WGU PHARMACOLOGY - C467 Already Passed 100%

WGU PHARMACOLOGY - C467 Already Passed 100% Differentiate between the five drug schedule categories defined in the U.S. Controlled Substances Act 1970 --- Schedule I Schedule II Schedules III Schedule IV Schedule V Schedule 1 --- Ex: heroin, ecstasy, marijuana Highly addictive Have no accepted medical use Illegal to process, distribute, and use May be used in carefully controlled research facilities Schedule 2 --- Ex: morphine, amphetamines, cocaine, PCP, Ritalin, hydrocodone, oxycodone) High potential for physical and psychological addiction Written prescription required No refills allowed Schedule 3 --- Schedules III Ex: anabolic steroids, ketamine, testosterone, Tylenol with codeine) Moderately addicting leading to limited dependence Five refills in 6 months Many are combinations of less-addictive medications with a small amount of a narcotic Prescriber must sign prescription written by allied health professional Schedule 4 --- Ex: Ativan, Valium, Xanax) Lower abuse potential Prescriber must sign prescription written by allied health professional Fax and phone orders are permitted Five refills in 6 months Schedule 5 --- Ex: cough suppressants with small amount of codeine and diarrhea preparations) Lowest potential for abuse OTC in some states require signature and ID of patient How many phases in the process involved in the development of a new drug --- 3 Phases Phase 1 --- Determines safety A few HEALTHY participants take a drug to measure any harmful effects (Ex: diarrhea or negatively affect vital signs) If the drug causes significant harmful effects, the trial stops Usually the participants are men because of concern giving experimental drugs to women who could become pregnant Phase 2 --- Involves HUNDREDS of patients (All whom have the disease targeted by the drug) for longer periods of time See whether a drug works as desired efficacy (Ex: if the drug is meant to lower cholesterol, samples of the participants blood are checked to see whether blood cholesterol levels are lower while participants are taking the medication) Phase 3 --- Drugs that have been proven to be safe and effective HUNDREDS to THOUSANDS of participants and can last 1 to 4 years Conducted in several facilities (Ex: hospitals, physicians' office, clinics) each of which enroll hundreds of participants Manufacturer tests for safety, effectiveness, and dosage Therapeutic (best) dose is evaluated during this phase Goal is to give least amount of drug possible to gain the necessary effect State FDA guidelines for new drugs. --- FDA requires that drugs be scientifically researched. The FDA insists on high standards of scientific research, so it may take 8 years or longer for a company to gain approval of a drug. Even if the drug was approved in another country Durham-Humphrey Amendment of 1951 --- Defines which type of drugs cannot be used without medical supervision Limits sale of these drugs to prescription only by a medical professional All other drugs available without prescription Kefauver-Harris Drug Amendments --- Requires drug makers to prove their drug works before approval for sale The Advisory Committee on Investigation Drugs advises the FDA on product approval and policy making Evaluate the importance of evidence-based practice in the development, preparation, and administration of drugs --- Several phases of clinical trials are used to test effectiveness of new drugs. All drugs must be proven safe & effective Written orders --- Desired whenever possible to make mistakes Written or typed clearly and accurately May be typed or written by others, but signed by prescriber in most instances Schedule II drugs MUST be written and signed by the prescriber Verbal Orders --- Prescriber directs another health-care professional to write the prescription The order may be in person (emergency) or via phone -Should be signed before administration of medication. Must be signed as soon as possible -Referred to as STAT order (immediately) Write words and numbers carefully and read what you have written back to the prescribers NOT PREMITTED for Schedule II drugs E-Prescription Orders --- Prescription created electronically by prescriber Sent directly to the pharmacy May be able to verify insurance coverage May identify any medication interactions standing medication orders --- List of orders used in specific circumstances that routinely occur (Ex: preparation for procedures) Even though pre-printed, they require review and signature by prescriber Should be routinely reviewed and updated automatic stop orders --- Orders for a limited period of time Most commonly used for Schedule II and III medications after injury or surgical procedure Usually needs to be recorded routinely (Ex: every 3 days) What is the Eternal method of dug administration? --- Any medication that involves the gastrointestinal tract · Capsules · Tablets · Enemas · Suppositories Most common route of administration is oral What is the Topical method of drug administration? --- Medication applied directly to and absorbed through the skin May be local or systemic effect Semi-solid preparations · Ointment: Petroleum-based to keep medication in contact with skin · Cream: Water-based, absorb into skin and disappear · Gel: Semisolid suspension · Plaster: Adhere to skin with paper, linen, moleskin · Liniment: Semisolid preparation causing irritation to skin to increase blood flow · Lotion: Water-based semisolid preparation Solid preparations · Powder: Reduces moisture · Transdermal patch: Delivers medication over time Nausea What is the Parenteral method of drug administration? --- All medications that are NOT introduced into the gastrointestinal system · Topical · Ophthalmic · Otic · Vaginal · Nasal · Inhaled · Injectable Agonist --- A drug is taken with another drug so the two can be more effective than each would be alone (synergism) Substance that attaches itself to receptors in the brain and then produces a chemical reaction Ex: Heroin is an opioid agonist Partial Agonist --- Drugs that bind to and activate a given receptor but have only partial efficacy at the receptors as opposed to a full agonist Antagonist --- A drug makes another drug less effective Is the opposite of agonist Is a chemical that acts against and blocks an action by attaching to the opioid receptors without activating them Causes no opioid effect and block full agonist opioids Ex: Naloxone (Narcan) which is used to reverse narcotic overdoses Pharmacodynamics --- The effect that drugs have on the body · Curative · Prophylactic · Diagnostic · Palliative · Replacement · Destructive Pharmacokinetics --- The study of the way in which drugs move through the body during absorption, distribution, metabolism, and excretion. Passive diffusion: Areas of high concentration to low concentration · Water soluble molecule: Will easily move through a channel or a pore that's in the membrane · Lipid soluble molecule: Easily pass through a membrane without any help Facilitated Diffusion: Area of high concentration to low concentration · Larger molecules will pass with the help of carrier proteins just like in passive diffusion Active Transport: · Drugs are transported across membrane via active energy (dependent transport) · Process is derived from ATP when ATP undergoes hydrolysis to ADP Pharmacoterapeutics --- The study of the therapeutic uses and effects of drugs Chemical Name --- First name; shows the mix of chemicals being studied Generic Name --- Common name When patent expires, other manufacturers may produce the medication under its generic name letter of the generic name is capitalized ONLY if it begins in a sentence THE OFFICAL NAME Must have the same active ingredients as the brand name, but different fillers (inactive ingredients) Brand Name or Trade Name --- Manufacturer assigns after drug clears Phases 1-3of clinical trials ALWAYS CAPITALIZED and many followed by or TM Medication Labels Include --- Manufacturer labels and names NDC number and lot number The name of the medication (generic and trade name), strength, dosage form, quantity, and manufacturer (if generic) Route of administration Refill information Name of the prescribing physician and credentials (MD, FNP, DO, etc.) Expiration date of medication Warning labels legal prescription --- Name, contact information, and DEA number of prescriber Name, address, and DOB of patient Date of order RX (superscription): Means "take thou" Inscription: Name of drug, dosage, and quantity to be dispensed Sig code: Directions for taking the drug Subscription: Refill #'s (never blank) Whether a generic can be used Signature from prescriber · Name special considerations when administering medications to vulnerable clients. --- Nutrition and physical activity Age -Geriatric patients -Pediatric patients Gender Culture Environmental factors Pregnancy Patients with organ dysfunction how do cultural factors can influence the success of pharmacotherapy --- Cultures whose beliefs are grounded in science more likely to depend on primary health-care provider to choose drugs State the legal issues involved in administering medication in a given patient situation --- Right patient: Verify correct patient Right drug: Know correct medication Check the medication label THREE times · Before you take the medication container from the shelf · Before you pour the drug out · Before you put the medication container back on the shelf Right dose: Know the correct dosage If you suspect the order is incorrect, verify before administering Right time: Know the correct administration time Right route: Know the correct route of administration Right technique: Know the right technique for the ordered route Right documentation: Know how to accurately chart the medication given. You must chart: The medication name Dose Route/site For vaccines: lot # and manufacturer · Explain how holistic pharmacotherapy impacts a nurse's role in the administration of drugs. --- Holistic cultures believe imbalances cause disease Less likely to use conventional drugs and more inclined toward herbal remedies Believe that illness comes from evil spirits who hurt people if taboos (rules) are broken May search for alternative healers and may not continue to take medications prescribed by their primary health-care provider · Formulate specific, measurable, achievable, realistic, and time-stated (SMART) goals for a patient receiving a given drug therapy. --- SMART goals are: Specific, Measurable, Achievable, Realistic, and Time-limited By establishing long- and short- term SMART goals, professionals can maintain their focus on projects that are important to them and, more importantly, take on additional tasks that increase their job satisfaction or accomplish the overall goal EX: (Pharmacology/nurse) A patient teaching. Use short term SMART goals to overcome obstacles and introduce new elements to their job · Although a nurse may not be able to teach every patient about their new drug (or activity, order, etc.), if they work on teaching 1 each shift then move to doing 2 each shift and then 3. By setting short term, achievable goals, this employee can increase their job satisfaction and develop relationships with their patients · Implement strategies for optimizing patient safety and reducing errors in the administration of drugs. --- Patient information: Right to participate in planning treatment Patient consent: Right to refuse treatment -If you administer medication after a patient refuses, you are guilty of battery -Informed consent: Document signed after patient understands treatment planned Patient privacy -Medication records must be kept confidential -HIPAA holds health professionals accountable to protect the privacy of the patient Patient emergencies -Refer to agency protocols for how to respond · Notify physician · Begin ordered treatment For calls for toxic ingestion, call 911 or ask patient to call 911 · Will consult to poison control for treatment advice Activated charcoal administration to bind with poison Drinking large amount of water to dilute poison Drinking milk to reduce acidity of poison Monitoring vital signs for changes why is special considerations must be implemented when administering medications to vulnerable clients --- Nutrition and physical activity Age Gender Culture Environmental factors Pregnancy Patients with Organ dysfunction Nutrition and Physical Activity --- Poor diet may reduce therapeutic levels Check drug resource for food interactions Exercise can influence metabolism and increase speed of absorption Drug dosages are based on average body weight (150 pounds); if patient is to thin or obese, dose may need adjustment Age --- Gender --- Culture --- Environmental Factors --- Pregnancy --- Patients with Organ Dysfuntion --- -Liver: Metabolism affected Poor functioning leads to build-up of drugs and toxic effects Chronic alcohol abuse leads to decreased liver function -Kidneys: Excretion affected Some medications are excreted unmetabolized through the kidneys. This can destroy the kidneys, and those with kidney disease risk accumulating toxic amounts of drugs -Heart: Responsible for how a medication is distributed throughout circulatory system Congestion of blood vessels leads to decreased drug absorption and delivery of the drug to the liver This also compromises kidney function, leading to delayed excretion Name the three checks of medication administration --- Check the label before you take the bottle from the shelf Check the label before you pour the drug out Check the label before you put the bottle back on the shelf why is therapeutic dosing is essential to safe pharmacological practices. --- -Therapeutic drug index A ratio that compares the blood concentration at which a drug becomes toxic and the concentration at which the drug is effective. The larger the therapeutic index (TI), the safer the drug is. -Therapeutic level: Point at which the drug has the maximum desired effect Too low: Does not work Too high: Toxic effects Ex: If the therapeutic index is 4, it would take about 4 times the average dose to be lethal. The higher the TI, the greater amount of medication it would take to become lethal, the lower the dose (ex. TI of 1) it wouldn't take much of the medication to cause harm or become toxic/lethal to the patient 0 Cardiovascular and Drugs --- Also known as the circulatory system, includes the heart and blood vessels. Some of the most common diseases of the cardiovascular system are coronary artery disease, abnormal heart rhythms (or arrhythmias) and heart failure. This, in turn, means that there are a lot of medications to help correct or improve the lives of individuals with these conditions. The list comprises some of the most widely used medications. They are used to treat diseases and conditions of the cardiovascular system: Antianginals Antiarrhythmics Antihypertensives Vasopressors Antihyperlipidemics Thrombolytics Anticoagulants Within these classes are some subgroups of medications which will be important to know for your continued safe practice. For instance, the antihypertensives class has some of the most important and most widely used drugs. They include thiazide diuretics, calcium channel blockers, ACE inhibitors, angiotensin II receptor antagonists (ARBs), and beta blockers. Pulmonary and Drugs --- The human respiratory system is a series of organs responsible for taking in oxygen and expelling carbon dioxide. The primary organs of the respiratory system are the lungs, which carry out this exchange of gases as you breathe. Respiratory illness is a common problem in the United States. Many times, people are genetically more likely to get respiratory conditions, but work or environmental exposures could also play a role. Some common diseases or illnesses of the pulmonary system are chronic bronchitis, emphysema, reactive airway disease, and cystic fibrosis. Drugs that are used to treat respiratory diseases and disorders include: decongestants, antihistamines, antitussives, and bronchodilators. These agents act in a variety of ways to clear the airways and restore normal respiration and improve function. In this unit, you will be introduced to a variety of these medications. · Reproductive & Urinary Drugs --- Urine is formed by the kidney and travels through tubes called ureters, which transport it to the urinary bladder where it is stored and excreted via the urethra. The uterus is the major female reproductive organ, which supports and nourishes the developing fetus. The male reproductive system includes the scrotum, testes, spermatic ducts, sex glands, and penis. These organs work together to produce sperm. Issues with any of these organs can require medications to decrease symptoms or alleviate the condition altogether. In this unit, be prepared to learn about advances in your understanding about how the reproductive and urinary systems' functions have led to improved drug treatments for conditions such as infertility and prostate disorders. · Gastrointestinal Drugs --- The gastrointestinal (GI) tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The hollow organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestine, and anus. The liver, pancreas, and gallbladder are the solid organs of the digestive system. Constipation, irritable bowel syndrome, and Crohns disease are just a couple of illnesses that can plague the GI tract. These are some of the classifications of drugs used to treat disorders of the gastrointestinal tract: Enzymes Antidiarrheals Antiemetics Antiulcer Laxatives Endocrine Drugs --- The endocrine system is a collection of ductless glands that produces hormones and secretes them into the circulatory system, without the intermediate presence of ducts carrying secretions towards target organs. The major glands that make up the human endocrine system include the hypothalamus, pituitary gland, thyroid, parathyroid, adrenal glands, and pineal gland. Several classifications of drugs act on the endocrine system: Anti-diabetic Antithyroid Thyroid Adrenal · Integumentary Drugs --- The integumentary system is an organ system consisting of the skin, hair, and nails. Some common conditions of the integumentary system are acne, warts, eczema, and psoriasis, and more serious diseases like skin cancer. Drugs that may be used in the integumentary system fall into several therapeutic categories. In this unit, you will discover the countless medications that can be used to treat diseases and disorders of the integumentary system. · Musculoskeletal and Drugs --- There are many diseases and disorders of the musculoskeletal system. Arthritis, osteoarthritis, osteoporosis, muscle spasm, gout, tendonitis, and injury are a few disorders and conditions that are treated with musculoskeletal agents. The goal of treatment with medication is to increase motor function and range of motion and to decrease pain and inflammation associated with these conditions. In this unit, you will learn about medications that treat disorders of the musculoskeletal system alongside effects and special considerations for those drugs. In this unit, you will encounter numerous medications used in the treatment of musculoskeletal system disorders. Nervous system and drugs --- The nervous system is a complex network of nerves and cells that carry messages to and from the brain and spinal cord to various parts of the body. The nervous system includes both the central nervous system and peripheral nervous system. Several common neurological disorders are affected by abnormalities in neurotransmitter release or response. Drugs used to treat neurological disorders correct disruptions or dysfunction of the complex chemical process of nerve transmission in the central nervous system. In this unit, be prepared to learn the complexity of medications and their uses in the treatment of nervous system disorders. Immunological and drugs --- The immune system is the body's defense against infectious organisms and other invaders. Through a series of steps called the immune response, the immune system attacks organisms and substances that invade body systems and cause disease. Types of drug used to treat immune system malfunction include antiallergy drugs, which counter overreaction of the immune system; immunosuppressants, which prevent the immune system attacking the body's own tissues; and interferon drugs, which boost immunity. In this unit, be prepared to learn the intricacy of these medications and their uses for treating the immunological system. Eye and Ear drugs --- Our most important sensory receptors are the eyes and the ears. The eye is the primary organ for sight, and the ear is the primary organ for sound and equilibrium. Obviously, any impairment of either of these sensory receptors can be a traumatic experience and can cause serious disability. Many infections and chronic (long-term) conditions can be treated effectively with drugs. Ophthalmic agents are used to treat various conditions or disorders of the eye. Ophthalmic agents are used for eye diseases (glaucoma) or infections (pink eye). In this unit, you will be exposed to the uniqueness related to the preparation and administration of medications for the eyes or ears. Biologics therapies --- Commercial products derived from biotechnology Are powerful medications that are developed from blood, proteins, viruses, and living organisms Used to prevent, treat, and cure human diseases Work by targeting particular chemicals or cells involved in the body's immune system response Examples · Vaccines · Gene and cellular-based therapies · Botox · Lantus (type of insulin) · Humira (treat rheumatoid arthritis) Alternative therapies --- Therapies that include treatments such as · Message therapy · Aromatherapy · Acupuncture · Acupressure · Medications Herbs Minerals Vitamins · When informing a client of a medication error you must submit 3 steps --- Fill out an incident report Contact the healthcare provider Reassess the client for needed additional treatments Medication Errors --- A No error, capacity to cause error B Error that did not reach the patient C Error that reached patient by unlikely to cause harm D Error that reached the patient and could have necessitated and/or intervention to preclude harm E Error that could have caused temporary harm F Error that could have caused temporary harm requiring initial or prolonged hospitalization G Error that could have resulted in permanent harm H Error that could have necessitated intervention to sustain life I Error that could have resulted in death What are the Recall Classification --- Class I = A dangerous or defective product that could cause serious health problems or death Class II = A product that might cause temporary health problem, or pose slight threat of a serious nature Class III = A products that is unlikely to cause any adverse health reaction, but that violates FDA labeling or manufacturing laws What is a Randomized Clinical Trial (RCT) --- An experiment where every person in a trial is randomly assigned to either a treatment group or a control group. A clinical trial is performed in a controlled setting (ex: a clinic or hospital), targets a specific disease, and has an event as a measure of trial outcome (ex: cure/no cure) What is a Systematic review --- Research study that collects and looks at multiple studies (ex: several RCT's). The systemic review of the randomized controlled trial is traditionally the gold standard for judging the benefits of treatments, mainly because it is easier to attribute any observed effects to the treatments being compared