Pathopharmacology Exam One

Medication practices, nutrition and pain/inflammation

What are the components of the nursing process?

ADPIE

Assessment, diagnosis, planning, implementation, evaluation

10 rights of medication administration

Right….

patient

medication

time

dosage

route

education

documentation

evaluation

assessment

to refuse

High risk drugs

PINCH

Potassium and other electrolytes, insulin, narcotics, chemo, heparin

How do drugs work?

Pharmodynamics!

• replace missing chemicals

• increase or decrease cellular activity

• interfere with functioning of foreign cells

to do this they use receptor sites, enzyme interactions, and selective toxicity

4 phases of pharmacokinetics

Absorption - from the time the drug is introduced to when it reaches circulation

Distribution - the drug distributing to the body’s tissues (many protein-bind)

Metabolism - make the drug easier to excrete (liver - monitor ALT and AST)

Excretion - glomerular filtration in kidneys - creatinine, BUN

When should you measure the trough

Right before giving the next dose

Primary action

Extension of the drugs action

ie. warfarin —> bleeding

Secondary action

Effects other than the desired effect

ie. diphenhydramine —> drowsiness

Anaphylaxis

a life threatening emergency

• treated with epinephrine

• monitor airway

• administer diphenhydramine

Stomatitis

Inflammation of the gum lining

Stevens-Johnson Syndrome

A painful dermatologic adverse effect that involves blistering of the skin, similar to a burn.

Blood dyscrasia

Suppression of the bone marrow

• drugs that cause cell death can do this

• ie. gold compund, chemotherapy

Manifestations of hepatotoxicity

• fever

• malaise

• nausea

• jaundice

• abdominal pain

• elevated ALT and AST

Manifestations of nephrotoxicity

• decreased urine output

• fatigue

• elevated BUN and creatinine

• electrolyte imbalances

Hypokalemia

Deficiency of potassium (<3.5 mEq/L )

• weakness

• numbness

• irregular heart rhythm

• decreased bowel sounds

Hyperkalemia

Excess potassium ( >5mEq/L )

• weakness

• muscle cramps

• slow heart rate

• diarrhea

• difficulty breathing

What causes damage to the vestibulocochlear nerve?

Macrolide and aminoglycoside antibiotics

What causes ocular damage?

Chloroquine

Anti-cholinergic drugs

Drugs that block the effects of the parasympathetic nervous system

• antihistamines, cold medication

• dry mouth, constipation, urinary retention, dry skin, headache.