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PHARMACOLOGY
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What are the classification of Aspirin?
an analgesic, antipyretic, anti-inflammatory, and anti-platelet
reactive site on a cell or tissue
Receptor
Reye’s syndrome is found in?
Infants
“clumping” together
Platelet aggregation
Vaginal medications
Creams, foams, gels - Suppositories - Lubricate with water-soluble, i.e. KY Jelly
Adults - Infant or child younger than 3 years old - Up and back – adult - Down and back – child
Ear drops
Drops - Ointments - For babies - Erythromycin treatment from inner canthus to outer canthus
Eye medications
Age at next birthday (in years) x adult dose/24 = dose for child
Cowling’s Rule
Age (in months) x adult dose/150 = dose for infant
Fried’s Rule (infant):
Age/Age +12 x adults dose = dose for child
Young's Rule
1 grain = mg?
65 mg
1000 mL = L?
1 L
1 cup = oz?
8 oz
1oz = Tbsp?
2 Tbsp
1oz = mL?
30 mL
3tsp = Tbsp ?
1 Tbsp
15mL = Tbsp?
1 Tbsp
1000g = kg?
1 kg
1 kg = lbs?
2.2 lbs
degree to which a drug binds with a receptor
Affinity
Unpredictable effects-overreacts or under reacts to a medication or has a reaction different from normal
Idiosyncratic reactions
Unpredictable response to a medication
Allergic Reactions
What happened when there is severe reaction?
– Anaphylactic reaction
hives (pamamantal), rash (pamumula), pruritus (itchiness
Mild Reaction
May develop after prolonged intake or when a med accumulates in the blood because of impaired metabolism or excretion, or excessive amount taken
Toxic Effects
Undesirable response of a medication
Adverse Effects
Not involving a receptor site or alteration in enzyme function
Non-specific Interaction
Unintended secondary effects a medication predictably will cause
Side effects
Enzymes are substances that catalyze nearly every biochemical reaction in a cell
Enzyme Interaction
drug that binds at the same time blocks
Agonist-Antagonist or Partial Agonist
changes genetic composition (radiation, chemicals)
Mutagenic
Elevated liver enzyme (hepatitis-like symptoms)
Hepatic Toxicity
Unintentional adverse effects that occur during therapy
Iatrogenic Responses
Destruction of blood cells (chemotherapy)
Blood Dyscrasias
Occurs when one med modifies the action of another
Drug Interaction
Aminoglycoside antibiotics, NSAIDS, contrast medium
Renal Damage
Time it takes for excretion processes to lower the serum medication concentration by ½
Serum Half-life
medication no longer has the desired effect because the patient’s body has become accustomed to the medication
Drug Tolerance
Effect of 2 meds combined is greater than the meds given separately
Synergistic Effect
drug binds to receptor-no response- prevents binding of agonists (Alpha & Beta Blockers)
Antagonist
rash, hives, acne
Treatment-induced Dermatologic
Structural effect in unborn fetus (thalidomide)
Teratogenic
causes cancer
Carcinogenic
drug binds to receptor-there is a response (Adrenergic Agents)
Agonist
The time it takes for a drug to reach its maximum therapeutic response
Peak
The expected or predictable physiological response or medication causes
Therapeutic Effect
The time it takes for the drug to elicit a therapeutic response
Onset
The time a drug concentration is sufficient to elicit a therapeutic response
Duration
no need IV fluids, only need medication
Intermittent lock (heplock)
which site is the least preferred for IM
Dorsogluteal site
when a person injects insulin near the belly button.
Lipodystrophy
Sites for ID?
Upper chest/back, Anterior aspect of forearm
For medications that are irritating to the tissues or can stain
Z-track method
Whenever a medication dose has been missed, what should the nurse do?
the nurse should contact the physician to clarify for what is best for the patient
If sciatic nerve is hit, what will happen to the patient?
injection palsy
Give examples of Parenteral Route
Subcutaneous (SQ) - Intramuscular (IM) - Intravenous (IV) - Intradermal (ID)
Easiest, most commonly used route
Oral Route
How does first pass effect work?
Drug-Stomach-Intestine-Liver-Systemic Circulation
which site is the most preferred for babies in IM?
Vastus lateralis site
Non-First Pass Route?
Aural, Buccal, Inhaled, Intraarterial, Intramuscular, Intranasal, Intraocular, Vaginal, Intravenous, Subcutaneous, Sublingual, Transdermal
Involve medications that are visually similar in physical appearance or packaging and names of medications that have spelling similarities and/or similar phonetics
LASA
If a nurse experiences a problem reading a physician’s medication order, the most appropriate action will be: A. Call the physician to verify the order B. Call the pharmacist to verify the order C. Consult with other nursing staff to verify the order D. Withhold the medication until the physician makes rounds
A. Call the physician to verify the order
What method is used to recap a needle?
Scoop Method
WHAT DOES LASA MEANS?
LOOK ALIKE SOUND ALIKE (LASA) MEDICATIONS
The metabolism of a drug and its passage from the liver into the circulation
First pass effect
Enteral Drugs
Giving oral medications - Giving sublingual or buccal medications - Liquid medications - Giving oral medications to infants - Administrating drugs through a nasogastric or gastrostomy tube - Rectal administration
Needle angles for Intramuscular (IM) - Subcutaneous (SC or SQ) - Intradermal (ID)
Intramuscular (IM) - 90 degrees Subcutaneous (SC or SQ) - 45 degrees Intradermal (ID)- 10-15 degrees
which site is the most preferred for IM?
Ventrogluteal site
Nurses are legally required to document medications that are administered to clients. The nurse is mandated to document: A. Medication before administering it B. Medication after administering it. C. Rationale for administering the medication D. Prescriber’s rationale for prescribing the medication
B. Medication after administering it.
What does USPMERP stands for?
United States Pharmacopeia Medication Errors Reporting Program
Do not use 1.0 mg: use 1 mg
TRAILING ZEROS
administration of written prescription for treatment, therapies, oral, topical, and parenteral medication
RA 9173 (Philippine Nursing Act of 2002) ARTICLE VI: Nursing Practice, Section 28a
bony landmark to locate appropriate injection
Acromion process
Registered nurses have to gain knowledge and understanding of man’s cultural, social, spiritual, physiological, psychological, and ecological aspects of illness, utilizing the therapeutic process.
Code of Ethics for Nurses
why is the dorsogluteal the least preferred site?
high risk in hitting the sciatic nerve
First Pass Routes?
oral, rectal
Respecting the patient's bill of rights is what under section?
Section 8
T or F: By definition all ADRs are also ADEs then all ADEs are ADRs
False, By definition all ADRs are also ADEs but all ADEs are not ADRs
injury resulting from medical interventions relating to drugs
ADE – Adverse Drug Events
What are the cultural assessment?
Health beliefs and practices - Past uses of medicine - Folk remedies - Home remedies
What section is under of Code of Ethics for Nurses?
Section 5
Leading Zeros is also known as?
Naked Decimal
Unpredictable effect of the drug
Allergic reactions
Inflammation?
Tumor
do not occur in most patients but happens in some people
Idiosyncratic reactions
Always label your answer with appropriate unit
LABELING
RA 9173
(Philippine Nursing Act of 2002)
Pain?
Dolor
Always round your answers to the nearest dose that is measurable, after verifying that the dose is correct for that patient
ROUNDING
What are the 4 responsibilities of a nurse regarding drug administration?
Follow institutional policy, Consider client’s desires and abilities, Foster compliance, Correctly document all actions related to medication administration and medication errors
to safeguard the integrity of its territory and the well-being of its citizenry particularly the youth, from the harmful effects of dangerous drugs
RA No. 9165
Do not use.25mg: use 0.25 mg
LEADING ZEROS
Who stated the ff, "The very first requirement in a hospital is that it should do the sick no harm”
Florence Nightingale
Warmth?
Calor
2 types of ADR?
Allergic reactions AND Idiosyncratic reactions
Confirm the rationale for the ordered medication.
Right Reason
What is the standard of documentation?
“if it was not documented it was not done.”
What are the cultural considerations?
Assess the influence of a patient’s cultural beliefs, values, and customs. Compliance level with therapy Environmental considerations Genetic factors Varying responses to specific agents
Make sure that the drug led to the desired effect. If an antihypertensive was given, has his/her blood pressure improved? Does the patient verbalize improvement in depression while on an antidepressant?
Right Response
Redness?
Rubor
What are the nursing implications?
Be familiar with various measurement system and the conversion from one system to another
Chart the time, route, and any other specific information as necessary.
Right Documentation
Check the frequency of the ordered medication it can be seen in the medication administration record or in the patient’s chart
Right Time
Confirm that the patient can take or receive the medication by the ordered route
Right Route
T or F: When measuring drops of medication with a dropper, always hold the dropper horizontally and close to the medication cup.
False
T or F: Shake all suspensions and emulsions
True.
T or F: Attempt to divide unscored tablets .
False
How do you properly identify the patient before administering a drug?
check the name and date of birth on the patient record and ask the patient to state his/her name and date of birth.
Order that is given once and usually at a specific time
Single order
T or F: Leave a prepared drug unattended.
False.
beginning with the abbreviation Sig; contains directions to the patient how to use the medication
Signature
Protocols derived from guidelines created by healthcare for use in specific settings, for treating certain disease or symptoms. Pre-written and signed by the physician
Standing Order
contains the name of drug, the dosage strength and the drug form
Inscription
Rx (at the beginning of every prescription)
Superscription
Check for the appropriateness of the dose using a current drug reference If necessary, calculate the dose and have another nurse calculate as well.
Right Dose
T or F: – Never give a drug that someone else has prepared
True
What are the measuring devices?
Measuring cups, droppers, and syringes (tuberculin & insulin)
begins with either the # symbol or with N, which stands for number
Subscription
T or F: do not administer tablets which have been broken unevenly along the scoring.
True.
How many hours a telephone order should be cosigned by the physician?
24 hours
Given at the patient’s request and nurse’s judgement concerning order and safety For fever, headache, BP
PRN Order
Maybe ongoing order, may be given for a specific number of doses or days
Standard Order
Given once immediately
STAT Order
What are the 3 elements that should be paid close attention when administering drug?
Route, Dose and Form of Medication
How will you know if you got the right patient?
Check the name on the order and patient
given through routes that allow the drugs to be absorbed or distributed into the bloodstream
Systemic Effect
T or F: Always use the appropriate measuring device and don't read it.
False.
What are the 2 identifiers to check if you have the right patient?
1. Ask patient to identify himself/herself 2. When available, use technology such as bar code system
applied directly to skin, tissue, or mucous membranes
Local Effect
-Check the medication label -----Check the order -For hospitalize clients, drug orders are written on doctor’s order sheet and signed by authorized person A telephone order must be cosigned by physician within 24 hours
Right Medication
Modifies/enhances or blocks cellular function. Examples: inhibitors, beta-blockers.
Alteration in cellular function
Selective interaction with enzymes that affect the target molecule. Can inhibit or enhance enzyme action.
Changes in enzymatic action.
Biochemical changes that occur in the body as a result of taking a drug.
PHARMACODYNAMICS
Lowers or lessens activity in some parts of the body. Examples: morphine, CNS depression, cardiac depression.
Depression
Act by soothing or relieving symptoms of irritation on mucous membranes. Example: lozenges
Demulcents.
What are the Site of Actions?
Local and Systemic
Increases the function or activity of a part of the body. Example: epinephrine increases PR (flatline ECG)
Stimulation.
What are the 6 rights?
Right Drug Right dose Right time Right route Right patient Right documentation
Judgment or conclusion about the need/problem (actual or at risk for) of the patient. Based upon an accurate assessment. NANDA format.
Nursing Diagnosis
produce actions and effects at the site where they are applied. Not absorbed in the bloodstream.
Local
Data collection - subjective, objective. Data collected on the patient, drug, environment. Medication History. Physical Assessment. Data analysis.
Assessment
Deciding how the patient is responding to the interventions in relation to the stated goals and expected outcomes. Subj: COLDSPA - Character, Onset, Location, Duration. PAIN: PQRST
Evaluation
the effect is throughout the body because the drug is absorbed into the bloodstream and distributed.
Systemic
An organized framework for the practice of nursing. Orderly, systemic. Central to all nursing care. Encompasses all steps taken by the nurse in caring for a patient. Flexibility is important.
The Nursing Process
Identification of goals and outcome criteria. Prioritization. Time Frame. SMART - Specific, Measurable, Attainable, Realistic, Time Bound.
Planning
Primarily applied to the skin or mucous membrane, causing inflammation. Symptoms include redness, warmth, and pain.
Irritation
Changes the structure of a cell. Example: antibiotics that prevent cell wall replication/synthesis of bacteria.
Changes in cellular environment
WHAT ARE THE 4 MAJOR DRUG ACTIONS
1. Depression 2. Stimulation 3. Irritation 4. Demulcents
Interaction between a drug and its target receptor. Can be agonist (activates receptor) or antagonist (blocks receptor).
Drug receptor interaction
Initiation and completion of the nursing care plan as defined by the nursing diagnosis and outcome criteria. Follow the '12 Rights' of medication administration
Intervention
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Flashcards on pharmacology - drugs, dosage calculations, and medication administration. Easy to edit and study!
Pharmacology
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Medical Procedures
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