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54 Cards in this Set
- Front
- Back
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Define pharmacokinetics
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"How the body affects the drug"
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Define pharmacodynamics
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"How the drug affects the body" Drugs reaching their site of action bind to receptors and mimic or block the action of the body's own regulatory mechanisms.
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What are iatrogenic diseases?
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Iatrogenic diseases are those that are caused by medical treatment. Eg. foley catheter causing infection, chemotherapy leading to pneumonia, etc.
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What is teratogenic effect?
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Birth defects caused by medical treatment.
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Name 5 components of pre-administration of medication assessment
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Obtaining baseline data. Identifying high risk patients. Patient history. Physical examination. Lab tests.
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Name four components of pharmacokinetics.
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Absorption, distribution, metabolism, excretion.
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What are agonists?
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Agonists are molecules that activate receptors
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What are antagonists?
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Antagonists are molecules the block receptor. The presence of an agonist is needed for this to produce an effect.
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What is an idiosyncratic effect?
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An uncommon or completely different or unpredictable drug effect from what is expected.
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Define intrathecal route of injection.
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Introduced in the space between under the arachnoid membrane of the brain or spinal cord.
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Which route is better for drugs with poor solubility or depot preparations? IM, IV or sub-q?
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IM and sub-q
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IM and sub-q dosages are typically what volume?
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0.5 - 3 mL
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How many pounds in a kilogram?
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2.2
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What does mEq mean?
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"milliequivalent". The number of grams in 1 mL of a normal solution.
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How many mL in an ounce?
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30mL=1 ounce
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How many mg in a grain?
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gr 1=60 mg.
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What is a typical sub-Q dose range?
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0.5-1mL
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What is a typical dose range for IM injection to the deltoid muscle? How is that different from other IM sites?
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0.5-1mL Other sites can be as high as 3mL.
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When looking at a syringe, what numerical notation is on the right? Left?
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Metric notation will be on the right. Minim notation may be on the left.
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What is the most common size of hypodermic syringe?
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3mL
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How are TB syringes calibrated?
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In hundredths of a milliliter. Total volume in a TB syringe is 1mL.
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Prefilled Tubex and Carpuject cartridges come in what size and calibration
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2.5mL total volume with calibrations in tenths of a mL
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To reconstitute powdered medications, what action is applied?
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Rolling rather than shaking to minimize bubbling.
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What are the three types of insulin and how are they measured?
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Rapid acting, intermediate acting and long acting. Insulin is measure in units using U-100 syringes.
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List onset, peak and duration for rapid acting insulin.
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Onset 30 min. Peak 2.5 - 5 hours. Duration 8 hours. eg. regular insulin
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List onset, peak and duration for intermediate acting insulin.
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Onset 1.5 - 2.5 hours. Peak 8-15 hours. Duration 16-24 hours. eg. NPH
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List onset, peak and duration for long acting insulin.
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Onset 4 hours. Peak 10-30 hours. Duration 36 hours. eg. Ultralente
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What are the 5 rights +1 in drug administration?
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Right drug, right dose, right route, right patient, right time. +1 refers to evaluation of drug efficacy.
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How do we evaluate the success of drug therapy?
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First we need to know the purpose for the drug, the baseline information, patient history, possibly lab tests and certainly any adverse reactions.
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How can nurses minimize adverse effects of drug therapy?
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By knowing what adverse effects are known for a particular medication, early signs of adverse effects and treatments for them. Also knowing patient history and other drugs client is taking.
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What should a nurse be teaching her patient about the drugs they are taking?
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Drug name and use. Dosage, route and schedule. Expected therapeutic response and time to achieve. Non-drug measures to enhance response. Duration of tx. Method of storage. Ways to minimize adverse effect. Who to contact (prescribing physician).
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Describe the therapeutic index.
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The dosage window of a medication in between the minimum amount needed for efficacy and the minimum amount that causes toxic effects. A high therapeutic index medication is safer than a low.
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How does the WHO define an adverse drug reaction?
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Any noxious, unintended and undesired effect that occurs at normal drug dosages.
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Define side effect.
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Nearly unvoidable secondary drug effect produced at therapeutic dosages.
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Define toxicity.
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Any severe drug reaction regardless of the dose that caused it.
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Define anaphylaxis.
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A life threatening response to a drug characterized by bronchospasm, laryngeal edema and a precipitous drop in blood pressure.
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Describe some individual variations that may influence drug therapy.
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Body weight and composition, age, gender, intolerance and perhaps most important, pathologies such as liver or kidney disease.
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Name the most important consequence of renal impairmentin drug therapy.
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Decreased excretion of drugs leading to increased incidence of toxicity. Dosage requires careful consideration.
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Name the most important consequence of impaired liver function on drug therapy.
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Metabolism rates may fall and drug levels may accumulate in drugs requiring hepatic metabolism.
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Describe three categories of drug tolerance.
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Pharmacodynamic tolerance due to chronic receptor stimulation, metabolic tolerance resulting from accelerated drug metabolism, and tachyphylaxis which is the reduction in drug responsiveness brought on by repeated dosing over a short time.
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Drug sensitivity is increased or decreased in the elderly?
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Increased
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Name several factors contributing to adverse drug reactions in the elderly.
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Polypharmacy, severe pathologies, multiple pathologies, poor compliance, increased use or low therapeutic index medications, altered pharmacokinetics due to individual variations.
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Name several factors contributing to non-compliance.
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Not understanding directions or purpose of medication, cost, inconvenience, number of medications, adverse effects, forgetfulness, dissatisfaction with medical treatment or provider.
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List the information needed from drug books about a particular medication.
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Drug classification, indications, actions, pharmokinetics, contraindications,. major side effects, common adult or pediatric dosage, nursing implications in administration.
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Name several factors contributing to the rate and amount of absorption.
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Dissolution of drug, surface area available for absorption, blood flow in the vicinity and the lipid solubility of the drug.
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Name the enteral drug routes.
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Oral, rectal, feeding tube and PEG tube.
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Name the parenteral drug routes.
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IM, sub-q,IV, IO, intrathecal, transdermal, inhalants.
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Two important barriers to absorption.
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The placenta and the blood brain barrier.
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Seven essential parts of a drug order.
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1-Full name of client. 2-Date and time of order. 3-Name of drug to be administered. 4-Dosage. 5-Route. 6-Frequency. 7-Signature of ordering physician.
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Which way is the bevel facing on an intradermal injection?
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Bevel up. (TB)
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What size needle is used for intradermal injection.
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Generally 0.5 to 1mL capacity syringe calibrated into hundredths with a 25, 26 or 27 gauge, 1/4 to 5/8 in. long.
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When a 45 degree angle is required for sub-q injection, what size needle is used? 90 degree angle?
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25 gauge, 5/8 inch needle.(45)
25 gauge, 3/8 inch needle.(90) |
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What size needle is used for intramuscular injection?
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21-22 gauge, 1-1/2 inch needle.
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What type of needle is used for insulin injection?
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U-100 syringe with a 28 or 29 gauge 5/8 inch needle.
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