unit 5 chap 35

Sherley amendment 1912

prohibits false therapeutic labeling

Harrison narcotic act 1914

classified, regulates, increased record keeping for narcotics

FDC act 1938

requires accurate labels and drugs tested for harmful effects

Durham-Humphrey amendment 1951

established prescription and OTC meds

Kefauver-Harris drug amendments 1962

requires proof of drug safety

patient package insert requirement/comprehensive drug abuse prevention and control act 1970

oral meds have paper inserts, illegal to possess controlled substance without prescription

Generic: Panadol, Tylenol

acetaminophen

Generic: Excedrine

acetaminophen, aspirin, caffeine

Generic: Sinutab

acetaminophen, pseudoephedrine

Generic: Tylenol PM

acetaminophen, diphenhydramine

Generic: Benadryl

diphenhydramine

Generic: Aleve

naproxen

Generic: Sudafed

pseudoephedrine

Generic: bufferin

aspirin

Generic: Advil, Motrin

ibuprofen

Generic: Neosporin

triple antibiotic ointment

pharmacokinetics definition:

how medication enters, moves, and leaves through body

pharmacodynamics definition:

how medication interacts with cells to produce response

_______ is the passage of a drug from the administration site into the blood stream

absorption

_______ is the process of delivering the medication to tissues and organs and ultimately to the specific site of action

distribution

______ is the process by which a drug is altered toa less active form to prepare for excretion

metabolism

medication can build up in the ____

liver

_____ process removes the less active drug or its metabolites

excretion

pharmacodynamics: half-life definition

expected time it takes for blood concentration to measure half of the original drug dose due to metabolism and excretion

pharmacodynamics: onset of action definition

time the body takes to respond to drug after administration

pharmacodynamics: peak plasma level definition

indicates highest serum/blood concentration

pharmacodynamics: trough definition

lowest serum level of medication

predictable but unwanted and sometimes unavoidable reactions to medications:

side effects

severe, unintended, unwanted, and often unpredictable drug reactions:

adverse effects

result from a medication overdose or buildup of medication in the blood due to impaired metabolism and excretion:

toxic

unpredictable immune responses to medications:

allergic reactions

severe allergic reaction/medical emergency:

anaphylactic reaction

unpredictable patient response to medication:

idiosyncratic reaction

a ____ ____ occurs when the combined effect is greater than the effect of either substance if taken alone

synergistic effect

occurs when the drug effect is decreased by taking the drug with another substance, including herbs:

antagonism

what can lessen effect of birth control?

antibiotics

what can lessen the effect of statin absorption?

grapefruit juice

combining drug with another that causes adverse chemical reaction:

drug incompatibility

water soluble vitamins: 2

vitamin B, C

fat soluble vitamins: 4

vitamin A, D, E, K

what is vitamin is niacin:

B3

what is vitamin pyridoxine?

B6

what is vitamin is ascorbic acid?

C

what is folic acid?

b9

what is vitamin is retinol?

A

what is vitamin is calciferol?

D

water soluble vitamins and adverse effects: B3 (niacin) 3

flushing, redness of skin, upset stomach

water soluble vitamins and adverse effects: B6 (pyridoxine, pyridoxal, pyridoxamine) 4

nerve damage to limbs, numbness, trouble walking, pain

water soluble vitamins and adverse effects: C (ascorbic acid) 3

upset stomach, kidney stones, increased iron absorption

water soluble vitamins and adverse effects: folic acid (folate)

high levels in older adults may hide signs of b12 deficiency

fat soluble vitamins and adverse effects: A (retinol, retinal, retinoic acid) 7

nausea, headache, dizziness, blurred vision, birth defects, liver problems, risk of osteoporosis

fat soluble vitamins and adverse effects: D (calciferol) 9

nausea, vomiting, poor appetite, constipation, weakness, weight loss, confusion, arrhythmia, Ca/PO4 deposits

common herb uses: echinacea 3

stimulates immune system, wound healing, fights flu/cold

common herb uses: garlic 3

lowers BP, cholesterol, triglycerides

common herb uses: ginkgo biloba 2

improves memory, mental alertness

common herb uses: ginseng 2

increases stamina, mental concentration

common herb uses: saw palmetto

enlarged prostate, urinary inflammation

common herb uses: St. Johns Wort 3

mild depression, anxiety, sleep disorders

common herb interactions: echinacea 2

anabolic steroids, methotrexate

common herb interactions: garlic

potentiates action of anticoagulants

common herb interactions: gingko biloba

potentiates action of anticoagulants

common herb interactions: ginseng 2

decrease effectiveness of anticoagulants, oral hypoglycemia/insulin

common herb interactions: saw palmetto

interacts with hormones

common herb interactions: St. Johns Wort 9

interacts with antianxiety, antidepressants, anticoagulants, BC, cyclosporine, digoxin, statins, HIV, cancer medication

essential parts of medication order: 7

full name, date/time order was written, drug name, dosage, route, frequency, signature of person writing order

common routes of administration: 7

oral, sublingual, buccal, topical, inhaled, parenteral, tube

common forms of meds: tablets 4

oral, sublingual, buccal, enteric coated

common forms of meds: capsules

gelatin coated

common forms of meds: powder 3

inhaled, mixed with food, dissolved in liquids

common forms of meds: solutions 5

syrups, suspensions, elixirs, drops, injectable

common forms of meds: suppositories 3

rectally, vaginally, urethral for ED

medication administration routes: sublingual/buccal advantages

more potent due to bypassing liver and enters bloodstream

medication administration routes: sublingual/buccal disadvantages

may be inactivated by gastric juices if swallowed

medication administration routes: topical disadvantages

absorption may be irregular if skin broken

syringe selection: subcutaneous 4

0.5-3 mL, 30, 50, 100 units

syringe selection: intradermal

1 mL tuberculin syringe

syringe selection: IM adult

1-5 mL

syringe selection: IM infants, small children

0.5-1 mL

needle selection: subcutaneous 3

25-31g

needle selection: subcutaneous pre attached to insulin

29-33g

needle selection: IM adult 2

19-25g

needle selection: IM children 2

22-25g

needle selection: intradermal

25-27g

site selection: subcutaneous 4

abdomen, lateral aspects of upper arm/thigh, scapular area, upper ventrodorsal gluteal

site selection: intradermal 3

inner forearm, upper chest, across scapula

angle of entry: intradermal 3

5-15 degrees, bevel up, dont apply pressure

site selection: IM 3

ventrogluteal, vastus lateralis, deltoid

what to do before administering high-risk drug:

double check with another RN

patient rights related to medication administration: 4

right to be informed of name/purpose/potential side effects, refuse, have accurate med hx taken by qualified person, receive meds with 6 pt rights

do not break or crush a ___ ______ medication

time released

how much liquid can go in syringe

<5 mL

NG + gastronomy med administration: flush with __-__mL first, give one med at a time, flush __-__mL between each

15-30

NG + gastronomy med administration: crush tablet into powder and dissolve in at least __ mL of warm water

30 mL

abbreviations: pc

after meals

ampule: must use a ___ ____ to aspirate medication

filter needle

z-track technique medications: 2

iron, hydroxyzine