Pharm exam 1

Pharmacology Basics

a. What types of assessments and evaluations are important to do before and after giving a medication?

-Vital signs

-Modified head to toe exam

-Pt allergies

-Labs

• Med history

-Speci drug data

-Pt understand of drugs

• Age related concerns

-Liver failure? Malabsorption syndrome? Renal disease?

-Pt home drugs?

• When intended effect will happen

• Urine outpit

• Lung sounds

• Monitoring (desired outcome obtained? What was drug response? Any adverse effects? Any toxic effects?)

b. What are the 9 rights you must consider before giving a medication?

• Right pt

• Right drug

• Right dose

• Right route

• Right time

• Right indication

• Right documentation

• Right response

• Right to refuse

c. What drugs are considered to be controlled substances and why?

• Schedule 1-5 drugs due to the high abuse potential

d. What are black box warnings?

• Highest safety-related warning for meds that are assigned by FDA. This warning is intended to bring the consumer and the nurses attention to the major risk of the drug.

e. Why do you have to know the generic name of a drug?

• This is the name used on the NCLEX and the DR can call/prescribe it by either name. f. What is Pharmaceutics?

• Developing a chemical to be used as a drug.

g. What are enteral drugs?

• PO drugs, it has to pass through intestines/ be absorbed in GI tract h. What are parenteral drugs?

-Drug given by injection (passing outside the intestines)

i. What is Pharmacokinetics?

• Study of what happens to the drug while it is in the body

j. Why do we consider the absorption of the drug?

• Absorption affects the speed and concentration at which a drug may arrive at its desired location of effectg

k. What factors affect the absorption of a drug?

• CYP450= enzyme in liver responsible for breaking down drugs and making them bioavailable

l. What is the First Pass phenomenon?

m. Which route of administration will be absorbed fastest and slowest?

• IV/ parentral drugs are absorbed faster.

n. Why do we consider the distribution of the drug?

• -Distribution describes how a substance is spread throughout the body. To be effective, a medication must reach its designated compartmental destination, described by the volume of distribution, and not be protein-bound in order to be active.

o. What factors affect the distribution of a drug?

• biochemical properties of the drug as well as the physiology of the individual taking that medication, ; protein bound drugs, if it has protein bound to it, it makes it harder to reach the site.

p. What is a drug to drug interaction and why does this occur?

• Drug- drug interaction occurs when taking more than one medication together.

q. What is the importance of drug metabolism?

• Metabolism changed drug to inactive metabolite to more soluble form, to a more potent active metabolite. Affecting the liver.

r. What are the cytochrome P-450 enzymes and why are they so important to medication administration?

• This is an active enzyme used to break down the drug; there are multiple enzymes used to break down drugs by PY450 is common; if that enzyme is already in use for a drug the enzyme may not be effective for another drug taken at the same time requiring the action of that enzyme.

s. What organ is responsible for most drug metabolism? - Liver

t. What labs do we monitor to make sure that organ is not damaged from metabolizing the drugs?

• Liver labs

u. What factors affect the metabolism of drugs?

• The enzymes. Certain enzymes might make a drug more effective potentially causing toxicity and some enzymes can impede a drugs effectiveness.

v. What organ is most frequently responsible for excretion of drugs? - Kidneys

w. What labs do we monitor to make sure that organ is not damaged excreting the drugs? -Kidney function

x. What is the onset of action of a drug?

• Time required for drug to take effect

y. What is the peak level of a drug?

• Time required for drug to reach its maximum therapeutic response. z. What is the half-life of a drug

• Time required for 50% of the drug to be eliminated from the body. aa. What is the duration of action of a drug?

• Length of time that drug concentration is sufficient enough to elicit a therapeutic response.

bb. How do these time factors affect the way we nurses administer and evaluate drug affects?

• If a drug has a long half-life then we have to delay or put more time in between giving another dose.

cc. What are the common ways that drugs exert their actions?

• Through receptors, by effecting enzymes, nonselective interactions (will bind to multiple receptors because we haven’t been able to target just the one area which is why we have side effects)

dd. What is acute drug therapy used for?

• Antibiotics, given for a short amount of time to get rid of something specific

ee. What is maintenance drug therapy used for?

• BP meds, taken for a long time to maintain a function

ff. What is palliative drug therapy used for?

• Given to make someone more comfortable at end of life.

gg. What is prophylactic drug therapy used for?

• Given to prevent something

hh. What are adverse effects or adverse reactions to drugs and why are they important for nurses to recognize?

• Adverse effects are basically negative effects or responses to the drug from external sources; ie grapefruit garlic don’t react well with certain meds

ii. What is important to consider when giving a drug to a pregnant woman? - What trimester pt is in and category drug

jj. What is important to consider when giving a drug to a pediatric patient? - Pt weight

kk. What is important to consider when giving a drug to a geriatric patient? - Polypharmy, other drugs taken, physiologic issues, financial issues ll. Why are drugs categorized related to pregnancy?

• To determine the potential effects to the fetus

mm. What are some cultural or genetic factors you must consider when administering drugs?

• Speak different languages, may use herbal remedies that you need to ask about, how thee culture handles illness, be considerate of religious belief because some could affect care , how they feel about the treatment

nn. Why is it important to educate patients about their prescribed medications? - So they will know what is happening and how it is happening

oo. What are some factors that will improve the patient’s ability to learn about their medications? - Pt age, language barrier, cognitive abilities, literacy level, emotional status, environment at home, barriers of learning, any physical/psych/cognitive limitations

pp. What are the different routes of medication administration?

• PO, IM, IV, subcutaneous, topical, inhalation, nebulized, rectal, sublingual, intrathecal (epidural/spinal, transdermal

qq. Why are drugs ordered to be administered using different routes?

• Maybe poor liver, can’t swallow, needs to act quicker rr. What are common causes of drug administration errors?