pharm quiz 1

drug

chemicals that are introduced into the body to cause some sort of change; any chemical that affects the physiology of a living organism

plants, genetic engineering, animals, inorganic compounds

possible sources of ingredients for drug

prescription drug

drugs made legally available to consumers with written prescription

\-food and drug administration drug development approval required

otc drug

no prescription needed

\-used for minor ailment

\-used for short term symptoms treatment

\-FDA determines safety and effectiveness criteria

convenient, effective self treatment, possible cost savings

advantages of OTC (3)

may delay serious treatment, potential abuse, limited insurance coverage, potential adverse event

disadvantages of OTC (4)

therapeutic care, prophylactic care, nutrition, proactive care

herbal dietary supplements general use (4)

chamomile

interact with anticoagulation drug

cranberry

affect drug excretion from kidney

echinacea

interacts w antiviral and immunosuppressant drugs

garlic

interact with diabetic (hypo), anticoag (bleed) drugs

ginger

interact with cardiac, diabetes, and anticoag drugs

ginko

bleeding risk

grapefruit

affects metabolism of drugs

SIR drugs

nonprescription drugs with no known therapeutic use; used to enhance mood or increase pleasure

\-ex: cocaine

pharmacology

the study of biological effects of chemicals; the study of or the science of drugs

clinical pharmacology

application of concepts and principles of pharmacology to properly evaluate and manage drug therapy for patients in clinical setting

acute

what kind of drug therapy is critical condition-life sustaining

loading dose

higher than the usual dose to create critical concentration sooner

manintenance/treatment

drug therapy: chronic condition-prevent progression/occurrence

supplement

lack of/inadequate production by body, support normal function

ex: insulin, iron

palliative

relief from symptoms of serious illness (end stage) to improve quality of life

supportive

used during illness recovery/trauma to maintain body function

ex: fluid, blood transfusion

prophylactic

prevention of disease/undesirable outcome

empiric

prevention of disease based on high clinical chance of pathology related to symptoms (infection)

pharmacokinetics

what happens to a drug from the time it is introduced to the body until it reaches the circulating fluids and tissues

absorption, distribution, metabolism, excretion

ADME

PO, injection, inhalation, topical

routes of drug administration

absorption

how drug is administered, patient’s disease condition, how drugs are formulated, what other drugs are taken, blood flow, enzymatic breakdown, pH can all affect drug _________

liquids, elixirs, and syrups

fastest drug absorption

enteric coated tablets

slowest drug absorption

drug distribution

the transport of a drug by the bloodstream to its site of action

distribution

drug status, disease condition, brain structure, environment, hydration status, circulation structure, and genetics are all factors to consider in drug ______

drug metabolism/biotransformation

the biochemical alteration of a drug into an inactive metabolite, a more soluble compound

cytochrome p450 enzymes

enzymes in the liver used for drug metabolism/biotransformation

first pass effect

when the drug is absorbed and it goes through the liver, the liver metabolizes it, and sends it through the main circulation, some of the main particles have been lost, less amount of drug circulating

\-especially PO drugs

high first pass effect

drug is highly metabolised = don’t get full benefit of drug

bioavailability

amount of drug remaining after metabolism

drug excretion

the elimination of drugs from the body

kidney

main organ used for drug excretion

amount of drug/plasma concentration

volume of distribution equation

volume of distribution

measure of drug in circulation and rate of elimination

steady state

the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose

half life

the time required for one-half (50%) of a given drug to be removed from the body

pharmacodynamics

is the study of what the drug does to the body. mechanism of drug action in living tissue

\-what the drug does to the body processes

drug MOA

drug actions or how drug works; effects

MOA

receptors, enzymes, non-selective

receptors

MOA: 1. reactive protein (plasma protein) sites of the cell enable the metabolites to make contact with the cells 2. affinity (fit): degree of attachment of drug to receptor site to illicit greatest response-agonist

enzymes

can inhibit or enhance drug MOA

non-selective process

drug MOA: 1. disrupts the cellular structure involved in the disease process 2. alter the metabolic process of problems caused by an organism

pharmacotherapeutics

using drug for treatment

pharmacy

place where drugs are kept

toxicology

the aspect of pharm that studies what happens when we take too much of a specific drug that becomes detrimental to us

efficacy

how well drug treats what it says it will treat

onset of action

when does the drug begin to work

duration of action

how long does drug work in body

peak effect

once initially absorbed into system, the level of drug in system is very high

trough level

after PK drug has travelled through body and is at its lowest level.

therapeutic index

relationship b/w drug treating condition vs causing tocicity

adverse drug event

broad term for any undesirable occurrence involving medication

drug reaction

any reaction to a drug that is expected and undesirable and occurs at therapeutic dose

delay effect, decrease expected effect, enhance expected effect, unexpected side effect

possible results of drug interaction

anaphylactic reaction

deadly reaction to a drug

idiosyncratic drug reaction

opposite reaction of what everybody else presents

tolerance effect

after a while, body doesn’t react to drug much anymore

\-need to find different drug for patient

allergic reaction

an unusual unpredictable immunologic hypersensitivity reaction to a drug

anaphylactic reaction

vasodilation of blood vessels, constriction of bronchioles, increased hr, decreased bp, possible death are all signs of an

idiosyncratic reaction

unexpected response to normal drug dose peculiar to a patient due to genetic predisposition

adverse drug reaction

hives, swelling, redness, itching, pain, LOC changes are all possible signs and symptoms of an

interaction

how to prevent drug ____: learn about drug, read drug labels, take the drug as ordered, keep the drug in the original container, keep a list of all drugs/prescription/otc/herbs, check with provider, use one pharmacy

pharmaceutics

the aspect of pharmacology concerned with dosage form design

pharmaceutics dosage forms

the medium used to carry drug molecules to the site of action in the body

polypharmacy

taking five or more medications simultaneously

laxatives

_____ are the most reported drugs in polypharmacy among older adults

polypharmacy effect

poor/non adherence to treatment plan, drug-drug interaction, adverse drug reaction, hospitalization, cost

non-adherence to polypharmacy

LOC, physical body function, cost, associated symptoms are all reasons for

role of nurse in polypharmacy

learn about the drugs, assess patient/drug, assist patient in organizing drug, educate patient about drugs, provide other general information

administration responsibilities

safety/contamination/infection prevention, patient assessment/nursing care, medication administration process are all general medication _____ _______

do not

…. ….. administer any medication you have not reviewed, activate incomplete order, leave medication at bedside, administer any drug you did not prepare, prepare medication for more than one patient at a time

special drug considerations for infant/child

growth/developmental stage, special devices, technique, communication, safety

drug dosing considerations for older adults

polypharmacy/adherence, health impairments, aging/body size, abilities/special devices, drug reactions, and interaction

the 3 check principle

check drug 1. pulling out of drawer, 2. opening drug package, 3. after pouring and before giving to patient

right patient, right drug, right dose, right route, right time, right documentation

name the 6 rights

enteral route

PO (through mouth)

parenteral route

injections

other route

topicals

do not crush

controlled release, long acting, slow/sustained action, slow/sustained release, double strength, enteric coated, capsule

administering liquid drug

shake bottle as needed, use proper indicated measuring, pour/aspirate at eye level, protect drug label, mouth rinse as needed

checks patient’s armband

the first check during drug administration occurs when the nurse

enteric

intestinal obstruction, malabsorption syndrome, paralytic ileus, intractable vomiting, and diarrhea are all contradictions of the ___ route

opthalmic

eye

otic

ear

nasal

nose

ophthalmic route goals

prevent infection, prevent injury, prevent systemic absorption

inner corner

where do eye drops go?

swipe across towards outer eye

where does eye ointment go

otic route

soften wax, pain management, local anesthesia, infection treatment, foreign object are all uses of

pull ear lobe up and back

otic: for adult and children over 3 years old

pull ear lobe down and back

otic: children under 3 years

topical route-skin

assess skin site, remove old treatment, clean site, place new treatment/new site, date, time, initial, prevent contact with med site