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41 Cards in this Set
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Pharmaceutics
Pharmacokinetics Pharmacodynamics Pharmacotherapeutics |
4 components of pharmacology
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in clinical pharmacology, this term combines everything - drugs or chemicals used for treatment, prevention and diagnosis of disease
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Pharmacotherapeutics
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Interactions between drugs and chemical components of living tissues or systems (the basic science of the drug – how and why). It determines the nature and intensity of the response.
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Pharmacodynamics
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study of movement of drugs in body - absorption, distribution, metabolism, excretion
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Pharmacokinetics
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1.sources
2.constituents 3.dosage forms 4.routes of administration 5.stability 6.storage (follow directions of how to handle) |
Pharmaceutics
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ANY CHEMICAL that is put into the human body with the intent to affect function.
food extracts, herbs, supplements, Rx, illegal (natural is not safe) FDA definition: a chemical INTENDED to diagnose, cure, mitigate, treat, or prevent disease. |
Drug
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It reviews the implementation of the Food, Drug and Cosmetic Act of 1938 – to regulate drug safety, all new drugs must undergo testing for toxicity. It oversees and approves/denies new drugs for marketing, including both Rxs and OTCs
(BEFORE marketing, the MANUFACTURER determines with clinical trials: safety, effectiveness, possible interaction with other substances, appropriate dosages) |
Federal Drug Administration (FDA)
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1.Marketing
2.Not required to report OTC adverse reactions 3.Can substitute a GRASE* ingredient without changing name of OTC drug 4.Can substitute a GRASE ingredient without warning (label) to public *(GRASE generally regarded as safe equivalent) |
What is not regulated by the FDA of Over the Counter Drugs (OTCs)
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The FDA does not authorize or monitor premarket testing of these.
No quality control. As long as the manufacturer does not use the terms "cure" or "treat" a specific disease, they can legally get away with selling a lot of unproven things. NATURAL does not equal SAFE |
FDA does not regulate supplements - a supplement is not a drug
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1.Chemical classification - like structure
2.Pharmacological classification - mechanism of action 3.Therapeutic classification - indications or uses 4.Prototypes - Individual drugs that represent a group (classification) of drugs. Other drugs in that category will have similar features. |
Drug Classification
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This is therapeutically equivalent to original trade name.
Must prove BIOEQUIVALENCE without repeating all of the R&D (occasional differences in absorption - increase could lead to toxicity while decrease could lead to lessened therapeutic effect) FDA approved |
Generic Drug
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The generic name is consistent (universal) for all. For older drugs, there may be many trade names. Not everyone prescribes the same trade name.
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Why is the generic name used in drug reference books?
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-Not everyone knows/uses the same trade
-Single chemical can have multiple trade names -Different chemicals can have same trade name -leads to miscommunication and medication errors |
What are the disadvantages of using trade names?
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Unapproved use of an FDA approved drug.
Practitioner prescribes drug for a different Dx that has not undergone research for that use. Not illegal (malpractice if outcome is bad). |
Off label Drug (unlabeled)
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research only, no legal use
peyote, LSD, heroin |
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule I |
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Therapeutic use, high abuse potential
no refills on Rx; rewrite only amphetamine morphine cocaine opium |
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule II |
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lower abuse potential
5 refills before rewrite refills must be made w/i 6 mos stimulants amobarbital pentobarbital paregoric anabolic steroids |
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule III |
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lower abuse potential with possible psychological dependence
phenobarbital petazocine diazepam |
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule IV |
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low abuse potential
states vary Terpin hydrate w/ codeine triamine w/cod Lomotil Robitussin A-C |
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule V |
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TO ADMINISTER DRUGS
(per order of MD/DO, APN with *CTP) *CTP=certificate to prescribe |
What is the nursing legal responsibility regarding drugs?
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right drug
right dose right client right time right route of administration Documentation sometimes considered the "sixth right" |
5 Rights
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T/F: an RN Cannot DISPENSE DRUGS IN OHIO.
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T: an RN Cannot DISPENSE DRUGS IN OHIO.
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T/F: MD/DO, APN with CTP can prescribe drugs in Ohio.
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T: MD/DO, APN with CTP can prescribe drugs in Ohio.
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MD/DO, APN with CTP
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WHO CAN DISPENSE DRUGS or SAMPLES IN OH?
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When discussing the use of any chemical with a patient, the professional and ethical responsibility is the same no matter what the chemical.
What are the chemicals? |
Prescriptive
Over the counter FDA approved drug Herbal or supplement not approved by FDA |
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A customized medication prepared by a pharmacist according to a doctor's specifications to meet an individual patient need. Pharmacists make medications from scratch using raw chemicals, powders and devices to meet the unique needs of prescribers and patients.
Who:Pharmacists Where:Local pharmacy or corporate Regulated:FDA, Federal govt., State govt. |
Compound Pharmacy
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Ask your pharmacist for recipe
Ask your pharmacist for reference on pharmacokinetics e.g. at MCO: Micromedic data base |
How you find out about the drugs compounded
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drug used for Dx, Tx, or prevent disease or condition affecting <200,000 people USA.
Not considered good financial investment for R&D and marketing. |
orphan drug
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1. preadministration assessment
2. dosage and administration 3. evaluating and promoting therapeutic effects 4. minimizing adverse effects 5. minimizing adverse interactions 6. making PRN decisions 7. managing toxicity |
Seven aspects of drug therapy
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5 rights – drug, patient, dose, time, route (documentation), in addition,
1.certain drugs have more than one indication 2.Many drugs can be administered by more than one route and dosage 3.certain intravenous agents can cause severe local injury if the line through which they are infused becomes extravsated. *do not administer if you don’t understand |
"dosage and administration" basic guidelines to help the nurse provide correct drug administration
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pro re nata – as needed. Need to know the reason for the drug
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PRN decision
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1.drug name and therapeutic category
2.dosage size 3.dosing schedule 4.route and technique of administration 5.expected therapeutic response and when 6.nondrug measures to enhance 7.duration of tx 8.method of drug storage 9.symptoms of side-effects 10.drug-drug and drug-food interactions 11.whom to contact in event of therapeutic failure, severe adverse rxns, or interactions |
10 items the nurse must provide during patient education
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a.collect baseline data needed to evaluate therapeutic responses
b.collect baseline data needed to evaluate adverse effects c.ID high-risk pts d.asses the pts. capacity for self-care DRUG HISTORY: included Rx, OTCs, supplementals and herbals, and nonmedicals, allergies, and idiosyncratic to pt. |
Nursing Process For Drugs:
1. Preadministration Assessment |
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a.judge the appropriateness of the prescribed regimen
b.id potential problems the drug may cause c.determine the pts capacity for self-care |
Nursing Process For Drugs:
2.Analysis: 3 objectives |
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•the drug has no actions that are known to benefit individuals with the pts medical diagnosis
•the pt failed to respond to the drug in the past •the pt had a serious adverse rxn to the drug in the past •pt has a condition or is using a drug that contraindicates the prescribed drug |
When to question a drug's appropriateness
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goal: to produce maximum benefit with minimum harm.
Allows you to anticipate adverse effects, rather than react after the fact. a. define goals b. set priorities c. id interventions -drug administration, interventions to enhance therapeutic effects -interventions to minimize adverse effects and interactions -pt education d. establish criteria for interventions |
Nursing Process For Drugs:
3. Planning |
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a.drug administration
b.pt education c.interventions to promote therapeutic effects d.interventions to minimize adverse effects |
Nursing Process For Drugs:
Implementation |
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a.therapeutic responses
b.adverse drug rxns and interactions c.compliance d.satisfaction with Tx |
Nursing Process For Drugs:
5.Evaluation |
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To reinforce the relationship between pharmacologic knowledge and nursing practice.
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What is the reason nursing implications are integrated into each chapter?
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1.Preadministration Assessment
Therpaeutic Goals Baseline Data ID High-Risk Pts 2.Implementation: Administration-Routes, Administration Implementation: Measures to Enhance Therapeutic Effects 3.Ongoing Evaluation and Interventions Summary of Monitoring Evaluating Therapeutic Effects Minimizing Adverse Effects Minimizing Adverse Interactions Managing Toxicity |
Modified Nursing Process Format
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deficient knowledge related to the drug regimen
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A good all-purpose nursing diagnoses when it comes to drugs.
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