X Foundations - Chpt 23 - Med Amin Flashcards

1
Q

Who can prescribe Rx

A

Nurse Practitioner, PA’s

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2
Q

purpose of USP

A

US Pharmacopeia

program for standardization

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3
Q

purpose of NF

A

National Formulary

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4
Q

FDA tests all new drugs. 10 yrs min testing

A

.

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5
Q

How many years is proprietary for formulas

A

5yrs

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6
Q

Schedule 1

A

Highest potential for abuse. NO MEDICAL USE ACCEPTED

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7
Q

Schedule 2

A

Controlled Substance

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8
Q

Schedule 3

A

High potential for abuse

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9
Q

Schedule 4

A

Less potential for abuse

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10
Q

Types of Names for drugs

A

Brand Name
Generic Name
Checmical Name

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11
Q

Drug Action

A

Drugs ability to combine w cellular receptor. Local or systemic effect.

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12
Q

Pharmacology

A

study of drug’s effect on living organisms

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13
Q

Half Life

A

time taken to eliminate half the blood concentration of original drug dose. How well does the liver break down drug.

Heparin HL - 2hrs

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14
Q

Doctors create drug Rx based on

A

HL

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15
Q

Routes of entry - Speed

A

IV, SL, IM, PO, topical

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16
Q

Onset of Action

A

time for body to respond to drug

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17
Q

Peak plasma level

A

highest concentration of single drug dose before elimination rate equals rate of absorbtion

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18
Q

Plateau

A

when blood concentration level is maintained

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19
Q

Loading dose

A

extra high dose given at start of medication therapy.

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20
Q

drugs classiffied by

A
  • Body system with which they interact

- Drugs approved therapeutic use

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21
Q

Routes

A
  • Oral (SL, Buccal)
  • Parenteral - other than GUT (injection, subQ, IM, IV)
  • Topical
  • Respiratory/Inhalation
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22
Q

Pharmacokinetics

A

How drugs move through body

  • ABSORBTION (intest, rectal, SL)
  • DISTRIBUTION (from blood to tissue, fluid) *
  • METABOLISM (processed by body, Liver/kidney)
  • EXCRETION (meds w be in glomerular filtrate, kidneys)

(*worry about distro if person protein starved and drug needs to bind to protein molecules or if patient has low cardiac rate)

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23
Q

If patient has problems with liver or kidney, they will have problems with what Pharmokinetic function?

A

Metabolism and Excretion

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24
Q

Polypharmacy

A

taking multiple pills

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25
Q

Drug Interaction

A

effect one drug has on another.

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26
Q

Pharmacodynamics

A

why are we getting the drug?kill bacteria, softening stool, lower bp?

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27
Q

Side effect

A

non therapeutic effect of drug, mild and predicatble (i.e. Benadryl causes sleepiness)

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28
Q

Adverse reaction

A

bad reaction

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29
Q

Drug Tolerance

A

body accustomed to drug and require larger dose for efficacy

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30
Q

Toxic Effect

A

body cannot metabolize drug, accumulates in body

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31
Q

Idiosyncratic reaction

A

very unpredictable reaction. unexpected response

  • Over response (reacty violently to normal dose)
  • under response (1g morphine, still fee pain)
  • atypical response (opposite effect, awake for days when taking sleeping pill)
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32
Q

Factors affecting drug action

A
  • genetics
  • age
  • height (no Rx without height/weight)
  • weight
  • physical condition (muscle/fate)
  • mental condition
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33
Q

Pharmacokinteics

A

Absorption
Distribution
Metabolism
Excretion

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34
Q

DAW

A

dispense as written. (don’t substitute with generic)

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35
Q

MAR

A

Medication Admin Record

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36
Q

7 Rights

A
right client
right drug
right dose
right route
right time
right documentation
right to deny or refuse
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37
Q

Right TIME rules

A

have 1 hour on either side of scheduled medication time.

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38
Q

non compliant

A

when clients don’t take meds consitently

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39
Q

NEVER administer meds prepared by another nurse

A

never

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40
Q

NEVER leave meds by clients bedside to administer on their own

A

never

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41
Q

Pharmacology

A

study of drugs and their action on the living body

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42
Q

Pharmaceutical Phase

A

until given to patient - The making of the drug until absorption of the durg takes place in patient’s body

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43
Q

Pharmacokinetic Phase

A

movement of drugs’s active ingredient from body fluids into entire system to site where intended action of drug takes place.

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44
Q

Pharmacodynamic Phase

A

interaction of drug’s active ingredient with intended body tissue.

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45
Q

Drug Dosage based on

A

Half Life

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46
Q

Agonist

A

Drugs that bring on an effect.

47
Q

Antagonist

A

Drug that prevents the action of a another drug

48
Q

Drug Interaction types

A

Local vs Systemic

49
Q

Drug Interaction

A

One drug alters another

50
Q

Potentiation

A

one drug increases action or effect of another drug

51
Q

Incompatibility

A

drugs that do not combine chemically with other drugs

52
Q

Idiosyncratic response

A

a unique response to a drug

53
Q

Tolerance

A

reduced response to a drug

54
Q

Contraindications

A

conditions under which NOT to give a drug

55
Q

Factors affecting patient’s response to a drug

A

age, weight, height, health, phsycological, environ temp, gender, food in stomach, dosage forms

56
Q

Waste Narcotics

A

must have another certified witness to discard narcotics

57
Q

Standing Orders

A

already written by doctor for all patients in certain area/unit etc.

58
Q

Verbal Orders

A

given orally, and signed for by doc when present

59
Q

6 Rights

A

Right

  • medication
  • dose
  • time
  • route
  • patient
  • documentation
  • right to refuse
60
Q

Enteral

A

into GUT, via GI tract

Powders, pills, tabs, liq, suspensions, supp

61
Q

Percutaneous

A

through skin

Topical, instillation (eyes/nose drops), inhalation

62
Q

Parenteral

A

other than GUT

Usually means needle, ampules, vials, IM, subQ, ID, IV

63
Q

What routes of admin SKIP Pharmacokinetics

A

IV, SL and IM - they go directly into bloodstream

64
Q

Eyedrops administered here

A

Conjunctival Sac

65
Q

If you don’t eye drops to circulate , close which duct?

A

Lacrimal duct so won’t be absorbed into punctum

65
Q

Instillation

A

Nose or eye drops

66
Q

Inhalation

A

Through lungs

67
Q

What temp to use ear drops?

A

Room temp

68
Q

When using transdermal patches NEVER

A
  • use in same spot twice
  • use heating pads in same area as patch (w cause vasodilation and increase amt of drug being absorbed)
  • too close to umbilicus
69
Q

Angles for shots

A

IM - 90
SubQ - 45
ID - 10-15

70
Q

IM injection sites

A
  • Gluteal (dorsal/ventral or Maximus/medius)
  • Vastus lateralis
  • Rectus femoris
  • deltoid muscle
71
Q

3 checks before administration

A

1) take it out
2) pouring
3) b4 you put the bottle away

Administer medicine

72
Q

Needle Shaft

A

Length of needle
Nurses choice depending on type of shot

0.5 - 2.5”

73
Q

Filter needles used when?

A

Drawing from Glass ampules

74
Q

Smaller the lumen #

A

Larger the lumen diameter

18-27guage

18 for donating blood, large so doesn’t burst cells

75
Q

Max amount you can inject IM?

A

3 ml

76
Q

Never recap needle after use. Only scoop and recap…

A

After obtaining fluid in syringe and before injecting patient

77
Q

Purpose of syringe barrel

A

To hold med

78
Q

2 most common SQ injection mess

A
Insulin (rotates since taken for life) 
and Heparin (in abdomen)
79
Q

Insulin measured in

A

UNITS never in mg

80
Q

When injecting in abdomen, stay xxx from umbilicus

A

2 finger widths away

81
Q

Lipodystrophy

A

scar tissue making insulin no longer able to be asorbed

81
Q

?Lipoatrophy

A

Scar tissue, from repeated injection in same site. Insulin no longer absorbed through this site.

82
Q

Lipoatrophy

A

localized loss of fat tissue. breakdown of subq fat.

83
Q

Lipohypertrophy

A

buildup of subq fat.

84
Q

Cloudy Insulin

A

Long acting, added Zinc to absorb more slowly

gently rotate btwn hands, don’t shake. don’t want to break up insulin proteins

85
Q

can you mix clear and cloudy insulin in same syringe?

A

Yes, for a sort time. don’t leave long or they will combine though.

86
Q

never rub site after what shot?

A

Heparin (anti coagulant)

causes bruising and moving blood around

87
Q

aspirate air then administer Heparin shot to allow air bubble after shot to prevent

A

bleeding at injection site

88
Q

Dorsogluteal Site

A

upper outer quadrant to avoid sciatic nerve

89
Q

in IM injections, do you aspirate air?

A

Yes, to ensure you are not injecting into blood vessels, pull up needle to stay in muscle.

90
Q

Ventrogluteal Site

A

Gluteus Medius and minimus musles in hip

91
Q

Vastus lateralis site

A

vastus lateralis muscle, outer thigh

92
Q

Rectus Femoris site

A

anterior thigh

93
Q

Deltoid site

A

shoulder arm

94
Q

Ztrack technique

A

stretch skin slightly, inject, then release to prevent bleeding back through injection site

95
Q

Gerentological preferred Injection sites

A

Deltoid, Ventrogluteal. AVOID Dorsal Gluteal due to risk of sciatic nerve injury in diminished muscles

96
Q

Infant preferred injetion sites

A

leg only. Vastus lateralis, rectus femoris

97
Q

Teratogenicity (Teratogenic)

A

causes birth defects if taken during pregnancy

98
Q

Synegist

A

drug that when given with an agonist, action of both is greater than if each were given alone

99
Q

Biotransoformation

A

metabolism

100
Q

inability to excrete creates what condition?

A

toxicity

101
Q

AngioEdema

A

Swelling

102
Q

Urticaria

A

Rash

103
Q

NKA, NKDA

A

No known allergies, No know drug allergies

104
Q

IV bolus

A

dose given all at once, not broken down into intervals

105
Q

anaphalactic shock

A

drastic drop in bp

106
Q

Metabolism

A

drug broken down into metabolites

107
Q

Distribution

A

protein binding. worry in patients with low protein

108
Q

Onset of Action

A

time it takes for drug to take action

109
Q

Duration of Action

A

how long it works for.

110
Q

Ceiling effect

A

when a higher does won’t make a difference in effect on body. you just urinate out excess. (i.e. vitamins, tylenol

111
Q

Ototoxicity

A

affects crannial nerve VIII. (ringing in ears)

112
Q

Sub Q, Aspirate?

A

NO