Pathopharm TEST 1

Test on 2/5

generic drug name

the nonproprietary name that we will be tested on for NCLEX and found in MAR.

therapeutic class of drug

name related to what the drug treats (pain reliever or antihypertensive)

Pharmacologic class of drug

how a drug works at the molecular, tissue or body function level. It often addresses the drugs mechanism of action (ex- beta-blocker, vasodilator, diuretic)

trade drug name

Proprietary drug names that are owned by the distributing companies.

what are the routes of administration

1) Oral (Enteral)

2) Sublingual

3) Buccal

4) Nasogastric (NG) or gastrostomy tube (g-tube)

5) Topical ( skin, eyes (optic), ears (otic), nose (nasal), respiratory tract)

6) Parenteral - Outside GI tract (IV, IM, SubQ, intradermal)

why are certain meds given certain routes

Meds given rectally, sublingually, bucally do not have first pass metabolism since they get absorbed into the blood stream right away

Meds given via injection are often active in the body faster

5 steps of nursing process (cycle)

assessment, diagnosis, planning, implementation and evaluation.

10 med rights

1) Right patient: Is this the patients medication according to their 2 identifiers.

2) Right Medication: is this the medication the practitioner ordered? it it the generic version?

3) Right Dose: how many tablets are taken per dose, how many doses are taken per day, and how long does the patient need to continue to take the medication

4) Right time: what time of day should the medication be taken? Should it be taken with a meal, before a meal, after a meal?

5) Right route: oral, IV, IM, SubQ, eye drops, topical cream

6) Right assessment: does your assessment match the indications for the drug? did you preform the necessary assessments to give the med

7) Right documentation: document time, route (placement), if refused, etc. The MAR will populate most of this for you with barcode scanning

8) Right reason: does the assessment match the reasons to give the drug

9) right education: provide pt education for when to take it, potential side effects, etc.

10) Right evaluation: after providing the medicaiton, did you perform the right evaluation? DId you take BP after giving BP meds?

3 med checks

1) check drug with MAR when removing it from pyxis

2) check drug when prepping med and removing it from container - double check the dose when calculating it

3) Check the drug against the EMAR at the bedside

what is a medication error

any preventable event that may cause or lead to inappropriate medication use or patient harm while the emd is in the control of the healthcare professional

when can a medication error happen

any time to anyone. All nurses will make a med error at some point in their career

What are SALAD drugs (sound alike, look alike drugs) - why is tallman lettering used?

medications whose spellings or pronunciation are so similar they could inadvertently be mistaken for another medication. ex- dobutamine and dopamine, zyprexa and celexa, paroxetine and fluoxetine. Tallman lettering is used to help visually differentiate the drugs when looking quickly.

what is polypharmacy

multiple (5+) prescription meds taken often/on a daily basis

who is at risk for polypharmacy?

Often the elderly and people with chronic conditions are at risk for polypharmacy and the medication interactions that can occur because of it.

what drugs are affected or not affected by the blood brain barrier

Sedatives and anti-anxiety meds pass easily

Anti-cancer drugs cannot get across - so hard to treat brain cancer.

nursing considerations for the blood brain barrier

recognizing that its disruption allows toxins, pathogens, and fluids to enter the brain, leading to cerebral edema and increased intracranial pressure. Nurses must monitor for neurological changes, manage blood pressure and infections, ensure safety after trauma, and monitor pharmacological interventions

Pharmacokinetics/dynamics: Absorption

the movement of a substance, and the site of administration across body membranes to circulating fluids - via passive, active transport, diffusion or with help of ATP carrier proteins. IT DETERMINES HOW LONG BEFORE A DRUG TAKES EFFECT.

conditions that influence absorption

route of admin, size of drug molecule, form of medication, if its lipid-soluable, drug-drug interactions, dietary supplements and bowel conditions.

Pharmacokinetics/dynamics: Distribution

the movement of mediation from circulation to the body tissues. This happens bc blood flow to certain organs is greater, so smaller, lipid-soluable drugs are more easily distributed than water soluble drugs. Some tissues (like fat and skin) can store drugs.

Pharmacokinetics/dynamics: Metabolism

aka “biotransformation”, changing the medication to an active or inactive form more easily excreted by the body.

primary organ for metabolism of drugs

liver

Pharmacokinetics/dynamics: Elimination/excretion

the removal of drugs from the body. Kidneys, lungs, bile and glands all play a role in excretion.

what organ is primarily responsible for excretion

The kidneys! This means it is based on acid-base composition, and that water soluble drugs are more easily excreted than lipid soluble, and it

What is the first pass effect?

the medi ation may be rendered inactive as it goes through the liver - which means not everything can be given PO!

What drugs are affected by the first pass effect

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what is bioavailability?

it is the fraction of a medication that reaches circulation in its unchanged form

how is bioavailability affected by med routes?

parenteral meds will have greater bioavailability than PO meds since they don’t have to get processed by the liver before entering the blood stream.

What is a loading dose?

usually a higher dose (1-2x normal dose) of the med given at one time. It quickly increases blood levels, so it can reach the therapeutic level.

examples of meds that need a loading dose

heparin, amiodarone, cliopidogrel

What is a maintenance dose?

often the daily dose that a patient will take as long as they are on the drug. It is the amount that keeps the plasma levels of the drug constant

What is the therapeutic range

the dosage range or serum concentration that achieves a drugs desired effects. It is the range between a drugs lethal dose and it’s effective dose. (it can be wide or narrow, depending on the drug)

what is the therapeutic index?

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what are receptors

a macromolecule (protein) to which a medication binds to produce an effect. These exist in the body not for medications, but to bind molecules such as hormones, NTs and growth factors.

what are agonists

a drug that MIMICS the effect of an endogenous molecule. It can be partial, producing a weaker response than the full.

what are antagonists

a drug that occupies the receptor and BLOCKS the endogenous molecule action

what are the special considerations for meds for lactating moms

because drugs are able to enter breastmilk, it is recommended to give drugs with shorter half lives. Lipid soluble (CNS meds) have higher levels in BM and water soluable are lower levels in BM. Use non-pharmacologic alternatives if possible, and if not, give meds immediately after BF to reduce exposure to infant.

what are the special considerations for meds for geriatric patients

because of polypharmacy and degradation of organ systems, there is an increase of drug interactions and side effects. Provide them with opportunities for independence while also providing them assistance with reminders, aids and vaccines/preventables.