Pharmacology and Nursing: Medication Safety, Drug Development, Geriatric Considerations, and Administration

Comprehensive vocabulary flashcards covering drug safety, QSEN competencies, geriatric pharmacokinetics and pharmacodynamics, ethical principles and clinical research phases, drug naming standards, and parenteral/non-parenteral medication administration techniques.

Quality and Safety Education for Nurses (QSEN) Competencies

Six core nursing competencies designed to guide safe and comprehensive patient care: Patient-family centered care, Collaboration and teamwork, Evidence-based practice, Quality improvement, Safety, and Informatics.

Ten Rights of Medication Administration

A foundational safety framework consisting of: Right patient, Right medication, Right dose, Right assessment, Right time, Right route, Right documentation, Right education, Right to refuse, and Right evaluation.

Dual RN Validation

The safety practice of having two registered nurses independently calculate, check, and verify dosages for high-risk medications, such as insulin, magnesium sulfate, oxytocin, and heparin.

Just Culture

An organizational healthcare culture endorsed by the American Nurses Association (ANA) that encourages clinicians to report drug and medication errors freely so systemic flaws can be identified and repaired without unfair punitive blame.

The Joint Commission (TJC) National Patient Safety Goals

Targeted healthcare safety benchmarks established by TJC to resolve clinical safety issues, which include enforcing standards on selected acceptable abbreviations to prevent medication administration errors.

Drug Reconciliation

The formal clinical process of compiling and verifying an accurate, updated list of all medications a patient takes across transitions of care to avoid omissions, duplications, and adverse interactions.

Needlestick Safety and Prevention Act

An OSHA-mandated law requiring healthcare employers to implement safer medical sharps devices, maintain a secure workplace, provide educational opportunities, and enact written policies to prevent needlestick and sharps injuries.

Do Not Crush Label

A cautionary medication label instructing clinicians not to crush extended-release or sustained-release drug formulations, as crushing disrupts release mechanics and can cause severe dose-dumping toxicity.

High-Alert Medications

A class of drugs that bears a heightened risk of causing significant patient harm when administered in error; examples include epinephrine, insulin, oxytocin (Pitocin), nitroprusside, and potassium chloride injection.

Black Box Warning

A rigorous warning system established by the US FDA displayed on prescription drug labeling to highlight serious, life-threatening medication risks and adverse reactions.

Geriatric Pharmacokinetics

Age-related changes in drug absorption, distribution, metabolism, and excretion resulting from physiological declines such as reduced total body water, decreased lean body mass, reduced kidney mass and function, and decreased liver mass and hepatic blood flow.

Geriatric Pharmacodynamics

Age-related shifts in physiological responses to drugs driven by decreased receptor numbers, loss of adrenergic receptor sensitivity, blunting of compensatory reflexes, reduction of brain dopaminergic and cholinergic receptors, and reduced cerebral blood flow.

Polypharmacy

The concurrent administration of multiple medications to a single individual, frequently observed in older adult populations and linked to heightened risks of adverse reactions and drug-drug interactions.

Beers Criteria

An evidence-based clinical guide designating medications that are potentially inappropriate for use in older adults due to unfavorable risk-to-benefit profiles.

Adverse Drug Event (ADE)

Any injury resulting from medication interventions, comprising adverse drug reactions, medication errors, therapeutic failures, adverse drug withdrawal events, and accidental overdoses.

Vial of Life

A health teaching and emergency readiness resource recommended for older adults that compiles an updated record of medical history and all current prescription medications in a visible, accessible location in the home.

Respect for Persons

A core ethical principle in pharmaceutical research holding that individuals are autonomous agents capable of self-determination, protected in clinical practice via culturally competent informed consent.

Beneficence

A core ethical research principle obligating healthcare professionals to protect research participants from harm, maximize possible clinical benefits, and minimize potential risks.

Justice

A core ethical principle requiring fairness and equity in the distribution of research burdens and benefits, ensuring unbiased and fair selection of research participants.

Phases of Human Clinical Experimentation

The sequential four-stage clinical trial structure following preclinical animal studies: Phase I evaluates safety and dosage range; Phase II measures clinical efficacy in diseased subjects; Phase III confirms efficacy in large clinical populations; Phase IV provides post-marketing drug surveillance.

ANA Code of Ethics

A professional standard adopted in 1950 and revised in 2015 that serves as a guide for carrying out nursing duties consistent with quality care, ethical obligations, patient safety, and research protocol integrity.

Nurse Practice Acts

State-specific legislative statutes that define and govern the legal scope, licensing regulations, and professional responsibilities of nurses, including the standards for safe drug administration.

Generic Name

The official, nonproprietary name given to a pharmaceutical substance by regulatory bodies, written uniformly in lowercase letters independent of trademark rights (e.g., warfarin, acetaminophen, furosemide).

Brand / Trade Name

The proprietary, commercial trademark assigned to a medication by its manufacturer, conventionally capitalized (e.g., Coumadin, Tylenol, Lasix).

Over-the-Counter (OTC) Drugs

Medications approved by the FDA as safe and appropriate for public use without direct healthcare provider supervision, governed by standardized labeling regulations established in 2002 to detail indications and risks clearly.

Transdermal Drug Delivery

A topical drug route where medication is embedded in a specialized cutaneous patch applied to clean skin to achieve controlled, continuous systemic absorption.

Eyedrop Administration Technique

The procedure of gently pulling downward on the skin beneath the eye to expose the conjunctival sac, instilling drops into the middle third of the sac, and holding gentle pressure over the lacrimal duct to prevent systemic absorption.

Eye Ointment Administration

The ophthalmic administration procedure in which a clinician squeezes a $\frac{1}{4}\text{-inch-wide}$ strip of ointment directly into the exposed conjunctival sac.

Eardrop Administration Technique

The clinical method of straightening the auditory canal for otic drops by pulling the external ear canal down and back for children under $3\text{ years}$ of age, and pulling the auricle upward and outward for adults and children over $3\text{ years}$ of age.

Sims Position

A left lateral recumbent position with the hips and knees flexed, utilized to facilitate the comfortable and anatomically correct insertion of rectal suppositories past the internal anal sphincter.

Rectal Suppository Administration

The instillation of solid medicinal suppositories into the rectum, positioning the patient in Sims position and advancing the suppository past the internal anal sphincter along the mucosal wall.

Parenteral Injection Angles

The tissue-specific needle insertion angles: $10^\circ$ to $15^\circ$ for intradermal injections into the epidermis/dermis (creating a bleb), $45^\circ$ to $90^\circ$ for subcutaneous injections into adipose tissue, and $90^\circ$ for intramuscular injections into deep muscle.

Ventrogluteal Site

An intramuscular injection site located in the gluteus medius and minimus, determined using anatomical landmarks including the greater trochanter of the femur and the tubercle of the iliac crest.

Deltoid Injection Site

An intramuscular injection site on the lateral upper arm located using landmarks including the acromion process, clavicle, and the head of the humerus, avoiding the deep radial artery and radial nerve.

Vastus Lateralis Site

An intramuscular injection site situated in the anterolateral aspect of the middle third of the thigh, bounded by the greater trochanter of the femur and the patella, frequently chosen for pediatric patients.

Z-Track Technique

An intramuscular injection method where the overlying skin and subcutaneous tissue are pulled laterally before needle insertion, held during injection, paused for $10\text{ seconds}$, and released upon needle withdrawal to seal the tract and prevent medication leakage into subcutaneous tissue.