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pharm unit 1
multiple chapters
122
Nursing
Graduate
01/17/2012

Additional Nursing Flashcards

 


 

Cards

Term
5 steps in the nursing process
Definition

ADPIE

assesment

diagnosis

plan

implement

evaluate

Term
period in pregnancy that has the greatest danger fro drug-induced developmental defects?
Definition
first trimester
Term
in infant when can you give buttox injections?
Definition

at least when walking possibly 2-3

 

Term
why is absorbtion of drugs altered in the neonates?
Definition
itramuscular absorbtion faster and irregular, doesn't dissolve fluidly
Term
premi and young have an immature what?
Definition
liver-doesn't produce enough microsomal enzymes
Term
at what age are lungs mature?
Definition
9
Term
discuss how pediatric skin is different?
Definition
absorbs easy, but also irritates easy
Term
polypharmacy
Definition
prescribed many drugs, often from many diff. sources, always think about side effects
Term
the elderly are always fixated on what?
Definition
bowel movements
Term
what 2 drugs cause most readmissions for the elderly?
Definition
anticoagulants and insulin
Term
anticholinergics cause what problems in the elderly
Definition
GI function problems/bladder
Term
antidepressants cause what problems in the elderly
Definition
can cause BP to go too low
Term
how do cardiac glycosides work?(digoxin)
Definition
slows and strengthens heart
Term
orphan drugs
Definition
drugs that don't make money, but serve a purpose for a particular disorder
Term

Schedule I

 

Schedule II

 

Schedule III

 

Schedule IV

 

Schedule V

Definition

I- no acceptable med use-marijuana, LSD

II- high abuse and dependance narcotics, barbituates

III- mod. dependence sedatives, stimulants-Ritalin, Ambien

IV- less abuse potentials sedatives, non-narcotic analgesic

V-  limited potential for abuse, no rx but >18yo with ID-otc (behind counter)-cough syrup Terpenhydrate

Term

FDA Drug approval process

preclinical-

PH 1-

 

PH2

 

PH3-

 

PH4-

Definition

informed consent required for all four phases!

preclinical-lab animals

1.  healthy humans

2.  informed pt(they fully know drug may either kill or save them)

3. clinical implementation- wide spread use

4. continued evaluation-drug approved and used widespread

Term
mustard plaster
Definition
folk remedy- put on chest for cough/congestion
Term

8 med rights

normally 6

 

 

Definition

right patient

right drug

right storage*

right prep*

right dose

right time

right route

right charting

Term
what meds have higher opportunity for error
Definition

high alert meds

 

SALAD or LASA-sound alike and look alikes

Term
med error opportunities
Definition
procuring, prescribing, transcribing, dispensing, administering, monitoring
Term

can you use trailing zeros?

10.0

 

 

can you use leading zeros?

0.35

Definition

never use trailing zeros

10

 

always use leading zeros

0.35

Term
if med error occurs, what is first step?
Definition
report to prescriber then fill out occurance/incident report
Term
medication reconciliation
Definition

process that seeks to prevent med. errors through the ongoing assessment and updating of information on patients' meds throughout the healtcare process and the timely communication of this information to pts and their prescribers.

JCAHO requirement-automatic

Term
are alternative therapies regulated?
Definition

NO

think about Quality, Quanity, Purity

 

can interact with prescribed meds

toxicity

binding

Term

criteria for drug to have over-the-counter status

 

 

Definition

 indications for use-consumer must be able to easily diagnose condition, monitor effeciveness, benefits must outway risks

safety profile- drug should have favorable adverse event profile, limited interaction with other drugs, low potential for risk, high theraputic index

Practicality-easy to use, easy to monitor

 

Term
herbal products are considered
Definition

dietary supplements

 

Term
assess what things with use of herbs
Definition

system functions-esp. renal, liver, cardiac

 

conditions that are contraindicated

 

potential drug-drug and drug-herb interactions

Term
aloe
Definition

oral-treat constipation, cause bowel evacuation

can take up to 10hrs to work

monitor for deydration

topical-burns and skin irritation

Term
chamomile
Definition

oral (or tea)-restlessness, anxiety, motion sickness, D, indigestion

if allergic to ragweek family-may see anaphylaxis

not for use during pregnancy

amy increase anicoagulant effects

 

topical-inflammation, wound healing, burns

 

Term
cranberry
Definition

UTI prophylaxix or treatment

prevent renal calculi

use unsweetened for to prevent bacteria from adhering to bladder wall

 

Term
echinacea
Definition

used to prevent and treat common cold

supportive therapy, not replace antibiotic

Term
feverfew
Definition

prevent and treat migraines

hot flashes and menstral problems

rheumatoid arthritis

asthma

 

avoid use in pregnancy (abortifacient)

increase bleeding with anticoagulants or antiplatieltets

do not stop abruptly, tension headaches, insomnia, joint stiffness and pain, lethargy

Term
garlic
Definition

dec. cholesterol and triglyceride levels

age related vasc. changes

prevent GI CA

coughs, cold, fevers, sore throat

 

increase bleeding time if on anticoagulants

may have odor to breath/skin

raw form see more reaction

not use in diabetes, insomnia, pemphigus, rheumatoid arthritis, organ transplants

 

Term
Ginger
Definition

nausea, motion and morning sickness

GI upset (Flatulence, colic, indigestion)

High cholesterol, liver toxicity

burns, ulcers, depression

 

Inc. risk of bleeding, nosebleeds, bruising

caution in pregnancy and with other drugs

 

Term
Ginko Balboa
Definition

used as a memory improver

Alzheimer's , dementia, cerebral insufficiency

Intermittent Claudication

Tinnitius, HS

 

use for 6-8 wks, no longer than 3 mos

standardized:if at least 24% flavonoid glycosides and 6% terpene lactones

inc. effects of anticoagulants

50 seeds see seizure

Term
Ginseng
Definition

fatigue, improve concentration

atherosclerosis, strengthen resistance

 

inc. effects of anticoagulants

sided effects with lg. doses (diarrhea, nervousness, hypertension, edema, and rash, increased motor activity)

 

Term
Green tea
Definition

treat hyperlipidemia, prevent cancer

HA, mild diuretic, CNS stimulant

 

inc. effect of anticoagulants

causes restlessness, insomnia, palpitations, vertigo, HA,

milk decreases adverse effects

Term
Kava
Definition

stress, anti-anxiety, restlessness,

HA, seizures, colds

 

do not take with CNS depressants, MAOI, levodopa, antiplatelets, ETOH, anxiolytics

causes drowsiness

effects should be evident within 2 days

 

contraindicated in pregnancy and lactation

not use with st johns wart

Term
st johns wart
Definition

mild to mod. depression, anxiety

sciatica, viral infections

 

interacts with many drugs-not use if taking antidepressants or anit-anxiety meds

takes several weeks to be effective

stop if no response after 4-6 weeks

Term
Vitex
Definition

pms

take with water in the am

may take several cycles to ee action

Term
Yohimbe
Definition

aphrodisiac for impotence

causes CNS excitation, tremor, anxiety, inc BP and HR,

avoid if renal or hepatic toxicity

Term
who do you call for adverse effects of dietary supplementf or of any drugs or medical devices
Definition
FDA established-MEDWatch
Term
original source for all drugs?
Definition
plants!
Term
pharmacology
Definition

science of drugs, any chemical that affects the physiologica processs of a living organism

 

study of biological effects of chemicals

drugs trigger a change

theraputic

helpful

undesirable

dangerous

Term
pharmacognosy
Definition

the study of natural (plant and animal) drug sources

 

Term
four main sources for drugs
Definition

plants

animals

minerals

laboratory synthesis

Term
psyllium is?
Definition
plant- metamucil
Term
discuss synthroid
Definition
taken from thyroid of cows in the slaughter house
Term
what did insulin used to come from? and now?
Definition
used to be from pigs, now genetically engineered
Term
examples of inorganic drugs
Definition

iron tablet and

mylanta-aluminum

Term
example fo synthetic source of drug?
Definition
anticooagulant-arixtra
Term

chemical name

 

generic name

 

trade name

Definition

chemical name-chemical make up

 

generic name-nonpatented name-given by US Adopted Name Council

Trade name-proprietory name- registered trademark name, patent, usually by manufacturer

Term
pharmaceutics
Definition

the study of how  various drug forms influence pharmokinetics and pharmocodynamic activities

 

The science of preparing and dispensing drugs, including dosage from design

type affects what it does in the body

Term
pharmacokinetics
Definition

processing of drugs in the body

what body does to to drug

absorption

distribution

metabolism

excretion

Term
goal of pharmacokinetics?
Definition
get theraputic dose into the body
Term
dynamic equilibrium
Definition

actual concentration drug reaches in body

affected by absorbtion, distribution, biotransformation, excretion

Term

basic actions of drugs

4 things

Definition

Replace or act as substitute for missing

chemical

Increase or stimulate certain cellular

activities

Depress or slow cellular activities

Interfere with functioning of foreign cells

Term
drugs act by forming what?
Definition
chemical bonds with specific receptor sites, like a lock and key
Term
half life
Definition
the time required for half of an administered dose of drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50%
Term
first pass effect
Definition
the initial metabolism in the liver of a drug absorbed from the gi tract before the drug reaches systemic circulation through the bloodstream
Term
loading dose
Definition
give large dose first then less, to get meds on board to get therapeutic quicker
Term

dynamic equilibrium

 

Definition
the amt of drug that actually reaches the body results in a dynamic equilibrium
Term
drugs are sometimes absorbed in the _____ and not all excreted
Definition
tissues
Term
bioavailability
Definition

a measure of the extent of drug absorbtion for a given drug and route (0-100%)-ex. what is left after passes through stomach, liver, etc.  (first pass)

drugs given IV are 100% bioavailable- they bipass the liver,

Term
bioequivalent
Definition

if 2 drugs have the same concentration of active ingredients, they are equivalent

ex. generic vs. brand name drugs are often this

Term
absorbtion varies according to dosage from and route of
Definition


Food or fluids administered with the drug

Dosage formulation

 

Status of the absorptive surface

 

Rate of blood flow to the small intestine

 

Acidity of the stomach

 

Status of GI motility-ex. diarrha, constipation

 

Term
enteral route
Definition

the drug is absorbed into the systemic circulation through the oral or gastric mucosa or the sm. intenstine

oral

sublingual-under the tongue

buccal-cheek

rectal-(can also be topical)-enema, suppository, prep. H

Term
when give drug orally discuss metabolism
Definition
metabolized by liver before reaching systemic circulation
Term
parenteral route drug admission
Definition

by IV,

intra arterial (fastest del. into circulation)

intramuscular

subcutaneous-

intradermal

intrathecal-spinal

intraarticular

transdermal (can be considered parenteral)-on skin

Term

intramuscular-

 

 

subcutaneous

 

Definition

intramuscular (IM)-  into muscle, below subcutaneous fat

 

subcutaneous-into  fatty subcutaneous tissues, under dermal layer of skin

Term

intradermal-

 

intrathecal

 

intraarticular-

Definition

intradermal-  injections under the more superficial skin layers immediately underneath the epidermal layer(TB test)

 

intrathecal-  into the spinal chord(within a sheath)-subarachnoid space

 

intraarticular- within a joint

 

Term
topical routes of drug administration
Definition

skin, eyes, ears, nose, lungs, rectum, vagina(a little more acidic environment)

 

Term
distribution of drugs
Definition

movement of drug to body tissues

affected by solubility, ionization, perfusion

Term
protein binding
Definition

large, complex, cannot enter capillaries

if tightly bound are released slowly

if loosly bound act quickly

certain drugs compete with each other at site

drugs bind with the albumin mostly

only unbound drugs can leave the vascular system

Term
what type of drugs are often hard to eliminate
Definition
lipophilic-fat loving
Term
water soluble verses fat soluble drgs in relation to metabolism
Definition

water loving-hydrophilic are more easily metabolized

 

fat loving- lipophilic are difficult to eliminate

Term
discuss the blood brain barrier in relation to drug absorption 
Definition

barrier there to protect the CNS,

most drugs do not cross, ex. most antibiotics are not lipid soluble,

 

only lipids are more likely to cross

Term
do most drugs cross the placenta?
Definition
yes, and impact the fetus
Term

which type of meds are better for distribution, H2o sol or fat?

 

 

Definition
H2o soluble
Term

areas of body with rapid distribution of drugs...

 

slow....

Definition

rapid....heart, liver, kidneys, brain

 

slow...muscle, skin, fat

Term
drug actions
Definition
the cellular processes involved in the drug and cell interaction
Term
drug effect
Definition
the physiologic reaction of the body to the drug
Term

onset

 

peak

 

duration

Definition

onset- the time it takes for a drug to elicit a theraputic response

 

peak- the time it takes for a durg to reach its max. theraputic response

 

duration-the time a drug is conc. is sufficient to elicit a theraputic response

Term
what organ is most important with excretion?
Definition
kidneys
Term
excretion of drugs can happen  in what forms?
Definition
skin, saliva, lungs, bile, feces, kidnesy
Term

water soluble drugs are excreted by the process of _______ 

 

all other drugs are removed by________

Definition

water soluble-glomerular filtration

 

others-active transport

Term
why do we assess renal functioning with drug use?
Definition
to decrease toxicity risk
Term
pharmocodynamics
Definition

 

Science of dealing with interactions

 

between living organisms and foreign

 

chemicals

 

What a drug does to the body
Mechanism of drug actions in living tissues

 

Term
another name for metabolism
Definition
biotransformation
Term
all organs that aid in metabolism of drugs and which is primary?
Definition

liver-primary

skeletal muscle

kidneys

lungs

plasma

intestinal mucosa

Term
acetylator is influenced by what?
Definition
genetic ability to break down drugs at a specific rate, there are fast and slow acetylators
Term

factors that decrease metabolism

 

increase?

Definition

decrease-  cardiovascular dysfunction

renal insufficiency

starvation

obst. jaundice

slow acetylatory

erythromycin or ketoconazole drug therapy

increase-  fast acetylator

barbituate therapy

rifampin therapy(for TB)

Term
what happens when there is a delay in drug metabolism?
Definition

accumulation of drug in body

prolonged action of the drug-toxicity!

 

 

Term
stimulating drug metabolism causes?
Definition
diminished pharmocologic effects
Term
drug considered to be effectively removed after about how many half-lives?
Definition
five
Term
half life is affected by?
Definition
absorbtion, distribution, metabolism, excretion
Term
peak and trough
Definition

peak-highest blood level

trough-lowest blood level

Term
pharmacotherapeutics
Definition
use of drugs and clinical indications to prevent and treat diseases
Term
once drug is at site of action it can do what but not change what
Definition


 

can increase or decrease

rate at which cells or tissues function

but cannot make cell or tissue perform a function it was not designed to perform

 

 

Term

1.  emperical therapeutics

 

2.  rational theraputics

Definition

using shared knowledge to begin therapy before test results are positive

2.  waiting for confirmation-ex. chemotherapy

 

Term
contraindication
Definition

any characteristic of pt., esp. a disease state that makes use of a given medication dangerous

 

 

Term
tetracycline has an interaction when taken with what?
Definition
milk, alters absorbtion
Term

teratogenic

 

mutagenic

Definition

teratogenic- fetus danger

 

mutagenic-cellular danger

Term

pts on narcotics may build up a ____ to the drug

 

pts on sleeping pills may develop a ____ to the drug

Definition

Narcotics-tolerance

 

sleeping pills-dependence

Term

additive effect

 

synergistic effect

 

antagonistic effect

Definition

additive  1+1=2 (they are both equal together or seperate)

 

synergistic  1+1>2  (the combined effect is greater than each individual)

 

antagonistic  1+1< 2 (the combined effect is less than each individual, they block or reduce each other)

 

Term

side effect

 

verses

adverse effect

Definition

side effect-expected from studies and experience

may be tolerable and may subside

reason some people stop, but benefits may outweight the side effects

 

adverse effect-undesired, may be sudden and severe, need to stop medication immediately

 

 

Term

1.  cytotoxic reaction

 

2.  serum sickness reaction

 

 

Definition

1.  death of cells, break down

 

2.  horse syrum reaction to protein

Term
stomatitis
Definition

inflamation of mucous membranes

mouth, gut

see in antibiotics and chemo drugs

Term
to understand most drugs you need to understand how they affect what?
Definition
glucose!  this is key
Term

if hypoglycemic do what?

 

hyperglycemic?

Definition

hypo- low, administer foood or glucose

 

hyper- insulin

Term
some drugs affect auditory ..what nerve and what do you do.
Definition
8th cranial nerve., monitor loss, sometimes permanent and sometimes temp., discontinue meds and notify md
Term
alcohol has what effects?
Definition
diuretic
Term
effects of chronic ethanol ingestion
Definition

nutritional and vitamin deficiencies (B vit)

 

see physical changes, esp. nerve

Term
ethanol withdrawal if in severe DT's
Definition

hospitalize,

 

high BP, high temp, insomnia, high HR

tremors

agitation

 

ICU!

 

Term
ethanol withdraw treatment
Definition

benzo's -Diazapam(Valium), lorazapam (Ativan), chlordiazepoxide (Librium)

 

Disulfiram (Antabuse)-causes vomiting if drink alcohol

Term
nurses must be what 2 things when dealing with assessments with those suspected of drug abuse issues
Definition
nonjudgemental and observant
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