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| the study of drugs and their interactions with living systems, what is clinically relevant. |
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Book – use of drugs to diagnose, prevent, or treat disease or prevent pregnancy
Other - the treatment of all aspects of disease with medication to diagnose, treat, or cure |
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Assessment
Nursing Diagnosis
Implementation
Patient Teaching
Evaluation |
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| effect one or more body areas |
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| IV, IM, SQ any way that isn't enteral |
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| Mucous Membrane Application |
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| SL, Buccal, Inhalation, Vaginal, Rectal |
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| Dermal, Transdermal, Otic, Ophthalmic |
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| Medication, dose, route, number of times/day |
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| drops, number of i's = number of drops |
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| Seven rights of medication administration |
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| right:drug, dose,route,time,patient,of patient to refuse, documentation. (depart D) |
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| Already there, present in the system. |
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| Properties of an ideal drug (top 3) |
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Definition
| Effective, safe, selective (no ADR's) |
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Definition
| How the body works on drugs (absorption, distribution, metabolism, excretion) |
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| How drugs work on the body. |
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| entry of drug into the blood stream |
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| Absorption usually occurs via |
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| passive diffusion through cell membranes |
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| Absorbtion through blood brain barrier only with what kind of drug? |
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Definition
| Lipid Soluable and non tightly bound |
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| What drugs can pass through placenta |
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Definition
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| Portion/percent of drug that is absorbed and able to act. Amount available to cause a reaction. |
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| process by which drugs are carried throughout the body and delivered to targets of action. |
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| Proteins drug molecules bind to? |
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Definition
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| Multiple drugs that share receptor sites on RBC's cause what? |
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Definition
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| If you had low albumin how might that affect how a drug works |
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Definition
| more drug free to act (bioavalible) may produce more effect. |
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Definition
| a group of enzymes in the liver recognized and identified for their ability to break down drugs. |
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| Amount of time it takes for a drug to to be out of the system, each half like drops the amount of drug in the system by 50%. |
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| How many half lives till basically gone? |
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| keep a process from happening |
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| ability of a drug to cause an effect |
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| ratio of lethal dose to effective dose |
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| a wider/bigger therapeutic index is? |
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Definition
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| The affinity is a measure of how tightly a drug binds to the receptor. |
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| the strength of the attraction between a drug and it's receptor |
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Definition
| ability of a drug to to activate upon binding to a receptor. High= high receptor activity. |
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Definition
| highly desirable characteristic of drug, the more selective it is the fewer side effects it has. Refers to drugs that are attracted to specific receptor sites. |
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| Modified occupancy theory |
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Definition
| explains observed drug interactions that cannot be accounted for in simple occupancy theory. Utilizes affinity and intrinsic activity. |
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Definition
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| varients based on heredity that effect pharmicokinetics and pharmicodynamics. |
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| Synergistic drug reactions |
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Definition
| positive drug interactions, work well together |
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| term used for negative drug interactions |
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Definition
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Definition
Physical: precipitate
Chemical: inactivate each other |
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| Possible effects of drugs given together |
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Definition
| incompatibility, change in absorption, altered protein binding, biotransformation. |
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| unexpected, rarely seen, usually genetic |
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| 2 tbsp, 30 cubic centimeters (cc) |
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| Upper GI disorders, erosion of the gut wall. |
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Definition
| Imbalance between mucosal and aggressive factors |
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Definition
| bacteria that attacks stomach in way that protects the bacteria from natural defenses |
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| Risk factors for H pylori |
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Definition
| Smoking, NSAIDS use, Hypersecretion of gastric acid |
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| Prevention & Treatment of H pylori |
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Definition
Elimination of H. Pylori Avoid irritating drugs Avoid smoking
Elimination of H. pylori bacteria
Diet changes: 6 small meals/day
Decrease stress |
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Term
| Classes of Antiulcer Drugs |
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Definition
Antibiotics
Antisecretory agents
Mucosal protectants
Antisecretory agents that enhance mucosal defenses
Antacids |
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Term
| A combination of two out of these 5 antibiotics are prescribed |
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Definition
bismuth (Pepto bismol)*
clarithromycin (Biaxin)
amoxicillin (Amoxil)
tetracycline
metronidazole (Flagyl) |
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Definition
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Definition
| promotes intestinal absorption, decreases prositglandin synthesis, acts as antibiotic in H pylori infection. |
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| Contraindications for bismuth |
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Definition
| Asprin hypersensitivity, cross sensitivity with NSAIDS, Pedi- reyes syndrome, Geriatric- fecal impaction. |
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Definition
| Constipation, black/grey stool, impaction. |
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| Drug interactions of Bismuth |
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Definition
| Asprin- increases absorption of aspirin, decreases absorption of tetracycline. |
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| Route of Administration of Bismuth |
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Definition
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| Antibiotic for use in H Pylori treatment |
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Definition
| Antibiotic used in H Pylori treatment |
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Definition
| Antibiotic used in H Pylori treatment, if used with bismuth, dose given 2-4 hours apart to allow for proper absorption. |
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Term
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Definition
Antibiotic for use in treatment of H pylori
anti-infective
antiprotozoals
antiulcer agent |
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Term
| Antibiotic regimen for treatment of H pylori |
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Definition
| 2-3 antibiotics to decrease resistance, antisecretory agent, 14 day course. |
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| Histamine H2 receptor antagonists action |
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Definition
| Inhibits gastric acid secretion. |
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Definition
| Decrease symptoms and complications of PUD, Prevent stress ulcers, Decrease heartburn, GERD, Zollinger-Ellison syndrome, H. pylori |
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Definition
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| Side effect of cimetidine(Tagamet) |
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Definition
| confusion in elderly, antiandrogen |
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Term
| ranitidine (Zantac, Zantac EFFERdose) |
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Definition
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Term
| Histamine H2Antagonists action |
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Definition
| Inhibits action of histamine receptor located in gastric cells, resulting in inhibition of gastric acid production. |
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| Contraindications of H2 Antagonists |
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Definition
| Avoid in patients with alcohol intolerance. Some contain aspartame, avoid in patients with PKU. |
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Term
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Definition
| Confusion, dizzyness, drowsyness, hallucinations, headache, arrythmias, constipation, diarrhea, Agranulocytosis, Aplastic anemia. |
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Definition
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Term
| famotidine(Pepcid, PepcidAC, PepcidRPD |
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Definition
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| nizatidine(Axid, AxidAR, AxidPulvules) |
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Definition
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| nizatidine(Axid, AxidAR, AxidPulvules) Concern? |
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Definition
| Some risk pneumonia with ↓ acid GI: colonization stomach and respiratory tract |
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| Action of Proton Pump Inhibitors |
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Definition
| Blocks enzyme needed for acid formation |
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| Uses for Proton Pump inhibitors |
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Definition
| active ulcer disease, erosive esophagitis(GERD’s) |
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| omeprazole(Prilosec, PrilosecOTC, Zegerid)* |
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Definition
| Anti ulcer, proton pump inhibitor |
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| Common side effect of omeprazole |
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Definition
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| Routes for Proton pump inhibitors |
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Definition
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| esomeprazole(Nexium, NexiumIV) |
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Definition
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Definition
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Definition
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| pantoprazole(Protonix, ProtonixIV) |
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Definition
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Term
| action of Mucosal Protectants |
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Definition
| Local protectant action: adheres to surface and promotes healing, prevents injury for up to 6 hr |
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| Uses for Mucosal Protectants |
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Definition
short term therapy of duodenal and gastric ulcers
prevention of stress ulcers
relief of pain from oral & mucosal ulcers |
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| Nursing Implications of Mucosal Protectants |
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Definition
may harden with enteral feedings (tube)
Associated with constipation (2%) |
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Definition
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Definition
| inhibit gastric acid secretion, & promotes mucous production, and increases blood flow via vasodilation |
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Definition
| prevention of NSAID-induced ulcers, induction of labor or used in abortions. |
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Definition
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Definition
| acid indigestion, heartburn, reflux esophagitis, peptic ulcers, prevention of stress ulcers, pain from ulcers, and hyperphosphatemia in chronic renal failure (aluminum only) (Amphogel) |
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Definition
neutralize gastric acid
does NOT absorb acid or coat stomach wall
raise pH to above 5 |
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Definition
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Definition
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Definition
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Definition
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| Problem with sodium bicarbonate |
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Definition
| can cause electrolyte imbalance. |
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| Contraindications of antacids |
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Definition
| renal dysfunction (except aluminum) |
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| Adverse effects of antacids |
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Definition
constipation -calcium & aluminum
diarrhea -magnesium |
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Definition
| po, liquid suspension (most effective), chewable tablet, must take with water! |
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Term
| What is another use for MOM milk of magnesia |
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Definition
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Term
| what is Magnesium hydroxide*, oxide, carbonate often combined with |
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Definition
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| Indications for Aluminum hydroxide |
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Definition
| lowers phosphate levels in pat with renal faliure, treatment of ulcers, hyper acidity, indigestion and reflux |
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Term
| Calcium carbonate also known as |
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Definition
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| History & Patient Teaching for pat with upper gastric issues |
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Definition
H. Pylori
medication
eating habits
lifestyle
smoking -stop or at least eliminate smoking after last dose of the day
Alcohol |
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Term
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Definition
constipation
preparation for surgery or diagnostic tests
-Soften the stool
–Increase stool volume
–Hasten fecal passage through the intestine
–Facilitate evacuation from the rectum
decreased systemic absorption of ammonia in hepatomegaly |
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Term
| Indications for Laxative Use |
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Definition
Diagnosis
Treatment/procedure preparation
Constipation
Poisoning |
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Term
| Classification of Laxatives |
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Definition
| Bulk-forming laxatives, Surfactant laxatives, Stimulant laxatives, Osmotic laxatives. |
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Term
| Bulk-Forming Laxatives Action |
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Definition
| absorb water into fecal contents & expand increasing bulk of stool |
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| Nursing Implications of Bulk-Forming Laxatives |
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Definition
must be administered with 8 oz fluid
Non habit forming, often part of popular diet products |
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Term
| Agents of Bulk-Forming Laxatives |
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Definition
psycillium (Metamucil, Konsyl, Fiberall)*
polycarbophil (Fibercon) |
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Term
| Surfactant laxatives agents |
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Definition
docusate sodium (Colace)*
docusate calcium (Surfak) |
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Term
| Surfactant laxatives Uses |
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Definition
Soften or lubricate hard feces
Prevents constipation, does not treat it once it is present |
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Term
| Stimulant Laxatives agents |
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Definition
senna (Senokot)*
bisacodyl (Ducolax) |
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Term
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Definition
short term use in constipation (abused often)
opioid-induced constipation |
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Term
| Stimulant Laxatives ADR's |
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Definition
cramping, N/V, diarrhea
Bisacodyl: avoid with milk and antacids, coating
Senna: yellow brown or pink tinge to urine |
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Term
| magnesium citrate (Citrate of Magnesia) |
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Definition
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Term
| sodium phosphate (Phospho-soda Fleet) |
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Definition
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Term
| polyethylene glycol-electrolyte (Golytely, Half-Lytely)* |
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Definition
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Term
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Definition
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Term
| polyethylene glycol (MiraLax) |
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Definition
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Term
| Osmotic/Saline Laxatives uses |
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Definition
short term treatment of constipation
preparation for diagnostic tests
decrease ammonia in hepatomegaly (Lactulose |
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Term
| Lubricant Laxatives agents |
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Definition
| Mineral oil, Glycerin suppositories |
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Term
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Definition
| Actions -softens and lubricates stool |
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Term
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Definition
| nutritional deficiency, aspiration |
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Term
| Glycerin suppositories actions |
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Definition
| promote peristalsis through local irritation (30 minutes) |
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Term
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Definition
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Term
| methylnaltrexone (Relistor) uses |
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Definition
| Treatment of constipation caused by opioid use in patients being treated palliatively, when laxative therapy has failed. |
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Term
| Nursing Implications of laxative use |
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Definition
Assess bowel and laxative history
Eating habits
Potential causes
Most laxatives administered at night for action in AM
Patient teaching
normal bowel habits
dangers of chronic use |
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Term
| tools to prevent constipation |
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Definition
Increase fluids
Increase dietary bulk
Increase ambulation
Consider patient’s own remedies
coffee
tea
prunes
pineapple |
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Term
| Nausea and Vomiting causes |
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Definition
stimulation of the chemoreceptor trigger zone (CTZ)
Activation of vomiting center: smells, sights, odors, inner ear etc. |
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Term
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Definition
| Antiemetic, Serotonin Receptor Antagonists |
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Term
| granisetron(Granisol, Kytril, Sancuso |
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Definition
Antiemetics
Serotonin Receptor Antagonists |
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Term
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Definition
Antiemetics
Serotonin Receptor Antagonists |
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Term
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Definition
Antiemetics
Serotonin Receptor Antagonists |
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Term
| uses for Serotonin Receptor Antagonists Antiemetics |
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Definition
Chemotherapy-induced N/V
Postoperative N/V |
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Term
| Serotonin Receptor Antagonists Antiemetics are more effective when used with: |
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Definition
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Term
| Substance P/neurokinin antagonist |
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Definition
| Aprepitant/fosaprepitant (Emend)* |
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Term
| What is Aprepitant/fosaprepitant (Emend)* used for |
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Definition
| Prevents CINV (chemo induced N/V) |
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Term
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Definition
| Phenothiazines Antiemetics |
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Term
| prochlorperazine (Compazine)* |
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Definition
| Phenothiazines Antiemetics |
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Term
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Definition
| Phenothiazines Antiemetics |
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Term
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Definition
| Phenothiazines Antiemetics |
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Term
| Caution must be used with phenothiazines becuase |
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Definition
| may be toxic, act centrally |
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Term
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Definition
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Term
| scopolamine (Transderm Scop)* |
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Definition
| Drug used for Motion Sickness |
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Term
| dimenhydrinate (Dramamine) |
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Definition
| Drug used for motion sickness |
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Term
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Definition
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Term
| Actions of motion sickness drugs? |
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Definition
| Suppress nerve stimulation in CNS |
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Term
| What are anticholergenic effects (those associated with motion sickness drugs)? |
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Definition
| dry mouth, blurred vision, drowsiness, urinary retention, constipation |
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Term
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Definition
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Term
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Definition
infection (E. coli)
GI disease
change in diet
nervousness and anxiety
allergic reaction
intoxication
side effect of medications |
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Term
| Causes of Chronic Diarrhea |
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Definition
malabsorption syndrome
inflammatory bowel disease
endocrine disorder |
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Term
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Definition
symptomatic relief
decrease in number & volume of stools in patients with ostomies |
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Term
| bismuth subsalicylate (Pepto-Bismol) |
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Definition
| Local acting antidiarrheal |
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Term
| kaolin (Kaopectolin), attapulgite (Rheaban) |
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Definition
| Local acting antidiarrheals |
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Term
| paregoric (tincture of opium) |
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Definition
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Term
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Definition
| systemic antidiarrheal (opioid) |
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Term
| diphenoxylate/atropine (Lomotil)* |
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Definition
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Term
| difenoxin/atropine (Motofen) |
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Definition
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Term
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Definition
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Term
| How to opioids help with diarrhea |
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Definition
| Activate opioid receptors in the GI tract, decrease intestinal motility, slow intestinal transmit, more time for fluids and electrolytes to be absorbed |
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Term
| what is Irritable Bowel Syndrome |
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Definition
| Intermittent diarrhea/constipation |
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Term
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Definition
| Only approved for women with severe diarrhea-inducing IBS dangerous |
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Term
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Definition
| Discontinued, Now available with restricted use for women younger than 55 with IBS with diarrhea |
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Term
| Ulcerative Colitis Agents |
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Definition
sulfasalazine (Azulfidine)
mesalamine (Rowasa)
olsalazine (Dipentum) |
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Term
| Ulcerative Colitis agent actions |
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Definition
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Term
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Definition
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Term
| sibutramine (Meridia) action |
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Definition
| Increases serotonin (SE), norepinephrine (NE), and dopamine in brain |
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Term
| sibutramine (Meridia) adr's |
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Definition
| headache (HA), dry mouth, constipation, insomnia, nervousness, anxiety,Small increase in BP and HR |
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Term
| contraindications of use of sibutramine (Meridia) |
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Definition
| use of other serotonin type drugs |
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Term
| orlistat (Xenical, Alli) action |
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Definition
| Decreases absorption of fat by blocking enzymes used to break down fat |
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Term
| Adrs of orlistat (Xenical, Alli) |
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Definition
| May have incontinence, flatulence, greasy stools, fecal urgency, flatus with discharge |
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