Absorption
Process that occurs from the time a drug enters the body to the time it enters the bloodstream to be circulated. Effects of absorption: Dosage, form, route, blood flow to the area, presence of food, GI functioning.
Agonist
Drugs that produce effects similar to those produced by naturally occurring hormones, neurotransmitters, and other substances.
Bioavailability
the portion of a drug dose that reaches the systemic circulation and is available to act on body cells.
Biotransformation
referred to as METABOLISM; when drugs are altered from their original form into a new form by the body
Distribution
transport of drug molecules within the body. after a drug is injected or absorbed into the bloodstream, it is carried by the blood and tissue fluids to its sites of action, metabolism, and excretion. Most drugs enter and leave the bloodstream at the capil
Enterohepatic recirculation
drugs or metabolites that are excreted in bile, reabsorbed from the small intestine, returned to the liver, metabolized, and excreted in the urine
Enzyme Induction
stimulate liver cells to produce larger amounts of drug metabolizing enzymes. Accelerates drug metabolism because larger amounts of the enzymes and more binding sites allow larger amounts of a drug to be metabolized at a given time. Enzyme induction does
Enzyme Inhibition
INHIBIT production of drug metabolizing enzymes and often occurs with concurrent administration of two or more drugs that compete for the same metabolizing enzymes; occurs within hours or days of starting an inhibiting agent.
Excretion
Elimination from the body
First-Pass Effect
initial metabolism of some oral drugs as they are carried from the intestine to the liver by the portal circulatory system prior to reaching the systemic circulation for distribution to the site of action
Hypersensitivity
or allergy; may occur with any drug, is unpredictable and can produce a variety of reactions from rash, to anaphylactic shock
Leukopenia
abnormally low white blood cell count
Metabolism
the method by which drugs are inactivated or biotransformed by the body.
Nephrotoxicity
toxic or damaging effect of a substance on the kidney; potentially serious because renal damage interferes with drug excretion, causing drug accumulation and increased adverse effects
Pharmacodynamics
reactions between living systems and drugs; drug actions on target cells and the resulting alterations in cellular and biochemical reactions and functions.
Pharmacogenetics
study of genetic variations that result in interindividual differences in drug response
Pharmacokinetics
involves drug movement through the body to reach sites of action, metabolism, and excretion
Prodrug
drugs initially inactive and exert no pharmacologic effects until they are metabolized
Protein Binding
many drugs form a compound with plasma proteins, mainly albumin, which act as carriers. they allow part of a drug dose to be stored and released as needed
Serum drug level
a lab measurement of the amount of a drug in the blood at a particular time
Serum Half-Life
also called elimination half life, is the time required for the serum concentration for a drug to decrease by 50%
What are the four processes involved in pharmacokinetics?
Absorption, Distribution, Metabolism, Excretion
Why is distribution into the CNS limited?
Because the capillaries in the blood brain barrier are tightly walled and thus movement into the brain tissue is limited. Only drugs that are lipid soluble or have a transport system can cross the blood brain barrier and reach therapeutic concentration in
When a drug is given at a stable dose how many half lives are required to achieve steady-state concentrations and to develop equilibrium between tissue and serum concentrations?
Four or Five. Also, when a drug dose is changed an additional four to five half lives are required to re-establish equilibrium.
List the "six rights" of safe drug administration:
Right Drug
Right Dose
Right Patient
Right Route
Right Time
Right Documentation
What are the parts of a drug order?
Routine
One-Time
PRN
STAT (emergency/within 30min to an hour)
Verbal
You are reading a research report about use of medication that describes the pharmocokinetics of a particular medication that your patient is on. You know that pharmacokinetics involves:
a. drug effects on human cells
b. drug binding with receptors
c. dru
C. Pharmacokinetics involves drug absorption, distribution, metabolism, and elimination.
The nurse practitioner has just changed your patient's medication from an oral form to a patch formulation to avoid the 'first pass effect'. The NP has explained it to the patient, but the patient still has questions and asks you to explain again what is
d. Initial metabolism of an oral drug occurs before it reaches systemic circulation
You are caring for a patient who has worsening liver disease. In monitoring his medication it is important that you know that a patient with liver disease may have impaired
a. Absorption
b. Distribution
c. Metabolism
D. Excretion
C. Metabolism: hepatic d/o mainly interfere with metabolism. Severe liver disease or cirrhosis may interfere with all PK processes
A patient with an overdose of an oral drug usually receives:
a. a specific antidote
b. activated charcoal
c. syrup of ipecac
d. a strong laxative
b. activated charcoal
You are looking for information about the effects of a drug on different receptors. You know that characteristics of receptors include which of the following:
a. they are carbohydrates located in cell membranes or inside cells
b. they are constantly synth
b. Receptors are mainly proteins that are manufactured and eliminated like other proteins in the body. Their numbers and binding capacities can be increased or decreased in particular situations. Most receptors bind with relatively few drugs. Some drugs d
An important safety measure in drug administration is
a. calling patient by name
b. using appropriate techniques for the ordered route of administration
c. asking a coworker about an ordered drug
d. leaving meds at the bedside
b. There are definite techniques to increase the safety of all routes of administration (e.g., having the patient sit or stand to take an oral medication, using anatomic landmarks for IM injections). Calling the patient by name (if safer means are availab
You are caring for a patient who has been taking his medications with only a small sip of water. You counsel him to drink an 8 ounce glass of water with his tablets or capsules, because you know that it aids in which of the following pharmocokinetic proce
a. Tablets and capsules must be dissolved before the drugs they contain can be absorbed; a full glass of water aids dissolution and therefore absorption. Other pharmacokinetic processes are not significantly affected.
When administering medications by nasogastric tube, which of the following nursing actions is indicated?
a. verify the position of the tube before giving the drugs
b. aspirate and discard stomach contents
c. mix medications with tube-feeding formulas
d. h
. a. The position of the tube should be checked to ensure that the medications are instilled into the stomach and to decrease risks of drug aspiration into the lungs. If the nurse aspirates stomach contents to verify tube placement or measure the amount,
Maintaining sterile technique is necessary while administering which of the following types of medication?
a. oral suspensions
b. vaginal suppositories
c. nasal inhalation products
d. injections
d. Clean technique (e.g., clean hands) is needed for most medications; sterile technique is required for all injections.
Anatomic landmarks are very important in which of the following routes of drug administration?
a. oral
b. inhalation
c. intramuscular
d. topical
c. Anatomic landmarks must be used in selecting sites for IM injections because appropriate sites avoid the risk of damaging blood vessels and/or nerves. With oral, inhalation, and topical drugs, the appropriate site is usually quite clear.
During an initial nursing assessment, the patient reports that he is allergic to a particular medicine. The nurse should:
a. ask what symptoms occurred with the allergic reaction
b. conduct a detailed medical history and physical examination
c. disregard
. a. Patients often report mild nausea as an allergic reaction. The nurse needs to determine whether potentially serious effects occurred, such as difficulty breathing or urticaria. Calling any side effect an "allergic reaction" can result in the patient
Interventions to increase safety and effectiveness of drug therapy include
a. avoiding the use of nondrug measures during drug therapy
b. using multiple drugs to relieve most symptoms
c. teaching patients about their drug therapy regimens
d. avoiding inst
. c. Most drugs are self-administered by patients in their homes and teaching is needed. Using non-drug interventions and altering lifestyle habits can often decrease the need for medications or decrease the amount of medication required for therapeutic e
When evaluating a patient's response to drug therapy the nurse should keep in mind that
a. few drugs cause adverse effects
b. drugs may cause virtually any symptom or problem
c. patients usually report adverse drug effects without being asked
d. therapeut
. b. Most drugs produce a mixture of therapeutic and adverse effects and may cause essentially any sign or symptom of disease processes. Any drug may cause adverse effects; there is no such thing as an entirely 'safe drug.' Patients usually do not report
Considerations in individualizing drug therapy for a child include
a. age and development
b. equivalent drug selection and dosage for adults
c. length of illness
d. the child's usual diet
a. A child's age and developmental level affect drug pharmacokinetics and pharmacodynamics. Many drugs used for adults are not used for children and, when used, dosages generally need to be smaller than those for adults because of smaller size and weight
In teaching a patient about adverse effects of a newly ordered drug, which of the following should be included?
a. a detailed list of all potential adverse effects
b. percentages of particular adverse effects that occurred during clinical trials
c. advers
c. The nurse needs to emphasize adverse effects than can be seen or felt. A short, written list of common effects and how to manage them is helpful. Too much information can cause anxiety in the patient or family and decrease adherence to the medication r
Clinical Pathways:
Guidelines for the care of patients with particular conditions
Evidence Based practice
a conscientious and continuing effort to provide high quality care to patients by obtaining and analyzing the best available scientific evidence from research; the scientific evidence is integrated with the nurse's clinical expertise and the patient's pre
Medication History
information about a patient's use of prescription and non-prescription drugs
Nursing Process:
Assessment
Nursing Diagnosis
Planning/Goals
Interventions
Evaluation
Legal Responsibility Notes:
-when giving medications, the nurse is legally responsible for safe and accurate administration. The nurse may be held liable for not giving a drug or for giving a wrong drug or wrong dose. It's also nurses responsibility to have the knowledge to know whe
Medication Error Notes:
1999 report of Institute of Medicine estimated that 44k to 98k deaths occur in US because of medical errors, including medication errors.
Commonly reported errors are: incorrect dose, not giving an ordered drug, and giving an unordered drug
Describe the four processes involved in pharmacokinetics
Absorption
Distribution
Metabolism/Biotransformation
Excretion
Describe how drugs work on the body (Pharmacodynamics)
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Discus drugs and client-related variables which influence drug actions
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Identify parts of a drug order
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Describe drug preparations/dosage forms
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Discus routes of administration
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Describe instructions that clients should be give about their medications
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Utilize the steps of the nursing process to discuss interventions related to administering medications
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