PHARMACOLOGY EXAM 1: Ch. 1, 2, 3, 4, 6, 10, 11, 12, 13, 14, 18, 19, Q & A

PHARMACOLOGY EXAM 1: Ch. 1, 2, 3, 4, 6, 10, 11, 12, 13, 14, 18, 19, Q & A Pharmacology - - CORRECT ANSWER-- the study of drugs and their effects on the human body Review dosage calculations and basic math concepts *** - CORRECT ANSWER-ch. 14 1 kg = ..... g - CORRECT ANSWER-1,000 1 g = ...... mg - CORRECT ANSWER-1,000 1 KL (kiloliter) = ...... L - CORRECT ANSWER-1,000 1 glass = .... oz 1 coffee cup = ... oz - CORRECT ANSWER-8 oz 6 oz 1 Km = ..... m - CORRECT ANSWER-1,000 1 cm = ... m - CORRECT ANSWER-0.01 1 mm = ..... m - CORRECT ANSWER-0.001 1 oz =...... T - CORRECT ANSWER-2 1 T = .... t - CORRECT ANSWER-3 1 t = ..... gtt - CORRECT ANSWER-60 gtt 1 gt = ..... minim (min, m) - CORRECT ANSWER-1 1 tsp = ..... mL - CORRECT ANSWER-5 1 lb = ..... oz - CORRECT ANSWER-16 1 kg = .... oz - CORRECT ANSWER-35.27 1 kg = .... lb - CORRECT ANSWER-2.2 1 oz = ..... mL - CORRECT ANSWER-30 1 T = .... mL - CORRECT ANSWER-15 1 L = .... mL - CORRECT ANSWER-1000 1 mL = .... cc - CORRECT ANSWER-1 1 c = .... oz - CORRECT ANSWER-8 3 areas of pharmacology - - CORRECT ANSWER-pharmaceutics, pharmacokinetics, pharmodynamics Look up a memory notebook of nursing on pinterest ***** - CORRECT ANSWER- Pharmaceutics - ***** - CORRECT ANSWER-- How medication is put into cells Disintegration: breaks solid into smaller pieces Dissolution: dissolves before absorption address how various drug forms affect - Dissolution Absorption rate Onset Pharmacokinetics - ****** - CORRECT ANSWER-- The study of movement of drugs in the body 4 phases: Absorption** 1. Lipid soluble and nonionized pass faster than H2O soluble 2. Bioavailability: % of a drug that reaches circulation 3. Neonates: delayed absorption (IM injections) 4. Infants/kids: increased absorption (IM injection) 5. Slower gastric emptying until 6-8 mo. 6. Gastric pH is higher until 2 yr. Distribution*** 1. Protein binding: bound portion is inactive; unbound is active and "free drug" 2. Higher water/lower body fat in infants and less effective BBB Metabolism/biotransformation (in liver) ** 1. Changes to more/less potent 2. Changes to more soluble 3. Changes to inactive 4. Fewer enzymes produced my immature liver (mature at age 1) 5. Half-life: time it takes for half the drug conc. to be eliminated EX: Aspirin (650 mg) T1/2: 3 hrs. 1 t1/2 325 mg (3 hrs) 2 t1/2 162 mg (6 hrs) 3 t1/3 81 mg (9 hrs) Excretion/elimination*** Creatine Clearance: how well the kidneys filter Protein binding - ***** - CORRECT ANSWER- "free drug" - ***** - CORRECT ANSWER- creatine Clearance - ***** - CORRECT ANSWER- Pharmacodynamics - ******** - CORRECT ANSWER-- biochemical/ physiological changes that occur in the body as a result of taking a drug **Dose response: relationship between min & max amount needed for drug response. If drug albumin levels decreased BELOW threshold: adequate drug dosing isn't met!!! **Therapeutic Range: level of drug between min. effective conc. and min toxic conc. **Peak levels: rate of absorption **Trough Levels: rate of elimination **Therapeutic Index: margin of safety; the closer to 1 the more toxic drug- receptor interaction ***** - CORRECT ANSWER- Assessment - ******* - CORRECT ANSWER-Subjective Allergies Known meds Mental status Finances Support Past health Language Objective Labs nursing diagnosis - ****** - CORRECT ANSWER-Abnormal data Risk factors Guide to care plan NANDA R/t: cause AEB- prob. identified planning - ******** - CORRECT ANSWER-Setting goals Specific Measurable Attainable Relevant Time-based implementation - ******** - CORRECT ANSWER-Intervention Patient teaching Carrying out care plan "Take these meds, don't advance dose" Nursing actions Side effects Warning changes (urine/stool) evaluation - ******* - CORRECT ANSWER-Goals met How well interventions work Revise if not working well Most important "Was this effective?" Therapeutic effects - - CORRECT ANSWER-- positive effects a drug has on the human body (intended) - drug can have multiple therapeutic effects side or adverse effects - - CORRECT ANSWER-- negative effects a drug has on the human body - occur at a therapeutic dose - unintended side - mild, result of drugs effect on the body adverse - more severe or life threatening, result of drugs effect on the body allergic reaction - CORRECT ANSWER-- adverse reaction - previous exposure increases sensitivity anaphylactic shock - CORRECT ANSWER-- exaggerated response of a bodies immune system to a drug - massive release of histamine and other chemical mediators - swelling of eyes, face, mouth , throat, difficulty breathing, wheezing, rapid heart rate, low bp , cardiac arrest must re-establish an airway administer epinephrine to raise bp and dilate bronchi administer diphenhydramine to block additional release of histamine contraindications / precautions / interactions - - CORRECT ANSWER- categories of drugs relating to body systems - - CORRECT ANSWER-- neurological - musculoskeletal - cardiovascular - respiratory - hematologic - gastrointestinal - reproductive/ urinary - endocrine - immune 5 rights of drug administration ***** - CORRECT ANSWER-Right patient- DO NOT use room number Right drug- read 3 times Right dose- Read again, verify safety and order by second opinion Right time- check b.i.d., t.i.d., q6h, military time Right route- oral, PO-oral, buccal-between gum and cheek (Tramp) 5 additional rights of drug administration ***** - CORRECT ANSWER-Right assessment- BP, assess pain level Right documentation- Route, sight, initials, patient response Right to education- informed consent, purpose, side effects, restrictions Right to evaluation- therapeutic response, getting better or worse Right to refuse meds- Reason, provide further education, follow-ups, potential harm for not taking The rights of a nurse - - CORRECT ANSWER-Right to complete, clear order Right to correct dosage, drug and route Right to access info about drug Right to policies Right to identify safety problems Right to stop and evaluate Medication Errors - ***** - CORRECT ANSWER-Administration- 41%, nurse Documentation- 21%, nurse Dispensing- 17%, pharmacist Prescribing- 11%, provider Monitoring- 1% Other- 9% Factors that contribute to medication errors - ***** - CORRECT ANSWER-- dramatic increase in the number of drugs available - violation of the rights of nursing medication administration - lack of drug knowledge - memory lapse - transcription, dispensing or delivery problems - inadequate monitoring - distractions - overworked staff - lack of standardization - equipment failures - inadequate patient history - poor interdepartmental communication FDA Pregnancy categories - - CORRECT ANSWER-A- No risk to fetus B- No problems in animal studies C- Risk to animal study- risk to benefit comparison required D- Risk to fetus; proven, risk to benefit required X- RISK. Outweighs benefit Smart pumps ***** - CORRECT ANSWER- barcoding enhancing safety ***** - CORRECT ANSWER-- "Bar code label requirements for human drug products and blood" rule proposed by the FDA - every bar code must contain: the drug's national code, which "uniquely identifies the drug, its strength, and its dosage form." - part of the database is encoded in the patient's wristband and is accessible to the nurse using a handheld device EMR used to enhance safety ***** - CORRECT ANSWER- pain / inflammation class of drugs - - CORRECT ANSWER- Nursing guidelines for drug administration - ***** - CORRECT ANSWER-Preparation Administration ONLY ADMINISTER WHAT YOU PREPARE Record after given Record effectiveness Stay with patient until all is taken Recheck calculations Appropriate position NO MORE than 1 mL w/ SubQ NEVER recap needle Narcotics in double lock Report all drug errors patient teaching in relation to drug therapy plans- **** - CORRECT ANSWER-(part of implementation) - assess their motivation to learn, attention span and level of frustration - using a family member is an excellent idea - general, self-administration, diet, side effects, cultural considerations, Generic name / drugs - CORRECT ANSWER-- not capitalized - company develops drug and gives it an official name ex: aceteminophin - usually cheaper yet same components and effect as brand name - may have several brand names - same active ingredients as the brand Brand name / drugs - CORRECT ANSWER-- Drug's commercial name, which may vary ex: Tylenol - same make up as generic drug OTC vs herbal vs prescription drugs - **** - CORRECT ANSWER-- herbal is less potent Examples of prescription drugs - CORRECT ANSWER-Antibiotics - drugs to treat infection ex: Rosephin Antihypertensives - drugs to treat high bp ex: Capoten Diuretics - drugs to promote urination ex: furosemide/ lasix narcotic analgesics - pain relief ex: duragesic drug "categories" - - CORRECT ANSWER-- drugs in the same category act in a similar manner - easier to learn drugs by category!! Central nervous system drugs - - CORRECT ANSWER-- depressants - stimulants - anesthetics - anticonvulsants - neurodegenerative - pshychotherapeutic oral drugs - - CORRECT ANSWER-- taken by mouth - tablets, capsules or liquid - inhaled into lungs in powder form delayed release of oral drugs - - CORRECT ANSWER-- Enteric coated - dissolves when drug reaches intestine - extended release - releases drug over a period of time - extended length (XL) - sustained release (SR) - sustained action (SA) - immediate release form parenteral / injectable drugs - - CORRECT ANSWER-- intravenous (iv) - immediate absorption/ onset - subcutaneous (sub Q) - variable absorption rate - intramuscular (IM) - variable absorption rate Sub Q/ IM = rapid absorption if- highly water soluble and good circulatory blood flow slow onset if- poorly water soluble and/ or circulatory blood flow is slow/ impaired - liquid or dry form that needs liquid added (reconstitution) topical / transdermal - - CORRECT ANSWER-- apply directly to patients skin - absorbed in skin have delayed onset of action - act directly on skin has direct action Absorption - *** - CORRECT ANSWER-- movement of drug from site of administration to various tissues of the body - oral - absorbed through intestinal wall and enter portal vein, then liver, then blood to bodies circulation - parenteral - absorbed directly through vein or indirectly through muscle tissue or subcutaneous tissue, enters the blood and then passes through liver - metabolism mainly takes place in the liver distribution - *** - CORRECT ANSWER-- movement by the circulatory system to its intended site of action - organs with more blood will receive greater amounts of the drug than organs w/o (ex: brains blood brain barrier) metabolism - **** - CORRECT ANSWER-- change that occurs in a drug; more soluble form of the drug, more potent form or an inactive form - the liver is the main site of metabolism of drugs in the body biotransformation - change that occurs in a drugs chemical nature during metabolism (majority occurs in liver) metabolite - new or altered version of a drug (by product of metabolism) excretion - ***** - CORRECT ANSWER-- the elimination of a drug or its metabolites throughout various parts of the body - kidneys through urine (can reabsorb) - gI tract - skin