General terms for formative 1

module 1

Absorption

movement of a drug from the site of administration into the bloodstream for distribution to the tissues

Ways of absorption

• enteral routes - “e” for eat

  • extended release

• parenteral routes - “p” for push it

• inhalation

• topical

Bioavailability

how much of the drug actually gets absorbed into the bloodstream

Additive Effect

Two similar drugs given together (1+1=2)

• ex: giving two pain medications to relieve more pain

Adverse Effect

Predictable, unwanted reactions to medication therapy

• AKA side effect

Agonist

Fits into a cell receptor and activates it to produce a natural or enhanced cellular action

• acts like a key to a lock

Allergic reaction

Hypersensitivity reaction involving patient’s immune system

Antagonistic effect

Two unlike drugs given, resulting in one medication being stopped (1+1=0)

• ex: using Narcan to reverse an opioid overdose

Assessment

• collecting data

  • helps to identify actual and potential health problems

• subjective vs objective

• “what is happening”

Nursing Diagnosis

• AKA human needs statement

• analyze assessment data

• nursing diagnosis guides patient-centered care

• “what needs to be corrected first”

Planning

• define goals, priorities, and interventions for success

• “how do we fix this”

Implementation

• involves carrying out the plan

• “lets do this”

Rights of medication administration

NEED TO KNOW:

• right patient

• right medication

• right route/form

• right time

• right dose

• right documentation

Additional rights:

• right assessment

• right indication

• right education

• right evaluation

• right to refuse

Evaluation

• patient response to interventions or treatment

• “did the plan work”

Medication Errors

• medication errors can occur at any time

• preventable events that can lead to inappropriate drug use or patient harm

• as nurses, we are a patient LAST line of defense against medication errors

Pharmacodynamics

what the drug does to the body

• therapeutic effects

• mechanisms of action

• receptors

Therapeutic effects

desired effect of a medication

• benefit

Mechanism of action

how a medication produces an action

• some meds do not have a known or well-understood MOA

Receptors

• antagonist vs agonist

• enzymes

• non-selective

Contraindication

condition that makes a given medication dangerous to administer

• ex: pt is pregnant and drug could harm the fetus

Indication

Disease or condition for why a medication is prescribed

Precaution

Situation when a drug is given, but requires close monitoring

Tolerance

Decrease response to a repeated drug test

Dependence

Physiologic or psychologic need for a drug

Drug interaction

With drugs, food, or substances that cause an alteration

Potency

Amount of drug that must be given to produce a response

Efficacy

How well a drug produces a response

Synergistic Effect

Two unlike drugs together create a greater effect than one alone (1+1=3)

• ex: antibiotic A works to kill a certain bacterial process and antibiotic B works against another part of the bacteria, making them kill the bacteria more efficiently together

Potentiated Effect

Two unlike drugs given together but only ONE medication is enhanced (1+.5=2)

• ex: Levodopa (a Parkinson’s med) is taken alongside Carbidopa and even though Carbidopa has no effect on Parkinson’s, it helps Levodopa get to the brain better before being broken down, giving Levodopa a greater effect

Idiosyncratic Effect

Unexpected reaction because of an abnormal response to a dosage

Drug Accumulation

dosage exceeds the amount the body can eliminate through metabolism and excretion

Drug Toxicity

drug accumulation that causes damage to tissues and organs

Nephrotoxicity

Kidney toxicity

Hepatotoxicity

Liver toxicity

Blood Dyscrasia

Bone marrow toxicity

Otoxicity

Ear toxicity

Beer’s List

• list of medications associated with the imbalance of risks & benefits in elderly patients

• as we age, our organ function declines

Pregnancy categories of drugs

A - no risk to fetus

B - no risk to animal, no human data

C - adverse effects to animal, no human data

D - possible effects to human, some cases benefits may outweigh the risks

X - fetal abnormalities, DO NOT USE

Black Box Warning

On certain medications that warn of serious adverse effects or death

Pharmacokinetics

what the body does to the drug

• four phases:

  • absorption

  • distribution

  • metabolism

  • excretion

Half life

Time required for half of a dose to be eliminated by the body

Steady State

Physiological state in which the drug amount removed equals the amount absorbed

Peak

Maximum concentration of a drug in the body

Onset

Time required for a drug to elicit a therapeutic response

Duration

Length of time the concentration of a drug in the blood to tissues is sufficient to elicit a response

Trough

Minimum concentration of a drug in the body

Distribution

transport of a drug by the bloodstream to the site of action

• barriers include blood brain barrier and blood placenta barrier

• depends on:

  • blood flow (more blood = faster)

  • affinity to body tissue

  • protein binding effects

Protein Binding Effects

• high protein binding of a drug allows only a few drug molecules to be free and active

• high protein bound medication + low albumin = high risk of toxicity

Metabolism

a sequence of chemical events that changes a drug after it enters the body (the breakdown of a med)

• elderly and infants have a reduced ability to metabolize medications

• uses the P450 system

• AKA Biotransformation

  • primary organ of metabolism is the liver

First-Pass Effect

Oral route medication effects are reduced and decreases the amount of medication available for system circulation

P450 System

enzymes that breakdown drugs

• substances can influence this system by blocking or inducing the system

• grapefruit juice inhibits the P450 system, which increases drug levels in the blood

Excretion

in the kidneys

• process of drugs being eliminated from the body

• most drugs leave the body via the kidneys through urine, but they can also be excreted via bile, sweat, saliva, breastmilk, or feces

• decreased kidney function = decreased excretion

Generic drug name

nonproprietary name and most universally known

• starts with lowercase letter

  • ex: acetaminophen and ibuprofen

Trade drug name

proprietary name

• trademarked

• starts with capital letter

  • ex: Tylenol

Enteral Routes

“e” for eat

• extended release

Parenteral Routes

“p” for push it

Topical Routes

on the skin

Short Gut Syndrome

when someone has too little functioning small intestine to properly absorb nutrients, water, and electrolytes

Blood Brain Barrier

a protective barrier that controls what substances can move from the bloodstream into the brain