General Pharmacology & Medication Safety simpler

What is the purpose of medication safety, and what are the 6 medication rights?

Prevent harm and give medications correctly. Right patient, medication, dose, route, time, and documentation.

What should the nurse check before giving any medication?

The medication order, allergies, patient, vital signs, labs, and patient condition.

Why and how should patient identifiers be checked?

To make sure the correct patient receives the medication; use at least 2 approved identifiers.

What should the nurse do with an unclear, incomplete, illegible, wrong-dose, or inappropriate-route order?

Do not give it. Clarify the order first.

What should the nurse do if a medication appears unsafe or contraindicated?

Hold the medication and clarify the order with the provider.

When should a medication be held, and what should happen after holding it?

Hold it when the patient's condition, vital signs, labs, or order make it unsafe. Assess the patient and notify or clarify with the provider.

Why are relevant vital signs and laboratory results checked before medications?

They can show whether the medication is safe to give or whether a dose adjustment may be needed.

What should be checked after giving a medication?

Therapeutic effectiveness and adverse effects.

What should medication documentation include?

What was given, the dose, route, time, and other required information.

Why is accurate documentation important, and what are the nurse's legal and ethical responsibilities?

It prevents duplicate or missed doses. The nurse must administer safely, question unsafe orders, document accurately, protect the patient, and advocate for safe care.

What happen during assessment and planning for medication therapy?

Assessment: assess the patient first. Planning: determine the expected patient outcome.

What happen during implementation and evaluation?

Implementation: administer the medication safely. Evaluation: determine whether it worked and check for adverse effects.

What are a medication category and a prototype medication?

A category is a group of medications with similar actions/effects. A prototype is the main medication used to learn the category.

What is the difference between generic and brand names?

Generic = official medication name. Brand/trade = commercial name. Both contain the same active medication.

What is the difference between prescription and OTC medications?

Prescription medications require an order from a licensed provider; OTC medications can be purchased without a prescription.

What is pharmaceutics?

How a medication's form affects dissolution (how it breaks down), absorption, and onset of action.

What is pharmacokinetics, and what does ADME stand for?

Pharmacokinetics = what the body does to a medication. ADME = Absorption, Distribution, Metabolism, Excretion.

What are absorption and distribution?

Absorption = movement into the bloodstream. Distribution = movement through the blood to tissues and the site of action.

What is metabolism, and what organ performs most medication metabolism?

The body chemically changes or breaks down a medication, mainly in the liver.

What are biotransformation and a metabolite?

Biotransformation is when the body chemically changes a medication during metabolism, and a metabolite is the substance formed after the medication is broken down during metabolism.

What is excretion, and what organs are most important for it?

Removal of medications or metabolites (drug breakdown products) from the body; mainly through the kidneys.

Why can kidney or liver impairment cause medication toxicity?

Kidney impairment decreases excretion (slows medication removal), and liver impairment decreases metabolism (slows medication breakdown). Both can cause medication buildup (drug builds up in the body).

What is a medication's half-life?

The time it takes for the amount of medication in the body to decrease by half.

What do short and long half-lives usually mean?

Short half-life = medication may need to be given more often. Long half-life = it may be given less often.

What are onset, peak, and duration of action?

Onset = when it begins working. Peak = strongest effect. Duration = how long the therapeutic effect lasts.

What is pharmacodynamics?

What a medication does to the body, including receptor actions and effects.

What is a therapeutic effect, and how do you know a medication is working?

It is the intended effect; the expected therapeutic outcome occurs.

What is an adverse effect, and what should the nurse do if it is serious?

An unwanted or harmful effect. Assess, hold the medication when indicated, intervene for safety, and notify the provider.

What is an agonist vs. antagonist?

Agonist = binds to a receptor and increases a response. Antagonist = binds and blocks or decreases a response.

What is medication tolerance?

A decreased response after repeated use; a larger dose may eventually be needed for the same effect.

What are medication dependence and withdrawal?

Dependence = a physical or psychological need for a medication. Sudden stopping may cause withdrawal syndrome.

What is a cumulative medication effect, and who is at greater risk?

Medication builds up because the body cannot remove it fast enough; patients with impaired liver or kidney function are at greater risk.

What is medication toxicity and what can cause it?

Harm from excessive medication levels; causes include excessive doses, buildup, organ impairment, interactions, or dosing errors.

How can nurses prevent and detect medication toxicity?

Assess the patient, monitor important lab results, and use the lowest effective medication dose.

What is the difference between a contraindication and a precaution?

Contraindication = medication should not be used because it could cause serious harm. Precaution = extra care is required.

What is a boxed warning, and why should medical history be reviewed?

A boxed warning is the FDA's highest safety warning. Medical history helps find contraindications, precautions, and other risks.

What are peak and trough medication levels?

Peak = highest medication concentration in the blood. Trough = lowest concentration.

When is a trough usually drawn, and why are peak/trough levels measured?

Right before the next dose; they help keep medication levels effective and safe.

What is the therapeutic range, and what happens above or below it?

The level expected to work without toxicity. Below = medication may not work enough. Above = toxicity risk increases.

What is a medication interaction and what substances can cause one?

Another substance changes the medication's expected action. Medications, foods, drinks, and supplements can interact.

What interactions involve grapefruit juice and tyramine?

Grapefruit can increase some medication levels/toxicity. Tyramine can cause a hypertensive crisis with certain medications.

How can calcium and vitamin K-rich foods affect medications?

Calcium can decrease tetracycline absorption; vitamin K-rich foods can decrease warfarin's anticoagulant effect.

What factors can affect a patient's medication response?

Age, weight, kidney function, liver function, genetics, illness, other medications, food, supplements, and tolerance.

Why do older adults and children require extra medication consideration?

Older adults may have decreased metabolism/excretion. Children's absorption, distribution, metabolism, and excretion differ.

What do EC and ER mean, and should they be crushed?

EC = enteric-coated. ER = extended-release. They generally should not be crushed.

What does parenteral medication mean, and what are common parenteral routes?

Medication given by injection; common routes are IV, SubQ, and IM.

How fast is IV medication absorption, and what is reconstitution?

IV absorption is immediate and complete. Reconstitution means adding liquid to a dry medication before administration.

What should patient medication teaching include?

Medication purpose, names, schedule, administration, adverse reactions, and precautions.

What should the nurse assess before medication teaching?

Learning level, language, learning style, and readiness to learn.

Who should help when a patient does not speak English?

A qualified medical interpreter.