Pharm Exam 1

mechanism of action

the specific way a drug produces its effect in the body

body mass effect on drug

some drugs are water soluble, some are fat soluble

generic name

less complicated and easier to remember

• lowercase spelling

chemical name

drugs are sometimes classified by a portion of their chemical structure

trade names

assigned by company marketing the drug

• each drug has multiple trade names

  • Benadryl is the “ “ name for diphenhydramine

nurse responsibilities

• what drug is ordered

• name and drug classifications

• intended purpose or use

• effects on body

• absolute contraindications

• special oconsiderations

• side effects

• why med is prescribed

allergic reactions

an acquired hyper response of body defenses to a foreign substance

anaphylaxis

severe allergic reaction involving the massive systemic release of histamin to cause inflammation

• life threatening

five rights

dose, med, time, route, patient

MAR

medication administration record

pyxis

where you get the drug from

three checks

reading MAR, getting med from pyxis, the bedside

enteral routes

swallowed, under tongue, cheek, rectal, NG tubes, PEG

topical

on skin

parenteral route

injections (IV, IM, SubQ)

therapeutic index

measure of a drug’s safety margin

• the higher the value, the safer the drug

agonists

bind to receptor, increase response

partial agonists

bind to receptor, increase response at weaker level

antagonist

occupy receptor, stop response

medication reconciliation

record of every prescription med, OTC, supplements

sentinel events

unexpected occurrence in a healthcare setting that results in patient death, permanent harm, or severe temporary harm, unrelated to the natural course of their illness

ISBARR

identify, situation, background, assessment, recommendation, read back orders

absorption

drug moving from admin site into body’s circulatuon

distribution

drug moves from bloodstream into interstitial and intracellular fluids to reach target tissues

metabolism

converting drug into water-soluble metabolites for easier excretion

• primary organ is liver

excretion

drug leaving body

• primary organ is kidney

first pass effect

when drug is metabolised before it can reach target site

therapeutic effect

how much it needs to be in the plasma to be working

bioavailability

fraction of an administered drug that reaches the systemic circulation unchanged

tolerance

a person can tolerate more and more of the substance

withdrawal

a sudden absence of a tolerated substance messes with the person physically and psychologically

pharmacokinetics

how the body effects a drug overtime, drug movement

pharmacodynamics

how the drug effects the body

withdrawal

a sudden absence of a tolerated substance messes with the person physically and psychologically

affinity

some tissues take more to certain drugs than others

adverse effect

unexpected bad reaction

side effect

predictable but not as bad effect

half life of drug

amount of time it takes 50% of med to leave plasma

therapeutic efficacy

how much the drug worked in the way we want it to

• check vitals

• observation

• lab results

narrow therapeutic index

smaller range of dosage before toxicity

beta agonist

albuterol —> lung expansion

beta blocker

metoprolol

high alert meds

insulin, blood products, lithium

drug-food interaction

grapefruit, cheese, orange juice, milk, pickles, vitamin K

what affect excretion

renal function, pH of urine, and med interactions

pH of urine

alkaline meds will mesh better with acidic urine and vice versa

receptor interactions

relationship that occurs when a med is consumed and interacts with receptor site in body

titrated

personalizing the dosage of a med and limiting the potential for side effects by slowly increasing dosage

receptor down-regulation

number of receptors on cell decreases from endocytosis and successive degradation due to long-term med agonists

arrestin

protein that helps regulate pathways within the cell

up-regulation

increase in number of receptors that increases cellular activity and response to meds

ligands

substances often found bound to the receptors

competitive antagonist

bind and prevent other substances from binding to that receptor

reversible competitive antagonists

short but lasting bonds on the receptor, results in slow, steady blocking of agonist

noncompetitive antagonist

allow agonists to bind, but the agonist will decrease action of agonist

inhibitors

block enzymes

sedation vacation

the breaking of sedation infusions for a designated time to assist with the titrating down of sedation med

concentration

when this increases, therapeutic efficacy increases

affinity

the factor that demonstrates how likely a med is to bind with the receptor

• dependent on structures of med and reveptor

• higher level of this usually means higher effect

selectivity

a med’s ability to bind readily with a receptor site

drug-drug interaction of metabolism

one med may cause another to become inactive before it can work, or slow gastric emptying which effects enteral route

drug-drug interaction of perfusion

a med speeds or slow cardiac output or compete for protein bonding sites

drug-drug interaction of metabolism

blood flow dependency for clearance from hepatocytes

drug-drug interaction of excretion

when multiple meds are admin together, or the perfusion of the kidneys, GFR, and tubular function

urticaria

welts or swollen areas on the skin that are red and itchy

angioedema

swelling of subQ or soft tissues

stevens-johnson syndrome

flu-like manifestations followed by a rash that blisters, which causes the top layer of skin to die, shed, and heal several days later

aim of interventions

pt returned to optimal level of wellness, safe and effective admin of med

documentation of med admin

• admin of med

• therapeutic and adverse effects

• pt statements

• objective assess data

root cause analysis

seeks to prevent another occurrence by asking what happened, why, and what can be done to prevent it

changes during pregnancy

• absorption: hormonal changes

• distribution and metabolism: changes in cardiac

• excretion: rate may increase

pregnancy and lactating labeling rule

requires drug labels to include pregnancy, labor, and delivery, lactation, those that might want to conceive soon

controlled substance

substance that has high disuse rate

complementary medicine

mainstream practice and conventional medicine

alternative medicine

non mainstream in place of conventional med

integrative medicine

traditional and complementary used together to promote wellness

DSHEA

regulatory act for dietary supplements