Compare and contrast traditional drugs, biologics, and complementary and alternate medicine (CAM) therapies. 

• a.       TRADITIONAL DRUGS ARE MEDICATIONS WHICH HAVE GONE THROUGH RIGOUROUS TESTING AND APPRROVAL PROCESSES
• b.      BIOLOGICS ARE MEDICACATIONS WHICH ARE PRODUCED BY THE BODY
• c.       COMPLENENTARY AND ALTERNATIVE MEDICINE THERAPIES ARE THINGS SUCH AS HERBS, VITAMINS, PHYSICAL THERAPY, ACCUPUNCTURE, ETC…
•  

a.       PRESCRIPTION DRUGS ARE DRUGS WHICH MUST BE PRESCRIBED TO SOMEONE BY A DOCTOR AND ARE USUALLY MEDICATIONS WHICH HAVE A HIGH CHANCE OF BEING ABBUSED OR CERTAIN DRUGS WHICH ARE DIFFICULT TO PRODUCE.

b.      OVER THE COUNTER (OTC) DRUGS ARE DRUGS WHICH POSE SMALL RISK FOR ABBUSE AND ARE EASILY PRODUCED

Discuss the role of the U.S. Food and Drug Administration (FDA) in the drug approval process. 

a.       THE FDA CONTROLS THE APPROVAL OF A DRUG FROM THE VERY INCEPTION TO THE FINAL APPROVAL PROCESS. THE PROCESS CAN TAKE MANY YEARS AND THE QUALITY ASSURANCE CONTROLS IN PLACE ARE VERY HIGH 

Drug Enforcement Administration

a.       PRECLINICAL PHASE: DRUGS ARE TESTED ON ANIMALS

b.      CLINICAL INVESTIGATION: HEALTHY HUMAN VOLUNTEERS AND LARGE GROUPS OF PATIENTS WITH DISEASE ARE TESTED

c.       NEW DRUG APPLICATION: IF THE DRUG APPEARS TO WORK THEN THE DRUG IS REVIEWED FOR APPROVAL BY THE FDA

d.      POST MARKETING SURVEILLANCE: THE DRUG IS MARKETED FOR GENERAL USE WHILE MONITORING THE DRUGS EFFECTS

Prototype drug

generic name

trade name

Combination drug

Bioavailability

Addiction

Dependence

Scheduled drugs

a.       THE MECHANISM OF ACTION IS HOW A DRUG PHYSIOLOGICALLY AFFECTS THE BODY

 Explain the differences between brand-name drugs and their generic equivalents

a.       AFTER 17 YEARS A BRAND NAME DRUG IS AVAILABLE TO OTHER COMPANIES TO PRODUCE. USUALLY THE DRUGS ARE THE SAME BUT SOMETIMES THERE CAN BE DIFFERENCES IN THE FORMULAS

Absorption

Distribution

Metabolism

Excretion

 Discuss factors affecting drug absorption.

a.       THE FORM THE MEDICATION TAKES

b.      THE ROUTE THE MEDICATION TAKES

c.       CONCENTRATION OF THE DRUG

d.      BODY COMPOSITION

Toxic concentration

Therapeutic range

Plasma half-life 

Loading dose

Maintenance dose

Onset

peak 

duration 

1Explain the applications of a drug’s onset, peak, and plasma half-life to duration of pharmacotherapy. 

a.       WHEN CONSIDERING THE PROPER COURSE OF TREATMENT THE COURSE OF THE DRUG IS TO BE CONSIDERED. FAST ONSET CAN BE USEFUL IN EMERGENCY SITUATIONS WHEN LIFE SAVING DRUGS ARE NEEDED. A LONG HALF LIFE AND PEAK ARE USEFUL WHEN CONSIDERING A CONDITION WHERE LEVELS OF A DRUG ARE NEEDED TO BE MAINTAINED SUCH AS WITH ANTI-PSYCHOTICS

a.AN AGONIST IS A DRUG THAT PRODUCES THE SAME OR GREATER TYPE OF RESPONSE AS THE ENDOGENOUS SUBSTANCE

b.A PARTIAL AGONIST IS A DRUG THAT PRODUCES ONLY SLIGHTLY THE SAME EFFECT AS THE ENDOGENOUS SUBSTANCE 

c.AN ANTAGONIST IS A DRUG THAT PREVENTS THE ENDOGENOUS SUBSTANCE FROM ACTING ON A RECEPTOR 

a.       DRUGS ARE DESIGNED TO AFFECT CERTAIN RECEPTORS IN THE BODY WHICH IN TURN EITHER RELEASE OR BLOCK CERTAIN ENDOGENOUS CHEMICALS. DRUGS ARE NORMALLY TAILORED SPECIFICALLY TO AFFECT CERTAIN NEUROTRANSMITTERS.

 List, in order, the different steps of the nursing process.

a. ASSESSMENT: FIRST EXAMINING THE PATIENT AND GATHERING BASELINE DATA

b. DIAGNOSING: ANALYZE DATA GATHERED DURING ASSESSMENT AND THEN WORK TO DETERMINE WHAT HEALTH PROBLEMS THERE MAY BE

c. PLANNING: MAKING A CARE PLAN FOR THE PATIENT THAT IS TAILORED TO THEIR EXACT NEEDS

d. IMPLEMENTING: ENSURING THAT THE CARE PLAN DRAWN UP IS CARRIED OUT. IMPLEMENT ANY NURSE INTERVENTIONS THAT ARE DETERMINED TO BE NECESSARY

e. EVALUATING: FOLLOW UP AFTER TREATMENT HAS BEEN GIVEN. RE-ASSESS TO DETERMINE IF PATIENT REQUIRES ANY OTHER INTERVENTIONS AND IF CARE PLAN IS WORKING

Polypharmacy

Genetic polymorphism

Pharmacogenetics

1.      Identify the 5 categories of teratogenic drug classification.

a.       CATEGORY A: ANIMAL AND HUMAN STUDIES HAVE SHOWN NO RISK TO FETUS

b.      CATEGORY B: ANIMAL STUDIES HAVE SHOWN NO HARM BUT NO HUMAN STUDIES EXIST; POSSIBLE RISK

c.       CATEGORY C: ANIMAL STUDIES HAVE SHOWN AN ADVERSE EFFECT BUT NO HUMAN STUDIES EXIST; SLIGHT RISK

d.      CATEGORY D: HUMAN STUDIES HAVE SHOWN A RISK TO FETUS; MODERATE RISK

e.      CATEGORY X: HUMAN AND ANIMAL STUDIES HAVE SHOWN POSITIVE FETAL ABNORMALITIES OR LARGE RISK; LARGE RISK, DO NOT USE

       Identify the differences that a nurse should be aware of when administering medications to children and older adults? 

a.       WHEN ADMINISTERING MEDICATION TO CHILDREN BE GENTLE AND DO NOT CAUSE UNDUE STRESS. BE SURE TO CHECK DOSAGE IS CORRECT FOR A CHILD. TAKE GREAT CARE WHEN ADMINISTERING ANY MEDICATION IV OR IM.

b.      WHEN ADMINISTERING MEDICATION TO OLDER ADULTS MAKE SURE TO TREAT THEM WITH THE SAME RESPECT YOU WOULD GIVE A MIDDLE AGED ADULT. BE SURE TO PROVIDE CLEAR AND PRECISE INSTRUCTIONS. ENSURE THE PATIENT IS ALLOWED TO HELP AS MUCH AS POSSIBLE.

       Explain the roles of complementary and alternative medicine in promoting patient wellness. 

a.       OFFERING CAM’S TO PATIENTS CAN OFTEN BE AS BENEFICIAL AS BIOLOGICAL AND TRADITIONAL MEDICINE. MASSAGE IS A VERY EFFECTIVE ACCOMPANIMENT TO STANDARD TREATMENT FOR MOST CONDITIONS.

a.       THE NURSE IS TO MAKE ANY AND ALL ACCEPTABLE FORMS OF TREATMENT AVAILABLE TO THE PATIENT. THE NURSE WILL ALSO EDUCATE AND ENCOURAGE THE PATIENT TO SEEK AS MANY POSITIVE AVENUES OF TREATMENT AS POSSIBLE

a.       IN THE EVENT OF A CATASTROPHIC EMERGENCY HAVING READY ACCESS TO CRITICAL DRUGS WILL HELP WITH CONTROLLING THE PROBLEM AS WELL AS HELPING SAVE MORE LIVES IN THE EVEN OF AN EMERGENCY

Strategic National Stockpile

Anthrax

Gastric lavage

Activated charcoal

Whole bowel irrigation

       Identify important divisions of the peripheral nervous system.

a.       MOTOR NEURONS

                                                               i.      SOMATIC NERVOUS SYSTEM

                                                             ii.      AUTONOMIC NERVOUS SYSTEM

1.       SYMPATHETIC DIVISION

a.       ADRENERGIC RECEPTORS

                                                                                                                                       i.      ALPHA

                                                                                                                                     ii.      BETA

1.       PARASYMPATHETIC NERVOUS SYSTEM

a.       CHOLINERGIC RECEPTORS

b.      SENSORY NEURONS

1.       Compare and contrast the actions of the sympathetic and parasympathetic divisions of the Autonomic nervous system.

a.       SYMPATHETIC DIVISION IS THE “FIGHT OR FLIGHT” PORTION. IT PREPARES THE BODY FOR ACTION BY DILATING THE PUPILS, RELEASING ADRENELINE, EXPANDING THE BRONCHIOLES, ETC…..

b.      PARASYMPATHETIC DIVISION IS THE “REST AND DIGEST” PORTION. IT PREPARES THE BODY TO REST BY INCREASING GASTRIC JUICE OUTPUT, CONSTRICTING THE PUPILS AND BRONCHIOLES, STIMULATING SEX ORGANS, ETC….

Central Nervous System

Sympathetic Division

Parasympathetic Division

Cholinergic Receptors

Neurotransmitters

Sympathomimetics

Adrenergic antagonists

Parasympathomimetics

Anticholinergics

Orthostatic Hypotension

Phenylephrine (Neo-Synephrine)

Epinephrine

Prazosin (Minipress)

Bethanechol (Urecholine)

Physostigmine (Antilirium)

Atropine

Identify the major types of anxiety disorders.

generalized anxiety disorder (GAD)

- panic disorder

- phobias

- social anxiety

-  obsessive-compulsive disorder (OCD)

- post-traumatic stress disorder (PTSD)  

Identify the regions of the brain associated with anxiety, sleep, and wakefulness.

a)      LIMBIC SYSTEM- AREA OF THE BRAIN RESPONSIBLE FOR EMOTIONAL EXPRESSION, LEARNING, AND MEMORY

b)      RETICULAR FORMATION- NETWORK OF NEURONS WHICH CONNECT THE HYPTHALMUS

c)       RETICULAR ACTIVATING SYSTEM- RESPONSIBLE FOR SLEEPING AND WAKEFULNESS

  Identify the three classes of medications used to treat anxiety and sleep disorders.

a)      ANTIDEPRESSANTS

b)      BENZODIAZEPINES

c)       BARBITURATES

escitalopram oxalate (Lexapro)

lorazepam (Ativan)

zolpidem (Ambien)

General anesthesia

Local anesthesia

A.      OCCURS WHEN SENSATION IS LOST IN A CERTAIN AREA OF THE BODY

  Epidural

A.      INJECTION INTO EPIDURAL SPACE OF THE SPINAL CORD; MOST COMMONLY USED DURING LABOR AND DELIVERY

A.      DIRECT INJECTION INTO TISSUE IMMEDIATE TO THE SURGICAL SITE; DRUG DIFFUSES INTO TISSUE TO BLOCK  A SPECIFIC GROUP OF NERVES 

  nerve block

A.      DIRECT INJECTION INTO TISSUE THAT MAY BE DISTANT FROM THE OPERATING SITE; BLOCKS NERVE BUNDLES SERVING A SPECIFIC AREA

A.      INJECTION INTO THE CEREBRAL SPINAL FLUID; DRUG AFFECTS LARGE, REGIONAL AREA SUCH AS THE LOWER ABDOMEN AND THE LEGS

Balanced Anesthesia

Malignant hyperthermia

Lidocaine (Xylocaine)

Nitrous oxide

Fentanyl (Sublimaze)

Succinylcholine (Anectine)

ANY PREVENTABLE EVENT THAT MY CAUSE OR LEAD TO INNAPROPRIATE MEDICATION USE OR PATIENT HARM 

Describe organizations that are involved with medication safety

A.      U.S. FOOD AND DRUG ADMINISTRATION (USDA)

B.      U.S. PHARMACOPEIA (USP)

C.      INSITITURE FOR SAFE MEDICATION PRACTICES (ISMP)

D.      THE JOINT COMMISSION

Differentiate between the various medication delivery systems

A.      UNIT DOSE SYSTEM- MEDICATIONS PACKAGED INDIVIDUALLY

B.      MULTIPLE DOSE SYSTEMS- MORE THAN ONE DOSE IN A CONTAINER

C.      AUTOMATED MEDICATION DISPENSING SYSTEMS- COMPUTER STORAGE AND DISPENSING

    SIX RIGHTS OF MEDICATION ADIMINISTRATION

a.       RIGHT PATIENT

b.      RIGHT DRUG

c.       RIGHT DOSE

d.      RIGHT ROUTE

e.      RIGHT TIME

f.        RIGHT DOCUMENTATION

a.       WHEN COLLECTING THE MEDICATIONS

b.      PRIOR TO ENTERING THE PATIENTS ROOM

c.       AT THE BEDSIDE

 Describe point-of-care barcode technology and how it improves the accuracy of medication

A.      WITH THIS TYPE OF TECHNOLOGY IT ALLOWS THE NURSE TO CHECK ELECTRONICALLY THAT THEY HAVE THE RIGHT PATIENT BEFORE THEY ADMINISTER THE MEDICATION WHICH HELPS WITH CONFUSION 

Explain the proper methods of administering oral drugs.

a.       CHECK FOR ALLERGIES

b.      CHECK LABEL THREE TIMES

c.       OPEN UNIT DOSE AT BEDSIDE

d.      POUR LIQUID AT EYE LEVEL

e.      RECHECK DRUG CALCULATION OF A DOSE WITH ANOTHER NURSE AS NEDDED

f.        ADMINISTER ONLY DRUGS THAT YOU HAVE PREPARED

g.       PREPARE MEDICATION FOR ONE PATIENT AT A TIME

h.      DO NOT OPEN WRAPPER UNTIL YOU ARE AT THE BEDSIDE

  Differentiate between the types of medication orders.

a.       WRITTEN ORDER

b.      TELEPHONE ORDER

c.       VERBAL ORDER

d.      COMPUTER ORDER

  Identify the components of a medication label.

a.       CHEMICAL COMPOSITION

b.      WHAT DISEASE OR DISORDER THE DRUG IS USED TO TREAT

c.       PRESCRIBING GUIDELINES

d.      KNOWN ADVERSE DRUG REACTIONS AND INTERACTIONS

e.      WARNINGS AND CAUTIONS ABOUT THE USE OF THE DRUG

   SOLID MEDICATIONS

                                                               i.      TABLETS

                                                             ii.      CAPSULES

                                                            iii.      GRANULES

                                                           iv.      CHEWABLE

                                                             v.      COATED

                                                           vi.      EFFERVESCENT

                                                          vii.      MODIFIED RELEASE

                                                        viii.      MULTILAYER

                                                           ix.      SOLUBLE

                                                             x.      TROCHE

                                                           xi.      LOZENGE

a.       SOLUTIONS

b.      SUSPENSIONS

c.       EMULSIONS

d.      ELIXIRS

e.      SYRUPS