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What is a drug?
Any chemical that affects the physiologic processes of a living organism.
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What are the 4 types of drugs?
- 1.Prescription-dispensed upon an order of a license helathcare provider
- 2.Non-prescription-over the counter drug
- 3.Controlled substance-potentially addictive substances/medications
- 4.Recreational-illicit drugs. not approved for treatment or disease
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What is the chemical name of a drug?
Describes the drugs chemical composition and molecular structure.
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What is the generic name of a drug?
Name given by the united states adopted name council.
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What is the trade name of a drug?
registered trademark name.
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Ibuprofen, Mortion, 50 mg, PO, daily. Mortion is the what name?
Trade name.
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What is Pharmaceutics?
Study of how various drug forms influence pharmacokinetic and pharmacodynamic activities.
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The study of the body absorbs, distriubtes, metabolizes, and excretes a drug is what?
Pharmacokinetics
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As the drug metabolizies and it passes the liver first and then into the circulation is called?
First-Pass effect
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Which routes go throught the first pass effect?
- -Hepatic arterial
- -oral
- -portal venous
- -rectal
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What are the routes of administering a drug?
- -Eternal route- drug absorbed into the systemic circulation through the oral or gastric mucosa
- -Parenteral rote- only doctors right orders for. All by pass the first-pass effect
- -Topical-localized areas that will only be used in that area
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What is the most common blood protein?
Albumin
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What carries the majority of protein bound drug molecules. If another drug binds, there will be a limited amount of the drug that is not bound.
Albumin
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What is unbound or a "free drug"?
Drug that the body can use
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Metabolism/Biotransformation of a drug is what?
- - an inactive metabolite.
- - a more soluble compound
- - a more potent metabolite
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What are the factors that decrease metabolism?
- -Cardiovascular dysfunction
- -Renal insufficiency
- -Starvation
- -Obstructive jaundice
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What is excretion of a drug?
- The elimination of drugs from the body.
- -Kidney
- -Liver
- -Bowel
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What excretion of a drug by intestines, taken by liver, released into bile and then eliminated in feces?
Biliary excretion
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How is a drug absorbed in an enterohepatic recirculation?
Drug in bile, reaborbed into bloodstream, return to liver, then again secreted into the bile.
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What is the primary process involved in drug excretion and the approximate location where these processes take place in the kidneys?
Glomerular filtration rate
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What is half time?
The time it takes for one original amount of a drug to be removed from the body.
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How long does it take most drugs to be considered effectively removed?
about five half lives
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The physiological state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose. Is what?
the steady state
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What are drug actions?
The cellular processes involved in the drug and cell interaction.
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What is the drug effect?
The physiological reaction of the body to the drug?
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The time it takes for a drug to elicit a therapeutic response, is when?
Onset, also known as the absorption time.
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The time a drug concentration is sufficient to elicit a therapeutic response, is when?
Duration, the whole process of absorption to elimination.
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The time it takes for a drug to reach its maximum therapeutic response, is when?
Peak, right before distribution starts.
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What is the peak level?
The highest blood level. Blood level too high then drug toxicity occurs.
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What is the trough level?
The lowest blood level. Blood level too low at therapeutic levels.
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How does a drugs produce therapeutic effects?
1. Increase/decrease the rate at which the cells or tissues function.
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What are the 3 ways drugs can exert their actions?
- 1.receptor interactions
- 2.enzyme interactions
- 3.nonselective interactions
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What is pharmacodynamics?
Concerned with the mechanisms of a drug and its action in living tissues.
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The ratio of a drug's toxic level to the level that provides therapeutic benefits is referred to as?
Therapeutic index. A low index indicates that a drug may have a more chance of having an adverse reaction and causes more monitoring.
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What is tolerance to a drug?
A decreasing response to repeated drug doses.
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what is dependence to a drug?
- A physiological or psychological need to a drug.
- -Physical dependence=needs drug to avoid symptoms
- -Psychologic dependenc=addiction
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What are the TJC National Patient Safety Goals for administering meds?
- 1. The nursing process is the foundation for medication administration.
- 2.Ensuring patient safety is the nurse's primary responsibility in administering medication.
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How many identifiers are required to administer meds? And what are they?
- 2 idenitifers
- Name and DOB
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What to look for on the patients id bracelet?
2 idenitifers and any known allergies
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How many times should you check the medication before administering? How many signatures required for high alert drugs?
check 3 times before administering. 2 signatures required.
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When charting medications on the MAR what are you charting?
- 1.Therapeutic responses
- 2.Adverse reactions
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True/False.
It is okay to leave the patient if they have not finished all their meds.
False, never leave medications on the bedside table or meal trays
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Single dose/Unit dose are distruibuted and stored where?
Distributed by pharmacy and stored in the med cart
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Stock meds are distributed by and stored where?
Distributed by nurse. Stored on unit.
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What are the components of a Physician orders?
- 1.Client full name
- 2.Date & time
- 3.Drug name
- 4.Drug dose
- 5.Route
- 6.Frequency
- 7.Signature
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What are the six rights?
- Right...
- -Medication
- -Dose
- -Route
- -Patient
- -Time
- -Document
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What are the forms of medications?
- -solid (pill form)
- -liquid
- --Troche (lozenge)
- --Aerosol (inhalers)
- --sustained release (not crushable pills)
- -Topical (eye drop)
- -Parenteral (IV & injections0
- -Suppositories
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True/False.
Oral (PO) is the easiest and most common route for patients.
True.
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Which route of a drug prevents destruction of a drug in the GI. Allow rapid absorption into bloodstream. No fluids allowed. Can not swallow.
Sublingual and Buccal
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After administering a topical route (eye drops) how long should you apply pressure to the patients nasolacrimal duct.
30 to 60 seconds
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What is the difference between side effects and adverse effects?
- S/e=are predictable and unavoidable
- A/e=unintendeds, undesirable, and unpredictiable
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What is a idiosyncratic reactions?
an abnormal and unexpected response to a medication, not an allergic reaction.
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The effect of two medications that is greater than the effect of one medication given separately is known as a?
Synergistic effect
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What are the steps in a collaborative process in regards to drug administration?
- 1.physician writes the order
- 2.pharmacist checks and fills/inputs medication orders
- 3.nurse checks and administers the meds & documents
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What are the nurses responsibilites in drug administrations?
- Correct adminstration
- Assessment & interventions for therapuetic reactions and adverse effects of the medication
- Ready to respond to adverse/side effects
- First to respond to drug responses
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Where should you be looking when assessing patient?
- chart
- medical records
- diagnostic studies
- interview with families/client
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True/False.
Never tell the patient what drug they are getting, why they are getting it, effectiveness and route of the drug.
False. Always tell patient.
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What are tips for teaching about drugs?
- be positive
- include significant others
- emphasize to take drug as prescribed
- provide written instructions
- space instructions over serval sessions
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What are the two ethical nursing practices?
- American Nurses Association (ANA)
- International Council of Nurses (ICN)
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What is the nursing responsibilities under the ANA?
Respect the rights, dignity, and wishes of each client.
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True/False.
Clients have the right to refuse drugs, be informed about their drugs, drug actions, and any side effects.
True.
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In the US, who has to approve all prescription drugs?
FDA
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What are the FDA approval process steps?
- 1.Preclinical testing
- 2.Clinical studies
- 3.Investigational drug studies
- 4.Expedited drug approval
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What are the clinical phases of investigational studies?
- Phase I-small groups of healthy adults
- Phase II-volunteers w/ the disease
- Phase III-Large groups of pts. w/ medical researchers
- Phase IV-post market studies
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List the ethical principles involvoing human subjects.
- Autonomy-respect for the person
- Beneficence-duty not to harm others
- Justice-be fair to all patients
- Veracity-tell the truth
- Confidentiality-respect privileged information
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The RN is responsible for what in a drug study?
- Promotes individual autonomy
- Protects clients from harm
- Avoids fraud in health care
- Encourage professionals to be thorough and clear in communicating information
- Promotes educated decision making among clients
- Promotes of self-determiniation of the client
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What is drug polymorphism?
The effect of a patient's age, gender, size, and body composition and other variables on the client's ability to metabolize specific drugs
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What theraphy maintains the integrity of body functions while patient is recovering from illness or trauma?
Supportive theraphy
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What theraphy supplies the body with a substance needed to maintain normal function?
Supplemental theraphy
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What theraphy involves more intensive drug treatments and is implemented in the acutely ill or even critically ill?
Acute theraphy
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What theraphy goal it to make the patient as comfortable as possible. Typically used in the end stages of an illness when all else has failed.
Palliative theraphy
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What theraphy typically does not remove a problem the patient has but does prevent progression of a disease or condition?
Maintenance theraphy
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