Pharmacology
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| Various drug classes enables to understand: | A. Therapeutic b. Potential side effects or toxicities |
| Drugs are classified by how they??? | Affect certain body systems, by their therapeutic use or based on their chemical characteristics. |
| Drug names: | Trade name Generic name |
| Drug names: Generic name: When a manufacturer receives a patent for a new drug, this means that? | No other company can produce the drug until the patent expires. |
| Drug names: Generic name: Once this patent expires...? | Other companies may manufacture the drug with a different trade name but equivalent chemical makeup. |
| Drug approval process: | Phase 1: Drug discovery and development Phase 2: Preclinical research and development Phase 3: Clinical trial Phase 4: FDA reviews NDA Phase 5: Manufacturing |
| Drug approval process: Phase 1: 2-10 years | Drug Discovery and development |
| Drug approval process: Phase 2: Initial synthesis of substance; Laboratory studies and animal testing; Institutional review boards 3-6 years | Preclinical research and development |
| Drug approval process: Phase 4: FDA expects review data; Company addresses FDA concerns; Advisory hearing may be called 1-2 years | FDA reviews NDA |
| Controlled Substances Categories Designated by the U.S. Government: | Schedule: I II III IV V |
| Legal-Ethical Aspects of drug therapy: The legal responsibilities of nurses for medication administration are defined in | State nurse practice acts and healthcare organization policies and procedures. |
| Legal-Ethical Aspects of drug therapy: 8 rights of Medication Administration: | 1. The right drug is given 2. The right patient 3. The right dose 4. The right route 5. The right time 6. The right reasons 7. The right documentation 8. The right response Additional rights: 9. Right education 10. Right to refuse |
| Legal-Ethical Aspects of drug therapy: 8 rights of Medication Administration: 1. | The right drug is given |
| Legal-Ethical Aspects of drug therapy: 8 rights of Medication Administration: 7: | The right documentation |
| Legal-Ethical Aspects of drug therapy: 8 rights of Medication Administration: Additional rights: 9: | Right education |
| Legal-Ethical Aspects of drug therapy: 8 rights of Medication Administration: Additional rights: 10 | Right to refuse |
| Legal-Ethical Aspects of drug therapy: 8 rights of Medication Administration: Most medication errors result from? | Failure to follow one of these "rights". |
| Ethical aspects of nursing care were identified by the American Nurses Association (ANA) in the? | 2001 code of ethics. |
| Ethical aspects of nursing care were identified by the American Nurses Association (ANA) in the 2001 code of ethics. The guidelines provide ethical principles to be adhered by every professional nurse: | 1. Respect the dignity of all patients, regardless of ethnicity, socio-economic status, or specific health problem; 2. Participate in activities to support maintenance of their professional competence 3. Protect patient's privacy and confidentiality 4. Make a commitment to providing quality patient care in every setting. |
| Ethical aspects of nursing care were identified by the American Nurses Association (ANA) in the 2001 code of ethics. The guidelines provide ethical principles to be adhered by every professional nurse: 1: | Respect the dignity of all patients, regardless of ethnicity, socio-economic status, or specific health problem; |
| Ethical aspects of nursing care were identified by the American Nurses Association (ANA) in the 2001 code of ethics. The guidelines provide ethical principles to be adhered by every professional nurse: 2: | Participate in activities to support maintenance of their professional competence. |
| Ethical aspects of nursing care were identified by the American Nurses Association (ANA) in the 2001 code of ethics. The guidelines provide ethical principles to be adhered by every professional nurse: 4: | Make a commitment to providing quality patient care in every setting. |
| 9 provisions to 2015 Code of Ethics for Nurses with Interpretive Statements: | 1. Respect for human dignity 2. Primacy of patient interest 3. Protection of patient privacy and confidentiality 4. Authority, accountability, and responsibility for nursing practice. 5. Duty to self and others 6. Maintaining an ethical environment 7. Contributions through research and scholarly inquiry. 8. Health as a universal right 9. Articulation and assertion of nursing values. |
| Medication errors: Errors can occur during the? | Prescribing, dispensing, administration, or right documentation phases of medication administration. |
| How can errors be prevented? | 1. During patient transfer 2. Patient identification 3. Environmental factors |
| Patient teaching is also a key to preventing errors - an informed patient will | Question his or her nurse if the medication looks different from the usual pill |
| Pharmacology is derived from the Greek word? | Pharmakon; and -logia meaning "the knowledge gained through study" |
| Pharmakon, the word derived from to Pharmacology translates into? | Poison in classic Greek; and drug in modern Greek, |
| Is a substance or chemical capable of altering a biochemical or physiological processes in the body | Drug |
| Drug responses or altering biochemical or physiological process in the body may be? | Desirable (therapeutic) or undesirable (adverse) |
| The goal of medication therapy is to? | Restore a dysfunctional or pathological biochemical or physiological process. |
| Every drug has at least three names: | 1. The chemical name 2. The generic name 3. The brand name |
| Every drug has at least three names: Refers to a common established name regardless of its manufacturer. There is only one one of it for a drug. | The generic name |
| The Liver: Anatomical First Stop for Orally administered Drugs: The first pass effect: | Oral drugs -> absorbed by small intestines -> Portal venous system -> Delivers absorbed molecules -> to the liver -> transforms most of the chemicals by a series of liver enzymes -> breaks the drugs into metabolites -> some will cause effect and some will be deactivated and readily excreted from the body -> as a result, large percentage of the oral dose is destroyed and never reaches the tissues. -> the portion of the drug that gets through is delivered to the circulatory system for transport throughout the body. |
| Means that the medication produces a beneficial effect for the patient. | Therapeutic response |
| Side effects range in: | Severity from mild to nuisance - to at worst-severe. |
| Dermatological Reactions: | Adverse reactions involving the skin. Drugs deposit toxic chemical reaction causing irritation to the tissue. |
| Dermatological Reactions: Drugs deposit ______ causing irritation to the tissue | Toxic chemical reaction. |
| Dermatological Reactions: Can range from: | Simple rash to potential fatal exfoliative dermatitis. |
| Dermatological Reactions: Assessment: | Hives, rashes Exfoliative dermatitis: -rash -scaling -fever -enlarged lymph node -enlarged liver -fatal erythema multiforme exudativum (Stevens-Johnson Syndrome) |
| Dermatological Reactions: intervention: | -In mild cases, discomfort of skin lesions: provide frequent skin care. -Instruct patient to avoid rubbing, avoid rough and tight clothing, avoid harsh soaps or perfumed lotion -administer antihistamines as appropriate. -in severe cases, D/C drug and notify AP -topical corticosteroids, antihistamines and emollients are used. |
| Stomatitis: | Inflammation of the mucous membranes. Direct toxic reaction to the drug deposits in the end capillaries in the mucous membranes, leading to inflammatin. |
| Stomatitis: Assessment: | - Swollen gums - Inflamed gums (gingivitis) - Swollen and red tongue (glossitis) - Difficulty swallowing - Bad breath -Pain in the mouth and throat |
| Stomatitis: Interventions: | -Provide frequent mouth care - Frequent small meals -Dental consultation -Antifungal agents and/or local anesthetics are sometimes used. |
| Superinfections: | When normal flora are destroyed by drugs (antibiotics) |
| Superinfections: Assessment: | Fever, diarrhea, black or hairy tongue, inflamed or swollen tongue, mucous membrane lesions, vaginal discharges with or without itching. |
| Superinfections: Interventions: | Provide supportive measures: - Frequent mouth care - Skin care - Access to bathroom facilities - Small, frequent feeding - Antifungal agents as appropriate - D/C drug responsible for superinfection. |
| Blood Dyscrasia: | Any abnormal condition of the blood Is bone marrow suppression Bone marrow cells multiply rapidly Multiple Cell division, highly susceptible to any agents that disrupts cell function. |
| Blood Dyscrasia: Use of? | Antineoplastics and antibiotics. |
| Blood Dyscrasia: Assessment: | Fever, chills, sore throat, weakness, back pain, dark urine Decreased/low platelet count (thrombocytopenia) Decreased/low WBC (leukopenia) decreased/low cellular elements of CBC (pancytopenia) |
| Blood Dyscrasia: Interventions: | Monitor blood counts Provide supportive measures: - Rest - Protection from exposure to infections - Protection from injury - Avoidance of activities that might result in injury or bleeding - D/C drug or stop administration until the bone marrow recovers to a safe level. |
| Toxicity: | 1. Liver injury 2. Renal injury |
| Toxicity: Liver injury: Assessment: | Fever, malaise, nausea, vomiting, jaundice, change in color of urine or stools, abdominal or colic pain. "Increased/high Liver enzymes (AST & ALT)" Alterations in bilirubin levels Change in clotting factor (PTT). |
| Toxicity: Liver injury: Intervention: | D/C drug and notify AP Supportive measures: -Rest -Small, frequent meals -Skin care -Cool environment |
| Toxicity: Renal injury: Enzymes or to watch for: | Crea or creatinine: 0.6 to 1.3 milligrams per deciliter (53 to 115 micromoles per liter) BUN- is an indication of renal health. Normal ranges 8-20 mmol/L |
| Toxicity: Renal injury: Assessment: | Increased or high BUN, creatinine concentration Decreased or low HCT Electrolyte imbalances Fatigue, malaise, edema, irritability Skin rashes |
| Toxicity: Renal injury: Intervention: | Notify AP and D/C drug Supportive measures: -Positioning -Diet and fluid restrictions - skin care, - electrolyte therapy - rest periods - controlled environment If severe, DIALYSIS!!! |
| Alterations in Glucose Metabolism: | 1. Hypoglycemia 2. Hyperglycemia |
| Alterations in Glucose Metabolism: Hypoglycemia: Assessment: | Fatigue, drowsiness, hunger, anxiety, headache; cold clammy skin; shaking; lack of coordination. Increased or high HR, Bp Numbness and tingling of mouth, tongue, lips. Confusion Rapid, shallow respirations Sever cases: Seizures or coma |
| Alterations in Glucose Metabolism: Hypoglycemia: Interventions: | Restore glucose, IV or P.O. Supportive measures: -skin care, environmental control of light and temperature, rest. Institute safety measures to prevent fall or injury. |
| Alterations in Glucose Metabolism: Hyperglycemia: Assessment: | Fatigue Polyuria Polydipsia Kussmaul respiration (deep respiration) Restlessness Polyphagia Nausea Hot or flushed face Fruity odor to breath |
| Alterations in Glucose Metabolism: Hyperglycemia: Intervention: | Administer insulin to decrease blood glucose Provide support to help the patient deal with S/S. -Access to bathroom -Controlled environment -Reassurance -Mouth care |
| Electrolyte Imbalances: | 1. Hypokalemia 2. Hyper kalemia |
| Electrolyte Imbalances: Hypokalemia: Assessment: | - Lower K+ levels, decreased or lower than 3.5 milliequivalent/Liter - Weakness - Numbness and tingling in the extremities - Muscle cramps - N&V, diarrhea, decreased or low bowel sounds, irregular pulse, weak pulse. - Orthostatic hypotension - Disorientation - Severe cases, paralytic ileus, abdominal distention, absent bowel sounds, acute abdomen |
| Electrolyte Imbalances: Hypokalemia: Intervention: | - Replace serum K+ - Monitor serum K+ levels and patient response. - Provide support: - Safety precaution to prevent falls and injury -Orientation of the patient -Comfort measures for pain and discomfort. |