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Mechanism of action
how a drug producces ites effect in the body
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Prototype drug
drug model with which other drugs in its representative class are compared
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Chemical name
assigned using standard nomenclature established by International Union of Pure and Applied Chemistry (IUPAC)
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Generic name
assigned by U.S. Adopted Name Council, easier than Trade names
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Trade name
assigned by company marketing the drug
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Combination drug
contains more than one active generic ingredient
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Bioavailability
physiologic ability of the drug to reach its target cells and produce its effect
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Dependence
physiologic/psychologic need for a substance
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Scheduled Drugs
- classified according to their potential for abuse
- I, II, III, IV, V
- I=highest dependency
- V=lowest dependency
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Controlled substance
drug whose use is restricted by the Controlled Substances Act of 1970 and later revisions
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Schedule I
- highest dependency and abuse potential
- heroin, lysergic acid diethlamide (LSD), marijana, and methaqualone
- limited or no therapeutic use
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Schedule II
- high dependency and abuse potential
- morphine, phncyclidine (PCP), cocaine, methadone, methamphetamine
- used therapeutically w/ prescription; some drugs no longer used
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Schedule III
- moderate dependency and abuse potential
- high psychological dependency
- anabolic steroids, codeine & hydrocodone w/ aspirin or Tylenol, and some barbiturates
- used therapeutically w/ prescription; some drugs no longer used
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Schedule IV
- lower dependency and abuse potential
- dextropropoxyphene, pentazocine, meprobamate, diazepam, alprazolam
- used therapeutically w/ prescription; some drugs no longer used
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Schedule V
- lowest dependency and abuse potential
- OTC cough medicines w/ codeine, diphenoxylate with atropine
- used therapeutically without prescription
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Allergic reaction
acquired hyperresponse of body defenses to a foreign substance (allergen)
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Anaphylaxis
severe type of allergic reaction that involves the massive, systemic release of histamine and otehr chemical mediators of inflammation that can lead to life-threatening shock
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5 Rights of Patient Drug Administration
- 1. right patient
- 2. right medication
- 3. right dose
- 4. right route of administration
- 5. right time of delivery
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3 checks of drug administration
- 1. Check drug with MAR, when pulling it from storage device
- 2. Check drug when preping
- 3. Check drug before administering to patient
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Compliance
taking a medication in manner prescribed by health care provider, or labels directions
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STAT order
any med needed immediately, only given once
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ASAP order
as soon as possible, within 30min of drug's written order
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Single order
drug that is to be given only once, at a specific time, ie preop order
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PRN order
administered as required by patient's condition
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Routine order
usually begin within 2 hr of written order (hospital environment)
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Standing order
written in advance of a situation that is to be carried out under specific circumstances
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Enteral route
drugs given orally and those administered through nasogastric or gastrostomy tubes
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Enteric-coated
tablets designed to dissolve slowly
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Sustained-release
tablets or capsules are designed to dissolve slowly
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Sublingual route
medication is placed under the tongue and allowed to dissolve slowly
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Buccal route
tablet or capsule is placed in oral cavity between gum and cheek
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Topical drugs
applied locally to skin or membranous linings of eye, ear, nose, respiratory tract, urinary tract, vagina, and rectum
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Topical differences
- Transdermal
- Ophthalmic
- Otic
- Nasal
- Vaginal
- Rectal
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Parenteral route
drug delivery via needle into the skin layers, subcutaneous tissue, muscles, or veins
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Intradermal injection
administration into the dermis layer of the skin
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Subcutaneous injection
- delivered to deepest layers of skin
- ie insulin, vaccines
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Intramuscular injection
delivers medication into specific muscles
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Pharmokinetics
study of drug movement or motionĀ
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Absorption
process involving the movement of a substance from its site of administration, across body membranes, to circulating fluids.
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Distribution
involves the transport of pharmacologic agents throughout the body
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Affinity
specific tissues/complexes have high attraction to certain medications
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Drug-protein complexes
drug-protein complexes are too large to cross capillary membranes, thus minimizing distribution of medication to appropriate tissues
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Blood-brain barrier
prevents specific chemicals and medications from crossing the membrane
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Fetal-placental barrier
prevents specific chemicals and medications from crossing the membrane
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Conjugates
added side chains, allowing for higher water solubility and more easily excreted by kidneys
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Hepatic microsomal enzyme system
metabolism in liver
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Prodrugs
medications that are not active until first metabolized within the body
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Enzyme induction
Ability to increase metabolic activity in liver by drug
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First-pass effect
important mechanism since a large number of oral drugs are rendered inactive by hepatic metabolic reactions
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Excretion
removal of drugs in body, rate of excretion determines concentration within bloodstream and tissues
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Enterohepatic recirculation
when expressed with bile, may be reabsorbed due to liver's affinity to reabsorb bile
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Minimum effective concentration
amount of drug required to produce a therapeutic effect
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Toxic concentration
level of drug that will result in serious adverse effects
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Therapeutic range
Between minimum effective concentration and toxic concentration
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Loading dose
higher amount of drug, given only 1-2x to prime bloodstream
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Maintenance dose
intermittent doses given to keep drug concentration in therapeutic range
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Assessment phase
Systemic collection, organization, validation, and documentation of patient data
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Baseline data
data gathered to compare to later readings/measurements
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Subjective data
gathering of data from what patient says or perceives
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Objective data
data gathered through physical assessment, lab tests, and other diagnostic sources
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Nursing Diagnosis
clinical judgements of a patient's actual or potential health problem that is within the nurse's scope of practic to address
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Planning phase
nursing process prioritizes diagnoses, formulates desired outcomes, and selects nursing interventions that can assist the patient to return to establish an optimum level of wellnes
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Outcomes
specifically define what the patient will do, under what circumstances, and within a specified time
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Implementation phase
when the nurse applies the knowledge, skills and principles of nursing care to help move the patient toward the desired goal and optimal wellness
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Evaluation phase
compares the patient's current health status with the desired outcome
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Medication error
'any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer'
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Medication Administration Record
source that should contain information about what medication was give or omitted, includes list of drugs patient is on or has been on
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Polypharmacy
patients who receive multiple prescriptions, sometimes for same condition, that have conflicting pharmacologic actions
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Medication reconciliation
process of 'keeping track' of a patient's medications as they proceed from one health care provider to another.
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