Pharmacology Foundations, Medication Safety, and Clinical Administration Flashcards

A comprehensive review deck of 130 question-and-answer practice flashcards covering foundational pharmacology, ADME, cardiac drugs, medication administration safety, insulins, anticoagulants, patient education, and geriatric drug considerations.

What is the definition of pharmacokinetics?

Pharmacokinetics is defined as what the BODY does to the DRUG.

What do the four letters in the ADME acronym stand for in pharmacokinetics?

Absorption, Distribution, Metabolism, and Excretion.

Which organ is mainly responsible for drug metabolism?

The liver.

Which organs are mainly responsible for drug excretion?

The kidneys.

What is the definition of pharmacodynamics?

Pharmacodynamics is defined as what the DRUG does to the BODY.

What is a drug agonist?

An agonist activates a receptor.

What is a drug antagonist?

An antagonist blocks a receptor.

How is the half-life of a drug defined?

The time required for drug concentration to decrease by $50\%$.

What is peak drug concentration?

The highest drug concentration achieved in the body.

What is trough drug concentration and when is it usually measured?

The lowest concentration of the drug, usually measured right before the next dose.

What is the difference between a therapeutic level and a toxic level?

A therapeutic level is the concentration needed to produce desired beneficial effects safely, whereas a toxic level is an excessive concentration that causes adverse harm.

What is the difference between a loading dose and a maintenance dose?

A loading dose is a higher initial dose given to achieve therapeutic levels quickly, whereas a maintenance dose is given to maintain steady therapeutic levels.

What is the first-pass effect?

The initial metabolism of an oral drug in the liver before it reaches systemic circulation.

What are the three basic types of drug interactions outlined in foundational pharmacology?

Additive, synergistic, and antagonistic interactions.

What is the difference between a generic name and a trade/brand name?

A generic name is the official non-proprietary name, while a trade or brand name is the proprietary name assigned by the drug manufacturer.

What is a prototype drug?

An individual representative drug used to model a drug class or group.

What is a boxed warning on a drug label?

The strongest safety warning issued for a medication to highlight serious or life-threatening risks.

What specific rule applies to refilling Schedule II controlled-substance medications?

Schedule II medications cannot be refilled.

What is the mathematical equation for Cardiac Output ($CO$)?

$$CO = HR \times SV$$

What three primary physiological changes do beta blockers produce on cardiac function and blood pressure?

They cause a decrease in heart rate ($\downarrow$ heart rate), a decrease in force of contraction ($\downarrow$ force of contraction), and a decrease in blood pressure ($\downarrow$ BP).

How do beta blockers affect cardiac workload and oxygen demand?

They decrease cardiac workload and decrease oxygen demand ($\downarrow$ cardiac workload/$O_2$ demand).

Which two clinical measurements must be assessed prior to administering atenolol?

Assess blood pressure (BP) and heart rate (HR).

At what heart rate threshold should atenolol be held and the provider notified?

Hold atenolol and notify the provider if heart rate is $HR \le 60\,\text{bpm}$.

At what systolic blood pressure threshold should atenolol be held and the provider notified?

Hold atenolol and notify the provider if systolic blood pressure is $SBP < 90\,\text{mmHg}$.

What six cardiovascular and general adverse effects should nurses watch for in patients receiving atenolol?

Bradycardia, hypotension, dizziness/syncope, fatigue, heart block, and possible worsening heart failure.

What respiratory adverse effect must be monitored during beta blocker therapy?

Bronchospasm.

What metabolic warning is associated with beta blocker administration in diabetic patients?

Beta blockers can mask hypoglycemia symptoms.

What is the general guideline regarding the discontinuation of beta blockers?

Beta blockers generally should not be stopped abruptly.

What is the primary overarching takeaway from the 8/19 reading?

Learn how drugs move through the body, how they affect the body, and how to safely assess a patient receiving a cardiovascular medication.

What are the five types of medication orders described

Routine, standing, PRN, one-time, and STAT orders.

What does a STAT medication order mandate?

A STAT order must be administered immediately.

What two factors must a nurse assess prior to administering a PRN medication?

1. Assess whether the patient actually meets the criteria. 2. Assess whether enough time has passed since the previous dose.

What are the seven required components of a complete medication order?

1. Patient identification, 2. Date/time, 3. Medication, 4. Dose, 5. Route, 6. Frequency, 7. Prescriber signature.

What action should a nurse take if a medication order is unclear or unsafe?

DON'T GUESS $\rightarrow$ clarify it.

When are the three medication checks performed during preparation and administration?

1. When removing medication, 2. Compare medication with MAR/eMAR, 3. Immediately before giving/returning multidose container.

What are the 11 rights of medication administration?

Right Patient, Right Medication, Right Dose, Right Route, Right Time, Right Reason, Right Assessment, Right Documentation, Right Response, Right Education, and Right to Refuse.

How many patient identifiers must be used prior to administering medications?

Use $2$ patient identifiers.

Does a patient's room number count as a valid patient identifier?

No, room number doesn't count.

What is the decimal safety rule regarding leading zeros?

Always write a leading zero before a decimal point (e.g., $0.5\,\text{mg}$ is correct; $.5\,\text{mg}$ is incorrect).

What is the decimal safety rule regarding trailing zeros?

Never write a trailing zero after a decimal point (e.g., $1\,\text{mg}$ is correct; $1.0\,\text{mg}$ is incorrect).

Which drug administration routes are explicitly contrasted in the 8/20 reading?

Oral, enteral, sublingual (SL), buccal, subcutaneous (SubQ), intramuscular (IM), intradermal (ID), intravenous (IV), and topical/transdermal.

What is medication reconciliation?

The process of compiling and comparing a patient's full medication history against current orders to prevent errors.

What specific procedures are required for controlled-substance management?

Controlled-substance counts and witnessing/documenting wasting.

What is the difference between pediatric dosing written as $\text{mg/kg/day}$ versus $\text{mg/kg/dose}$?

$\text{mg/kg/day}$ represents the total dose for an entire day (divided across doses), whereas $\text{mg/kg/dose}$ represents the exact dosage given in a single administration.

What rule applies to crushing enteric-coated or extended-release medications?

Don't crush enteric-coated or extended-release medications.

When should medication administration be documented?

Document after administration, not before.

What key safety topics are emphasized in the 8/20 reading material summary?

Order types, parts of an order, checks, rights, identifiers, decimal safety, controlled substances, pediatric calculations, crushing rules, documentation, nursing process, and medication-error response.

What is the primary action of an anticoagulant drug?

Prevents new clots from forming or existing clots from enlarging.

What is the primary action of an antiplatelet drug?

Prevents platelets from sticking together.

What is the primary action of a thrombolytic drug?

Actually breaks down an existing clot.

What is the primary action of a hemostatic drug?

Helps stop bleeding.

Which laboratory value is monitored to assess Heparin therapy?

aPTT.

What is the reversal agent/antidote for Heparin?

Protamine sulfate.

By which routes can Heparin be administered?

IV or SubQ.

What is the primary clinical risk associated with Heparin therapy?

BLEEDING.

What six assessments should be conducted to evaluate for bleeding in a patient on Heparin?

Assess bruising, gums, urine, stool, Hgb/Hct, and neuro changes.

Should a subcutaneous Heparin injection site be massaged after injection?

Do not massage SubQ site.

What does the acronym HIT stand for in Heparin therapy?

Heparin-induced thrombocytopenia.

What combination of laboratory and clinical findings defines Heparin-Induced Thrombocytopenia (HIT)?

Decreased platelets ($\downarrow$ platelets) paired with increased clot formation ($\uparrow$ clot formation).

What two actions must be taken immediately if HIT is suspected?

Stop heparin and notify provider.

What drug classification does enoxaparin belong to?

Low Molecular Weight Heparin (LMWH).

What route and injection site are used for enoxaparin administration?

SubQ injection in the abdomen.

What injection site practice must be followed when administering enoxaparin?

Rotate sites.

Should the injection site be massaged after giving enoxaparin?

Don't massage.

Does enoxaparin generally require routine aPTT monitoring?

No, enoxaparin does not generally require routine aPTT monitoring like IV unfractionated heparin.

Which laboratory tests are monitored for Warfarin therapy?

PT/INR.

What is the antidote for Warfarin?

Vitamin K.

What dietary teaching regarding Vitamin K must be provided to a patient taking Warfarin?

Keep vitamin K intake consistent — don't completely eliminate vitamin K foods.

Which over-the-counter pain medications require extra caution when taken with Warfarin?

Aspirin and NSAIDs.

What four insulin types are categorized by action length in the 8/25 reading?

Rapid-acting, Short-acting, Intermediate, and Long-acting.

Which insulin formulation is categorized as short-acting?

Regular insulin.

Which insulin formulation is categorized as intermediate-acting?

NPH insulin.

What is the physical appearance of Regular insulin compared to NPH insulin?

Regular insulin is CLEAR; NPH insulin is CLOUDY.

What phrase describes the correct order for drawing up Regular and NPH insulin into one syringe?

CLEAR BEFORE CLOUDY.

What is the most important clinical complication of insulin therapy?

HYPOGLYCEMIA.

What three clinical checks must a nurse perform before giving mealtime insulin?

1. Check blood glucose (BG), 2. Make sure food is available, 3. Make sure patient can/will eat.

Which type of insulin is commonly administered via intravenous (IV) infusion?

Regular insulin.

What type of coverage does long-acting insulin provide, and can it be mixed?

Long-acting insulin gives basal coverage and is generally not mixed.

Why is insulin classified as a high-alert medication?

It carries a heightened risk of causing significant patient harm if administered incorrectly.

What are the two main mechanisms of action of metformin?

Decreases liver glucose production ($\downarrow$ liver glucose production) and increases insulin sensitivity ($\uparrow$ insulin sensitivity).

What is the most common adverse effect associated with metformin?

GI upset.

What rare but severe complication can occur with metformin use?

Lactic acidosis.

Which organ function is crucial to evaluate before and during metformin therapy?

Kidney function.

What is the mechanism of action of sulfonylureas?

Stimulate insulin release.

What two common side effects are associated with sulfonylurea therapy?

Hypoglycemia and weight gain.

What three non-insulin diabetes drug classes are recognized in the 8/25 reading?

GLP-1 receptor agonists, SGLT2 inhibitors, and DPP-4 inhibitors.

What is the complete 6-step medication administration sequence in proper order?

VERIFY $\rightarrow$ ASSESS $\rightarrow$ PREPARE $\rightarrow$ ADMINISTER $\rightarrow$ DOCUMENT $\rightarrow$ REASSESS.

What specific assessment is required before administering an antihypertensive drug?

Blood pressure (BP).

What specific assessment is required before administering digoxin?

Apical pulse.

What specific assessments must be performed prior to administering insulin?

Glucose and meal timing.

What three assessments must be performed prior to administering an opioid?

Pain level, respiratory rate (RR), and sedation level.

What two assessments must be performed prior to administering an anticoagulant?

Bleeding signs and lab values.

What oral medication abbreviations designate modified-release formulations that must NOT be crushed?

Enteric-coated (EC) and ER, XR, SR, CR, or XL.

How is a sublingual (SL) medication administered?

Placed under the tongue.

How is a buccal medication administered?

Placed between the cheek and gum.

What is the proper sequence for administering medication through a feeding tube?

FLUSH $\rightarrow$ MED $\rightarrow$ FLUSH.

What specific device must be used when drawing medication from a glass ampule?

A filter needle/device.

What five steps are followed when drawing medication from a glass/rubber vial?

1. Clean stopper, 2. Draw up air equal to medication amount, 3. Inject air into vial, 4. Invert vial, 5. Withdraw drug.

What is the step-by-step air injection and drawing sequence when mixing NPH (cloudy) and Regular (clear) insulin?

Inject air into cloudy $\rightarrow$ Inject air into clear $\rightarrow$ Draw clear $\rightarrow$ Draw cloudy.

What is the standard needle insertion angle for an Intradermal (ID) injection?

$$5\text{--}15^\circ$$