Ch 9 Pharmological Nursing

Principles of Safe Medication Administration

-Safely written Rx and Med Order
-Knowing the differences between trade and generic names
-Safe Mechanical Process of Administration
-Understanding Absorption, distribution, metabolism, and elimination.
-Routes of administration
-drug units of measurement

Harrison Narcotic Act

A federal law passed in 1914 that classified narcotics and established regulations governing their importation, manufacture, sale, and use.

Narcotics

Marijuana, opium, cocaine, and their derivatives, along with combined analgesics.

Properly written Drug Script

Provider information-Name, address, phone number, DEA number.
Superscription-Patient name, address, age DOB, and current date.
Inscription-Drug, Dose
Amount to be dispensed-number of units.
Route-how and when to take medication.
Provider Signature-with ti

Generic

The nonproprietary name of a drug. Active ingredient same as trade, but may contain different inactive ingredients and binding agents.

Trade Name

The name that a drug company has assigned to a product.

Chemical Name

A name that provides information about the chemical composition of a drug; these names are not used clinically but are of interest to research pharmacists and chemists.

Official Name

The name of a drug as published in the U.S. Pharmacopeia and National Formulary; this name may be identical to the drug's generic name.

pharmacokinetics

The combined processes of drug absorption, distribution, biotransformation, and excretion.

Drug Absorption

The entry of a drug into body cells by means of diffusion, active transport, or pinocytosis.

Diffusion

The process by which certain dissolved substances passively move back and forth across a cell membrane.

Active Transport

The process in which energy is expended in order to move a molecule across a cell membrane.

Pioncytosis

The process by which a hollowed-out portion of a cell's membrane encloses a substance and then carries it into the cell.

Routes of Absorption

Skin
Mucous Membrane
Oral
Inhalation
Injection (ID, SQ, IM, IV)

Drug Distribution

The process by which a drug is delivered throughout the body.

drug biotransformation

The process by which a drug is broken down and used by the body.

first pass effect

A term that refers to the absorption of a drug through the intestinal tract and the drug's entry into the portal circulation before entering the systemic circulation; this allows the liver to detoxify the substance before its wide distribution throughout

Prodrug

A drug that, upon biotransformation in the liver, produces active metabolites.

half-life (t�)

The length of time necessary for the concentration of a drug in a specific area of the body to decrease by 50 percent.

clearance

The rate of drug removal from the body.

Therapeutic Effects

Using the drug to meet the expected outcome.

Curative Drug

A drug that has healing as its therapeutic effect.

Palliative Drug

A drug that has the relief or alleviation of disease signs and symptoms as its therapeutic effect.

Prophylactic Drug

A drug that has the prevention of infection and disease as its therapeutic effect.

Diagnostic Drug

A drug that has certain effects that will rule in or rule out a specific disease.

Supportive Therapy

The promotion and maintenance of healing and/or normal physiologic processes.

Side Effects

Actions or effects of a drug that are not specifically intended.

iatrogenic effect

An illness that is induced in a client by a drug given for a treatment or therapeutic purpose.

adverse effects

Undesirable drug side effects that can range from tolerable or manageable to life threatening.
-Bone Marrow Supression
-Neurotoxic Reactions
-GI Irritation
-Hepatotoxicity
-Nephtotoxicity
-Ototoxicity
-Cardiotoxicity
-Respiratory Depression
-Alopecia
-Cut

toxic effects

Effects secondary to an elevated plasma concentration of a drug.

Allergic Reaction

Type I-IgE reaction. Mast cell release histamines. S/Sx: swelling, anaphylaxis, dyspnea, sneezing, rash, and rhinitis.
Type II-IgG and IgM. Hemolysis, fever, flank pain, wheezing, NV+D. Usually seen with blood transfusions.
Type III-immunine complex forma

Carcinogenic Reaction

Drug-induced changes in DNA, which may lead to the development of cancer.

Chain Reaction

The situation in which a drug causes a cascade of effects that each relate to the effects take took place before them.

cumulative effects

Effects that occur when the serum plasma level of a drug rises or when the amount ingested exceeds that excreted.

idiosyncratic reactions

Unexpected, abnormal reactions to a drug.

Teratogenic Reactions

Drug reactions that result in abnormal fetal development.

tolerance

A condition of decreased responsiveness to an agent after repeated exposure.

Dependence

A condition characterized by withdrawal symptoms upon discontinuation of a drug.

intradermal agents

Drugs that are administered between the layers of the skin.

Eye Drops and Ointments

Applied to local areas for local affects.

Ear Instillation

Drops or irrigation into the ear canal. For a child pull the lobe down and back, as an adult pull up and back.

Nasal Instillation

Sprays and metered doses. Puff into the nostril.

Vaginal Medication

Suppositories, foams, gels, creams directly into the vagina.

Rectal Instillations

Suppositories, creams, and enemas.

Inhalers

Metered-dose medication inhaled directly into the lungs.

nebulizer

A device that delivers a fine mist or spray; it may be used to deliver medication and moisture to the lungs.

Spinhaler

An inhaler that accepts capsules containing cromolyn or albuterol in powdered form; the capsule is punctured, and the inhaler then releases a powdered mist to be inhaled.

Rotahaler

An inhaler that accepts capsules containing cromolyn or albuterol in powdered form; the capsule is punctured, and the inhaler then releases a powdered mist to be inhaled.

titration

Adjusting a dose to achieve a desired effect.

FIVE RIGHTS

Right Patient
Right Drug
Right Dose
Right Time
Right Route
Patient also has the right to refuse and be informed what the drug does for them.

Therapeutic Index

A ratio of the dose of a drug that was lethal in 50 percent of the animals tested to the dose of the drug that was effective in 50 percent of the animals tested.

onset of drug action

The interval of time between the administration of a drug and the time at which the drug reaches a concentration that produces a
response.

Time to Peak

The interval of time between the administration of a drug and the time at which the drug reaches its highest effective concentration.

plateau/steady-state principle

The fact that, when a drug is given at fixed intervals, it takes four or five half-lives for its plasma concentration to reach a steady state or a plateau level.

Trough Level

The plasma concentration of a drug prior to the next dose.

acetylation

A drug biotransformation process that occurs in the liver. The rate at which the drug is metabolized at.