What are the 6 rights?

Right patient
Right drug
Right dose
Right route
Right time
Right documentation

What are two safety resources?

QSEN and JC

What is QSEN?

Quality and Safety Education for Nurses

What is the Joint Commision (JC)?

An accrediting body for health care organizations and programs. Their national patient safety goal is to improve patient safety.

What is pharmacology?

the study of or the science of drugs.

What is pharmacokinetics?

the process of drug movement throughout the body that is necessary to achieve drug action.

What is pharmacodyanmics?

the study of the effects of drugs on the body.

What is pharmacogenetics?

the study of genetic factors that influence an individual's response to a specific drug.

What are the eight routes of administration?

Orally
Sublingual/Buccal
Suppositories
Transdermal/Topical
Instillation
Inhalation
Enteral
Parenteral

What five forms do oral medications come in?

Tablets
Capsules
Liquids
Suspensions
Elixirs

Where does a sublingual medication go?

Under the tongue.

Where does a buccal medication go?

Between the cheek and the gum.

What are the three different types of Suppositories and where do they go?

Cone of spindle-shaped: rectum
Globular or egg-shaped: vagina
Pencil-shaped: urethra

What is the range in which you can leave a transdermal patch on for?

As little as 12 hours and as long as 7 days.

With patches, how do you avoid skin breakdown?

By rotating the patch to different sites.

What are two ways you would leave a topical medication?

Open to the air
Wrapped and covered.

What three forms do instillations come in?

Drops
Sprays
Eye ointments

What are the two forms of inhalation devices?

Meter-Dosed Inhalers
Nebulizer

What is a meter-dosed inhaler (MDI)?

It is a handheld device used to administer asthma and bronchi drugs to the lower respiratory tract.

What is a nebulizer?

A device that changes a liquid medication into a fine mist or aerosol and has the ability to reach the lower, smaller airways of the respiratory tract.

What is a spacer?

A device used to enhance the delivery of medications from an MDI.

What are the two types of enteral administration?

Nasogastric tubes
Gastrostomy tubes

What is a nasogastric (NG) tube?

A soft, flexible tube inserted by way of the nasopharynx with the lip lying in the stomach.

What is a gastrostomy (G) tube?

A surgically placed tube directly into the patient's stomach.

What are the 6 types of parenteral administration?

Intadermal
Subcutaneous
Intramuscular
Z-track technique
Intravenous
Intraosseous

What are the two patient identifiers?

Name
Birthdate

What are the seven key components of a drug label?

Uses
Purpose
Warnings
Directions
Active ingredients
Inactive ingredients
Storing information (optional)

What are the eight key nursing responsibilities?

6 rights of medication administration
2 patient identifiers
3 checks before administration
Environment is clean/clear
Verify/clarify orders
Check vitals
Perform focused assessment
Scanning system

What are the three parts to a drug name?

Chemical name
Generic name
Brand (Trade) name

What is a chemical name?

the chemical structure of the drug.

What is the generic name?

the official, nonproprietary name and is always lower case.

What is the brand (trade) name?

the proprietary name and is always upper case.

What are four significant things about generic name drugs compared to brand (trade) name drugs?

Must be approved by the FDA
Same active ingredients
Generic is usually less expensive
HCP must state whether generic drug can be substituted for brand name drug

What is the NCCIH?

National Center for Complementary and Integrative Health

What does the NCCIH do?

Researches the usefulness and safety of complementary and integrative interventions and their roles in improving health and health care.

What is the DSHEA

Dietary Supplement Health and Education Act

What does the DSHEA do?

Ensures products are safe and label information is truthful and not misleading.

What is the CGMP?

Current Good Manufacturing Practices

What does the CGMP do?

Standards requiring package labels to declare quality and strength of contents and that product is without contaminants/impurities.

Is it important for the HCP to know the OTC and CAMs a patient is taking? Why or why not?

Yes
Possible interactions

How many mL are in 1 tsp?

5 mL

How many tsp are in 1 tbsp?

3 tsp

How many lb(s) are in 1 kg?

2.2 lbs

How many mL are in 1 oz?

30 mL

What is the key number when converting between mcg to mg, mg to g, mL to L, and g to kg?

1,000

What is the rounding rule, unless otherwise specified?

Round to the nearest tenth.

How do you round for enteric coated (EC) tablets/capsules? Why?

to the nearest whole number
you cannot cut EC tablets/capsules.

How do you round for scored tablets?

To the nearest half.

How do you round drops (gtts)?

To the nearest whole.

About how long is the process to approve a new drug?

10-12 years

What are the three core ethical principles for nursing derived from the Belmont Report?

Respect for persons
Beneficence
Justice

What is autonomy?

the right to self determination

What is informed consent?

the right to be informed and participant is not coerced.

Who is responsible for conveying and explaining information?

The health care provider (HCP)

What is beneficence?

the duty to protect research subjects from harm.

What is justice?

the duty to treat the research subjects with fairness.

How long before surgery should you stop taking CAMs?

2-3 weeks.

What three groups of people should not be taking CAMs?

Pregnant women
Breastfeeding women
Children

Where are drugs mostly absorbed in the body?

The small intestines

What is an elixir?

Medications mixed with a sweet syrup/liquid.

What is an emulsion?

Two liquids that are not mutually soluble unless shaken well.

What is a suspension?

mixed solution, but not dissolved.

What is the American Nurses Association (ANA) Code of Ethics?

A guide for carrying out nursing responsibilities with consistent quality of nursing care and ethical obligation

What is an over-the-counter (OTC) drug?

An appropriate and safe for consumption medication without a prescription.

What are the four processes of pharmacokinetics?

Absorption
Distibution
Metabolism (biotransformation)
Excretion (elimination)

What is drug absorption?

The movement of the drug into the bloodstream after administration.

What will two things will be affected if you crush/cut an enteric coated (EC) tablet/capsule?

It will not be absorbed in the intended location or time.

What are the three transportation methods?

Active transport
Passive transport
Pinocytosis

What is active transport?

This movement requires energy and a carrier enzyme/protein to move drug against the concentration gradient.

What is passive transport?

The movement of the drug via diffusion or facilitated diffusion.

What is diffusion?

The movement of a drug from higher concentration to lower concentration.

What is facilitated diffusion?

The movement of a drug that relies on a carrier to diffuse.

What is pinocytosis?

When a cell carries a drug across by engulfing the drug particles into a vesicle.

What two aspects of a drug can make it pass more rapidly?

Lipid-soluble
Nonionized

What is the first-pass effect?

The first metabolism of a drug and its passage from the liver into the circulation.

What is bioavailability?

the percent of administered drug available for activity after the first-pass effect.

What is drug distribution?

the movement of a drug from the circulatory body tissues.

What drugs will win a receptor cite to circulate first?

High-protein bound drugs.

What is drug metabolism (biotransformation)?

the body chemically changes drugs into a form that can be excreted.

Which organ is the primary metabolism place?

The liver

What is the half-life (T1/2) of a drug?

the time it takes for the amount of the drug in the body to be reduced to half

What is the loading dose of a drug?

a large initial dose administered

What is the main route of excretion?

Through the kidneys.

What are three other elimination sites?

Bile
Lungs
Saliva, sweat, breastmilk

What two labs will test renal function?

Creatinine (CR)
Blood urea nitrogen (BUN)

What is the primary effect of a drug?

A desired effect

What is the secondary effect of a drug?

A desired or undesired effect, aka side effects

What is potency?

The amount of a drug needed to elicit a response.

What is maximal efficacy?

When increasing the drug dosage no longer increases desired therapeutic response.

What is the therapeutic index of a drug?

The area between a therapeutic dose and the toxic dose of a drug.

What is onset?

The time it takes for a drug to reach minimum effective concentration after administration.

What is the peak level of a drug?

When the drug reaches it's highest concentration in the blood.

What is duration of action?

Length of time it takes for a drug to exert a therapeutic effect.

What is the trough level of a drug?

the lowest plasma concentration of a drug.

What is the receptor theory?

That a drug with either bind and activate a receptor or it will bind and block or inactivate a receptor.

What does an agonist do?

Activates receptors and produces a desired response.

What does an antagonist do?

Prevents receptor activation and blocks a response

What are the six locations of cholinergic receptors?

Eyes
Heart
Blood vessels
Bronchi
Stomach
Bladder

What are the seven mechanisms of actions for a drug?

Stimulation
Depression
Irritation
Replacement
Cytotoxic action
Antimicrobial action
Modification of immune status

What does stimulation do?

Enhances intrinsic activity.

What do depressants do?

Decreases neural activity and bodily functions.

What do irritants cause?

Noxious effects

What does replacement do?

Replaces essential body compounds

What does cytotoxicity do?

Selectively kills invading parasites or cancers.

What do antimicrobials do?

Prevents/inhibits/kills infectious organisms.

What do modifications of immune system drugs do?

Modifies/enhances/depresses immune system.

What are adverse reactions?

unintentional/unexpected reactions to drug therapy that occurs at normal drug dosages and are always undesirable.

What is drug toxicity?

When drug levels exceed therapeutic range.

What is tolerance?

A decreased responsiveness to a drug over the course of therapy.

What is tachyphyaxis?

An acute, rapid decrease in response to a drug

What is the placebo effect?

When drug response is not attributed to the chemical properties of the drug.

What is a drug-interaction?

An altered/modified action/effect of a drug as a result of interacting with one or multiple more drugs.

What is photosensitivity?

Skin reaction caused by exposure to sunlight and often drug-induced.

What is a botanical?

An additive substance that comes from plants.

What does Astragalus do?

Used as an adjunct to boost the immune system.

What does Chamomile do?

To treat sleeplessness, anxiety, and stomach/intestinal ailments.

What does cinnamon do?

Used to treat bronchitis, gastrointestinal (GI) problems, anorexia, and diabetes.

What does Echinacea do?

Helps with colds, flu and infections.

What does garlic do?

Lowers cholesterol, decreases blood pressure (BP), and reduced heart disease.

What does ginger do?

treats postoperative, pregnancy-related, and chemotherapy-related nausea, motion sickness and diarrhea.

What does gingko do?

Treats asthma, bronchitis, fatigue and tinnitus. Can also help with memory and prevent Alzheimer/Dementia, intermitten claudation, erectile dysfunction (ED), and multiple sclerosis (MS).

What does ginseng do?

Boost immune system.

What does hawthorne do?

Helps with heart disease, digestive issues, and kidney disease.

What does licorice root do?

Helps with stomach ulcers, bronchitis, sore throat, and viral hepatitis. Large amounts can elevate BP.

What does St. John's Wart do?

Helps with mental disorders and nerve pain.

What does Tumeric do?

Helps with heartburn, stomach ulcers, gallstones, inflammation and cancers.

What does Valerian do?

Helps with insomnia and used for anxiety, headaches, depression, irregular heart beat and tremors.