pentobarbital |
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What are schedule III drugs? |
Drugs that have a moderate potential for abuse. They include: -Anabolic steroids -Codeine with aspirin or Tylenol -Some barbiturates -Benzaphetamine |
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What are schedule IV drugs? |
Drugs that have a low potential for abuse. They include: -Aprazolam -Clonaepam -Diazepam -Lorazepam -Clorazepate -Pentazocine -Dextropropoxypene |
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What are schedule V drugs? |
Drugs with the lowest potential for abuse. Some drugs in this tier may be dispensed without prescription because the quantities of the controlled drug are so low the possibility of causing dependence is extremely remote. They include: -Cough preparations with less than 200mg of codeine per 100 mL |
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What is a controlled substance? |
A drug whose use is restricted by the Controlled Substances Act of 1970. |
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How are controlled substances regulated? |
By the DEA (Drug Enforcement Administration) who assigns registration numbers. Special order forms are required for ordering drugs with certain schedules. Certain drug orders cannot be made over the phone (e.g., schedule II drugs). |
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What are the five teratogenic classifications? |
A, B, C, D, and X. |
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What is a category A teratogenic drug? |
A drug in which controlled studies have failed to show a risk to the fetus and the possibility of fetal harm appears unlikely. |
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What is a category B teratogenic drug? |
A drug in which animal-reproduction studies have not shown a fetal risk or adverse effect, but risks have not been confirmed in controlled studies in women. |
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What is a category C teratogenic drug? |
A drug in which studies in animals have revealed adverse effects on the fetus, but there are no controlled studies on women. In some cases a drug may be classified as this type if testing was never completed on pregnant animals or women. |
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What is a category D teratogenic drug? |
A drug in which there is confirmation of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used). |
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What is a category X teratogenic drug? |
A drug in which animal and human studies have shown fetal abnormalities. The drug is contraindicated in women who are or may become pregnant. |
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What is addiction? |
The overwhelming feeling that drives a person to use a drug repeatedly. |
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What is dependence? |
A physiologic or psychologic need for a substance. |
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What is physical dependence? |
An altered physical condition caused by the adaptation of the nervous system to repeated drug use. When the drug is no longer available, the individual expresses physical signs of discomfort known as withdrawal. |
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What is psychological dependence? |
Having little physical discomfort when the drug is withdrawn, but an intense or compelling desire to continue its use. |
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Which drugs are not regulated by the Controlled Substance Act? |
Tobacco, alcohol, and caffeine |
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What are benefits of using the enteral route for medications? |
-Costs less -Safest due to skin barrier not being broken -OD can be reversed via vomiting -Take advantage of vast absorptive surfaces of the oral mucosa, stomach, or small intestine -Convenient
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What are benefits of using the topical drug route for medications? |
-Can be administered during religious fasting -Very rapid onset of drug action (e.g., inhaler) |
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What are routine orders? |
Orders not written as STAT, ASAP, NOW, or PRN. |
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What is a standing order? |
A drug order written in advance of a situation that is to be carried out under specific circumstances. |
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Which drugs are best administered during bed time? |
CNS or antihypersensitive drugs. |
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What are disadvantages in using the enteral route? |
-Difficulty swallowing for some patients -Tablets may become inactivated if accidentally crushed or opened. -Dependent on patient GI motility and mobility |
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What are advantages in using the parenteral route? |
-Bypasses first-pass effect and enzymes -Available to patients unable to take medication orally |
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What are disadvantages in using the parenteral route? |
-Only small doses can be used -Pain and swelling at injection site |
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What is the first pass effect? |
A mechanism whereby drugs are absorbed across the intestinal wall and enter the hepatic portal circulation. Here drugs may become metabolized or inactivated by hepatic metabolic reactions. In order to bypass this, drugs may have to be administered via a different route such as the sublingual, rectal, or parenteral route. |
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Medication in an acidic environment will what? |
Absorb better. |
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What is the onset of drug action? |
The amount of time it takes to produce a therapeutic effect after drug administration. |
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What is the peak plasma level? |
When medication has reached its highest concentration in the blood stream. |
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What factors affect drug absorption? |
-Route -Drug composition -Dosage -Digestive motility -Digestive tract enzymes -Blood flow at administration site -Other drugs or supplements |
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What is the primary site of metabolism? |
The liver. |
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What do the blood brain barrier or fetal-placenta barrier do? |
They prevent many chemicals or medications from entering. These obstacles can make tumors difficult to treat. |
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What is the primary site of drug excretion? |
The kidneys. |
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What are other sites of drug excretion? |
The respiratory system, the glands, or the biliary system. |
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How do you calculate the therapeutic index? |
How many doses would it take for the dose to become lethal? |
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What is the median toxicity dose? |
The dose that will produce a given toxicity in 50% of a group of patients. This data may be extrapolated from animal data or based on adverse effects recorded in patient clinical trials. |
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What is subjective data? |
What the patient says or perceives. "My head hurts". |
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What is objective data? |
What the nurse sees or gathers via physical assessment, lab tests, or other diagnostic sources. "Pulse at 88". |
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What is a medication error? |
Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of a health care professional, patient, or consumer. |
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What are examples of medication errors? |
-Misinterpretations -Miscalculations -Misadministration -Misunderstanding (verbal/nonverbal) |
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Why should medication errors be reported? |
So nurses can learn from mistakes, and not for disciplining purposes. |
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When a medication errors does occur, what must the nurse do in most cases? |
Complete an incident report, contact the physician, and assess the patient. |
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What is a sentinel event? |
Unexpected occurrences involving death or serious physical or psychological injury, or risk thereof. They are always investigated by the joint commission. Does not always occur due to a medication error. |
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What bodily functions should you assess before passing medications? |
Liver, kidney, and other body systems. |
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What is medication reconciliation? |
The process of keeping track of a patient's medications as they proceed from one health care provider to another. |
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What two agencies track medication errors? |
FDA and NCC MERP |
