NURS 2535 week 1

what is a drug?

any chemical that affects the physiologic processes of a living organism

What is pharmacology?

study of drugs

what are the 3 types of names a drug can be given?

- chemical name

- generic name

- trade name

what is a chemical name?

name which describes drug's chemical composition and molecular structure

What is the generic name?

name given to drug that is approved by health Canada

what is a trade name?

name given when a drug has a registered trademark therefore name is used by the brand/owner eg. Advil

What name do nurses use and why

generic name eg. ibuprofen NOT Advil

How are drugs classified?

According to their effects, structure or therapeutic use

what are the 3 phases of pharmacology?

pharmaceutics, pharmacokinetics, and pharmacodynamics

what are pharmaceutics?

How drug forms influence the way in which the body metabolizes a drug and how the drug effects the body

What is dissolution?

the process of dissolving

What are pharmacodynamics?

what the drug does to the body

What are pharmacokinetics?

what the body does to the drug

when does pharmacokinetics occur?

from time drug enters body till parent drug and metabolites leave body

what are the 4 stages of pharmacokinetics?

1. Absorption

2. Distribution

3. Metabolism

4. Excretion

where does absorption of drugs occur?

stomach and small intestine

where does distribution of drugs occur?

bloodstream

where does metabolism of drugs occur?

liver

where does excretion of drugs occur?

large intestine and kidneys

What is bioavailability?

amount of drug that reaches circulation unchanged

at what stage of pharmacokinetics is bioavailability measured?

absorption

what is a drug's bioavailability dependent on?

dosage of drug and how much reaches target location

What is the first pass effect?

drugs absorbed from the GI tract enter the portal vein and pass through the liver before entering circulation.

how does the first pass effect alter bioavailability?

less amount of the drug reaches it's target

how does first pass effect alter dosage of drugs?

increase dosage

What is the enteral route?

drug is absorbed into the systemic circulation through mucosa of stomach or small or large intestine

Types of enteral routes

- Oral (mouth)

- Sublingual (under tongue)

- Buccal (cheek)

- Rectal (anus)

What is the parenteral route?

The medications will be administered by injections

types of parenteral routes

intravenous, intramuscular, subcutaneous, intradermal, intra-material, intrathecal, intra-articular

What is intravenous injection?

An injection into a vein.

What is intramuscular injection?

injection into a muscle

what is subcutaneous injection?

An injection into tissues just below the dermis.

What is a intradermal injection?

injection into the dermis

what is a intra-arterial injection?

injection into artery

What is intrathecal injection?

into the spinal canal

What is intra-articular injection?

into a joint

what are topical routes?

Skin (including transdermal patches)

Eyes

Ears

Nose

Lungs (inhalation)

Rectum

Vagina

what is the peak level in pharmacokinetics?

highest blood level of a drug

what is the trough level in pharmacokinetics?

lowest blood level of a drug

when does drug toxicity occur?

if peak blood level of drug is too high

how do we ensure drug toxicity does not occur?

drug monitoring

What is a loading dose?

An initial dose of drug that is higher than rest of doses.

What is a maintenance dose?

The doses of drug that maintain a steady state to ensure therapeutic level of drug in bloodstream

What is pharmacodynamics?

The study of what the drug does to the body

what are the mechanisms of action involved in pharmacodynamics?

receptor and enzyme interactions

what does pharmacotherapeutics mean?

use of drugs to help people regain optimal level of health

what is acute therapy?

Short term drug therapy, such as taking antibacterial drugs to clear up a bacterial infection

what is maintenance therapy?

Taken long term to maintain a condition in a stable state, such as drugs for hypertension or schizophrenia

what is supplemental therapy?

supplies the body with a substance needed to maintain normal function for eg. if you have low iron you take an iron supplement

what is palliative therapy?

-Prevent / relieve symptoms instead of trying to cure (seen in terminally ill pt)

what is supportive therapy?

maintains the integrity of body functions while the patient is recovering from illness or trauma

What is prophylactic therapy?

treatment aimed at preventing infection

what is empirical therapy?

Therapy directed at organisms that are known to cause the infection in question

what does tolerance mean?

decrease response to drug due to repeated use

What does dependence mean?

physiologic or psychological need for a drug

what is the difference between physiologic and psychologic dependence?

physiologic means body needs to the drug to avoid physical withdraw symptoms

psychologic dependence means addiction

what is the nursing process?

A systematic problem-solving process that guides all nursing actions

what does nursing process require?

critical thinking

What is clinical reasoning?

the thinking a nurse does which leads to clinical judgement

what is clinical judgement?

conclusion of what pt needs to progress

what are the 5 stages of nursing process?

1. Assessment

2. Diagnosis

3. Planning

4. Implementation

5. Evaluation

What does the nurse do during assessment?

Data is collected

such as drug use, alcohol, tobacco and caffeine intake, prescriptions, family hx, past and present hx, health concerns

what does the nurse do during planning?

- goals are created which are objective, measurable and reasonable

- outcome criteria of how pt should be progressing

what does the nurse do during analysis?

identifies actual and potential problems based on data

what does the nurse do during implementation?

initiate and complete nursing actions based on goals, diagnoses and outcome criteria nurse previously developed

what does independent action mean?

nurse provides care by themselves

what does dependent action mean?

practice is out of scope of practice therefore order is dependent on other health care provider eg. prescribing medication must be done by a doctor, nurse can then administer medication

if the order is not clear, complete or appropriate what can occur ?

wrong medication can be given leading to errors and further implications

if the order is not clear, complete or appropriate what should the nurse do?

do not perform and follow up with prescriber

what must the nurse consider when given an order?

1. Do i understand the order?

2. Does order contain all necessary information in order to administer medication?

3. Is the order appropriate based on pt current condition?

what must the nurse consider when administering medication?

1. Are proper authorized mechanisms in place?

2. Do I have the proper competence (knowledge) to administer?

3. Are the needed systems in place to support administration?

4. Is it appropriate based on client?

If a nurse does not have a authorized mechanism such as a direct order to administer medication should they administer?

No

What are the 10 Rights of Medication Administration

1. Right medication

2. Right patient

3. Right time

4. Right dose

5. Right route

6. Right reason

7. Right documentation

8. Right evaluation

9. Right patient education

10. Right to refuse

What are time critical medications?

Medication that must be given at the exact time when needed or 30 min before or after time

What are non- time critical medications?

Daily, weekly or monthly medications administered within 2 hours before or after scheduled time

When should medication that is non-time critical be administered within 1 hour before or after scheduled time?

if medication is prescribed more frequently than once daily but no more than every 4 hours

what is the evaluation in nursing process?

The final step in the nursing process; requires nurse to review patient goals and determine if expected outcome criteria were met/achieved.

what should nurse monitor when giving pt medication?

therapeutic, expected and toxic responses

What is a medication error?

any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer

what is a disease?

an unhealthy condition, illness, or disorder

what does studying diseases include?

- basic structural and functional changes due to disease

- sequence of events leading from abnormalities to clinical manifestations

What does etiology mean?

cause of disease

what are manifestations?

all data collected on disease which pt has

what are manifestations that we are interested in as nurses?

signs, symptoms, lab abnormalities and radio graphic finding

what is a symptom?

what the patient tells you/feels

what is a signs

objective finding nurse can see

what are laboratory abnormalities?

results of tests that are abnormal

what are radiographic abnormalities?

abnormalities shown in xrays, CT, MRI and ultrasound

what is a diagnosis?

process of using information from history, lab results and physical exams to determine a condition which is causing disease

what is an example of a diagnosis?

Cancer

what is a syndrome?

a specific group of signs and symptoms that accompany a disease

what is a structural disease?

Characterized by structural changes (lesions) within body

what are common categories of structural diseases?

- genetic and developmental diseases

- degenerative and inflammatory diseases and trauma

- hyperplasias and neoplasms

what is a functional disease?

disease without visible lesions at onset

provide examples of a functional disease.

- tension headaches

- irritable bowel syndrome

- diabetes

- hypertension

What does exogenous mean?

from outside the body

what are exogenous causes of diseases?

- chemical

- physical

- microbiological

provide examples of chemical, physical and microbiologic injuries

chemical:

- poisoning

- drug reaction

- environmental toxins

physical:

- trauma

- temperature threats

- electricity

microbiologic:

- bacteria

- viruses

- fungi

What does endogenous mean?

Produced within the body

what are endogenous causes of disease?

- vascular

-immunologic

- metabolic