Term
| Therapeutic Classification |
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Definition
| ~usefulness in treating a particular disease |
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Term
| Pharmacologic Classification |
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Definition
| ~the way a drug works at the molecular, tissue, or body systems level |
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| ~feeling that drives a person to use a drug repeatedly |
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| ~a physiologic or psychologic need for a substance |
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Definition
| ~an altered physical condition caused by the adaptation of the nervous system to repeated drug use |
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Term
| Controlled Substance Classification |
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Definition
~I-highest abuse potential; limited or no therapeutic use Ex: heroin, LSD, ecstasy
~II-high abuse & dependence potential; Rx only; orders written, not called in; no refills permitted
~III-moderate abuse or physical dependence; high psychological dependence
~IV-lower abuse potential
~V-lowest abuse potential; available w/out Rx |
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Term
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Definition
~A-studies have failed to demonstrate a risk to the fetus in first trimester, or later trimesters
~B-animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well controlled studies in pregnant women
~C-animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks
~D-there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of drug in pregnant women despite potential risks.
~X-studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits |
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Term
| Nurse's Responsibility in Medication Administration |
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Definition
~know what is ordered, the name and classification
~intended use and effects on the body
~contraindications
~special considerations
~side effects/adverse effects
~why this is prescribed, how it is supplied, how it's to be administered, safe ranges
~nursing considerations |
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Term
| 9 Rights of Drug Administration |
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Definition
~right patient
~right medication
~right dose
~right route
~right time
~right to refuse
~right to education
~right preparation
~right documentation |
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| ~after meals/after eating |
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| ~every 2 hours (even or when first given) |
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~hyperresponse of the body to a foreign substance
~signs include-rash with or without itching; edema; runny nose; reddened eye |
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~severe allergy that involves massive, systemic release of histamine and other chemical mediators that can lead to life-threatening shock
~symptoms include-acute dyspnea; sudden hypotension or tachycardia following drug administration |
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Definition
| ~undesirable reaction of drug therapy |
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| ~drug reaction that is expected, not life-threatening |
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Term
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Definition
| ~taking a medication in the manner prescribed by the provider or following the instructions on the label |
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Term
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Definition
~Enteral:oral, nasogastric, or gastrostomy tube; sublingual; buccal
~Parenteral:intradermal ID; subcutaneous subQ; intramuscular IM; intravenous IV
~Topical: transdermal; opthalmic; inhalations; otic; nasal solutions; vaginal; rectal |
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Term
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Definition
~10-15 degrees
~avoids first pass effect
~allows only small volumes
~can cause pain and swelling |
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Term
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Definition
~45 degrees
~delivered into the deepest layer of skin
~used for easy access and rapid absorption
~sites must be rotated
~not typically aspirated |
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Term
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Definition
~90 degree angle
~delivers medication into a specific muscle
~more rapid absorption than PO, SQ, or ID
~allows larger volumes
~site is very important...must avoid bone, vessels, and nerves |
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Term
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Definition
~deltoid- used for vaccines, aspiration is not necessary
~ventrogluteal- BEST site for large volumes, void of vessels and nerves
~dorsogluteal- can hold large volumes, sciatic nerve and great vessels run behind this muscle
~vastus lateralis- largest muscle in infants and children |
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Term
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Definition
~delivered into vascular space
~rapid onset
~most dangerous due to contamination and rapid adverse reactions |
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Definition
~large volume infusion- fluid maintenance, replacement, or supplementation
~intermittent- small amount of fluid infusing in tandem with primary large volume fluids; used for medications
~bolus- concentrated dose delivered quickly, single dose medications |
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Term
| Advantages of Parenteral Medications |
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Definition
~bypass first pass effect and enzymes
~available to people unable to take oral meds |
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Term
| Disadvantages of Parenteral Medications |
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Definition
~only small doses can be used
~pain and swelling at injection sites |
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Term
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Definition
~drug is absorbed; enters into hepatic circulation in the liver
~metabolized to inactive form; conjugates and leaves the liver
~distributed to general circulation; most are inactive by this first pass effect |
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Term
| Fastest Rates of Absorption |
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Definition
~sublingual=3-5 mins
~IV=30-60 secs
~inhalation=3 mins |
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Term
| Mid to Slow Rates of Absorption |
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Definition
~PO=30-90 mins
~IM & SQ=3-20 mins |
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Term
| Slowest Rates of Absorption |
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Definition
~Rectal=5-30 mins
~sustained release medications |
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Term
| Factors Affecting Absorption |
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Definition
~route of administration
~drug formulation
~drug dosage
~digestive motility
~digestive tract enzymes
~blood flow at administration site |
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Definition
~transport of drugs thru the body; affected by the amount of blood flow to body tissues
~physical properties of the drug influence
~certain tissue has high affinity for certain medications |
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Definition
~blood brain: some drugs, sedatives, anti-anxiety,& anti-convulsants readily cross; other drugs, antoneoplastics, anti-tumor meds do not, making brain tumors difficult to treat
~fetal placental: this prevents potentially harmful chemicals from reaching the fetus; alcohol, cocaine, caffeine, and some Rx easily cross & harm the fetus |
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Definition
~also known as biotransformation
~changes the drug to be excreted
~involves biochemical reactions
~primarily occurs in the liver by process of hydrolysis, oxidation, or reduction
~conjugates, addition of side chains, make drugs water soluble and more easily excreted |
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Term
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Definition
~removal of a drug from the body
~rate determine the concentration of drugs in the bloodstream and tissues
~primary site is the kidneys
~concentration in the blood stream determines the duration of action |
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Term
| Factors Effecting Excretion |
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Definition
~liver or kidney impairment
~blood flow to organs
~degree of ionization
~lipid solubility
~drug protein complexes
~metabolic activity
~pH
~respiratory, glandular, or biliary activity |
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Term
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Definition
~length of time required for plasma concentration to decrease by half after administration
~the longer to be excreted, the greater the half life
~drugs with short half life are typically given more often |
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Term
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Definition
| ~higher amount of a drug to prime the bloodstream with a sufficient level of the drug |
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Term
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Definition
| ~smaller doses to keep the plasma level in a therapeutic range |
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Term
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Definition
~a more potent drug will produce a therapeutic effect at a lower dose
~example: morphine is more potent than Demerol, so it take less to achieve desired effect |
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Term
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Definition
| ~magnitude of maximal response that can be produced from a particular drug |
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Term
| Drug Receptor Interactions |
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Definition
~agonist: drugs that interact with a receptor
~antagonist: drugs that resist or oppose the action of another agent
~partial agonist: drug that produces a weaker response than an agonist |
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Term
| Nursing Process Assessment |
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Definition
| ~assessment: assess for desired response; monitor for adverse effects; capability of patient to self administer |
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| Nursing Process Diagnosis |
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Definition
~focus on patient's needs
~areas of concern: promote therapeutic drug effects; minimize adverse drug effects; maximize patient ability for self care |
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Term
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Definition
| ~establish goals and outcomes for safe and effective administration; therapeutic outcome; treatment of side effects |
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Term
| Nursing Process Implementation |
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Definition
| ~Involves ACTION: patient teaching; drug administration; demonstration; assessing the patient's response |
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Term
| Nursing Process Evaluation |
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Definition
~compare the patient's current health status with desired outcome
~did they meet the goal? |
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Term
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Definition
~most medications are avoided during pregnancy
~some conditions require treatment, such as epilepsy, HTN, & psychiatric disorders; antibiotics may be needed to treat infections or STI's.
~conditions caused by pregnancy must be treated/managed: gestational HTN or diabetes |
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Term
| Absorption Changes With Pregnancy |
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Definition
~hormonal changes
~blood supply to abdominal organs increases |
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Term
| Distribution and Metabolism Changes in Pregnancy |
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Definition
~increased cardiac output
~increased plasma volume
~altered blood flow |
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Term
| Excretion Changes in Pregnancy |
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Definition
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Term
| Medications Taken During Lactation |
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Definition
~most drugs are secreted in breast milk, however, few may cause injury to infant
~meds that completely contraindicated during lactation usually have safer alternative available
~meds should only be given if the benefit to the mother clearly outweighs the risk to infant |
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Term
| Typical Guidelines for Medications while Breastfeeding |
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Definition
~postpone pharmcotherapy until infant is weaned if possible
~take meds directly after a feeding
~patient teaching to avoid illicit drugs, tobacco
~drugs with shorter half life are preferred
~drugs with high protein binding are preferable, as they do not cross as readily into breast milk
~herbal and dietary supplements should be avoided |
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Term
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Definition
~infant= birth-12 months of age
~neonatal period is first 28 days of life
~goals of infant care are: safety first; proper dosing; complete amount of medication ingested
~droppers are typically used in inner cheeks; rectal meds should be held for at least 5-10 mins
~IM and IV require special considerations; smallest needle should be used
~doses are calculated by weight
~IM in vastus lateralis
~volumes <1mL can be given with TB syringe
~rotate injection sites
~IV sites can be found in feet and scalp |
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Term
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Definition
~age = 1-3 yoa
~never tell child that med is candy
~give short explanations and immediately follow with administration
~oral meds can be mixed with small amounts of jam, syrup, or fruit puree and followed with carbonated drink or mint candy
~IM in vastus lateralis
~IV meds in patent, secure site |
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Term
| Medications and Preschool |
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Definition
~ages 3-5 yoa
~administration techniques used for toddlers work with preschoolers |
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Term
| Medication and School Age Kids |
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Definition
~ages 6-12 yoa
~chewable tablets are easily taken; some may be able to swallow tablets or capsules
~IM in ventrogluteal sites |
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Term
| Medications and Adolescents |
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Definition
~ages 13-16 yoa
~common problems: skin problems; headaches; menstrual symptoms; eating disorders; contraception; alcohol and tobacco use; sports related injuries |
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Term
| Medications and Young to Middle Adults |
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Definition
~absorption, metabolism, and excretion are at their peak
~little medication is used except for chronic disease
~compliance is usually positive
~substance abuse is more common between 18-24 yoa
~Rx for treatment of STI's is very common |
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| Medications and Late Middle Age Adults |
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Definition
~health concerns start to arise: cardiovascular disease, HTN, obesity, arthritis, cancer, and anxiety
~use of drugs to treat these conditions is common
~respiratory disorders related to tobacco use may begin to be common |
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Term
| Medications and Older Adults |
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Definition
~age related physiologic changes alter therapeutic and adverse effects
~treatment of chronic health problems is common and more drugs are used to treat
~polypharmacy is a concern; taking multiple medications concurrently
~using multiple providers and pharmacies can make polypharmacy worse |
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Term
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Definition
~absorption is slower due to diminished GI motility and decreased blood flow to digestive organs
~distribution: increased body fat is storage area for lipid soluble drugs and vitamins; plasma levels are reduced; therapeutic response is less
~dehydration is dramatic due to decreased body water; increased concentration of water soluble drugs
~older liver produces less protein binding plasma, so free drugs circulate
~decreased cardiac output and less efficient circulation slows distribution |
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Term
| Age Effects on Drugs (cont) |
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Definition
~metabolism: liver produces less enzymes, visceral blood flow is diminished, resulting in reduced hepatic metabolism
~excretion: reduced renal blood flow, GFR, tubular secretion, and nephron function decreases excretion by the kidneys; leads to higher serum drug levels and potential for toxicity
~lower dosages and less frequent administration may by helpful |
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Term
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Definition
| ~social and psychological aspect of a person |
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Term
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Definition
~incorporates the capacity to love, convey compassion, give and forgive, enjoy life, and find peach and fulfillment
~greatly influence perception of illness and outcomes of therapy |
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Term
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Definition
~seek care for heart related issues more readily
~adherence is lessened due to side effects; ex: impotence and HTN meds |
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Term
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Definition
~pay attention to health patterns
~seek care earlier
~disease thought to be mainly women's issues |
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Term
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Definition
~any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in control of the health car provider, patient, or consumer
~error index: categorizes medication errors by evaluating the extent of harm an error can cause |
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Term
| Contributing Factors to Medication Errors by Healthcare Providers |
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Definition
~omit one of the 5 rights; incorrect dose, not the ordered dose, wrong drug
~failing to perform a system check; pharmacist and nurse check the order before administering
~failing to account for variables such as age, body size, renal or hepatic impairment
~giving meds based on verbal orders; may be misinterpreted
~giving meds based on incomplete or illegible order
~practicing under stress or with multiple high acuity patients |
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| Contributing Factors to Medication Errors in Patients |
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Definition
~seeing multiple providers, pharmacies, not sharing complete list of drugs
~not filling or refilling medications
~taking meds incorrectly
~taking leftover meds or something prescribed for another condition |
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Term
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Definition
~right drug
~right patient
~right dose
~right route
~right time |
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